Litigation Secondary Trauma in Women Attorneys: A Therapist’s Clinical Guide

ATTORNEY MENTAL HEALTH • April 25, 2026

Last reviewed: June 2026 by Annie Wright, LMFT

In short: Litigation secondary trauma occurs when women attorneys absorb clients’ traumatic material and develop PTSD-like symptoms the legal profession largely refuses to name.

The Images That Arrive at Night

Simone, 40, a partner at a plaintiff’s civil rights firm in Atlanta, has been litigating for thirteen years. Last week, she deposed a survivor of human trafficking. Her face remained neutral, her questions precise, her record immaculate. She drove home, cooked dinner, bathed her kids, and tucked them in. At 10:45 p.m., lying in bed, the images arrived. Not hers to carry, not her body’s story. Yet they came unbidden. For six months, they’ve arrived like clockwork, uninvited and unrelenting. She hasn’t told anyone. She doesn’t even know what to call this.

In my clinical work with women attorneys, Simone’s experience is not the exception. It’s the norm. The legal profession gives women litigators every tool for managing evidence and none for managing what the evidence does to their nervous systems. The professional expectation is neutrality; the biological reality is that the human nervous system doesn’t neutralize trauma by proximity to a courtroom. It absorbs it, encodes it, and stores it. Exactly the way it stores primary trauma.

What Simone is experiencing has a name. It has a neurobiology, a clinical profile, and a treatment. And it can heal. But only if it’s named.

What Is Secondary Traumatic Stress. And How Is It Different from Burnout?

In my clinical work with women attorneys, I see that what Simone experiences is a form of trauma that the legal profession rarely names: secondary traumatic stress (STS). This condition is the neurological and emotional consequence of sustained, empathic exposure to others’ traumatic experiences. It is distinct from burnout, which is the depletion caused by cumulative job stress and organizational factors.

The foundational research on secondary traumatic stress comes from Charles Figley, PhD, director of the Tulane University Traumatology Institute and pioneer in trauma and helping professions. He defined STS as “the natural, consequent behaviors and emotions resulting from knowing about a traumatizing event experienced by a significant other and the stress resulting from helping or wanting to help a traumatized or suffering person.” For attorneys, this means the cost of sustained, detailed, empathic engagement with their clients’ traumatic experiences across a legal career.

Laurie Anne Pearlman, PhD, and Lisa McCann, PhD, clinical psychologists and trauma researchers, further expanded this framework with their constructivist self-development theory of vicarious traumatization, emphasizing how repeated exposure to trauma changes the helper’s internal worldview and sense of safety. Women litigators are particularly vulnerable because the profession expects emotional neutrality and valorizes stoicism, often dismissing the personal impact of trauma exposure as an indication of weakness rather than treating it as an occupational health issue.

Burnout and secondary traumatic stress are often conflated in legal settings, but they have different clinical profiles. Burnout stems from chronic workplace stressors. Excessive workload, lack of control, organizational dysfunction. And manifests as exhaustion, cynicism, and reduced efficacy. STS, in contrast, involves trauma symptoms such as intrusive memories, emotional numbing, hypervigilance, and avoidance. Triggered by exposure to others’ traumatic material. Many litigators present as “burned out” when they’re actually struggling with STS, leading to misdiagnosis and ineffective treatment. Recognizing STS for what it is constitutes the first step toward healing and sustainable practice.

The Neurobiology: Why the Courtroom Stays in the Body

Bessel van der Kolk, MD, psychiatrist, trauma researcher, and author of The Body Keeps the Score, provides the neurobiological framework for understanding why trauma. Including secondary trauma. Lodges in the body and nervous system rather than just the memory. Trauma memories bypass the hippocampus-dependent narrative memory system and instead encode in the amygdala and sensory cortices with high emotional urgency and sensory detail. They’re not stored as coherent stories but as fragmented images, sounds, and bodily sensations that intrude involuntarily.

For women litigators like Simone, who’ve spent years immersed in depositions, evidence, and testimony of horrific events, their nervous systems are encoding these traumatic materials as if they were direct experiences. This process is especially insidious because the attorney’s role requires sustained empathy without the usual trauma survivor’s markers of personal threat, making it difficult to recognize and address. The brain doesn’t distinguish your professional role from your neurobiological response to the content.

The default mode network (DMN), a brain system active during rest and self-referential thought, plays a key role in involuntary memory retrieval and rumination. Explaining why trauma images often arrive unbidden at night, when the professional role is down and the mind is free to wander. This is the mechanism behind Simone’s experience: the professional mask that held the images at bay during the workday releases at 10:45 p.m., and the nervous system delivers what it’s been holding.

