Aug. 19, 2009 – The intensive training for attorneys sharpens their natural abilities to reason and rationalize so they can successfully present evidence in a compelling way under stressful circumstances. Unfortunately, this can also make them more susceptible to denial when facing chemical dependency. The current economic turbulence intensifies this and creates considerable stress. It also increases risk factors that are already higher for attorneys than for the general population.

As a result, it is more important than ever for lawyers to recognize and acknowledge symptoms of stress, evaluate their response to stress and be able to ask for, and accept help when they are abusing a substance.

 Don’t deny the effects of stress

According to Jay Kasner, MD, the medical director of chemical dependency services at Rogers Memorial Hospital – Milwaukee, the number one trigger toward chemical dependency is clear: stress.

 And it’s not any specific type of stress, he explained. “Stress is stress. It’s in the eye of the beholder. The difference is how you deal with that stress.” The effects of stress are even more serious with attorneys, a group that is more likely to suffer from depression and attempt suicide than the general population.

Linda Albert, LCSW, CSAC, coordinator of the Wisconsin Lawyers Assistance Program (WisLAP), confidentially helps attorneys, judges, and law students recognize and get assistance for the chemical dependency problem they are skillfully avoiding. “In law school they train you to deny, defend, and debate. Don’t show weakness. To seek treatment, you have to not deny, not defend and not debate. You have to be willing to admit that you can be vulnerable – you’re human,” she said.

Declining economy increases the risks

Today’s economy has been generating more stress for attorneys across all stages of their careers and disciplines. New graduates are finding employment opportunities are scarcer than they anticipated. Private practice attorneys are losing clients who are cutting costs by representing themselves. And large firms have increased the pressure to deliver billable hours and increase the firm’s financial stability.

Taking time to regroup, refresh, and seek a healthy outlet can appear to be an elusive luxury. The importance of self-care is downplayed and delayed. Proven stress-reducers like exercise and low-key vacations are ignored in the name of productivity. When lawyers are presented with an easy way to “relax” or “perk up,” internal justifications begin drowning out the weakening voice of caution.

Recognizing the risks

Dr. Kasner noted that statistically, the average age for starting these unhealthy behaviors is in the early 40s, but can start at any time depending on the level of stress. “It could be someone who is just graduating or is struggling with retirement because they’re removed from the day-to-day structure and support of their work,” he explained.

For more than 25 years, Dr. Kasner has limited his medical practice to treating people who are chemically dependent. Since joining Rogers Memorial Hospital in 2000, more than 5,000 patients have been under his care.

Dr. Kasner added that the majority of chemically dependent individuals come to rely on alcohol as their primary “stress relief.” He also listed cocaine and prescription medications as substances being widely abused by the patients he sees in treatment.

“The biggest obstacle for entering treatment is often with chemically dependent individuals themselves,” Dr. Kasner said. According to Dr. Kasner, the vast majority of his patients enter treatment because they wanted to reduce the pressure from their families, employers, or the legal system.

“In most cases a mild to moderate or severe crisis has to happen,” he said. “They are having consequences – financial, spousal, or an OWI. They see treatment as a way to ease their discomfort.” Dr. Kasner explained that denial is such a powerful force; they refuse to recognize the problems that are surfacing in their homes, at their jobs and with their finances.

These warning signs are viewed by impaired professionals as external problems:

• Relationships suffer. Whether at work or at home, the people closest to impaired attorneys are seeing a change in their relationships. They may be expressing their concern directly, or issuing ultimatums. Feeling “misunderstood” or accusations of “overreacting” are common defenses that help the individual distance the problem from the chemical.

• Problematic finances When trouble shows up on a bank statement, it could be the cost of obtaining drugs or covering up the consequences of poor decisions. Family members may also be bearing the financial cost of a loved one’s problem.

• Legal consequences Whether presenting as ethical lapses or OWIs, these indicate the existence of a problem. If impaired individuals do not receive treatment, they can convince themselves that they just had bad luck. Underlying issues go unaddressed and contribute to a higher stress level.

Understanding success and recovery

Treatment programs, such as the impaired professional program at Rogers Memorial Hospital, are intended to help individuals get the level of help they need while helping them address the consequences of the illness and the effects of their denial.

Once individuals are in treatment, they learn to identify the numerous ways it has changed their priorities, even in subtle ways. They begin to see the negative effects their dependency has on the people around them and understand their role in a successful recovery.

“We help them diminish the denial and change their behaviors,” Dr. Kasner said. “They have to accept that they have a chronic illness and need to continue the behavior changes and non-chemical coping skills they have learned in treatment to be successful.”

This article was developed through a cooperative effort involving Rogers Memorial Hospital and WisLAP staff.