stress mgmt for lawyers
TRANSCRIPT
STRESS MANAGEMENT FOR LAWYERS: BUILDING RESILIENCE
AND AVOIDING BURNOUT
Linda Benoit, LICSW, ICADC, CADC
December 1, 2015
Welcome!
A Quote About Stress
Stress: “The confusion created when one's mind overrides the body's basic desire to choke the living daylights out of some jerk who desperately deserves it.”-Unknown
• Why Stress Management is Important1
• Understanding Stress 2
• Building Resilience3
Overview
• Why Stress Management is Important1
Lawyers & Stress
Research studies show that a high percentage of lawyers are dissatisfied with their work.1 Reasons for work dissatisfaction are stress related and include long hours, conflicting demands on time and energy, and the exacting and confrontational nature of the work. Many lawyers are leaving the profession, and it appears that job burnout is implicated in the exodus.2 Lawyers have an unusually high rate of suicide and drug and alcohol problems, compared to other professions.3 This underscores the importance of understanding and dealing effectively with stress in the work environment.
Research Says• Over 1/3 of attorneys say they are dissatisfied and would choose another profession
if they could.1
• According to an often cited Johns Hopkins University study of more than 100 occupations, researchers found that lawyers lead the nation with the highest incidence of depression.2
• In 1996, lawyers overtook dentists as the profession with the highest rate of suicide.2
• 15-18% of attorneys will have substance abuse problem vs. 10% of general population.1
• The ABA estimates that 15-20 percent of all U.S. lawyers suffer from alcoholism or substance abuse.3
Lawyers Are Different: Is there a “Legal Personality?”
• Need for achievement• Extroverted and sociable• Competitive, aggressive, dominant• Less interest in people, emotional concerns and interpersonal
matters• Disproportionate preference for(Myers-Briggs) thinking vs.
feeling• Focus on economic bottom-line and material concerns• A markedly higher incidence of psychological distress and
substance abuse
Chronic, Unmanaged Stress is (a Killer) Implicated in:
• 75-90% of doctor’s visits• 50% of all illnesses • Atherosclerosis• Hypertension• Increased cortisol & weight gain• Memory impairment*• Decreased immune system functioning• Increased blood glucose levels• Mental health problems• Substance misuse problems
General Adaptation Syndrome
OR Recovery/Energy Conservation/Arousal
Chronic Stress Cycle
Stress
Obesity
Sleep Disturbance
Depression
Common Stressors
Money Work Economy Family Health0
10
20
30
40
50
60
70
BASE: ALL QUALFIED RESPONDENTS 2014 (n=3068) Stress in America: Paying With Our Health, by the American Psychological Association, Released February 4, 2015.
What is Stress?
• The term was coined by Hans Selye in 1936, who defined it as “the non-specific response of the body to any demand for change.”
– A challenge or demand– A cause and effect – A stimulus and response
It’s a highly subjective phenomenon!
The Bad News: Any type of stress can have negative effects depending on the strength of the stressor and how the individual deals with it.
Most stress is psychological"We don't see things as they are, we see them as we are.”- Anais Nin
A Quote About Stress
Stress: “The confusion created when one's mind overrides the body's basic desire to choke the living daylights out of some jerk who desperately deserves it.”-Unknown
Another Quote About Stress
“Stress is like spice - in the right proportion it enhances the flavor of a dish. Too little produces a bland, dull meal; too much may choke you.” - Donald Tubesing
The Good News: Any type of stress can have positive effects depending on the strength of the stressor and how the individual deals with it!
Eustress• “Good” stress • The positive cognitive response to a challenge that is
healthy, or gives one a feeling of fulfillment or other positive feelings.
Effects
• Encourages creative thought• Enhances performance• Energizes• Improves mood• Facilitates memory
Distress• “Bad” Stress• Stress perceived of as an unfavorable or oppressive demand,
it involves a negative cognitive response.
Effects • Nervousness, anxiety• Lack of interest, motivation• Fatigue• Feeling overwhelmed• Depression
Job Stress
As defined by OSHA: “Job stress results when the requirements of the job do not match the capabilities, resources, or needs of the worker.”
