Traci Cipriano, J.D., Ph.D.

The societal need for, and value of, lawyers has been officially recognized in Connecticut and the United States since at least 1784, when America’s first law school, the Litchfield Law School, was established. Lawyers ensure all aspects of society—business, government, nonprofit, personal—are functioning in accordance with a set of predefined values related to fairness and efficiency. Lawyers protect us from injustice and preserve our rights and freedoms.

At the same time, the profession is struggling like never before. Research related to lawyer stress, depression, health care utilization and suicide all suggest that law is a particularly stressful profession, and lawyer stress often arises as a result of the nature of the work, especially in combination with common lawyer traits.

In recognition of attorney struggles, the American Bar Association (as well as some state bar associations) has created a Lawyer Well-Being Task Force. Advances in technology once revered as products which would make our lives easier, particularly smartphones and mobile devices, have further blurred the line between work and home life. This lack of separation of professional and personal roles has limited attorney “downtime,” while at the same time arguably exacerbating the negative effects of certain pre-existing personal traits and professional stressors, with an overall negative impact on attorney well-being. It is incumbent on the legal profession to acknowledge there is a problem, own it, and begin to address it. Change is slow and imperfect, but needs to begin somewhere. At the very least this needs to begin at the top.

‘Who Cares About Attorneys?’ As a psychologist and former practicing attorney, I have both an academic understanding of stress; the many ways it impacts us and the individual and environmental forces which promote and enhance it, as well as personal experience training and working in the legal culture. Recently, I moderated a lawyer well-being panel at the 2018 Connecticut Legal Conference, where I shared a story from graduate school. During an interview with a prominent psychologist, he asked about my dissertation research. I eagerly began to tell him about my then-cutting-edge study (involving relationships among work-life balance, perfectionism and optimism, and physical and mental health outcomes in Connecticut attorneys). He soon interrupted me and said, “Hold on. Who the hell cares about attorneys?”

Initially, I was shocked. But once I had a chance reflect on his comment, I realized that his sentiments were probably more universal than I would have liked to acknowledge. Attorneys are viewed by many as a privileged class, whose rewards are substantial enough to balance any adversity the profession creates. Few people, if any, outside the legal community are paying much attention to attorney struggles. It is up to the profession itself to acknowledge and unequivocally address some of the unhealthy aspects of legal culture.

There are a myriad of occupational risk factors faced by attorneys, such as time pressures, billing pressures, rainmaking pressures, the adversarial nature of profession … and technology. Attorneys are particularly susceptible to the disadvantages of modern technology—always accessible by phone, email or text, 24/7, 365. Common pressures, such as multiple competing deadlines, time management and organizational difficulties, unreasonable opposing counsel, office politics and personal crises over time can lead to chronic stress. In addition, depending on practice area or pro bono work, lawyers often experience compassion fatigue, burnout and vicarious trauma.

Many young attorneys do not know how to set boundaries with their clients or simply how to separate their work and home lives. They find themselves always “on” and without any downtime. Legal culture is hard-driving and often carries a distaste for emotionally laden concerns. This climate was more workable decades ago when attorneys went home for the evening and had some downtime on the weekends. Today, with 24/7 access via those mobile devices and, accordingly, expectations of instantaneous responses, attorneys do not have time for self-care or to simply relax. This can lead to a constant unhealthy cycle of stress or worse, with negative impacts on performance, productivity, health and well-being.

Chronic stress results from constant activation of the fight-or-flight response. This primitive response enabled our ancestors to fight the woolly mammoth or run away to safety. When this response is activated, blood pressure increases, muscles become tense, breathing becomes shallow and rapid, and cortisol and adrenaline course through our veins. Once our ancestors downed the woolly mammoth, or escaped, this response would stop.

While effective in the short term, continuous activation of the fight-or-flight response and its associated hormone release exerts an incredible toxic strain on the body, immune system and brain. Lower-back or neck pain, headaches, frequent colds or viruses, difficulty concentrating, decreased problem-solving ability, poorer memory, increased weight (particularly in the abdomen), sleep problems, anxiety and depression are all indirect symptoms of chronic stress. Stress also causes inflammation, and at its most sinister, it can indirectly increase risk for autoimmune diseases, cardiovascular diseases and cancer. The cycle of stress, beginning with a decreased ability to tolerate seemingly small stressors or hassles, if not addressed, can lead to anger and hostility and to acting out with verbal or physical aggression toward colleagues or loved ones. Such acting out often has negative consequences, which then leads to more stress in a never-ending vicious cycle.

