Guest Post: Recognizing, understanding, and referring a colleague in need

Chelsy A. Castro, JD, MA, MSW, LCSW, is Director of Outreach and Clinical Programming for the Illinois Lawyers’ Assistance Program. She joined the LAP staff in 2014.

As lawyers, we are a vulnerable population. Recent studies have confirmed that the overwhelming stress that is commonplace in our legal profession disproportionately results in attorneys suffering levels of depression, anxiety, addiction, and other serious issues at rates much higher than those seen in the general population.¹ Statistics collected by the Illinois Lawyers’ Assistance Program, a not-for-profit providing free and confidential support for all Illinois lawyers, judges, and law students in the areas of stress, anxiety, overall well-being, burnout prevention, grief, process addictions, and substances abuse, among other concerns, show that the nationwide issues identified by these studies are also very present here in the state of Illinois. Many outside the profession are surprised to learn that, while we are problem solvers and we do have influence, we are also a vulnerable population suffering at alarming rates.

So why are attorneys a vulnerable population? Our consistently demanding careers are a key factor, but it goes deeper than that. As attorneys, we typically face three categories of stressors: 1) Life Stressors; 2) Organizational Stressors; and 3) Individual Stressors.

Life Stressors

Life Stressors are those factors that come along with being human. Just because we are lawyers does not mean we get to avoid issues with our partners; problems with our children; health concerns; and/or financial hurdles. Rather, we have to cope with all those often inevitable stressors in the context of our already very stressful careers.

Organizational Stressors

The Organizational Stressors are those factors that are unique to the practice of law. For many attorneys, legal practice can be characterized as one of high pressure, but little credit. We are often the workhorses for our firms or agencies. That is OK, but it can be a big stressor for those accustomed to praise in exchange for effort and/or sacrifice, as we are conditioned to expect throughout our schooling.

We are also functioning in what is usually a zero-sum game. Our legal system is adversarial in nature, usually resulting in one side loosing while the other wins. Even in a contract negotiation with that "meeting of the minds," rarely does everyone walk away from the table with everything they wanted. We all logically understand this, but we struggle to accept that, statistically, we must loose sometimes, resulting in psychological stress.

We also have client expectations to contend with. Have you ever had a client who was OK with receiving work next week and that it be "good enough?" It is highly unlikely that this describes anyone's typical caseload, and for a good reason. As attorneys we are dealing with very important issues for other people; we often have their livelihoods, family's wellbeing, or even their lives in our hands. There is a lot on the line, causing an enormous amount of pressure to get it right.

Finally, there is our legal culture’s definition of success. Culturally, we base a lot of our self-worth on external validating factors, things that are external to who we are as people. The most common ones are: what law school you graduated from, your class ranking, what journal you wrote for, who you work for, who your clients are, what your title is, and what you get paid. There is nothing wrong with success or these factors, but, if our self-worth is primarily defined by these, we stand to suffer a great deal when one of them goes awry, often by no fault of our own.

Individual Stressors

Individual Stressors are those factors that we both see in ourselves and share with many attorneys. Pessimism is a widely shared personality trait in lawyers which is simultaneously beneficial and harmful. Pessimism can actually make you a very good law student and later an excellent attorney because it helps you keep a look out for all of the potential problems. In fact, it’s one of the first things they teach you in law school – only it's called issue spotting! Whereas pessimism can be very useful in the form of issue spotting in the context of our legal profession, it can be detrimental in our personal lives, making us bad partners, bad parents, bad friends, and bad to ourselves. We are our own worst enemies when it comes to pessimism, often focusing on the losses or negatives, rather than identifying strengths and opportunities.

In addition to being pessimists, we are also often perfectionists. Many will argue that perfectionism drives attorneys to be better and work harder, but how many of us are actually perfect? (If you have identified yourself as perfect, please do contact us. We should have a chat.) We logically know we are not perfect, but somehow we continue to expect ourselves to be, often beating ourselves up psychologically whenever we fail to measure up to this unattainable goal. Moreover, perfectionism is often a double edged sword. Yes, it can drive you to do better (likely causing suffering along the way due to unrealistic expectations), but it can also keep you from attempting things because you are fearful of not being perfect at them. When was the last time perfectionism held you back?