General Job Stressors• Lack of control over input or pace of work• Poor work conditions and environments• Lack of effective communication in workplace• Excessive demands• Conflicting and unrealistic work expectations• Lack of appreciation/recognition• Lack of promotion or career growth opportunities• Lots of responsibility and little authority• Job insecurity• Workaholic work ethic
Top Job Stressors for Lawyers
• Billable hour pressures• Long hours• Lack of vacations• Deadlines• Interpersonal difficulties with colleagues and clients• Adversarial nature of the work• Perfectionist tendencies and expectations• Pressures to make partner • Public image• Student loan debt
General Job Stressors/Top Stressors for Lawyers
• Job insecurity• Inadequate salary, finances• Lack of promotion or career
growth opportunities• Lack of
appreciation/recognition• Poor work conditions and
environments• Lots of responsibility and little
authority• Conflicting and unrealistic
work expectations• Excessive demands/lack of
control over input or pace • Lack of effective
communication in the workplace
• Student loan debt• Inadequate salary, finances• Pressures to make partner• Oppressive work ethic &
professional identity• Long hours, lack of time off• Multiple deadlines• Billable hour pressures• Interpersonal difficulties with
colleagues and clients• Adversarial nature of the
work • Perfectionist tendencies and
expectations• Long hours, lack of time off• Public image
Early Warning Signs of Job Stress
• Headache • Short temper • Job dissatisfaction
• Sleep disturbance • Upset stomach • Low morale
• Difficulty concentrating
• Irritability • Fatigue
Job Burnout
“Burnout is a state of mental and/or physical exhaustion caused by excessive and prolonged stress.” – Girdino et al, 1996.
3 Stages of Job Burnout
• Arousal
• Energy conservation
• Physical, mental, & emotional exhaustion
General Adaptation Syndrome
OR Recovery/Energy Conservation/Arousal
QUICK TIP BURNOUT QUIZ
Find the most advanced stage in which you identify with 2 or more of the characteristics
Stage 1: ArousalDoing more with less, juggling difficult deadlines and job pressures, not getting or taking enough breaks, taking on more work
Responses: Persistent irritability, persistent anxiety, periods of high blood pressure, insomnia, forgetfulness, periods of bruxism (nocturnal teeth grinding)
Extreme Responses to Stage 1 Burnout: Heart palpitations and arrhythmias, concentration and memory difficulties, headaches, gastrointestinal symptoms, stomachaches
Stage 2: Energy Conservation You attempt to compensate by conserving energy. You may feel like you aren’t accomplishing enough or anything at all. Cutting corners becomes a high priority. Avoidance, as a coping style, may be overused at this stage. Shame, doubt, guilt over not performing to personal expectations may arise. Responses: Excessive lateness, procrastination, excessive time off, increased cynicism, resentments, prolonged apathy
Extreme Responses to Stage 2 Burnout:Increased drug and alcohol use, increased cigarette smoking, heightened cardiovascular risk, isolation and withdrawal, decreased libido, depression
Stage 3: Physical, Mental & Emotional Exhaustion You feel like something is significantly wrong. You are worn out. There can be a profound sense of failure, helplessness, hopelessness.
Responses: Cynicism and callous behavior towards the job and others in your life increases. Ongoing mental and physical fatigue.
Extreme Responses to Stage 3 Burnout:Persistent and disruptive symptoms of depression and/or anxiety, energy depletion, suicidal ideation, ongoing drug & alcohol misuse or other compulsive behaviors such as overeating, shopping/spending money, gambling, working too much
There is hope!
Average Stress Levels
2007 2008 2009 2010 2011 2012 2013 20140
1
2
3
4
5
6
7
Mean Stress LevelMean Healthy Stress Level
Stress levels are declining, but still higher than healthy levels
The Basic Stress Sequence
Challenge or Demand
Physiological Response
Let’s Build on That
Challenge or Demand ME Physiological
Response
Cognitive Response Outcome
Q: Can a Stressor in the Environment Cause Stress?
A: We choose our stress response
Choosing Our Stress Responsea.k.a. “The Modifier in the Middle is ME”• Genetics• Cognitive style• Family style• Mood state• Relaxed or tense? Tired or energized?• Behavior & lifestyle• Medications• Ingested toxins• My relationships, social supports
Cognitive Response
• Cognitive pattern: Contingency planner? Able to visualize positive outcomes? Catastrophic thinking (worst case scenario-ing)?
• Perception of event: What am I telling myself about what happened? Is it realistic? Is it helping me? Do I need to think about it differently?
