(Credit: Brian Jackson-stock.adobe.com)
Court Is Assembled
Conversation Curveballs
A Trauma-Informed Communication Skills Toolkit to Enhance JAG Corps
Health & Well-Being
By Elizabeth F. Pillsbury, LICSW
The U.S. Army Judge Advocate General’s (JAG) Corps recently created the
Wellness Program Director position as a part of the effort to expand
holistic health. As the new Wellness Program Director, I learned within
the first few months of taking on my role that military legal
professionals, particularly those with experience in military justice,
regularly handle sensitive and potentially traumatizing information. As
a psychotherapist who has been in practice for nearly twenty-five years
and specializes in trauma (to include child abuse, sexual violence,
combat trauma and everything in between), I began reflecting on specific
characteristics of communication that relate to wellness within the Army
Judge Advocate Legal Services (JALS) community.
In this article, I offer some of these reflections as a mini
communication skills toolkit with the hope of increasing our
trauma-informed practices within the JAG Corps. My goal is to provide
real-world applications of practical tools to respond to everyday
situations you may encounter in a way that is compassionate and based on
the mental health field’s best practices.
Trauma-Informed Practice: The Foundation of the Solution
Trauma-informed care is a universal framework that
any organization
can implement to build a culture that acknowledges and anticipates
that many people we serve or interact with have histories of trauma, and that the environment and
interpersonal interactions within an organization can exacerbate the
physical, mental, and behavioral manifestations of trauma.1
The term “trauma-informed care” or practice may not be new to you or the
JAG Corps. It is a widely accepted framework in the health services,
education, and legal professions. An American Bar Association article
discusses the concept in the legal context: “Establishing a
trauma-informed law practice is a two-fold process: (1) taking steps
that help prevent re-traumatization of our clients, and (2) taking steps
that protect lawyers’ health and well-being from exposure to
trauma.”2 Regarding the second arm
of this process in particular, we have room to expand our efforts and
further consider ways to be sensitive to the needs of those in our ranks
who may have experienced adversity impacting their health, well-being,
or ability to perform at their highest level. The following
communication skills offer concrete ways to do so.
Problem 1: Sharing potentially upsetting stories without warning someone
of what you are about to say.
One of the first stories a judge advocate (JA) shared with me involved a
child abuse case that several members of our military judiciary were
exposed to while preparing for and conducting a court-martial. The
individual shared this story to help me understand some of the
challenges that JALS personnel face daily and to inform my Wellness
Program development efforts. However, he recounted the story immediately
after discussion of a completely unrelated topic and without warning.
The conversation shifted so suddenly that I was unprepared to hear such
information. After he finished the account, the conversation shifted to
a different, unrelated topic just as suddenly. The story’s content was
not the most disturbing aspect of the interaction; rather, it was how
abruptly the story was interwoven with an otherwise benign subject
matter.
The second incident occurred about a week later at a training session
focused on healthy ways to manage work-related stress, such as playing
frisbee with a pet dog in the park. We then had a ten-minute break.
When I returned from the break, I inadvertently entered an on-going
conversation about crime scene responses. The course attendees casually
shared “war stories” about their cases. One individual then launched
into a detailed monologue of a recent violent incident. I found myself
dealing with a sudden mental shift from the discussion about playful
puppies to processing objectively appalling details.
Solution to Problem 1: Give a “warning shot” before sharing something a
listener may perceive as upsetting or traumatic.
The tricky part about this solution is being aware that what you are
going to say may be upsetting to someone else. Many legal professionals
have been in this field for so long and/or have been exposed to so many
difficult stories and evidence that they may be desensitized to
sensitive content. They may even think these types of things are
“normal” and “routine” because it is what they do daily. Despite the
alarmingly high rates of adverse childhood events (ACEs) in our country
and world, these experiences are not normal, and most people outside of
service professions—such as law, healthcare, and education—do not
typically see nor hear about these things on a routine basis.
Sidebar: Adverse Childhood Events
Adverse childhood events are potentially traumatic childhood events
(between zero and seventeen years old).3
They include abuse, violence, or neglect as well as “aspects of a
child’s environment that undermine their sense of safety, stability,
and bonding,” such as growing up with someone who has a mental
health or substance abuse problem, experiencing suicide in the
family, having a family member incarcerated, living in a community
of violence, and experiencing poverty.4
Additional ACEs include food scarcity, experiencing homelessness or
unstable housing, instability related to parental and family
separation, and discrimination.5
Please note the examples above are not a complete list of adverse
experiences. Many other traumatic experiences could impact health
and well-being.