What to look out for: Substance Abuse

The inherent role of stress both in human nature and the legal profession requires that attorneys develop coping mechanisms. Unfortunately, as recent studies and IL LAP statistics both reveal, substance abuse is often used as a coping mechanism for this stress. In a culture in which substance use (often alcohol) is acceptable in both professional and social contexts, it can be challenging to know when such use becomes a problem. Alcohol consumption is not the problem. Rather, the problem arises when alcohol and/or other substances are used as coping mechanisms. So what signs should tip you off that you or a colleague might be relying on a substance as an unhealthy coping mechanism?

Keep a look out for:

• Increase in tolerance
• Pattern of consumption
• Decrease in inhibition
• Not being able to stop after one or two drinks
• Wanting a substance to relax vs Needing a substance to relax

To help you remember, you can follow the MAP, a mnemonic device developed by IL LAP (Pacione & Belleau, ABA Solo Practice Journal, May 2015).

M: Mood or attitudinal disturbances
A: Appearance or physical changes
P: Productivity and quality of work

If you notice a big shift in a person's mood, appearance or productivity, take that as a sign that the individual is potentially relying on a substance as a coping mechanism.

As both recent studies and IL LAP statistics reveal, substance abuse among attorneys is often accompanied by issues such as anxiety and depression, two of the most common mental health issues identified among attorneys.

What to look out for: Anxiety

Symptoms:

• Irritability
• Fatigue
• Unexplained trembling
• Increased worry
• Headaches
• Digestive problems
• Perfectionism
• Unexplained pains
• Decrease in productivity
• Rumination

In the office:

• "I can’t cope."
• Increased arguing
• Increased sick days taken
• Work tasks taking longer to complete
• Increased fear of potential consequences
• Missed deadlines
• Office door closed more frequently

What to look out for: Depression

Symptoms:

• Changes in appetite
• Changes in sleep
• Fatigue
• Feelings of worthlessness or guilt
• Difficulty thinking, concentrating, and/or making decisions
• Loss of interest in previously enjoyable activities
• Thoughts, plans, and/or attempts of suicide

In the office:

• "I just don’t feel right."
• Obvious changes in mood
• Inability to enjoy things
• Work tasks taking longer to complete
• Noticeable rework
• Absenteeism, tardiness, withdrawal
• Indifference – apathy to self and/or others

What to do: Referring a friend to LAP

What do you do if you notice some of these symptoms in a colleague? You have options. Some would argue that you should not do anything because "it's none of your business," or because you might face repercussions from that individual. That is an option, but it is one that is more likely to result in hurting that individual and, potentially, causing harm to his or her clients and/or employer. It is not the responsible choice. That’s why LAP exists.

Through LAP you have a few choices: 1) You can tell your colleague about LAP and its cost-free and confidential services, encouraging him or her to contact us; 2) You can express your concern to your colleague and then call LAP with him; or 3) You can call LAP without your colleague and express your concern to a LAP clinician, with the option to remain anonymous. This last option eliminates the concern of repercussions.

What happens after a referral?

Once initial contact is made with LAP, the individual will meet with a LAP clinician for an assessment. Assessments last approximately 30-45 minutes and take place in person at one of LAP's four offices (accommodations can be made for individuals who cannot travel to an office). During the assessment, the individual and the clinician will discuss the individual's personal, medical, and family history, what precipitated the meeting, and his or her current goals. The meeting will conclude with an action plan for the individual's treatment. That plan might include one or more of the following: short-term individual counseling at LAP; a referral to a long-term therapist; attendance at one of LAP's weekly support groups; a pairing with one of LAP's trained Peer Support Volunteers; a referral to a higher level of care; or other. Regardless of the options or combination thereof, the individual will receive continued confidential support from LAP at no cost and for as long as necessary.

For more information, visit the LAP website at www.illinoislap.org, or contact the Chicago LAP office at 20 South Clark St, Suite 450, call to visit any of our office state-wide (312) 726-6607. You may also send a 100% confidential email to gethelp@illinoislap.org. The only wrong thing to do is to do nothing. LAP is here to help.

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¹ Buchanan, Bree et. al. The Path to Lawyer Well-Being Practical Recommendations for Positive Change. The Report of the National Task Force on Lawyer Well-Being. American Bar Association, https://www.americanbar.org/content/dam/aba/images/abanews/ThePathToLawyerWellBeingReportRevFINAL.pdf.