Judicial Stress & Wellness: Sources, Impact & Intervention

1. Judicial Stress & Wellness: Sources, Impact & Intervention David X. Swenson, PhD. LP The Hon. Shaun Floerke The Hon. Joan Bibelhausen Minnesota District Judges Association/ Minnesota District Judges Foundation. Brainerd, MN. Sept. 7, 2010

2. Agenda • Brief history of trauma & development of vicarious/secondary trauma • Nature of judicial stress • Impact of vicarious trauma on performance • Prevention & Intervention • Participant discussion & ideas

4. Origins of Post-Traumatic Stress Disorder (PTSD) • Historically described but not recognized (e.g., Hebrew Patriarch Jacob in the Book of Genesis, Achillies in Homer’s Illiad) • During the Civil War soldiers exposed to the horrors of war were afflicted with “nostalgia” or “Soldier’s Heart” • During the 1870s “Railroad Spine” was prominent owing to lawsuits related to frequent and terrible railroad incidents • By the end of the 19th century, “traumatic hysteria” and “traumatic neurasthenia” were conventional terms • WWI brought awareness of shock to nervous systems & “Shell Shock” • WWII introduced “Combat Fatigue” with one in three experiencing it • Viet Nam eventually brought about the diagnostic term “combat stress” & eventually “Posttraumatic Stress Disorder” in 1980

5. It’s not just war: Vicarious/Secondary Trauma, “Compassion Fatigue” It’s the cumulative effect of exposure to the suffering, horror, hopelessness, and other adverse consequences to others– the “cost of caring” Florida Judge Larry Seidlin breaks into tears three times during Anna Nicole Smith’s body disposition case • Therapists who hear victims’ trauma stories experience stress; 1990 studies showed it affected their work (Figley, 1990; McCann & Pearlman, 1990) • 10-20% of people who work with trauma victims have full PTSD Dx & moderate symptoms (Erisson, et al. 2001) • Trauma education & debriefing reduces PTSD (Kinzel & Nanson, 2000) • Judges experience secondary trauma (Jaffe, et al., 2003; Zimmerman, 2002)

6. Prime factor: Exposure to the pain & suffering of others Direct Trauma: direct personal exposure to situation involving personal risk during victimization, disaster, or war Secondary Trauma: continued, frequent, or close contact with persons who have experienced direct trauma Vicarious Trauma: Exposure to reports, descriptions, and photos of traumatic events

7. “I feel your pain”…literally! We are hardwired • Even when we simply observe others, “mirror cells” in the brain activate to reproduce the actions of the other person • When we hear vivid stories or see intense reactions our own brain produces emotions expressed by the other person • These occur unconsciously • Suppressing our empathic response does not eliminate it • Empathy is moderated by a sense of fairness

8. Yerkes-Dodson Law: Too much/little = stress

9. Comparison with Physician Stress • 85% family life suffers by professional demands • 81% said burnout is a significant problem • 75% patient satisfaction is affected by burnout • 67% burnout poses a problem to group practice • 62% Heavier workload than preferred • 60% increase disability claims by MD’s since 1990 • 59% unreasonable patient expectations • 59% feel guilty about insufficient time with patients • 58% shows significant signs of exhaustion • 55% personal life has suffered • 43% said they were already burned out • 38% very or extremely stressed by work • 33% think of changing professions Attorneys showed significantly higher levels of secondary traumatic stress and burnout than mental health workers and social workers (Levin & Griesberg, 2003). Judges may be higher due to isolation

10. The Judicial Experience of Compassion Fatigue • Survey of 105 judges attending domestic violence conference, average age 51 with 10 years experience, 54% male & 46% female. 81% heard criminal cases, 54% domestic & civil cases, 34% juvenile court (some overlap) • 63% reported one or more symptoms related to compassion fatigue (Jaffe, et al., 2003) (spouses believe judges underreport) • Judges with 7+ years reported higher levels of externalized symptoms (e.g., hostility, irritability) • Female judges reported more internalized symptoms (e.g., sleep problems, sadness, etc.) of compassion fatigue (73% female to 54% male) • Compassion fatigue seems to peak about the 7th year on the bench • 73% reported “relatively effective” coping strategies Jaffe, P. G., Crooks, C. V., Dunford-Jackson, B. L. & Town, M. (2003). Vicarious trauma in judges: The personal challenge of dispensing justice. Juvenile and Family Court Journal,45(4), 1-9.