Perfectionist tendencies among some attorneys can exacerbate the effects of chronic stress. While being conscientious, thorough and diligent are all essential traits for good legal practice, when taken to extremes perfectionism can lead to reduced productivity and extreme emotional distress. Lawyers’ competitive disposition can promote tunnel vision: an all-consuming drive to be named partner, for example, coupled with extreme difficulty with losing or simply not achieving all of one’s goals. There is often little room to consider work satisfaction and engagement in meaningful activities.

Just the idea of considering work satisfaction may seem trite and insignificant to many lawyers. The thought of discussing it, or one’s struggles with perfectionism, may be viewed as career nonstarters. I recall on-campus interviews during law school when the common knowledge was that you were supposed to respond to the question about your “worst trait” by saying with a sigh, “I am a perfectionist,” and by implication will therefore work myself to the bone for your firm. But perfectionism at its most unhealthy levels can lead to intense personal and professional dissatisfaction, difficulty with completing projects, as well as suicide when fears of being seen as imperfect or no longer “top dog” become overwhelming.

Constant strain leads to anxiety and depression in many attorneys. In 2014, CNN reported that lawyers ranked fourth in suicide rates when compared to other professions—behind dentists, pharmacists and physicians. In a 2007 study examining work-family stress in Connecticut attorneys, 46 percent of women and 33 percent of men reported experiencing “a lot” or “extreme” levels of overall stress. In the same study, 52 percent of the women and 36 percent of men reported “a lot” or “extreme” work stress. Lawyer health care costs for depression are above the norm, and lawyers tend to be more likely to experience depression than the general population. Informal data gathered from my own work with attorneys suggests that many attorneys not only experience acute levels of distress and a sense of isolation but also struggle to manage their intense negative emotions.

No one is immune from the stress of the legal profession. Chronic stress can be insidious in that often people are unaware of its physical and psychological effects on their own performance or well-being, or the unhealthy behavior patterns that they begin to develop over time. Without self-care, the stressful nature of the legal culture takes its toll on all attorneys in one form or another: physical, cognitive, physiological or emotional. Everyone responds to stress in their own ways.

Self-care vs. Self-medication Self-care tends to be low on the attorney priority list. When thinking about self-care, you might have the following internal conversation: “Sleep? Overrated. Exercise? Who has time? You mean a take-out burger and fries are not healthy? They are protein and vegetables, right? What if I don’t eat the bun?” Not to mention the cycle of waking up with caffeine and winding down with alcohol. Long hours leave little room for focus on exercise, social activities, diet and hobbies. Excessive caffeine can make us more aggressive and hostile. Alcohol, although it may help some fall asleep, also negatively impacts sleep quality and can lead to early waking, which leads to fatigue and increased caffeine consumption, another vicious cycle. Coping skills vary, but busy attorneys often seek a quick fix—such as alcohol—to alleviate stress, anxiety and depression, rather than a long-term behavior or lifestyle change.

In addition, if an attorney already struggled with a mental health or substance use issue before entering the profession, the inherently stressful nature of the legal practice can reignite or exacerbate these difficulties, and the stigma attached to mental health and substance abuse issues often leads to suffering in silence.

The legal profession may be reaching a breaking point, quite possibly brought on by technology and 24/7 access to work via smartphone and tablet. Early career attorneys who grew up on smartphones are suddenly finding that being tethered to one’s smartphone to stay connected socially is one thing, but being fully accessible and always “on” to deal with work crises and anxious clients is a whole different ballgame.

Despite all of this, I do have hope for the profession and believe change can occur. Nonetheless, change is slow, particularly in the legal community in the land of steady habits.

If there is a sincere desire to improve lawyer well-being, the focus needs to be on prevention and on promoting wellness before someone reaches a crisis point, begins abusing alcohol or drugs, or even looks to suicide; or before work suffers because thinking is not as quick, clear and sharp; before physical illness takes its toll; or before relationships with colleagues, significant others, friends and children deteriorate. Stress is toxic, and it permeates all aspects of our lives and our work. It is easy for conscientious, Type-A, hard-driving individuals, such as ourselves, to take for granted our minds, our bodies and our relationships; but if we do not tend to them, they will suffer, along with our work quality and productivity.

