by Anne Chambers, LCSW, Director, Missouri Lawyers’ Assistance Program
Webster's dictionary defines burnout as the exhaustion of physical or emotional strength or motivation, usually as the result of prolonged stress or frustration. Exhaustion tops the list of symptoms of burnout and appears to be a hallmark feature. Bateson and Hart describe burnout as complete mental or emotional fatigue lasting weeks at a time, generally as a result of exposure to stress that is pervasive, complete and prolonged. Common symptoms include exhaustion, fatigue, detachment, boredom, cynicism, sadness, irritability or annoyance. Judges facing burnout often feel drained, as if they have nothing left to give, feel a lack of achievement, purpose and sense of hope. Some experience distrust or a sense of impending failure. Burnout is a disillusioning experience. Doing the minimum becomes a challenge. Unrelieved, burnout may harden into a fixed element of one’s outlook and depersonalization of cases one must deal with. When burnout is advanced, the judge's usual demeanor may harden and they may come across as detached.
Compassion satisfaction occurs when you feel good about what you do because you care. There is a sense of purpose, achievement, and meaning. Compassion fatigue is generally defined as the cumulative impact of continual exposure to traumatic or distressing stories and events when working in a helping capacity over a long period of time. Compassion fatigue is related to the nature, intensity and quantity of the subject matter handles as part of their job. Moraites notes that compassion fatigue comes from “working with the big uglies in life.” Common signs of compassion fatigue include intrusive thoughts, anger or fear, disturbed sleep, fatigue, loss of appetite, loss of empathy, loss of faith in humanity, a sense of isolation from others and physical complaints.
The emotional impact of compassion fatigue can include feelings of powerlessness, alienation from others and becoming indecisive or anxious. Beliefs about the meaning of one’s work can be questioned. The judge’s sense of safety, security, truth and justice are shaken. Pessimism, irritability, a sick feeling or sense of depression can creep in. Some attempt to cope in ways that are unhelpful.
Signs of compassion fatigue in judges and attorneys include:
Sources: Jaffe et al (2003) Levin et al. (2003), Michener (2009), Osofsky, Putnam and Lederman (2008), Vrkelvski et al (2008)
What is the difference between burnout and compassion fatigue?
Long and Manghelli describe burnout as an advanced state of physical emotional and mental exhaustion related to the stresses of the job. Time away from work revives us. Compassion fatigue results from the cumulative impact of long term exposure to disturbing material. It is when compassion hurts. It involves burnout plus a negative shift in one’s world view.
Judges are exposed to a number of risk factors for compassion fatigue: graphic medical evidence, 911 tapes, photos and videos of injuries, victim impact statements, testimony at trial and sentencing, and statements of surviving family members. With the increasing use of specialty courts and dockets, judges may experience a greater concentration of highly emotional cases where difficult material is being reviewed. They are expected to be neutral in the face of tragedy, perform duties impartially without being unduly swayed by emotion, and serve as the balance point and decision maker. Judges are expected to appear unaffected by disturbing information they see and hear. Judges face isolation due to the uniqueness of their role, make weighty decisions and are expected to keep their own counsel. Highly complex, emotionally charged cases can take a toll over time.
In 1996, Saakvitne and Pearlman identified factors that influence vulnerability to compassion fatigue. Individual vulnerabilities include a history of or current trauma, health problems, alcohol or drug abuse troubles, poor job performance and the presence of depression or anxiety. Life factors that increase vulnerability include times of difficulty with one’s spouse or partner, children, parents or finances. Organizational stressors include performing multiple jobs, times of budget cuts or eliminating positions in the workplace and a sense of unrecognized accomplishments. Judges were identified as 20th of 21 professions at risk for compassion fatigue.
Legal professionals at greater risk for compassion fatigue are those who work in in criminal, family or juvenile law; those with caseloads involving lots of human-induced trauma; those with high percentage of exposure to graphic evidence day in and day out; those who work grim dockets over a long period of time; those who work alone; those with higher caseloads; and those with limited support. Personality factors that that increase susceptibility include a high need for control, over dedication, perfectionism and workaholic tendencies. Others at greater risk are idealists, those with unrealistic expectations or low coping abilities. Very empathic people who pour high levels of emotional energy into their work can become overwhelmed over time.