11. Other concerns • Safety: In a survey of Pennsylvania judges, 52% reported one or more threatening messages; 70% inside the court, 44% outside. Whether to carry firearms • Culture shift: from paternalistic to more participative, individual to team, paper & people to electronic media, secure staffing to anxious and Chamberlain, J., & Miller, M. K. (2009). Evidence of secondary traumatic stress, safety concerns, and burnout among a homogeneous group of judges in a single jurisdiction. Journal of the American Academy of Psychiatry and the Law, 37, 214-224.

12. Challenges of Culture Shift: “We hate this place…don’t change it”

13. Early Warning Signs of Judicial Burnout Above 12: I am probably experiencing burnout. Between 8-12: I am on the borderline. Below 8: I am coping with stress reasonably well. Isaiah M. Zimmerman, Ph.D.

15. Personal factors related to stress & resiliency • Personal history of previous trauma exposure or sheltered from such events; resilience vs. oversensitized • Personality features such as temperament, introversion-extraversion, mood, emotionality, etc. • Personal values & attitudes that may conflict with requirements of the profession • Sense of control vs. dealing with unknown & unpredictable factors; tolerance of ambiguity & change The Hon. Judith R. Eiler was reprimanded by the Washington State Commission on Judicial Conduct due to her compulsion to interrupt and verbally intimidate litigants. She has also been instructed to never again wear her "Wanna Piece of Me?" T-shirt or use her "Annoying People Annoy Me" coffee mug while conducting business inside the courtroom. Alabama Chief Justice Judge Roy Moore defied federal order to remove 5,300 lb 10 Commandments monument from state judicial building

16. Texas federal judge describes cynicism, alcohol, sexual harassment following wife’s cancer Michigan district judge accused of sexual harassment, living outside jurisdiction. Suicide attempt in 2004 Personal Factors cont’d • Personal strength, patience & resiliency vs. overload over time & willingness to ask for & accept support • Residual and cumulative stress level vs. time for self care, relaxation • General state of health and level of endurance vs fatigue • Personal crises such as substance abuse, health crisis, domestic concerns, etc.

17. Organizational & Professional Factors • Work overload: heavy docket, insufficient support, long hours • Employer-employee relationships & conflicts • Case characteristics: long trials, interruptions, concern for personal & family safety • Significant decisions: precedents, prominent cases • Isolation: confidentiality,adversarial relationships • Exposure: specialty courts, extensive information of traumatic details, exposure to impact on victims • Courthouse culture: collegial vs adversarial, expectations of sacrifice in personal life • Code Requirement: non-impaired judges must take action on impaired judges Miller, M. K., Chamberlain, J. , Flores, D. and Richardson, J. (2007, Jul) "Exploring Causes and Effects of Judicial Stress" Paper presented at the annual meeting of the The Law and Society Association, TBA, Berlin, Germany <Not Available>. 2008-06-26 from http://www.allacademic.com/meta/p182122_index.html

18. The stress of dealing with public opinion

19. Societal Factors • Media monitoring • Prominent social issues • Social pressures • Political pressures • Complex scientific or ethical issues, expert opinion, self represented litigants Judge Angela Stokes accused presiding judge of pressuring her to withdraw arrest warrant for wife of political ally Justice O’Connor criticized judicial election race for spending $9.3 million

21. Personal Stress Management • Adequate sleep (8 hours) • Regular, frequent exercise (81%) • Balanced nutrition • Relaxation (74%) • Hobbies, recreation removed from the judicial world • Diverse socializing friendships (65%) Judge Patrick Johnson singing Jaffe, P. G., Crooks, C. V., Dunford-Jackson, B. L. & Town, M. (2003). Vicarious trauma in judges: The personal challenge of dispensing justice. Juvenile and Family Court Journal,45(4), 1-9.

