'Compassion fatigue' - For lawyers, the well of empathy can run dry, with consequences

By David Donovan
BridgeTower Media Newswires

RALEIGH, North Carolina - German philosopher Friedrich Nietzsche and, more recently, pop singer Kelly Clarkson have observed that which "does not kill us, makes us stronger."

But more recent discoveries about mental health show that observation to be wildly off-base, however.

The cumulative toll of repeated exposure to traumatic events, psychologists have learned, can have profoundly negative effects on a person's mental state. For individuals whose workdays typically revolve around trying to help people who have been victimized by certain types of trauma-that is to say, lawyers in a variety of fields of practice-the effects can sometimes lead to a state of secondary traumatic stress for the professionals.

Psychologists refer to this condition as "compassion fatigue."

The symptoms of compassion fatigue look like, and thus are sometimes mistaken for, those of depression or burnout: a lack of diligence at work that can lead to absenteeism or avoiding clients, difficulty making decisions, and pervasively negative attitudes. At home, sufferers may withdraw from loved ones or cease finding enjoyment in once-pleasurable hobbies. In both ways, sufferers build up emotional walls between themselves and other people as a way to shielding themselves from exposure.

Robynn Moraites, director of the North Carolina Lawyer Assistance Program, has been working to educate attorneys about compassion fatigue, a condition that has likely been around forever, but is becoming recognized more frequently as mental health professionals learn more about it.

"I think there is a better understanding of the different manifestations that professional stress and pressure have on people," Moraites said. "There's a difference between depression, which could be chemically happening or unrelated to someone's job, whereas compassion fatigue is entirely related to someone's job, and it's totally correlated with workload and the type of distress you are exposed to on a day-to-day basis."

After all that we've

been through

The increasing specialization of the legal industry may be one factor that is causing an upswing in the number of attorneys suffering from compassion fatigue. In the bygone days of legal generalists, an attorney might have an especially contentious divorce case or harrowing criminal case, but also have a docket balanced with helping clients start a new business or purchase a home-work that often leads to a strong sense of personal achievement that researchers call "compassion satisfaction."

But today's lawyers are more likely to have a caseload of nothing but family law cases, or criminal cases, or bankruptcy cases, creating a lack of balance between fatigue and satisfaction. And indeed, these are all areas of practice strongly correlated with compassion fatigue and other mental health risks.

What's more, attorneys who have experienced a particular time of trauma in their personal life-for instance, sexual abuse-may be motivated to take on cases helping clients who have experienced that same sort of trauma. That motivation is easy to understand, but dealing with those same sorts of cases repeatedly can actually trigger fatigue even faster than it might for other attorneys.

But Moraites said that she was surprised to find an especially high prevalence of compassion fatigue among workers' compensation attorneys, both in the workers' and defense bars. That's likely attributable to the tremendous caseloads shouldered by workers' comp attorneys, which often range from 250-400 cases at a time, many of them involving workers who have suffered catastrophic injuries. (District court judges, who likewise have to churn through a crushing caseload, are also at particular risk of developing compassion fatigue.)

"You're dealing with people who are in a very bad place, some of whom may not ever be able to return to work and are very frustrated, and it's hard for them to understand you're dealing with a limited set of tools," said Will Wallace of the Law Offices of Michael A. DeMayo in Charlotte and chair of the North Carolina Bar Association's workers' comp section.

"Often you get into a significant amount of stress because of an inability to fix many of the problems the client is facing, and the more catastrophically injured a person is, the less you can do. That's the biggest stress of workers' comp law is that I'm not able to do everything they need to put their life back together, and so you can get inundated with unhappy clients. You're doing your best, but they don't always understand that there's nothing more you can do."

Even lawyers

need a holiday

So what can attorneys do to insulate themselves, and their colleagues, from the risk of compassion fatigue? Besides working to cultivate a better balance of compassion satisfaction, Moraites said that lawyers would do well to get rigorous physical exercise regularly, maintain meaningful connections to other people, and devote time for hobbies that stimulate other parts of the brain. Crucially, lawyers also need to cultivate the often underdeveloped ability to recognize when they need to say "no" to taking on a particular case.

Taking a real vacation, ideally at least two weeks every year, is also essential for helping lawyers maintain their resilience. Some firms have been especially forward-thinking in encouraging attorneys to take extended breaks to recharge and recover from the stresses of the job. Robinson Bradshaw, based in Charlotte, offers its partners the opportunity to take what the firm calls a "vacattical"-three weeks of time off to be taken as a block once every five years. Many attorneys will often piggyback regular vacation time on top of their vacatticals to give themselves added time to decompress.

Kelly Loving, a partner at the firm who has taken two vacatticals, says that with shorter breaks, by the time a lawyer has made a full transition into personal time, it's nearly time to return to the office. With the longer breaks, conversely, colleagues typically come back looking visibly refreshed.

"The idea is really to unplug and do whatever you're going to do to get away and really rejuvenate and renew your focus," Loving said. "So we think that kind of unplugging really helps people stay fresh and really helps out clients because we are fresher and more focused and can really hit the ground running when people get back."

Loving said that the breaks are not mandatory, but eligible attorneys are encouraged to take them, and most partners at the firm do. But it surely says something about the profession that some attorneys choose to opt to soldier on rather than take advantage of the time to get away. But Loving noted that the policy works so well for Robinson Bradshaw because attorneys are keen to pitch in to help cover for colleagues who are away-a month away from work may be less realistic for attorneys at smaller firms.

Very hard to say

"I'm only human"

Talking candidly about the stresses of the job can also be a lifeline for attorneys, experts say, whether that sounding board comes from a loved one, another attorney, or a professional therapist. Interestingly, therapists themselves have to be cognizant of the very same risks that attorneys face, since their jobs also involve constantly trying to help clients find solutions to life-altering problems.

"Attorneys hear a lot of stuff, and without good boundaries and even sometimes with good boundaries, it's hard to let that stuff wash off of us," said Margaret Wyche, a therapist with Elemental Healing in Charlotte who routinely counsels attorneys.

"It shows up as withdrawal or isolation, that feeling like I don't really want to hear anybody else's problems right now. I even notice that with myself. Sometimes I feel like, can I just take care of me for a few minutes and not have to come up with any answer for anyone? We're expected to have the answers, and know how to help people and direct them, and sometimes it's like I don't know what to tell you because we don't always have all the answers, and I think that's a really tough place."

The most important thing for attorneys to understand, Wyche said, is that they don't have super powers and that it's okay to not have all the answers sometimes. Talking about those feelings honestly can help validate them, she said.

Opening up about their work-related stresses may not come naturally for many attorneys, however. Moraites said she suspects that the cases of compassion fatigue that she sees reflect only a fraction of its prevalence within the state's bar.

"I think that only a small percentage of lawyers are actually getting the help that they need," Moraites said. "I think most lawyers just buckle down with grim determination that they're going to get through whatever it is. Lawyers are not inclined to ask for help."

Ironically, then, a profession of helpers is often disinclined to ask for help itself. But a growing body of evidence about the toll of the profession suggests that they really ought not to be.

Published: Thu, May 04, 2017