Recent studies confirm that compassion fatigue and STS are prevalent among legal professionals. Women lawyers experience higher rates of secondary trauma symptoms than male counterparts, linked in part to their higher caseloads of sexual assault, child abuse, and family violence cases. The neurobiology explains why these symptoms are not “in your head” or a sign of personal weakness. They’re embedded in your brain and body’s response to sustained trauma exposure. Understanding this changes how you treat the problem.

How Secondary Trauma Shows Up in Women Litigators

Casey, 36, is an assistant district attorney in a large urban prosecutor’s office specializing in sexual assault cases. She’s been in this role for four years and is known as the “go-to” for the hardest cases. She’s handled thirty-seven such cases, many involving graphic evidence and victim testimony. She’s exceptionally good at her job. But Casey has noticed changes: intrusive images of crime scenes and victims’ faces invade her mind unexpectedly. She startles at loud noises. A symptom she never had before. To cope, she’s drinking more than she did in law school.

She’s never connected these experiences to the cases she prosecutes. Instead, she chalks it up to stress or “just the pressure of the job.” This is a classic presentation of secondary traumatic stress. The intrusive imagery, hypervigilance, and substance use signal the nervous system’s response to trauma exposure. But Casey’s legal culture makes it almost impossible to name it that way. “Stress” is acceptable. “Trauma” is not.

These patterns are common among women litigators, whose roles often require deep emotional engagement without access to trauma-informed support. STS in women attorneys commonly presents as: sleep disruption; emotional numbing that bleeds from professional into personal life; hypervigilance; avoidance of certain cases or clients; increased substance use; withdrawal from family and intimate relationships; and a creeping inability to experience ordinary pleasure. These signs often masquerade as professional fatigue or personal weakness, delaying proper intervention by years.

Megan, 43, a plaintiffs’ employment attorney who has litigated sexual harassment cases for fifteen years, describes the turning point this way: “I started avoiding my most vulnerable clients. Not consciously. I’d always return calls. But I’d find reasons to delay. I told myself I was managing my time. In therapy, I learned I was managing my exposure.” Megan’s avoidance wasn’t indifference; it was her nervous system’s attempt to reduce the incoming traumatic load. That self-protective mechanism was having professional consequences. And it needed clinical treatment, not willpower.

The Culture of Legal Stoicism: Why Litigators Don’t Name What’s Happening

The legal profession is built on a culture of emotional suppression and performance under pressure. The “neutral record,” composed cross-examinations, and even-keeled briefs aren’t just professional standards. They’re survival skills. This stoicism is both a genuine competency and a barrier to recognizing when the professional herself is suffering.

Law schools and firms select for individuals who see themselves as capable of handling anything, reinforcing the belief that trauma exposure is part of the job, not a source of injury. For women litigators, this is compounded by the need to prove themselves in a male-dominated environment, often by taking on the hardest cases as proof of competence. The woman who volunteers for the graphic cases isn’t reckless; she’s strategic in a culture where the hardest cases demonstrate fitness for the most important roles.

Admitting to secondary trauma can feel like conceding weakness, risking professional reputation and career advancement. This silence perpetuates the systemic failure to acknowledge litigation secondary trauma in women attorneys. The result is that women who’ve spent a decade in the courtroom carry ten years of accumulated secondary traumatic stress. And don’t seek treatment until a crisis point forces the issue.

For more on the attorney mental health landscape and the specific dynamics women attorneys navigate, see Annie’s guides to female prosecutor secondary trauma and leaving BigLaw and identity rebuild.

Both/And: You Are an Exceptional Advocate AND You’ve Been Carrying Their Trauma

Christine, 44, is a public defender in a capital cases unit. She’s practiced for eighteen years without ever stepping into therapy. After the execution of a client she represented for eleven years, Christine sought help. In therapy, she realized she’d been carrying STS symptoms since year three of her career. She’d labeled it “empathy” and “commitment,” never naming it trauma. Because in her professional culture, trauma only happened to clients.

This is the Both/And reality: Christine is an exceptional advocate, deeply dedicated to her clients, AND this dedication has accumulated in her nervous system as secondary traumatic stress. Naming this doesn’t mean abandoning her clients or her professional identity. On the contrary. Processing STS fosters resilience and restores the capacity to advocate effectively. Christine came out of therapy more present with clients, not less.

