For the Good of the Order— Treating Secondary Trauma From PTSD
We are pleased to announce WaLAL's collaboration with the Federal Bar Association for the Western District of Washington to provide a monthly "For the Good of the Order" column on lawyer well-being in its Newsletter.
February is National Self-Check Month, an annual health observance urging individuals to take charge of their well-being through proactive self-exams and health screenings. This includes monitoring for symptoms of mental health issues and promoting early detection and preventive care. WaLaL has links to free self-tests on a variety of health issues. These tests can help identify patterns of feelings, thoughts, or behaviors that can lead to negative consequences in your relationships and decision making.
Secondary Trauma PTSD Among Lawyers and Judges is Real, Frequent, and Increasing. Help Exists
Published in Federal Bar Association, Feb. 2026 ,Newsletter
Leslie Hagin, WA Lawyers Assisting Lawyers (WaLAL)
My Story
I have personal experience with indirect or secondary trauma syndrome or stress. This has recently become recognized as a valid DSM-5 “Criterion A stressor” for posttraumatic stress disorder (PTSD).[1] I have now received treatment and strategies for it. Peer support has been essential and nothing less than life saving for me.[2]
I was oblivious to my condition until I was in my early 50s, after more than three decades as a lawyer. As a civil rights, employment and criminal defense lawyer, I certainly knew most of my clients were in often-severe emotional distress. I felt much empathy for them and was determined to help them. My clients regularly commented about what a caring lawyer I was. I had no idea how high the risk is for me and other lawyers, as well as judges, for secondary trauma PTSD. It is not anything I ever remember being discussed among lawyers and judges. I am grateful the Federal Bar Association for the Western District of Washington is committed to helping change that.
In my law practice I was exposed to highly charged, emotional situations, as well as often disturbing evidence, which led to my secondary or indirect traumatization. This manifested in a persistent, negative emotional state. This included changes in my self-identity and diminishment in my sense of safety and trust. I lost sleep, worried incessantly if I was missing something or doing enough to help my clients, had trouble concentrating, felt “burned out,” compassion fatigue, and experienced severe mood swings, irritable behavior and angry outbursts.[3] As is common, I “self-medicated” to “calm my nerves,” which became its own problem with its own adverse and complicating (and further traumatic) consequences.[4]
Our Story
I am not alone. Neither are you. This form of PTSD is real and it is frequent among lawyers and judges. And it is increasing. This is especially true of those practicing and adjudicating in certain areas of law, such as criminal, civil rights, immigration, personal injury and mass torts. In fact, studies comparing legal professionals’ secondary trauma to other occupations have shown PTSD symptoms and psychological distress were often greater for lawyers than for social workers, psychologists, and mental health providers; and higher for immigration lawyers than for hospital or prison staff.In October 2017, the National Judicial College published a its survey of nearly 800 judges who were asked: “Have you suffered secondary traumatic stress from being a judge?” 45% answered “Yes.”[5] This study was conducted before events in the current socio-legal climate, including direct attacks on judges and their families, including those in our district.
More recently, in 2024 congressional testimony, the head of the U.S. Marshal’s Service reported that serious threats to federal judges have tripled over the last decade; in 2023 alone over 400 individual judges faced serious threats, more than double the number in 2021; these threats include “swatting” incidents, death threats, and harassment at homes. He also noted that threats to federal prosecutors and court staff have shown a similar “alarming” increase.[6]
Help Exists
The Federal Bar Association of the Western District of Washington lists WA Lawyers Assisting Lawyers (WaLAL) as a Help resource. https://fba-wdwash.org/help
[1] The latest edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published in 2013 by the American Psychiatric Association (APA), is the authoritative guide used by clinicians to diagnose and classify mental disorders. It is admissible and frequently used as evidence in both civil and criminal legal proceedings to establish diagnoses and has been called the “bible of psychiatry” in court. Changes in the latest edition include the relocation of PTSD from the “anxiety disorders” category to a new diagnostic category named “trauma and stressor-related disorders;” and within it, the formal inclusion of “repeated or extreme indirect exposure to aversive traumatic events” (often called secondary trauma stressors of disorder, or vicarious trauma), including within or part of one’s occupation.