Prevention needs to begin in law school. While 1Ls are learning to think like lawyers during the first year of law school, they also need to be educated on the importance of maintaining healthy self-care habits and have adequate on-campus resources to promote well-being. Fortunately, many law schools have begun to recognize this and are introducing resources and programming, but the same top-down principles apply.

All attorneys, if they have not done so already, need to begin to think about how they deal with the stress of the profession and what strategy or strategies help to reduce their stress and improve their individual well-being. You may be one of the more resilient and healthy attorneys who has found a way to integrate exercise into your daily routine. Or you have taken up daily meditation or yoga, or a hobby of interest. Perhaps you have figured out a way to eat healthy most days and have developed a fairly consistent and adequate sleep schedule. Or maybe your office gives you the flexibility to navigate your work and home life without fear of absent face-time repercussions, while still getting your work done.

Small Steps: Committing to Change If you are just beginning to consider making a change to improve your well-being, start small. Commit to one small change, such as drinking more water during the day and less caffeine. Bring a healthy and satisfying snack to work, such as almonds. Take a 15-minute walk at lunchtime, and if possible later in the day. Practice deep breathing, enroll in a yoga class, or download and use a meditation app. Establish a regular sleep schedule, striving for seven to eight hours of sleep daily. Meet a friend for a meal, an entertainment activity or exercise. Recognize that you will likely have days when you will not accomplish your well-being goal, and eventually, goals. Accept this and commit to getting back on track the next day.

We are not going to eliminate the stress of the legal profession, though changes in organizational culture can be made to mitigate it. It is no longer adequate to expect individual attorneys to figure everything out on their own, even after attending a few workshops.

Broad cultural change within the legal community is needed, and it is essential that this change come from the top down, promoted and role-modeled by senior attorneys, not just human-resources staff. Each workplace has its own culture, and some are better than others. Senior attorney leaders, as the definers of organizational culture, must embrace changes that promote well-being and also model them for the rest of their organization. Do associates really need to be continuously accessible at 2 a.m.? It is time to define when a “crisis” truly is a crisis, versus someone’s unmanaged anxiety. It is time to empower associates to have greater control over their unscheduled calendar time and to protect their sleep.

Colleague mentors are good resources and can assist new associates with learning how to manage their time, prioritize, set boundaries, and ask for assistance in prioritizing when faced with multiple competing deadlines. Is it really necessary to place paramount importance on “face time”? As professionals, with the intrinsic responsibility to get the job done, attorneys should also have the flexibility, within reason, to do so without concern about being in the office for extended hours every day. Is your organization actively promoting healthy communication?

Recognition of the difference between being assertive and being aggressive is a good place to begin. You can also assign interested mentors for new associates to safely talk with when feeling overwhelmed. Senior attorneys can mentor upcoming and new firm leaders in the areas of leadership, effective communication with team members and delegation of responsibilities.

Does the firm have informal outlets for social connection and stress reduction, such as a lunchtime meditation room, or a lunchtime walking group, women’s group meeting, or other group of interest? Your firm might consider encouraging informal, healthy team activities, such as a 5k running group, hiking, intramural sports or biking. Or perhaps a meal-of-the-month, quick-and-healthy cooking class, or another activity or competition based on attorney and staff interest and input. These are just a few examples representing possible changes toward reducing stress and improving organizational culture.

If you are an organizational leader, I ask you to begin the dialogue, and if you are early or mid-career, I ask you to suggest such a conversation to your leaders. These can be organizationwide, practice-group specific or based on some other defined group, depending on the size of the organization. If you do not know where to begin, start with this article. Ask those attorneys you work with, “What do you think about this lawyer well-being stuff? What would make your work and life easier? What about this workplace works for you? What can we think about changing or improving?” Allow people to safely brainstorm and state their ideal situation, then work back from there. By simply allowing, enabling and participating in this conversation, you are opening the door to better communication, improving your workplace culture, and taking an important step toward lawyer well-being.

Traci Cipriano, J.D., Ph.D., is a former practicing attorney, coach, consultant and writer, a member of the Connecticut Bar Association Lawyer Well-Being Task Force, and an assistant clinical professor in the Yale School of Medicine.