Personal Issues and Effective Practice
Anne Chambers, LCSW, Director, Missouri Lawyers’ Assistance Program
and law students are at an increased risk for alcohol, depression and
marital/family concerns. The rates of alcohol use, depression and divorce for
attorneys have all been identified as above average compared to other
are hard-working professionals. In 2010-2011, the Bureau of Labor Statistics
estimated that a third of attorneys work 50 or more hours a week. Attorneys
also face some unique pressures, including critical deadlines, the competitive
nature of law, the responsibility of helping clients resolve difficult,
complicated or contested matters, and the pressure that accompanies the
awareness that one party may emerge from court a perceived victor and another a
2010, The Substance Abuse and Mental Health Services Administration (SAMHSA)
reported a 7% rate of alcohol abuse or alcohol dependence in the United States
for people age 12 or older. That figure represented 17.9 million people. Of
attorneys with substance abuse problems, alcoholism accounts for 95% of
substance abuse problems in lawyers and judges. Although it can and does
happen, addiction to prescription and illegal drugs is much less common for
of communication and lack of diligence are the top two ethical complaints
clients make about attorneys overall, not only in Missouri but in general. In
2012, these two categories areas alone accounted for about half of total
complaints resulting in OCDC investigations. Serious, unaddressed problems
appear to increase risk. Studies in the US and Canada estimate that up to
50-60% of discipline prosecutions and malpractice claims against attorneys
involve alcoholism and other unaddressed personal concerns.
abuse is generally seen as a maladaptive pattern of alcohol use leading to
significant impairment or distress. Examples include failure to fulfill major
role obligations at work, school or home, recurrent use in hazardous situations
and repeat problems. Work performance may suffer, as may the attorney’s
personal life. Abuse may continue despite the problems but there may be times
the person “swears off” drinking for periods of time, then resumes it. With
alcohol dependence, tolerance develops, with the person requiring more alcohol
for the person to get the desired effect. The person continues drinking in
spite of adverse consequences, which can grow more severe and include things
like DWIs, illnesses, liver disease, financial hardship and other problems. The
person may make unsuccessful attempts to control or cut down use, devote
substantial time to consuming alcohol and start to give up or reduce other
activities that were important. Morning drinking or drinking throughout the day
may enter the picture to hold off withdrawal. Withdrawal serves to fuel further
drinking because of symptoms such as sweating, racing pulse, hand tremors,
insomnia, nausea, vomiting, physical agitation or anxiety that may start hours
after cessation or reduction of alcohol intake.
The person may find themselves in a spiral.
of a possible problem with alcohol can include blackouts, unexplained accidents
and injuries, repeated or multiple auto accidents, delayed treatment for
injuries, tardiness, defensiveness, financial problems, drinking becoming more
of a focus and other activities taking second fiddle. Denial is often present,
and words of concern may meet with insistence that things are fine. Physical
concerns may include sudden weight loss or gain, slurred speech, persistent
cough, pupil changes, bloodshot eyes, increased temperature, heart rate or
blood pressure, changes in sleeping patterns, an unusual smell on the breath or
body, tremors, reduced coordination, deteriorating appearance, and a declining
quality of life.
is a disease that can be treated. The earlier the person receives treatment,
the better the chance of recovery. Alcoholism is a progressive disease that kills
over 250,000 annually. Active alcoholics are at greater risk for serious
accidents and substance abuse increases risk for other health problems. The
good news about substance abuse is that attorneys with successful treatment
often return better than ever. Professional care and self help and
support groups can play important roles in recovery. The attorney who was a
rainmaker can get that edge back.
has different forms and symptoms can range from mild to severe. Adjustment
concerns occur when a person has a difficult time coping with a challenging
situation, or the challenge has endured for a long time and the person feels
overloaded. Examples might include feeling depressed while caring for a loved
one with a long term illness, while facing financial hardship or some other
stressor. For some people with depression, there is a family history.
Dysthymia is chronic, lower grade depression. Major depression includes
symptoms that can pose major challenges including feeling depressed most of the
day, feeling depressed more days than not, feeling sad, empty and tearful,
losing pleasure in activities, withdrawal, changes in appetite, fatigue, weight
loss or gain and difficulty with sleeping too much or too little. A person
facing depression may feel helpless, hopeless, and worthless or that that
things cannot improve. Because depression can come with feelings of
inappropriate guilt people sometimes think that they are to blame for their
feelings versus viewing depression as an illness that is no one’s fault.
Concentration can become more difficult, and a previously confident and
decisive person may find themselves feeling indecisive. Performance may start
to suffer; productivity may slow down.
disorder is a mood disorder characterized by significantly elevated mood,
sometimes interspersed with depression. Mood swings, agitation, impulsive
ideas, poor judgment and loss of sleep can cause problems during acute phases
of the illness. Bipolar disorder can move more quickly than some other forms of
mental illness so it is important to stay on top of the condition.
Medication and treatment noncompliance can be challenges. People
sometimes feel so well in between episodes they may feel the condition is gone
for good. If the disorder remains unchecked, impulsivity, mood swings, spending
sprees, and social indiscretion can cause problems at work and at
depression, most people who get help report significant symptomatic relief
in a number of weeks. With improvement, people feel more like their usual
selves, more confident and light of spirit. Usually the improvement starts
subtly and increases.
are at the heart of all the work you do. When you sit down with a new client,
you bring all your knowledge about the law, your training, your skills of
persuasion and advocacy. Even strong professionals can have off days, where
fatigue, stress, an argument from last night, or a personal concern can
intrude. Caring for yourself can help you stay on top of your career,
help you bring your A game with you and keep your competitive edge
If a personal problem is interfering, please contact the
Missouri Lawyers' Assistance Program at 1-800-688-7859 for free, confidential
- Keeping the Edge: Professionalism without Burnout, Jim
Brady, LCSW, MOLAP, PowerPoint, 2012.
- Commission on Lawyer Assistance Programs, American Bar
Association Website, americanbar.org/groups/lawyer_assistance, 2012.
- “Drug and Alcohol Abuse and Addiction in the Legal
Profession,” The Legal Profession Assistance Conference.
- DSM-IV-TR: Diagnostic and Statistical Manual of
Mental Disorders, 4th Ed, Text Revision. American Psychiatric Association,
Washington, DC, 2000. DSM-IV:
- Diagnostic and Statistical Manual of Mental Disorders, 4th
Edition. American Psychiatric Association, Washington, DC, 1994.
- DSM-III-R: Diagnostic and Statistical Manual of
Mental Disorders, Third Edition, Revised. American Psychiatric Association,
Washington, DC, 1987.
- Howard, Jim. “How Can I Help a Loved One Who Has an
Alcohol Problem?” MOLAP, 2004.
- “Lawyers,” Occupational Outlook Handbook, 2010-2011 Edition,
US Department of Labor, Bureau of Labor Statistics, pp. 1-2.
- OCDC, “Report of the Office of the Chief Disciplinary
- Substance Abuse and Mental Health Services Administration, Results
from the 2010 National Survey on Drug Use and Health: Summary of National
Findings, NSDUH Series H-41, HHS Publication No. (SMA) 11-4658. Rockville,
MD: Substance Abuse and Mental Health Services Administration, 2011.
- “Warning Signs of Addiction”, Kansas City First Call