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Mamta Gautam
Australian Law Management Journal
Autumn Issue 2007
Stress, depression, even suicide - sadly, these are major issues for lawyers. In a recent speech in Australia, Canadian psychiatrist Mamta Gautam discussed the importance of mental wellness for the profession. Here's what she had to say
Is the mental health of lawyers a problem? Yes, it is. In an American study done in Boston, lawyers ranked first in depression out of 105 professions surveyed.
Most lawyers have three times the risk of depression than the general population. Twenty-five per cent of lawyers are known to suffer from elevated feelings of psychological distress. This includes anxiety, depression, a sense of insecurity, and a sense of questioning themselves and doubting themselves.
Something is happening with the practice of law, and the sense of stress perceived by lawyers is certainly increasing. We see a disproportionate number of lawyers committing suicide, much higher than you would expect compared to the general population.
The Australian Financial Review conducted a survey, showing that 45 per cent of young lawyers are thinking about quitting their job in two years. One per cent are planning to quit law altogether. You can't afford to lose any lawyers. You can't afford to lose these young minds that are necessary to the future of your profession. How can we understand this, and address the issues, so we can stem this flow?
What's behind the stress?
There are some biological factors at play that predispose one to stress. There are the lifestyle factors, including long hours and heavy workload, which can often lead to poor sleep, poor eating habits and lack of regular exercise. We also see some other biological factors. It's well known that if you have a strong family history of psychiatric illness it greatly increases the likelihood that you, too, are going to have difficulty coping under stress. It makes you more vulnerable to having similar psychiatric difficulties.
We see drugs and alcohol and the biological impact of that. If this is the type of behaviour we use to manage our stress, the type of illness we have is much more serious. We have higher than average incomes so can support this much more. As well, we see a lot of difficulties such as anxiety, depression, eating disorders and bipolar illness, all of which is part of how we understand the biological aspects of what's causing this problem.
What about the psychological aspects that add to this situation? There is a type of personality that is more likely to become a professional. Here are some of the traits: we are very conscientious; we want to do the very best we can. We want to please people. We have a huge sense of responsibility. Sometimes, responsibility is assigned to us, for example in the workplace, but often we'll just step into a situation and assume this responsibility. And sometimes, even when we know it is not necessarily our responsibility, we feel quite guilty when we do not do it. We're unrelentingly perfect. We are functioning at a very high level, but then take on the pressure to maintain this. We like to be in control, and we like to control other people and situations around us.
Another truth that we all share is one that always comes as a surprise - that we doubt ourselves and feel like a fraud. Many of us walk around with this feeling. This insecurity is part of why we do continue to strive do our best, and to be so conscientious and responsible, and to go that extra mile, to somehow "make up for this". We are not very good at saying how well we did, or accepting compliments.
And finally, because we're so busy focusing on doing all that, it is very easy for us to put off the very things we need to do to take care of ourselves. We are aware that these traits are positive and inherent. My goal is not to say" quit being like that". This is exactly the reason that you are successful in your careers. What you have to know, however, is that you don't have to be like that every minute of the day.
Warning signs
Sometimes we can manage our stress well. We can intellectualise things to help us cope. Yet this is not always enough.
Here are some early warning signs that let you know that you are not really coping quite so well:
1.You start to get more physical problems and illnesses.
2.There are more problems with relationships.
3.There is a greater sense of negativity.
4.There is a significant increase in bad habits.
5.And finally, exhaustion, which is actually quite a late sign.
These early warning signs are important to look out for. They are actually precursors to burnout. Burnout is chronic over-stress, often due to work· related stressors.
Burnout itself is not a psychiatric problem, but it can lead to serious psychiatric problems. It can lead to professional problems in terms of complaints or losing your Job or losing your privileges. It can lead to serious difficulty with major relationships, such as a marital separation or divorce, or being asked to leave the workplace. We see anxiety, depression, addictions and suicide. This is a process, and it's continuous.
There are two key points to be made. First, if you could understand that a colleague has one of those illnesses or is predisposed to some of the things that I've talked about, you can help them identify those early signs, and you can help them adapt and remain healthy. This is very compatible with success. With help and understanding, these colleagues can continue to have a very successful career.
Second, it's not just about helping those people who have pre-existing difficulties. Even the very healthiest and the most highly functioning professionals, put into an unhealthy environment, can become unhealthy. So this isn't just something that happens to somebody else. None of us are immune to this.
Coping strategies
Let's now identify some techniques on how to manage your own stress. The concept of work-life balance is of increasing concern within professions. Balance is a dynamic process; there IS no one right balance that you can achieve and maintain for the rest of your life. A choice works for as long as it does, and then it is time to re-examine the choices.
Another concept to help in balancing your life is the story of the Five Balls.This is an old fable, which I think works for all of us. It describes how we are constantly Juggling five balls at anyone time. There is the work ball, the home and family ball, the relationships ball,the friends ball, and the self-care ball. If you have to drop one of those balls, do It in a responsible way; but consider the work one as being the most resilient, the one least likely to be impacted by that change.