In therapy, Christine learned to separate her identity from her cases. She learned to recognize the bodily imprint of secondary trauma. The held breath before a verdict call, the scanning for threat in her own home. And to build a self-care framework that preserved her strength for the work she loves. “I thought getting help meant I couldn’t handle it,” she said. “It turned out that not getting help was the thing that was making me unable to handle it.”

This paradox is worth sitting with: the stoicism that protects your professional reputation in the short term is the mechanism that creates unsustainable accumulation in the long term. The attorneys who do this work for decades without self-destructing are, almost universally, the ones who take secondary trauma seriously.

The Systemic Lens: The Legal Profession’s Complicity in Attorney Suffering

The legal profession’s structural failures are central to the epidemic of secondary trauma among women litigators. Patrick Krill, JD, LLM, attorney well-being researcher and lead author of the 2016 ABA/Hazelden Betty Ford Foundation study, revealed staggering statistics: 46% of attorneys report problem drinking, 28% depression, and 19% anxiety. Rates far exceeding the general population. Follow-up data showed these numbers worsened during the pandemic. These aren’t statistics about people who should have chosen different careers. They’re statistics about a profession that has systematically failed the people inside it.

Despite these data, systemic responses remain inadequate. Lawyers Assistance Programs (LAPs) exist in every state but are chronically underfunded and carry cultural stigma. The billable hour model financially disincentivizes seeking therapy or coaching, since these hours aren’t billable. Socially, the profession punishes vulnerability. To be seen struggling is to be seen as unfit. The result is a perfect storm: massive exposure, minimal support, active cultural discouragement of help-seeking.

This is not an individual failure but a systemic one. The profession has a duty of care to clients but has yet to develop an equivalent framework for attorney well-being. Without institutional change, women litigators will continue carrying secondary trauma in silence. And leaving the profession at precisely the career stage when their expertise is most needed. For context on related attorney wellness issues, see Annie’s posts on partner-track anxiety and female general counsel burnout.

How to Heal: The Therapeutic Work for Secondary Traumatic Stress in Litigators

Secondary traumatic stress is treatable, and the path forward is clinical, concrete, and trauma-informed. Eye Movement Desensitization and Reprocessing (EMDR) therapy is effective for processing secondary traumatic material, helping the nervous system reprocess trauma memories without retraumatization. EMDR helps your brain do what it couldn’t do alone: integrate traumatic material into coherent, non-intrusive memory rather than leaving it stored as active, fragmented alarm.

Somatic therapies address the bodily storage of trauma that verbal talk therapy alone cannot reach, restoring regulation to the nervous system. The chronic hypervigilance, the bracing posture, the held breath. These are body-level responses that need body-level treatment. Internal Family Systems (IFS) therapy helps identify and work with the parts that have been carrying STS. Including the highly capable professional part that keeps performing while the rest of the system is in distress.

The clinical work also involves identifying the extent of STS accumulation, building a self-care framework in defiance of a profession that discourages it, and disentangling the attorney’s identity from her advocacy role. You are not your case file. You are not your verdicts. Learning to experience yourself outside the professional role. To have access to emotion, relationship, and rest that isn’t mediated by your client’s trauma. Is both therapeutic and essential to career sustainability.

Executive coaching complements therapy by supporting career sustainability: helping women litigators create boundaries and practices that allow them to continue this vital work without self-erasure. For more on coaching and therapy tailored to attorneys, see therapy with Annie and executive coaching. To connect with Annie’s clinical team, schedule a complimentary consultation.

Recognizing and treating secondary traumatic stress is not a sign of weakness. It’s a reclaiming of your full humanity and your professional effectiveness. The legal profession’s silence around this is a failure that deserves to be named and changed. Starting with every attorney who refuses to carry it alone.

I want to address something that comes up consistently with women litigators who are considering therapy: the fear that talking about their cases will put them in professional jeopardy. Therapy is confidential. You cannot violate attorney-client privilege by discussing your clients’ situations in a therapeutic context for the purpose of processing your own distress. The privilege belongs to the client and protects the client’s communications with you. It does not prohibit you from getting mental health treatment that references your work. Your well-being is a professional asset, not a professional liability.

There’s also a second fear worth addressing directly: the fear that if you start feeling things in therapy, you won’t be able to stop. This concern arises regularly for women who’ve spent years in dissociation as a functional strategy. Trauma-informed therapy works at a pace the nervous system can integrate. You don’t re-experience everything at once. You build capacity gradually, expanding your window of tolerance over time rather than blowing it open all at once. The therapeutic container is designed to hold this process safely.