Two out of three people in the United States have experienced at
least one ACE, and those who have are more likely to experience
multiple ACEs.6
That means that if you have not experienced one of these, chances
are the person to your right and left have (statistically
speaking).
Not all these experiences result in post-traumatic stress disorder,
but they do put people at higher risk for a variety of health
problems, and they are linked to earlier death rates. In fact,
ACEs are strongly associated, in a dose-response fashion, with some
of the most common, serious, and costly health conditions facing our
society today, including nine of the ten leading causes of death in
the United States, as well as earlier mortality. [They] can also
negatively impact education, job opportunities, and earning
potential.7
Some people are at greater risk of experiencing one or more ACEs
than others. While all children are at risk of ACEs, “numerous
studies have shown inequities in such experiences linked to the
historical, social, and economic environments in which some families
live. [Adverse childhood events] were highest among females,
non-Hispanic, American Indian, or Alaska Native adults, and adults
who are unemployed or unable to work.”8
Given the disparate exposure to ACEs based on gender and racial and
cultural groups, as a JAG Corps, we need to be cognizant of how
these factors disproportionately impact our clients and our
colleagues from diverse backgrounds.
Using specific communication tools, including warning someone that you
are about to cross into potentially upsetting or traumatic territory, is
a specific trauma-informed practice. This is a tool I have taught
doctors to use for years. Despite having the best intentions, I have
seen far too many doctors “sucker punch” their patients with bad news. I
have seen this happen in “practice” encounters and real-life medical
appointments. Once given this tool, they can share potentially
life-changing negative news in a way that is compassionate and sensitive
to their patients’ needs. This skill can be taught and learned not just
in medicine but in the legal profession as well.9
Ms. Beth Pillsbury. (Image courtesy of author)
The “warning shot” allows the person hearing the story or news to
psychologically brace for what is to come. The storyteller sends a
signal for the listener to get ready. The listener’s brain responds,
“Okay, time to protect myself; something bad is coming.” When we are not
given the warning shot, our brains automatically shift into survival
mode, which limits our ability to understand the information and process
it in a useful and meaningful way.
Here are some lines to try:
“Unfortunately, . . .”
“I need to share something that may be upsetting to hear.”
“I’m warning you that I’m going to tell you something that may be
unpleasant/disturbing to hear.”
Problem 2: Sharing graphic details puts the listener at risk for a
negative reaction and, at times, secondary trauma. It can also put the
storyteller at risk for a strong physical or emotional reaction.
Back to my chat on day one with my JA colleague. I have heard thousands
of accounts of abuse, neglect, interpersonal violence, and all that can
result from these experiences. I am trained to sit with people in pain
and tolerate their emotions. Nonetheless, I struggle with the detailed
content of their stories, even when I know they are coming. When the
colleague started to recount the child abuse, he included vivid,
graphic, sensory details to help me understand the situation. In the
second story, the course attendee also used graphic details to convey
the event’s impact.
Sensory material (sight, sound, taste, touch, and smell) can elicit
strong, often involuntary responses in us. The danger in using this type
of detail in storytelling is that once you start to describe something
using sensory material, a person’s brain can start to fill in the
gaps—often inaccurately because of the part of the brain that engages
with this type of information. Then, the brain can get stuck. I have
heard many say, “I can’t unsee the things I’ve seen.” This is the same
sentiment; the details can remain long after the conversation ends.
I do not believe most people share these types of stories to upset or
traumatize the listener. Rather, they are often trying to make sense of
the experience, looking for support and empathy, or determining whether
they have an accurate account of what happened. However, there are ways
to accomplish these tasks without potentially doing more harm.
Solution to Problem 2: Unless it is necessary and within the correct
context (time and place), consider telling stories and sharing
information without using vivid sensory descriptions and try to talk
more about the impact of the information instead.
If you are describing something in detail, your listener can likely
see/hear/smell/feel/taste it too. That is wonderful if you are talking
about an amazing trip you took or a delicious meal someone prepared for
you—not so much if you are in a social setting and begin to casually
provide details about a difficult case you are working on. It does not
have to be that severe; it could seem routine to you but be upsetting to
your audience.
This solution may run counter to the legal field’s culture, in which you
are trained to provide detailed evidence. While that is appropriate in
the context of an investigation, evidence collection, deposition, or
courtroom, it is not best practice for everyday conversation.
It is not a good idea to use even when sharing how challenging your work
is to someone who cares about you. They can support you without knowing
a case’s details, and conversely, you can unload your experiences
without risking traumatizing the person listening to you. In group
therapy with trauma survivors, one of our ground rules is not to provide
so much graphic detail that other people in the group can picture it
themselves. The same rule can be applied to legal work.