22. You have strong reasons not to change, but consider the trade-offs in immediate demands vs. long term consequences

23. Vicarious Resiliency • Originally developed by psychotherapists who worked with political survivors of trauma/torture • Ability to see positives in an adverse situation; to benefit by learning and become stronger for it • The “wounded healer” • Appreciating how a crisis can become a pivotal point for change • Noticing how trauma survivors demonstrate the vitality of the human spirit • Witnessing the coping and mastery of others in crisis; what helped them survive (Hernandez, Gangsei, & Engstrom, 2007)

24. Personal Stress Management • Mental quieting • Sense of humor • Social support, caring relationships • Values, faith, philosophy • Focus on positives (even when small) • Protected time • Self defense & security skills • Vicarious resiliency

25. Stress Management in the Profession • Attending workshops (60%) (eg. Judicial Wellness and Personal Security by NJC's ) • Peer support (53%) • Reading educational materials (29%) • Rotate to less stressful calendars • Generativity programs: New Judge programs, law school curricula, judge in residence, faculty development • New technology: WebEx reduces case management time by 2-3 months in civil cases Jaffe, P. G., Crooks, C. V., Dunford-Jackson, B. L. & Town, M. (2003). Vicarious trauma in judges: The personal challenge of dispensing justice. Juvenile and Family Court Journal,45(4), 1-9.

26. Stress Management in the Profession • Caseflow & courtroom management (e.g. rotate to less stressful calendar) • Law School training in how to deal with traumatized and disturbed clients • Willingness to confront and support colleagues • Judges’ & Lawyers’ Assistance Programs • Writing, publication • Sabbaticals

27. Office and Staff Culture • Involve staff in planning, procedures, scheduling and feedback • Hold periodic “state of the office” meetings • Compliment staff on particularly good work • Identify issues for staff meetings and discuss ways of handling them

28. Stress Management in Society • Public speaking on the role of the Courts (41%) • Coordination of courts and community service (38%) • Court reform to facilitate justice administration (29%) Judge Trudy M. White wrote and promoted historical documentary program on recreation opportunities for African-American youth in Baton Rouge Judge Sharon Hall joins other officials following a DWI trial demo at Coon Rapids High School Jaffe, P. G., Crooks, C. V., Dunford-Jackson, B. L. & Town, M. (2003). Vicarious trauma in judges: The personal challenge of dispensing justice. Juvenile and Family Court Journal,45(4), 1-9.

29. Culture/Working conditions: • Long hours • Heavy case loads & behind • Traumatic cases • Confidentiality & isolation • Staffing cuts & turnover • Needs of jurors • Unprepared attorneys • Conflicts with colleagues • Public ignorance of the courts • Public image & presentation • Public scrutiny & controversy • Annoying & ill-prepared litigants • Lack of appreciation, passed over • Violence & safety concerns • Inadequate reward structure • Performance Impact • Insensitivity • Indifference • Impatience • Indecisive • Irritability • Rudeness • Intimidation • Stereotyping • Low confidence • Inattention • Poor memory • Cynicism • Demoralization The Vicarious Trauma Process & Intervention • Health Impact • Substance & med abuse • Diabetes • Headaches • Eating disorders • Hypertension • Heart disease • Insomnia • Depression • Anxiety • Seizures • Stroke • Etc… • Stress Reaction • Sleep disturbance • Inattention • Fatigue • Sadness • Anxiety • Headaches • Etc… Judicial Code of Conduct– Career Requirements & Constraints • Interpersonal & Family Impact • Absence • Irritability • Family isolation • Domestic abuse • Social isolation • Low discretionary time • Gambling & financial issues • Extramarital affairs • Divorce • Stress Management • Clear boundaries • Physical fitness • Relaxation • Recreation, hobbies • Community involvement • Writing & teaching • Mentoring • Friendships outside of field • Honest dialog, etc… • Personal Factors • Empathy/identification • Personality, temperament, style (e.g., introversion extraversion, confrontive); • Personal history

30. Discussion • What do we do personally for stress management and how well does it work? • How can we better help stressed colleagues? • What are some practices you would like to implement among your staff and/or in the courthouse?