The attorneys who come to my clinical practice after years of untreated STS often describe the same experience: the relief of naming what they’ve been carrying, followed by genuine surprise at how much energy they’ve been spending on containment. That energy. The energy that’s been going into holding the images at bay, numbing the evenings, bracing for the night. Becomes available for something else once the underlying trauma is treated. Some of them describe feeling their advocacy capacity genuinely expand. Others describe reconnecting with the original reason they went into criminal law in the first place. That reconnection is not naive; it’s the result of finally having the support the work always required.

For ongoing support between sessions, Annie’s Strong & Stable newsletter provides weekly insights for driven women navigating these dynamics. The free quiz can help identify underlying wound patterns. And for attorneys exploring the professional identity questions that often surface alongside STS treatment, executive coaching offers a structured complement to clinical work.

One final point I want to make for any women reading this who are deeply skeptical of therapy in general: I understand the skepticism. Legal training selects for people who evaluate arguments carefully, who distrust claims that can’t be substantiated, and who are uncomfortable with ambiguity. Trauma-informed therapy isn’t ambiguous. The neurobiological evidence for STS and its treatment is robust. EMDR has more randomized controlled trials behind it than most legal wellness interventions combined. This isn’t soft science. It’s the application of precise, evidence-based neuroscience to a specific occupational injury that has been under-researched and under-treated in the legal profession for decades. You’re not being asked to believe anything on faith. You’re being offered a clinically validated treatment for a documented condition that your profession gave you and then refused to name.

The fact that it took this long to name it doesn’t make you responsible for having it. It makes the profession responsible for failing to address it. You’ve done the work. You deserve the support.

And finally: if you’ve read this guide and recognized yourself in Simone, Casey, Christine, or Megan, I want you to know that recognition itself is a form of progress. For women who’ve spent years interpreting their symptoms as character flaws or professional inadequacy, learning that there’s a name for what they’re carrying. A neurobiological explanation, a documented phenomenon with clinical treatment options. Can be profoundly relieving. You’re not broken. You’re injured. Those are different things, and they respond to different interventions. I look forward to being one of those interventions for the women who are ready.

Litigation secondary trauma also affects women’s career trajectories in ways that go beyond attrition. Many women who stay in the profession quietly narrow their practice to avoid the most traumatizing case types. Not because they’re less capable, but because their nervous systems are rationing exposure without clinical guidance. This narrowing costs them professionally, reducing their case diversity and reputation in areas of law where their expertise is genuinely valuable. Trauma-informed clinical support allows for intentional case management rather than unconscious avoidance. Which is a meaningfully different experience of agency over your professional life. The difference between choosing not to take a case and needing not to take a case is the difference between a professional decision and a symptom. Therapy helps you tell those apart.

Related Reading

• Figley, Charles R., PhD. “Compassion Fatigue: Psychotherapists’ Chronic Lack of Self Care.” Journal of Clinical Psychology 62, no. 11 (2006): 1433, 41..
• Pearlman, Laurie Anne, PhD, and Lisa McCann, PhD. “Vicarious Traumatization: An Empirical Study of the Effects of Trauma Work on Trauma Therapists.” Professional Psychology: Research and Practice 34, no. 6 (2003): 617, 24..
• Krill, Patrick R., JD, LLM, Ryan Johnson, and Linda Albert. “The Prevalence of Substance Use and Other Mental Health Concerns Among American Attorneys.” Journal of Addiction Medicine 10, no. 1 (2016): 46, 52. https://doi.org/10.1097/ADM.0000000000000182.
• van der Kolk, Bessel A., MD. The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma. New York: Viking, 2014.
• Herman, Judith Lewis, MD. Trauma and Recovery: The Aftermath of Violence. From Domestic Abuse to Political Terror. New York: Basic Books, 1992.
• Watts, Brian V., MD, et al. “Meta-Analysis of the Efficacy of Eye Movement Desensitization and Reprocessing (EMDR) for Posttraumatic Stress Disorder.” Journal of Clinical Psychiatry 82, no. 1 (2021): 20r13646..

References

Peer-Reviewed Research (Vancouver)

1. van der Kolk BA, Wang JB, Yehuda R, Bedrosian L, Coker AR, Harrison C, et al. Effects of MDMA-assisted therapy for PTSD on self-experience. PLoS One. 2024;19(1):e0295926. doi:10.1371/journal.pone.0295926. PMID: 38198456.

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