I am not encouraging people to remain silent about their experiences;
rather, I am encouraging people to share them in a way that allows for
support without threatening the listener’s well-being. If this feels
inadequate to you, I strongly recommend speaking with someone trained to
guide you through this process in a safe setting with scientifically
grounded techniques (i.e., a therapist experienced in working with
trauma).
Additional Solution to Problem 2: If you do need to share graphic
details on something potentially traumatic, give a warning shot first
(and consider asking permission). Here are a few lines you can try:
“I need to talk about some of the details of the case to give you an
understanding of the severity of what happened. This may be hard to
hear. Are you okay with that?”
“Unfortunately, I need to tell you something that may be upsetting. Is
now a good time to discuss this?”
Sidebar: Primitive Trauma Response
The brain responds to real or perceived threats in a way that is
designed to help you survive. This happens involuntarily and is
completely outside your control. This part of the brain, the
amygdala, is very primitive. It is not the part of the brain that
processes information, solves problems, or makes decisions—that is
the prefrontal cortex. When someone experiences trauma, the sensory
details of the memory get stored in the amygdala, and time and
sequencing can become distorted or inaccurate. You may see this
happen with some of your witnesses or victims who have difficulty
organizing the sequence of events in a case. When this distortion in
the amygdala occurs, it can interfere with the person’s ability to
fully process the events rationally because this primitive part of
the brain does not have the
capacity for rational thought. We have come a long way in science
and now have effective, evidence-based ways to help someone work
through the challenges of this trauma response in treatment. While
therapy cannot erase these experiences, it can significantly help
those memories, images, or videos that you “can’t unsee” become far
less vivid and lose impact on your day-to-day life. Check out the
resources in the Appendix to explore what may be a good fit for you.
Problem 3: Someone’s expression, body language, or nonverbal
communication does not match their story’s severity.
As my colleague recounted his difficult story, he avoided making eye
contact, and his gaze looked a million miles away. His face was flat and
expressionless. His voice was nearly monotone and steady, with little to
no emotion in it. He shared that he was deeply concerned about his
colleagues, yet his nonverbal communication did not match.
Similarly, the course attendee told his story about responding to the
crime scene from a detached perspective; his tone did not match what he
was recounting. He sounded like he was talking about something as
mundane as the weather rather than the scene he described.
In the therapy world, we call this an “incongruent affect,” or when
someone’s expression does not match their words. Both are concerning to
me as a therapist because they may be experiencing signs of depression
or secondary- (or post-) traumatic stress, such as emotional numbness
and cynicism. While these can be protective ways to manage hard,
overwhelming feelings in the short term, they can be dangerous in the
long term. The more detached and numb a person is, the longer it can
take them to work through these experiences and the higher their risk
for more symptoms of secondary- or post-traumatic stress.
Sidebar: Comparative Suffering
The course attendee seemed to share this story as if he was
comparing his experiences to those of his colleagues. He may have
felt his experiences were not as valid or may be perceived as less
(or more) traumatic than theirs. This is called comparative
suffering. Comparative suffering is “when we view our painful experiences in
terms of what other people are going through in order to determine
the level of validity our suffering warrants. Essentially, this is
the mindset that we aren’t allowed to complain or feel our feelings
when someone else has it worse than us.”10
It is ranking our suffering against that of others, which is then
used to either deny or give ourselves permission to feel.11
It is like using your trauma exposure to diminish or, at times, to
justify your own suffering because of your
perception of how it compares to someone else’s.
Researcher and social scientist Brené Brown talks about this in her book Rising Strong:
Comparative suffering is a function of fear and scarcity. Falling down, screwing up, and facing hurt often lead to
bouts of second-guessing our judgment, our self-trust, and even our
worthiness. I am enough can slowly turn into Am I really enough? If
there’s one thing I’ve learned over the past decade, it’s that fear
and scarcity immediately trigger comparison, and even pain and hurt
are not immune to being assessed and ranked. My husband died and
that grief is worse than your grief over an empty nest. I’m not
allowed to feel disappointed about being passed over for promotion
when my friend just found out that his wife has cancer. You’re
feeling shame for forgetting your son’s school play? Please—that’s a
first-world problem; there are people dying of starvation every
minute. The opposite of scarcity is not abundance; the opposite of
scarcity is simply enough. Empathy is not finite, and compassion is
not a pizza with eight slices. When you practice empathy and
compassion with someone, there is not less of these qualities to go
around. There’s more. Love is the last thing we need to ration in
this world. The refugee in Syria doesn’t benefit more if you
conserve your kindness only for her and withhold it from your
neighbor who’s going through a divorce…. Hurt is hurt, and every
time we honor our own struggle and the struggles of others by
responding with empathy and compassion, the healing that results
affects all of us.12
Solution to Problem 3: If someone’s body language and nonverbal
communication do not match what they are saying, consider it an
opportunity to offer support.
