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Daniel J. Cuneo, Ph.D., is a psychologist who wears many hats throughout Southern Illinois and in the St. Louis metropolitan area. He has been active with the Illinois State Bar Association, the St. Clair County Bar Association and Lawyers’ Assistance Program (LAP). Dr. Cuneo is also active in the criminal justice and education arenas. He currently serves as president of the St. Louis County Special School District, which has a budget in excess of $450 million and is responsible for children with special needs and Career Training Education (CTE).
Dr. Cuneo has a presentation entitled: “You Can’t Take Care of Someone Else Until You Take Care of Yourself First.” This presentation focuses upon the unique and pervasive stress faced by lawyers and the profession. It provides some insight, data and anecdotes that highlight what Mental Health Month is about—awareness, cognitive behavioral tools, emotional well-being and resources to help address the complex interrelationship between cognitions, behaviors, emotions, the profession and everyday life.
Dr. Cuneo notes:
Dr. Cuneo explains some of this is related to the behavioral characteristics of those who enter the profession, the demands of the profession (perfection, hours, stress, finances, the rainmaker syndrome and deadliness), that law schools teach students to think differently (particularly with how we disassemble and rearrange facts), and the fact that, in a sense, lawyers are first responders to the trauma of others, yet like priests, often cannot disclose to others what we see or hear. This is vicarious trauma, i.e., the residue of exposure to pain, fear, trepidation and feelings of the clients we represent and the circumstances involved. Vicarious trauma is often overlooked.
Dr. Cuneo sees the signs of vicarious trauma in a variety of behaviors, including:
Dr. Cuneo suggest a number of adaptive ways of dealing with trauma:
Dr. Cuneo also provides a number of worthwhile practical tips:
The major barrier is captured in the following John Kenneth Galbraith quote: “When given a choice between changing, and proving that it is not necessary, most people get busy with the proof.”However, avoidance is not the answer and isolation exacerbates the adverse consequences.
Dr. Cuneo graciously consented to the liberal use of his notes and opinions in the foregoing article.
May is recognized as Mental Health Month. It was created to heighten awareness of the pervasive impact on mental health, on the health of individuals and on our communities. One of its principal goals is to break the stigma attached to mental health and better understand it is an integral component of overall health.1
We have experienced a year like no other. A year of disruption and, at times, despair from COVID-19. We have suffered the loss of loved ones, the disability of others and the dislocation of many. We have recognized as essential many who were previously marginalized. Many of us may work from home, but many do not have this option. Many children have lost from the lack of in-person instruction, limits on socialization, and feeling of isolation.2 The underlying common denominator is the STRESS to our mental and emotional well-being.
These circumstances have given rise to increased awareness, but what has not occurred is an enhanced understanding and access to practical, evidence-based strategies of mental health that help to provide to individuals and families specific sets of tools, skills and support to address the complex interrelationships between cognitions, behaviors, emotions and everyday life.3 The importance of these issues is underscored by the Illinois Mental Health Task Force Virtual Summit convened by Illinois Supreme Court Chief Justice Anne M. Burke.4
COVID-19 has exacerbated many of the disparities between the haves and the have-nots. It has laid bare the instability of households, neighborhoods, schools and communities. The trauma of everyday life has been magnified in scope and depth. The following statistics can be found on the NAMI website:
Individual Impact:
Community Impact:
The impact of adverse childhood experiences (ACEs) has taken on a new dimension and has increased the generational impact not only on our children, but on our families and the communities within which we live. Studies have shown that the toxic stress upon our children can physically impact the development of a child’s brain. Likewise, the absence of a nutrient-rich diet and the absence of age-appropriate social and intellectual stimuli impairs the development of not only academic, but social skills fundamental to positive interaction and success.
We can ignore the disruption and hope that the return to normalcy will resolve the underlying anxiety, frayed nerves, and depression or we can use our heightened awareness to identify best practices and means of early identification of illness, marshal resources and develop the tools needed to confront the challenges our children are facing. Telehealth has increased access to mental health services. Wraparound services are being increasingly made available and communities are re-imagining ways to collaborate. We can stand back or we can stand up for reforms in how we address and deliver mental health services. If we stand back, we wait for a tsunami. If we step forward, we can prepare our children to respond with emotional flexibility, dexterity and resilience.
The Elite Medical Center has summarized the signs and symptoms of mental illness as follows:
At the very least we need to identify the strengths each person has; what resources are available or are missing and what type of resources might be most appropriate and how those services might be made available and delivered.
We support the mental wellness of future generations when we seek a greater understanding of the neuroscience of developmental research, the value of safe, but unstructured play, ways to communicate effectively and the better management of emotions and behavior. Emotional intelligence (EQ) is as important as academic intelligence (IQ) and has proven to not only enhance enjoyment of life, but success.7
Seek first to understand all that is involved and then advocate for optimizing the future of yourself, your family and your community by adopting a positive mindset, being deliberate and focused about your sources, resources and build on your strengths. With guidance we can learn actively, not passively, identify good sources of information that will challenge us, but not overwhelm us. We can take affirmative control of our well-being by staying active, eating right and getting enough sleep. Simplify down to the 3Ms: mindfulness, movement, and mastery.
Finally, we can find peace and joy through gratitude for blessings we too often overlook or imprudently discount when they may yield more lasting joy than the fleeting pleasure of material objects which are, by nature, transient. Such objects are a poor substitute for those relationships and experiences which can be shared and celebrated with others. Self-management requires we take an active role in our quest for wellness. We can focus on that over which we control, the intrinsic. We should not fear collaboration with qualified professionals, but embrace them. Life expands when we find the guidance, motivation and greater clarity of our self-value and purpose. Mental health professionals are ideally positioned to support our mental well-being. We just need to use them and advocate for equal access to quality care by all members of the community.
Robert E. Wells, Jr., is an attorney at Pessin, Baird & Wells, in Belleville, Illinois.
2. For other suggestions related to Covid-19 and mental health reference the observations of Dr. Alexandra Tsang in the February 2021 Newsletter of the Mental Health Section Council.
3. All of us recognize the C.D.C., i.e., Center for Disease Control. What is too often overlooked is the rest of its charge: “AND PREVENTION”.
4. Members can find summaries: Session 1: Strategies for Mental Health and Law Enforcement Collaboration to Prevent Justice Involvement (in the October 2020 Mental Health Newsletter) and Session 2: Mental Health Diversions from the Justice System; Session 3: Learning from the Voices of Lived Experience: Informing Change; Session 4: How Mental Illness and Trauma Affect Quality of Life; and Session 5: Illinois’ Path to Improving the Court and Community Responses to Persons with Mental Illness: Bringing the Community Together in One Voice and Common Mission (in the February 2021 Mental Health Newsletter).
5. Nami.org/MHstats.
6. https://elitelv.com, citing MHA, AHA (American Hospital Association), NAMI and the APA.
7. A good example of this is Feist and Barron’s 1996 retrospective study of 80 Ph.D.s in science who underwent a battery of personality tests, IQ tests, and interviews in the 1950s when they were graduate students at the University of California, Berkeley. When they were in their early 70s, about 40 years later, they were tracked down and had their resumes evaluated by experts to determine their level of success. According to this study, emotional abilities were 4 times more important than IQ in determining professional success and prestige. Prof. Jason M. Satterfield course, Boosting Your Emotional Intelligence (The Great Courses, 2017).