What the Scholarly Literature says about Compassion Fatigue
Levin and Griesburg studied compassion fatigue in attorneys. They surveyed attorneys working with victims of domestic violence and criminal defendants and compared them with social service and mental health workers. Their article was published in Pace Law Review in 2003. The attorneys demonstrated significantly higher levels of secondary traumatic stress and burnout, scoring higher on all areas. The difference appeared related to attorneys’ higher case loads and lack of supervision around trauma and its effects. Attorneys working with victims often reported they’d become over extended with clients. Increased client load predicted higher scores on secondary trauma and burnout scales in all of the occupations they examined.
Jaffe, Crooks, Dunford-Jackson and Judge Michael Town did a study which was published in the Juvenile and Family Court Journal in 2003. 105 judges completed a self-report measure and had the opportunity to answer open ended questions. They investigated symptoms of vicarious trauma, coping and prevention strategies in judges. 63% of the judges reported experiencing 1 or more symptoms related to vicarious trauma. Short term symptoms most frequently reported by the judges were sleep disturbances (17%), intolerance of others (11%) and physical complaints (8%). Long term symptoms more frequently reported were sleep disturbances (7%), depression (5%), and isolation (5%). The most common personal coping strategies judges used were physical activity, rest and relaxation and social contacts. Their most common professional coping strategies were attending workshops, peer support and reading educational materials. Their most common societal coping strategies used included public speaking on role of the courts, coordination of court and community services and court reform to facilitate administration of justice. Strategies to prevent compassion fatigue judges suggested included not dwelling on decisions once they are made, enjoying your job, doing your best at work, maintaining balance, having outside friendships, having date night with a spouse, laughing often, having collegial relationships in the work setting and being involved in fun groups that were not court related.
Lustig, Karnik, Deluchi, Tennakoon, Kual, Judge Marks and Judge Slavin studied compassion fatigue in immigration judges. Their work was published in Georgetown Immigration Law Journal in 2008. They found that many judges adjudicating cases of asylum seekers suffered from significant symptoms of secondary traumatic stress and job burnout. On a 5 point scale the judges scored 2.0 on symptoms of intrusion, 2.3 on avoidance, and 2.4 on symptoms of activation. Hearing the detailed stories of persecution and abuse took the greatest toll. One recommendation was that the immigration judges have the opportunity to research conditions in the countries of origin in the cases they were handling.
Tools to respond effectively
Research based suggestions for improving mood, increasing life satisfaction and mitigating stress include
Factors that buffer against burnout include
If you are already experiencing burnout or compassion fatigue, there are many ways to recover.
Sources: Blackford (2011), Crawford and Querin (2012), Jaffe et al (2003), Long and Manghelli (2011), Mergendahl (2012)
Having an opportunity to debrief the traumatic aspects of difficult cases has been identified as a helpful tool in preventing compassion fatigue. Low impact debriefing is a helpful strategy which involves providing fair warning, obtaining consent and giving limited disclosure, working from the outer circle from the least traumatic to the inner circle of the most traumatic information, and stopping when you feel relief.
Triggers are events that cause an intense emotional response. They are different for each of us. Common examples include abuse of vulnerable populations, situations that open an old wound or cut too close to home, certain kinds of disrespect, harsh realities of life and systems, and double bind situations in which all options seem grim. Reactions may include anger, anxiety, working harder, using coping methods that hurt more than help, physical complaints like headaches, stomach problems, back pain, fatigue and turning to coping methods that hurt more than help. Identify what kinds of cases are most likely to trigger a strong response for you. Identify ways to cope with them now so that you are well prepared when they present themselves.
Burnout and compassion fatigue are not mental health diagnoses. Some of the symptoms can overlap with signs of depression like sadness, detachment, pessimism and irritability. Judges and attorneys who suspect they are facing burnout or compassion fatigue combined with depression may benefit from additional assistance. By using the right tools, you can exercise compassion in ways that allow you to be a great professional who feels rewarded by the work you can do. The time you take to refresh and renew will be time well spent.
For professional, confidential assistance in recovering from burnout or compassion fatigue, contact MOLAP at 1-800-688-7859.
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Paid for by The Missouri Bar Sebrina Barrett, Executive Director PO Box 119 Jefferson City, MO 65102