“How did you go bankrupt?”, Bill asked. “Two ways”, Mike said. “Gradually and then suddenly.”
(Ernest Hemingway – The Sun Also Rises)
During the course of the year as events unfolded around and entangled him, Chris‘s sense of organisation and self-control diminished.
Thinking of his sailing experience, he said, “It was like being out in a storm with the rudder bust”.
It felt like he was at the mercy of the elements.
The creeping cumulative effect of unwanted changes affected him deeply.
Unwelcome stuff happened to him and around him.
From his point of view it felt like things were being done to him.
He simply had to react as best he could.
Earlier in his career Chris had stopped doing matrimonial work because he realised that he was losing his objectivity in representing clients.
Things came to a head when he realised that he was becoming too involved emotionally in a client’s claim for custody of his children.
At the time his daughter was a toddler and he realised vaguely that his natural feelings of parental protection had become entangled with his identification with his client’s problems.
His intense sense of injustice at his client’s position was at odds with the way that he was able to deal with the rest of his caseload.
As a result, shortly after conclusion of the case, he stopped doing matrimonial work and began to specialise more in clinical negligence.
During the course of his counselling later in the year Chris realised that the exhaustion that he felt after the inquest hearing was somehow tied up unconsciously with his feelings for his own daughter and the turmoil that she was experiencing in her relationship.
Not only was he carrying the expectations of the deceased girl’s family, observing the grief, and sharing their pain, but, at another level, was experiencing this himself in his anxiety for his daughter.
Somehow the two became inextricably linked.
Vicarious trauma
It is recognised that lawyers who deal with certain practice areas are more at risk of experiencing ‘vicarious trauma’ or ‘secondary trauma’ or ‘compassion fatigue’ than others.
In certain areas such as family, crime, children, or personal injury work lawyers have both a professional and pastoral role to fulfil.
They are routinely exposed to others’ trauma and as part of the workload will listen empathically to their clients’ stories and examine heart-breaking and gruesome evidence.
It can sometimes be difficult to separate the professional and pastoral roles and one can overspill into another.
Situations can be compounded where lawyers are working under significant time pressures, are overworked, where caseloads encroach on personal time, leading to feelings of exhaustion and being overwhelmed.
Sometimes disturbing images from clients’ stories can intrude into thoughts and dreams and lawyers can begin to see the world as an inherently dangerous place.
On one occasion when Chris was admitted for routine surgery, he realised that he was hyper-vigilant about what could go wrong, at the expense of trusting the surgeon and putting up with routine post-operative pain.
Nursing trauma
In her 1959 paper ‘Social Systems as a Defence Against Anxiety’ Isabel Menzies Lyth described how the stresses of nursing and the close relationship it required with patients impacted on the organisation of care, leaving those nearest to patients exposed to emotional pressures that more senior staff and managers were able to avoid [1].
In common with those on the frontline of the medical profession, nurses were recognised as experiencing high levels of tension, distress, and anxiety.
Menzies Lyth wondered how nurses could tolerate so much anxiety.
She and her colleagues found much evidence that they could not.
Withdrawal from duty was common.
One third of trainees did not complete their training, the majority leaving at their own request.
It was abundantly clear that significant dysfunctional institutional processes were directly affecting the physical and mental health of junior nurses.
Lawyers
Although removed from physical trauma by several steps, lawyers are also based in situations which are likely to evoke stress.
They may be in regular contact with clients who are physically ill or injured, often seriously.
The outcome of a family dispute or a serious injury claim may be uncertain and the lawyer has to guide the client through the process.
On occasions, as with Menzies Lyth’s nurses, “the work arouses strong and conflicting feelings: pity, compassion and love; guilt and anxiety; hatred and resentment of the patients who arouse these feelings; envy of the care they receive” [1].
At the time of the inquest, Chris was largely unaware of the unconscious associations between the girl who had died and his feelings for his daughter.
These were clarified during the course of the counselling.
This enabled him to think about and learn how to contain his own feelings of anger and sadness that he experienced for his daughter.
He began to be able to take a more objective view of himself and to see how his experiences earlier in the year had impacted one on the other.
In short, he was able to begin to mentalise, to understand something of what had happened to him, and to pinpoint some meanings behind this.
He learned to identify how his own wishes, feelings, reactions, thoughts, and aspirations for his daughter inter-related at a time when he had so much else on his plate to deal with …
(Next)
[1] Menzies Lyth, I. (1960) Social systems as a defence against anxiety. Human Relations, 13, 95-121.
(This is an edited excerpt from my book A Lawyer’s Guide to Wellbeing and Managing Stress published by ARK Group in 2015.)