[2] Peer support is highly effective for mental health, providing empathy, shared experience, and practical guidance that reduces stigma and social isolation and fosters hope, empowerment, and recovery. It is also known to increase productivity and reduce attrition, disciplinary action and malpractice costs. See e.g., Kolinski, How Peer Support Can Close the Gaps in Behavioral Healthcare, National Council on Quality Assurance (May 2025), at https://www.ncqa.org. See also Anker & Krill, Stress, Drink, Leave: An Examination of Gender-Specific Risk Factors for Mental Health Problems and Attrition Among Licensed Attorneys (2021) (25% of female attorneys report contemplating leaving legal profession due to mental health problems, “burnout,” or stress; 17% of male attorneys report same but also report higher rates of suicidal ideation); Reich, Capitalizing on Healthy Lawyers: The Business Case for Law Firms to Promote and Prioritize Lawyer Well-Being, 65 Vill. L.R. 261 nn.259-260 (2020) ((citing inter alia ABA Survey of NY and CA Lawyers (2020) (50%-70% of disciplinary cases involve alcoholism)); ABA/Hazelton Betty Ford Study, The Path to Lawyer Well-Being: Practical Recommendations for Positive Change (2016) (40%-70% of disciplinary and malpractice cases involve attorney alcoholism, depression, or both).
[3] See e.g., James, C., Towards a Trauma-Informed Legal Practice: A Review, 27(2) Psychiatry, Psychology and Law, 1–25 (Feb. 2020); Levin et al., Secondary Trauma and Stress Among Attorneys and Their Administrative Staff Working With Trauma-Exposed Clients, J. Nerv. Ment. Dis. 946-955 (2011). Repeated exposure to clients, witnesses and litigants, who haveencountered trauma is known dimension of working as lawyer, especially in certain areas -- e.g., criminal, civil rights, immigration, personal injury. Our work often involves direct and indirect exposure to highly traumatic information and images. Lawyers and judges may also experience strong emotions through consultation with distressed clients who are facing physical harm, disability, imprisonment, bankruptcy, deportation, unemployment, and other traumatic consequences. Secondary Trauma symptoms include intrusive thoughts, negative alterations in cognition (e.g., distractibility, forgetfulness, difficulty concentrating, mood arousal, reactivity, impulsiveness, irritability, anger, anxiety, depression, sense of impending doom, increased substance use, isolation, fatigue, sleep issues, GI issues, lack of empathy/burnout/shutdown).
[4] See Benjamin et al., Lawyer Distress: Alcohol-Related Problems and Other Psychological Concerns Among a Sample of Practicing Lawyers, 10 J. Law & Health 1-60, at 45 (1996) (data collected from actively practicing WA and AZ lawyers by University of Washington Professor Andrew Benjamin (JD, PhD, ABPP) and colleagues) (seminal methodological study showing from randomly selected sample of lawyers responding to Michigan Alcoholism Screening Test, that 2/3rds of lawyer sample met threshold for alcoholism because of reported negative consequences associated with their alcohol use). See also Krill et al., The Prevalence of Substance Use and Other Mental Health Concerns Among American Attorneys, 10 J. Addiction Med. 46-52 (2016); Krill et al., Stressed, Lonely and Overcommitted: Predictors of Lawyer Suicide Risk (Feb. 2023) (results from joint study of ~2000 lawyers from CA and DC), in Healthcare.
[5] October 2017 National Judicial College Survey. See also e.g., Grinsteiner, et al., How Judges Can Respond to Secondary Traumatization, ABA Judicial Division (June 24, 2025).
[6] In response to a Question of the Month for May 2024 (mental health awareness month) by the National Judicial College, over half of the judges who responded said that public physical and verbal attacks on the judiciary, along with the recent drop in public trust and confidence in the courts, have negatively affected their mental health. See also Whitehurst, Threats to Federal Judges Have More Than Doubled in “Alarming” Spike, US Marshal Director Says, Associated Press (Feb. 14, 2024); Goldstein-Street, "It's Just So Disgusting": Judges in WA Detail Threats After Trump-Related Rulings, The Recorder (Aug. 8, 2025) (detailing direct threats against WD WA District Court Judges Coughenour and Lasnik for their rulings).This month’s column by WaLaL President Leslie Hagin, highlights an often-overlooked but increasingly urgent issue in the legal profession: secondary trauma and PTSD among lawyers and judges. Drawing on personal experience and current research, Leslie sheds light on how repeated exposure to clients’ traumatic stories and high-stress legal environments can affect mental health and where members of the legal community can turn for confidential support. Click the link below to read the article.