Law Practice and its Relevance to Lawyers’ Mental Health:
Damages and Remedies
by Maxine Sushelsky, LMHC

Editor’s Note: Maxine Sushelsky is a Licensed Mental Health Counselor (LMHC) providing individual and group psychotherapy services in Arlington, MA. Her focus is working with people experiencing depression, anxiety, grief and loss; as well as transitions in a relationship, career, education, or life stage such as early adulthood or midlife. She is also an attorney. Her website is www.transitionstherapist.com

Do you have difficulty finding balance in your life? Do you neglect your own needs in the service of your work? Do your personal relationships take a backseat to obligations of the job? Do friends and family complain that conversations with you feel more like cross examination?

Lawyers, as a profession, are at a high risk for depression, suicide and substance abuse. The behaviors required for success in the law can be contrary to those that contribute to mental health, a sense of well-being and satisfying interpersonal relationships. In broad terms, legal work often calls for suppressing one’s emotions, involvement in relationships imbued with conflict; unrealistic self-expectations and a lack of balance between work and interpersonal relationships and leisure which are all behaviors that tend to contribute to depression, isolation, stress and anxiety.

Depression can fall at different points on a spectrum, ranging from general feelings of unease to debilitating despair. Some of the symptoms one might suffer are sleep difficulties (too much or too little), appetite changes, decrease in energy and motivation, feelings of sadness, guilt, worthlessness or hopelessness, low self-esteem, difficulty concentrating or making decisions and recurrent thoughts of death or suicide. Depressed people often experience anxiety and irritability, although when these feelings are excessive or predominate they can signal other problems.

Some of the more specific work qualities that make lawyers particularly prone to depression are long work hours; the competitive nature of the work; the adversarial nature of the work; the requirement for highly focused attention to detail; the extreme repercussions of professional errors; the need to be pessimistic and skeptical, and to be prepared to deal with “worst case scenarios;” responsibility for assisting clients and others who are in crisis or dealing with tragic situations; constant scrutiny of your work by employers, judges and opposing counsel; the reality that your work will directly impact the client’s financial, relationship, liberty and quality-of-life interests; the pressure of deadlines and the potential consequences of missing deadlines; rigid and particularized rules and procedures that must be followed carefully and completely; the need to perform, both in terms of achieving results and being “on-stage” and observed by others in public arenas; the need to advance or defend a position that might conflict with your personal values.

I recently learned of a law clerk position listing one of the job requirements as “perfectionist.” It’s no wonder. The breadth and depth of attention and follow-through required for legal work are robust. The consequences of inattention and error are grave. Such work challenges will vary depending on your area of law, place of employment, and unique personality, but it is not unusual for lawyers to experience some or all of these concerns. Sociologists and authors John Hagan and Fiona Kay found that women lawyers are particularly prone to internalizing job dissatisfaction, leading to feelings of depression and despondency.

Law students and lawyers are rarely provided with education or training in self-care and how to cope with the emotional aspects of their work and its effects on their mental health. I became particularly aware of this when, after practicing law for fourteen years, I returned to graduate school to study mental health counseling. Unlike legal training and practice, ongoing attentiveness to emotional awareness and self-care are built into the training and practice of mental health professionals.

One of the most difficult aspects of serving clients is the professional’s vulnerability to vicarious or secondary trauma. In their article Lawyers More Likely to Experience Second Hand Shock authors Ellie Izzo, PhD and Vicki Carpel Miller, BSN, MS, LMFT define secondary trauma as the professional’s “indirect exposure to trauma through a client’s firsthand account…of a traumatic event,” which can subject the professional to the symptoms of post traumatic stress disorder, including disturbances in one’s identity, memory, and beliefs; unwanted imagery; and physical ailments. For example, in an assault case, a victim experiences a frightening attack which leads to gruesome injuries. After listening to the victim describe the details of the assault, and the resulting physical and emotional injuries, the lawyers find themselves experiencing unwanted images or dreams of the incident. Unpleasant memories of their own might be triggered. Their sense of “safety, trust, esteem, intimacy, and self-control may become compromised.” Izzie & Miller found that lawyers suffer from secondary trauma at a higher rate than mental health professionals. I believe this is explained, at least in part, by the disparity in emphasis on, and training in, emotional awareness and self-care in the two professions.

On a more positive note, changes are afoot. More humanistic, holistic approaches to law practice are developing and growing, including therapeutic jurisprudence, collaborative law and restorative justice. These areas of law focus on respectful communication and a search for outcomes that serve the best interests of all parties involved. Lawyers can find guidance and inspiration in David Hall’s book, The Spiritual Revitalization of the Legal Profession: A Search for Sacred Rivers (2005), and on his website, SacredRivers.neu.edu. Also inspiring is The Reflective Counselor: Daily Meditations for Lawyers, a book of daily reflections that encourage lawyers to stay connected to their deeper selves and their life’s purpose.

You have a right to take care of yourself as well as your clients. You have options. Psychotherapy, especially with a professional who is knowledgeable about the challenges of lawyering, can help you find ways of understanding and changing how you approach your inner and outer life, and finding balance in your life. Over the life cycle, people’s priorities and needs often change. What was once satisfying may be less so as you enter a different stage of life. Studies show that people who find meaning in their work and who have more control over their work tend to have better mental and physical health than those who lack these qualities. Although taking the first step towards asking for help might feel uncomfortable, you will likely notice glimmers of relief and a lessening of your burden as you share it with a professional and start to make healthy changes in your life.