This may be incredibly challenging in a work setting, particularly with
someone with whom you are not close.
If it is a peer or near-peer with whom you do not have a close
relationship, consider asking someone who knows them or works closely
with them to reach out and check in with them.
Here is an example of how to bring this up:
“Sir/Ma’am, I have some concerns about how one of my peers is doing, but
I don’t feel it’s appropriate (or I don’t feel comfortable) for me to
talk with them about it directly. Could you please offer some guidance
and support? I’ve noticed that he/she hasn’t been acting like his/her
usual self, and I’m concerned about his/her well-being. I respectfully
ask if you would reach out to him/her to check in on how he/she is
doing.”
Even if the person is someone you are close with, you may feel awkward
about this and not know what to say. Sometimes, it is as simple as
telling someone,
“I can’t imagine what you’re going through. I’m here with you.”
Other times, it may be more of a discussion about ways you can support
them. You can open a discussion with one of these:
“Wow, you just told me about something really powerful, but it was like
you were somewhere else. . . . Are you okay?”
“Thanks for sharing that with me. As you were talking about something
really upsetting, I noticed that you seemed really calm. What’s going on
inside?”
“Thanks for telling me about this. I can’t imagine what that was like
for you. I wish I had the tools to help you more with it. Would you like
me to help you find someone who helps people with these kinds of
experiences?”
(Credit: Robert Wood Johnson Foundation)
In the case of someone who outranks you, consider reaching out to
someone who is a peer to them and respectfully express your concerns.
Remember that sometimes, when someone is detached or numb, they may be
in a lot of pain. They may or may not be ready to open up to you. Keep
an eye on them; they may benefit from extra support, even if it is just
casual conversation, going for a walk, or playing with puppies in the
park. One of the greatest gifts we can offer each other is compassion.
Solutions for the Listener (and the Storyteller)
Be prepared for people to tell you all kinds of things at any time,
regardless of the setting, relationship, etc. Even if you are caught off
guard, told something graphic, or communicated with in a way that seems
completely off, there are some things you can do afterward to calm down.
After hearing or saying something upsetting, here are three proven
strategies to help calm and relieve your body and brain. My clinical
recommendation is to practice these two to three times daily when you
are not feeling stressed. That way,
it is easier for your brain and body to use these when you
are stressed, upset, or triggered.
If it is hard for you to remember to do something like this, try setting
a timer on your phone or link it with something you already do
two-to-three times a day, like when you brush your teeth or eat a meal.
For bonus points, consider rating how you feel before and after
practicing these. For example, on a scale of zero to ten, where zero is
neutral and ten is the highest level of distress you can imagine, how do
you feel? (You can think of it in terms of a specific emotion like
anxiety, sadness, anger, or just generally speaking.)
1. Practice Grounding
This practice can help prevent upsetting thoughts, nightmares,
flashbacks, and body sensations linked to adverse experiences. Use your
five senses to stay in or return to the present moment. Use sight,
sound, touch, taste, and smell to connect with what is happening around
you right now.
-
What do you see? I see my
computer screen, clouds outside, and
my favorite coffee mug.
-
What do you hear? I hear the
sound of my keys tapping on the keyboard.
-
What do you feel (tactile/touch)?
I feel the keys under my fingers.
-
What do you taste? Yuck; I taste
coffee brewed about six hours ago.
-
What do you smell? Not a whole
lot, but if I sniff my sleeve, I can smell detergent.
Sidebar: The Five Senses
Smell is one of our most primitive senses, and when it is linked to
adverse or traumatic experiences, the response can be especially
hard to alleviate. Try smelling a marker, candle, or something
strong that does not remind you of the trauma. (For example, hand wipes or sanitizer are great unless you have
had upsetting medical experiences because they can remind you of a
hospital smell.) For each of your senses, if you have difficulty
finding something around you to feel, taste, hear, etc., you can
introduce something instead. For sight, check out your hands, look
for vivid colors and patterns, or perhaps a picture of something
peaceful. For sound, try some music or an audiobook. For touch,
squeeze your toes, have a stone or something you carry in your
pocket. And for taste, mints, candy, gum, flavored tea, or coffee do wonders!
