Lawyers and The Burnout syndrome

Lawyers are in the risk group that is prone to suffering from the Burnout syndrome. Several factors, like having a highly demanding workload, immense intricacies, bailable hours, competition, and client expectations, can affect a vast number of these professionals.

Published on Wednesday, 17th July 2019 – 11:42:27 am by Mario P. Proenca
Reading time: 8 minutes | Word count: 1881 words

The Burnout Syndrome—The single purpose of this article is to raise awareness about the mental health subjects covered, mainly the Burnout syndrome. It's not a scientific paper or essay. It's an invitation for readers to think and help raise awareness among their personal and professional circles.

Lawyers are a risk group prone to Burnout Syndrome. Several factors, such as a highly demanding workload, immense intricacies, bailable hours, competition, and client expectations, can affect many of these professionals.

The Burnout (Burn–out) Syndrome

The etiology of Burnout Syndrome is multifactorial. Its symptoms develop slowly and may not be recognized until they have become severe. It's also nonexclusive to work-related problems. Its scope can be observed in many other life situations and spans a wide range of ages and life stages.

The Burnout syndrome

Herbert Freudenberger, back in 1974, was the first researcher to publish a scientific journal paper using the term burnout. He characterized burnout by a set of symptoms that included exhaustion, resulting from work's excessive demands, as well as physical symptoms such as headaches, sleeplessness, "quickness to anger," and closed thinking, as the paper describes.

Following Herbert Freudenberger's paper, several researchers developed different conceptualizations of Burnout Syndrome. Some described the syndrome as characterized by emotional exhaustion, depersonalization, reduced feelings of work-related accomplishments, physical fatigue, and cognitive exhaustion, which resulted in several kinds of disengagement—mainly psychological.

Mental Health Systems Recognition

A full array of symptoms is now known as conditions for the diagnosis of Burnout Syndrome (sleep disturbance, cognitive impairment, irritability, depressive state, physical exhaustion, among others). The Diagnostic and Statistical Medical Manual of Mental Disorders (DSM) (https://www.psychiatry.org/psychiatrists/practice/dsm) is now in its fifth revision and still does not recognize it as a distinct disorder.

Although Burnout Syndrome is already in the International Statistical Classification of Diseases and Related Health Problems (ICD) (https://icd.who.int/), in its 11th revision, it is not a disorder. The ICD considers the syndrome under "Problems associated with employment or unemployment."

Occupational Groups, Statistics, and Symptomatology

The statistics in the US about suicide were, by the 90s, enlisting mental health practitioners at the top of the list. This professional group, along with police forces, military forces, firemen, teachers, airmen, lawyers, and other high–occupational stress groups, are still the ones most prone to suffer from Burnout Syndrome and at risk of its possible outcomes, including self-destructive behaviors.

The Japanese coined a term akin to the Burnout syndrome – "Karōshi," which can be translated into "overwork death" or occupation mortality. The major medical causes of karōshi deaths are, among others, heart attack and stroke due to stress. While it is now common knowledge in the mental health discipline, it's still not sufficiently understood by general medical practitioners.

This lack of knowledge, understanding, and diagnosis at early stages may cause serious aggravation of the Burnout syndrome in patients suffering from it, which in turn can potentiate other outcomes, including self-destructive behaviors.

How Lawyers Can Be Affected by Burnout Syndrome

A paper from the Journal of the Indian Academy of Applied Psychology, published in January 2010, Vol.36, No.1, 165-168, by N. Hasnain, Iram Naz, and Samina Bano Jamia Millia Islamia, New Delhi, shows that the stress levels—the primary cause of the Burnout syndrome—vary between criminal and civil lawyers.

How Lawyers can be affected by the Burnout syndrome

The study indicates a higher degree of stress among criminal lawyers than civil lawyers due to the nature of their work and responsibilities. Above all, the lives of individuals are at stake in criminal cases.

Demanding workloads, more intricacies, bailable hours, competition, client expectations, and above all, the responsibility of saving the life of an innocent person all wreak havoc more on the emotional health of criminal lawyers than civil lawyers.

From a quick survey made in 2018, I found that lawyers generally have different stress levels depending on the practice areas in which they work. At the top were lawyers practicing Criminal law, followed by Family law, Corporate law, Litigation, and Real estate law. The less stressful group was the government or civil service lawyers.

Treatment

The Burnout syndrome treatment can be complex because practitioners might face the treatment of symptoms that have different levels of resistance as well as requiring different methodologies—from drug prescriptions to psychiatric and psychological follow-ups.

Self-awareness, self-help, and willpower are tools that can help speed up the recovery process and even prevent the syndrome from developing. Disciplines and methods such as Mindfulness, Meditation, and Yoga have proven to be preventive and, at some levels, alternative approaches to treating Burnout Syndrome.

Prevention and Awareness

By being considered a high-occupational stress group because of its work and family demands and work-family conflict, it might be said that lawyers have an increased predisposition to be affected by Burnout Syndrome at a higher level than other professional groups. This fact requires law firms to implement mental health prevention plans and awareness programs to mitigate the possible cases within their staff.

A well-designed awareness and prevention plan results in significant financial savings and a more productive staff due to overall well-being.