• Building Resilience 3
Tips for Managing Legal Job Stress
• Align your abilities and interests with your type of practice
• If you can, leave a toxic or hostile work environment• Develop, redesign career goals. Need to hire help?• Decide to get organized: Plan your schedule, make
lists, file, prioritize tasks• Control as much of your scheduling as you can• It doesn’t have to be perfect: You can’t read every
law journal article
More Tips!• Accept that you might not finish everything every day• Get away from your desk, out of the office at least once
a day• Take frequent short breaks if possible• Remind yourself that you can’t solve all of your clients
problems• Educate your clients about the process• Avoid unpleasant colleagues as much as possible• Keep a positive attitude and generate goodwill• Avoid workaholism: Set limits & don’t put all of your
well-being eggs in your work basket• Make time for yourself & your relationships every day
General Stress Management Tips
• Cultivate a positive attitude• Find meaning & humor in life and personal
struggles*• Make time for rest and leisure• Spend time with friends and family*• Avoid caffeine, nicotine, drugs, and alcohol• Have a friend you can vent with and one you can’t• Practice good nutrition, sleep, & exercise habits
More Tips!
• Engage in distractions moderately*• Cultivate hobbies and interests• Get outside, reconnect with nature• Use mindfulness techniques*• Set aside, and limit, times to problem solve
“worry”• Set small achievable goals & rewards
Small Changes Ripple
Making one small change creates momentum and leads to other changes
Consider Taking the “30 Day Challenge” maybe to try a new stress management strategy?
The Basic Stress Sequence Reconceptualized
Challenge or
Demand
Modifiers/ME Response
The American Bar Association:Defending Liberty & Pursuing Justice
(Excerpted from ABA Mission & Goals)
• Promote competence, ethical conduct and professionalism.
• Promote pro bono and public service by the legal profession.
• Promote full and equal participation in the association, our profession, and the justice system by all persons.
• Eliminate bias in the legal profession and the justice system.
The Legal Profession as a Helping Profession with a Commitment to Social Justice
Public Service(From the ABA Model Rules of Professional Conduct)
Rule 6.1 Voluntary Pro Bono Publico ServiceThis rule expresses the commitment by the legal profession to helping financially needy people access legal aid. It also encourages activities which will improve the law, the legal system, or the legal profession in general.
Five Core Notions of Human Rights
• Human Dignity (Article I)• Non-Discrimination (Article 2) • Civil and Political Rights – (Articles 3-21)• Economic, Social, and Cultural Rights –
(Articles 22-27)• Solidarity Rights - (getting their sustenance
from articles 28-30)
The Legal Profession as a Healing Profession
The Comprehensive Law Movement
• Creative problem solving• Therapeutic jurisprudence• Preventive law• Restorative justice• Collaborative law• Transformative mediation• Holistic justice
Interconnected Levels of Response
• Structural, systemic (Macro)
• Working with groups and institutions (Mezzo)
• Working with individuals (Micro)
When You Need Help:Counseling for Stress
– Cognitive Behavioral Therapy (CBT)– Narrative Therapy– Dialectical Behavioral Therapy (DBT)– Mindfulness Based Therapy– Motivational Interviewing (MI)– Psychodynamic Therapy– Eye Movement Desensitization and Reprocessing (EMDR)– Accelerated Resolution Therapy (ART)
Other Therapeutic Interventions
• Deep breathing techniques• Meditation• Guided imagery (visualization)• Progressive muscle relaxation• Acupuncture• Yoga• Massage therapy
Quick Tip: Substance Misuse Peer Support
• AA• NA• Refuge Recovery • Smart Recovery• Celebrate Recovery• Dual Recovery Anonymous (DRA)
Quick Tip: Substance Misuse Treatment
• Detoxes• Intensive outpatient groups (IOP)• Recovery support groups• Individual counseling• Medication assisted treatment – Office Based– Clinic Based
Quick Tip: Mental Health Treatment
• Crisis lines• Inpatient psychiatric services• Outpatient (partial) hospital programs• Depression & anxiety support groups• Area counseling agencies• Private practice psychotherapists &
medication prescribers
When You Need Help:Lawyer Specific Resources
Lawyers Concerned for Lawyers31 Milk Street – Suite 810
Boston, MA 02109 (617) 482-9600 (800) 525-0210
Fax (617) 482-9909
Helpline: 1-800-525-0210
Be Aware
Choose Your Adaptive Response
Stress Management Take Away
Get Help When You
Need It
LINDA BENOIT, LICSW, ICADC, CADC241 KING STREET SUITE 218NORTHAMPTON, MA 01060
WWW.FACEBOOK.COM/LINDA.BENOIT.LICSW