Let's focus on each of these balls. The work ball causes a lot of stress, primarily because there IS a mismatch. There are mismatches in workload. If there is more work to be done than there are people to do it, it will lead to a stressful workplace. Other areas of mismatch are in terms of the sense of control and choice that people have in that workplace, in terms of the sense of being rewarded and recognised and acknowledged, the sense of community and connection, the sense of fairness and respect for the work that you do, and also the presence of conflicting values. If you're in a workplace where what you're being asked to do conflicts with what your values are, your level of stress is much higher. As key people In your workplace, you will want to consider each of those factors and ensure better matches.
A transition between your work and home life is essential. You cannot finish your day at work, wade straight home, and get right into what is happening there. As you are leaving work, mentally put yourself into what is waiting ahead at home. And once you get there, then you can much more easily move into this. At home, create a rule that says you can't take your work home with you. If you don't even have this as a rule, you won't know that you're breaking it every single day. If you do need to take work home, talk to your partner about that, and let them know you need a few hours to work and ask what they were planning and when it could work out best.
Let's talk about the home ball. Remember that when you are at home, your family deserves your full attention. It is not enough to Just be there. You are not with your family if you are physically in the room and talking on a mobile. Ultimately the biggest gift that you can give your children is time where they are the centre of your attention and you are available to them. If you're single or you're married, and you want to be, life is great. The problems, of course, come when you're single or you're married and you really don't want to be. Marriage is a lot of work and requires time together.
Time crunch is the biggest problem in most relationships, especially in two professional couples. Think about the children's game, Dot-To-Dot. Obviously you can't spend every single minute of your time together, but you can have a lot of little dots of connection in your day. So you wake up and you connect with a kiss; that's your first dot. And you've got to make sure that this point of connection to the second one is so close you can draw a straight line to that. And then the third point, and then the fourth point, and the fifth point of contact will all be separate and short, but close. Keep this as a constant thing. What you'll end up with is as you connect the dots is a picture of a full relationship. Think about what these dots are and how you can make that happen.
Friends are really important. As wonderful as our committed relationships can be, they are not going to meet all our needs. That's where friends come in. Some of your best, happiest times are with friends. And often they are a lifeline when there is a huge amount of stress in your life, when things change such as during a separation, getting chemotherapy or when you're having a job transition. It is crucial to make and maintain these social connections.
Care for yourself
Above all, take care of yourself first. This may mean quickly grabbing a sandwich when you are hungry even if there are many clients waiting to be seen. Define in your life what your priorities are. That's what you want to do for yourself. What do you want to do for the people in your life that are important to you? What do you want to do that's important at work? And this is not what's urgent, but is most important. Once you define what those are and make sure you commit time for that, then all the other things fall into place.
Make sure that you take holidays. I am shocked at how many professionals do not take the holidays that they're entitled to, or that they're encouraged to take. Similarly, do not end a holiday without booking one more. Do this for all the really important things in life, and all the things that you really enjoy in life.
Think also, about unplanned breaks, times like you're stuck in a traffic jam. You can either fret and fume and get yourself all worked up about that, or you can think about this as a Gift of Time. Here is time you didn't expect to have. You can relax; you can listen to music that you like in your car and really allow yourself to enjoy that gift.
Think about creating and sustaining support systems. Have at least one friend who is good for you.
And remember that those 'S' words go together. Silence and Shame - when you remain silent about something, it can lead to a sense of shame. Share and Support - when you share something that's happening to you, you actually get support at the very time you need it. Friends are great. Look for mentors among your colleagues, who can also be good resources for that. If they're not available, pets are great.
Pick a relaxation technique, and practise it regularly every day. Then, when you need it, it's going to be right there to guide you effortlessly.
A couple of more points: money is the number two reason why professionals do not make the changes they need to, to better manage their stress. Sometimes decreasing your stress means you have to work a little less.
Finally, the number one reason why most professionals cannot make the changes they need to become well and to better manage their stress is guilt. We push ourselves, we have to keep going, we have to do all of these things, and we can only do things for ourselves after that. Here is a rule about guilt. If there is something you're thinking of doing for yourself that you know is going to make you feel better, but feel guilty about, that's the very thing you should do.
If it's actually drifted up to the surface as a conscious thought, acknowledge the guilt and let it go; and go ahead and do it, enjoy it.
At the end of this, people often say, "Well, all that sounds great, but how am I actually going to make this happen?" The answer is "Don't just try". There is a huge difference between making a firm commitment to doing something to better manage your stress, and just saying you're going to try.
I would like you to pick one, two, three of these suggestions that I've outlined and make a determined commitment that you are going to do this, even if it's just one small change. I want to remind you of all the wonderful reasons that you chose to study law, all the things about it that bring you that satisfaction, that excitement, that glow, that sense of "I love this and I really want to keep doing this". You can keep doing that, and it's absolutely worth the effort and the time that it's going to take to do just a few of the things that I have shared with you, so you can sustain that feeling and enjoy this for the rest of your careers.
Every small change each of you makes will magnify to ensure the health of your profession.
This is an excerpt from the Tristan Jepson Memorial Lecture "Towards Managing Mental Wellness in the Legal Profession" by Associate Professor Or Mamta Gautam, a Canadian psychiatrist and specialist in physician health and wellbeing. It was delivered on September 7, 2006, in Sydney and jointly hosted by the Faculties of Law at UNSW and UTS, in partnership with the Tristan Jepson Memorial Fund, established by George and Marie Jepson in memory of their son, a much-loved law student and lawyer.
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