Final thoughts

Although the WHO and its Mental health department have long been working actively in the study, awareness, prevention, and intervention of the many mental health conditions affecting the world population, it has given special attention to self-destructive and suicidal behaviors. The WHO has issued several documents and guides focused on risk groups that are available for download at the WHO website.

It is crucial to remember that when someone fears for a colleague, speak and be helpful without judging. "If a word cannot save lives, silence may probably kill." Do not hesitate to approach a colleague to try to understand or offer support.

Online resources

There are several credible online resources, and I will point out here just a few that I think are worth visiting. Some are online courses, talks, and mental health links to credible institutions like the World Health Organization.

WHO Mental Health Department: http://www.who.int/mental_health
WHO International Statistical Classification of Diseases and Related Health Problems (ICD11): http://www.who.int/classifications/icd
WHO Depression – Let's Talk video: https://youtu.be/X-fAEMgQnt8
American Psychiatric Association: https://www.psychiatry.org
Mindfulness LinkedIn online course by Dr. John Ullmen: https://www.linkedin.com/learning/mindfulness
TED Talk – The burnout gamble by Hamza Khan at the University of Toronto: https://youtu.be/iEjukHJybm8

Disclaimer

This article was written in May 2018 and rewritten in 2020 and is not intended to substitute for medical professional help or advice. It only reflects the author's opinion and not the scientific organizations with which the author is affiliated; neither should be considered the only article on the subject.

About the author

Background Knowledge

From the study of self-destructive behaviors, suicide, and para-suicide and the many years of research and contact with mental health professionals and authors, at some point, Burnout Syndrome appeared in the psychiatric interview subject.

Shawn Christopher Shea MD., author of many books, sent me his latest book, back in the 90s, which became a reference in my studies—Psychiatric Interviewing: the Art of Understanding. A Practical Guide for Psychiatrists, Psychologists, Counselors, Social Workers, Nurses, and Other Mental Health Professionals.

It was the first time that I got acquainted with the term Burnout Syndrome, which, at the time, was quite a new or emerging concept in psychiatric and psychology practices.

The Burnout syndrome was, and still is, one of the dots that require to be connected and addressed by mental health professionals. Burnout Syndrome can lead to self-destructive behaviors and suicidal ideation at its very advanced stage.

Twenty years ago, after becoming one of the twenty founders—among psychiatrists and psychologists—of the Portuguese Scientific Society for the Study of Suicidal Behaviors, Portuguese Society of Suicidology (SPS), I started meeting every week with the first elected and former president of the SPS—Professor of Psychiatry at the Coimbra University Medical School (FMUC), Head of the Psychiatry Service at the Coimbra University Hospital (HUC), Coordinator of the Suicide Prevention Department of the HUC.

I was a "well-recognized and accepted outsider" with a very considerable amount of knowledge of self-destructive behaviors—suicide and para-suicide—which came from an almost obsession to understand, study, and research these social phenomena.

I bought almost every book on the subject to learn whatever I could about it. I also bought psychiatry and psychology books from the most renowned universities in the world—Harvard, Stanford, Cambridge, and others—and from the most prestigious authors in their respective fields, creating a library of over a hundred books.

I was hoping to connect the dots that lead people to try or successfully commit suicide in the hope of getting a clear answer to this mind-boggling question as well as understanding how society and institutions were tackling this prejudiced subject and mental health issue.

Not surprisingly, I quickly understood that this phenomenon had such a multidisciplinary scope that it became like a never-ending story, with routes I needed to follow to learn, understand, and connect them. The more I learned and read, the more I realized I had to dig deeper and further through disciplines and subjects that never occurred to me.

I needed to read about many topics, including religious studies, sociology, statistics, media, politics, economy, technology, forensics, law, art, and other related subjects.

The Suicide & Para-Suicide website was one of the first websites about suicide and suicidal behavior (no longer active). I launched this website in the early 90s, and it got into the radars of the scientific community, authors, and even the Mental Health Department of the World Health Organization.

Psychiatrists and psychologists from around the world started sending me their books to read and review, also asking for my contribution and knowledge. I got invited to participate in various international congresses, where I had the chance to meet, learn, and discuss the theme with some of whom the scientific community called the "fathers of Suicidology."

Alongside, I was several times commenting in the media whenever a tragic death by suicide was hitting the headlines. Since then, my dedication to this subject has been focused on awareness. The constant monitoring of new key factors introduced in and by our society and the perception of their effects on self-destructive behaviors kept me curious and collaborative with several institutions.

[1] Self–destructive behaviors, which may be deliberate, result from impulsive actions and thoughts or are developed as habits. The leading causes are, but are not limited to, substance abuse (drugs and alcohol), life-threatening behaviors (reckless driving, extreme sports, and activities where life is at stake), emotional distress with variable underlying causes, mental health illnesses (bulimia, borderline personality disorder (BPD), schizophrenia, depression and other mental health conditions known as having a potentially high risk of fatal outcomes.).

Self-destructiveness is, by definition, considered potentially fatal for the individual.

Photo credits: "Stressed": Photo by Andrea Piacquadio from Pexels, "Business photos" created by pressfoto - www.freepik.com,

Articles #Anger, #Anxiety, #BurnoutSyndrome, #Depression, #Exhaustion, #Lawyers, #MentalHealth, #Parasuicide, #Psychiatry, #Psychology, #Sleeplessness, #SuicidePrevention, #WHO, #Workload, #Mindfulness

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