(Credit: The Pragmatic Parent)
2. 4-7-8 (or Box) Breathing Technique
This technique was originally designed at Harvard University for
students with test-taking anxiety. It was very effective at lowering
their anxiety and has since been taught and used in all kinds of
settings. To correctly practice deep breathing, when you inhale, your
abdomen should expand outwards, and when you exhale, your belly should
contract inwards. Breathe from your belly, not your chest; otherwise, it
is shallow breathing and can lead to hyperventilation. If this is new
for you, practice it sitting down for the first few times—you may not be
used to getting this much oxygen and I do not want you to get
lightheaded!
(Credit: Inclusion, UK National Health Service)
3. Peaceful Place Imagery
Now is the time for graphic, vivid,
sensory details! Consider a place where you have been or want to go—real
or imaginary—that feels peaceful. Paint a sensory portrait of the place:
What does it look like? What sounds do you hear? What does it taste
like? What do you feel there? Where are you in the scene? What time of
year and day is it? What does it smell like?
Consider adding anything that increases your sense of peace and comfort.
Do you want cozy slippers? A cool or warm beverage?
Lastly, how will you get there in your mind? Can you just close your
eyes and imagine the place? Do you need to imagine walking down a path
or count to ten and you will be there?
Sidebar: Guests in Your Peaceful Place
You may be tempted to bring
someone to your imagined peaceful place. Don’t! Even if you only
have warm, happy thoughts about that person, if you get into an
argument or something happens later on in real life, your peaceful place will be tainted. You can
bring an animal as long as they do not cause you any upset.
The reality is that legal work (and life, for that matter!) is
inherently stressful. There is no way to completely avoid upsetting
stories, content, and sometimes even trauma exposure, particularly in
certain roles and specialties. Best practices and evidence-based
treatments can lessen the impact of the work and even help individuals
experience post-traumatic growth and compassion resilience.
Even if you do not work in military justice or a supervisory role,we all
have a responsibility to create a trauma-informed organization. As an
organization, we have a responsibility to be trauma-informed in a way
that meaningfully acknowledges and supports everyone. Consider ways you
can empower and be compassionate towards your clients, colleagues, and
yourselves. Take a “bite” of each communication skill and see what you
like. Maybe you will find you like them all, or they may take some
getting used to. Think about ways you may be able to incorporate these
into everyday interactions, even if they feel a bit clumsy and awkward
at first. With practice, you will be better equipped to help yourself
and others. TAL
Ms. Pillsbury is the Wellness Program Director in the Office of The
Judge Advocate General at the Pentagon.
Notes
1. Trauma-Informed Care,
Trauma Pol’y,
https://www.traumapolicy.org/topics/trauma-informed-care (last visited
Apr. 15, 2024).
2. Rebecca Howlett & Cynthia Sharp,
The Legal Burnout Solution: Strategies for a Trauma-Informed Law
Practice, Am. Bar Ass’n (Oct. 26, 2021),
https://www.americanbar.org/groups/gpsolo/publications/gpsolo_ereport/2021/october-2021/legal-burnout-solution-strategies-trauma-informed-law-practice.
3.
Fast Facts: Preventing Adverse Childhood Experiences,
Ctrs. for Disease Control & Prevention [hereinafter Fast Facts], https://www.cdc.gov/violenceprevention/aces/fastfact.html (last visited
Apr. 15, 2024).
4. Id.
5. Id.
6. Id.; VJ Felitti et al.,
Relationship of Childhood Abuse and Household Dysfunction to Many of
the Leading Causes of Death in Adults: The Adverse Childhood
Experiences (ACES) Study, 14
Am. J. Preventative Med. 245 (1998).
7.
The Science of ACEs & Toxic Stress, Aces Aware,
https://www.acesaware.org/ace-fundamentals/the-science-of-aces-toxic-stress
(last visited Apr. 15, 2024).
8. Fast Facts,
supra note 3.
9. See Walter F. Baile et al.,
SPIKES—A Six-Step Protocol for Delivering Bad News: Application to
the Patient with Cancer, 5 Oncologist 302 (2000).
10. Lacie Parker,
What Is ‘Comparative Suffering’—and Why Do HSPs So Often Get Stuck in
It?, Highly Sensitive Refuge (Feb.
23, 2022), https://highlysensitiverefuge.com/comparative-suffering.
11. Brené
Brown, Rising Strong: The Reckoning. The Rumble. The Revolution. 8 (2015).
12. Id. at 8-9.
