One of the leading mental health issues facing lawyers, including lawyers suffering from alcohol addiction or depression, is anxiety. Anxiety can be a terrible emotional experience. It is a feeling that something horrible is about to happen, that is not actually happening. A mechanism in our body has been triggered to put us into a state that seeks to defend us from something unknown in the present, or memories of something fearful that happened in the past or projections of uncertainty about the future. What makes anxiety so frustrating is that it is not about what is actually happening in the moment.
Although many people have a natural aversion to taking medication, pharmacological treatment for anxiety has become the first line treatment. It is easy for the general practicing physician to prescribe some pharmacological treatment for anxiety. The temptation is great because, for the most part, such treatments work for most individuals to temporarily relieve symptoms. Medications do not, however, treat the cause of the anxiety.
Moreover, the greatest difficulty with this first line approach is that by first taking medication the chances are that the individual will never learn basic skills that can control or eliminate their symptoms without medication. In addition, many of the medications for anxiety disorders are habit-forming and addictive. Often when alcohol is used when such medications are being taken, there is a significantly increased chance of the onset of addiction being triggered.
Therapy offers two different levels of help for anxiety. Both options may be pursued together, or one at a time. The first is in-depth counseling. Longer-term psychological counseling offers the possibility to get to the root causes of anxiety and help alleviate them. At a more immediate level, good therapeutically taught anxiety management tools offer the opportunity to mitigate or eliminate the symptoms of anxiety.
The purpose of this article is to try to focus on the second level approach: how to address the different physical symptoms that can often be dealt with in a relatively short time through therapy to bring relief to a lawyer. These symptoms fall into three groups: (1) the physical feeling of fear and panic, (2) the feeling of being stressed out; and, (3) the mental anguish of a mind that keeps worrying about the issues that seem to be producing the anxiety.*
The physical distress caused by anxiety is exemplified most notably in a panic attack, where one feels a racing heart and rapid pulse. There is shortness of breath and dizziness. These symptoms often send the lawyer to take addictive drugs like Xanax.
*This article owes many of the suggestions here to Margaret Wehrenberg, author of Stress Solutions: Effective Strategies to Eliminate Your Stress.
However, these symptoms can be dealt with very effectively by other tools. These include learning to manage anxiety prone bodily conditions. This includes learning to avoid eating just carbohydrates, sugar and caffeine in the morning and during the day at work. Instead, we learn to have good protein based breakfasts and lunches and to avoid alcohol, caffeine and nicotine. Simply putting the body on a more stable regimen of good nutrition and sleep can go a long way to prevent anxiety.
Many of us have participated in, or with a spouse, in breathing methods related to childbirth. These methods show the effectiveness of breathing techniques to ease pain and allow its passage. Similarly, good breathing techniques, using diaphragmatic breathing, can be very effective in warding off anxiety and panic attacks. The biggest block to the effectiveness of breathing techniques is getting the patient to understand how effective such a simple technique can be and to spend the time to develop these breathing habits. Once this learning has occurred, these habits will be sufficiently ingrained to defuse the anxiety when the warning signs of an anxiety episode are on the horizon. Put little notes on the bathroom mirror, pause before blessings at meals, and figure out other times during the day when one can become conscious of one’s breathing. These little techniques to remember to breathe deeply can easily make this an effective technique and an ingrown pattern.
Anxiety often comes from fear of the unknown in the future. Whenever this is happening, the lawyer is not anchored in present reality. Techniques such as practicing mindfulness awareness help us learn to be anchored in the present and are good ways to avoid the mind creating the opportunity for anxiety. These are simple techniques which a counselor can easily teach a lawyer in a session or two, that can always be at the lawyer’s disposal to use should they be needed. These kinds of techniques can become second nature as you are sitting in court waiting for your case to be called.
The second group of symptoms that anxiety sufferers have centers on feeling stressed out. There are techniques to help reduce this chronic tension. First, one can learn not to listen when worry calls. In this approach, patients learn progressive muscle relaxation techniques to get relief. When worry enters the mind, then this is the signal for the patient to begin these techniques to physically relax. It seems to be almost impossible for the anxiety to be experienced while the physical body is in a state of relaxation.
The second method for dealing with this type of anxiety symptom has to do with anger. Often those lawyers experiencing a great deal of anxiety have substantial amounts of anger that is unknown to them. The lawyer may experience anger because of past experiences or in worrying about future ones. To address this, a therapist will often help the lawyer learn techniques for bringing the source of anger into consciousness and learning to take effective action to deal with it. Once it is brought into consciousness, it will begin to dissipate and almost completely evaporate once some positive action is taken based on what had been unconscious anger.
A third approach to dealing with this type of anxiety symptom is to develop ways to increase laughter. There is a problem-solving technique that therapists can use with a lawyer to help the lawyer figure out good ways to have more fun in his or her life. Often the anxiety ridden patient is the lawyer on the treadmill all the time who is simply not having the normal, natural antidote of fun and relaxation to go with the difficulties that we must face in life. Getting in touch with fun and play isn’t easy for the serious worrier. It often involves going back to what caused the lawyer to laugh and have fun at an earlier stage in life, but a good therapist can be effective in helping the patient to understand how he or she can lighten up.
The third group of symptoms for anxiety has to do with the mind that won’t stop worrying. This sort of rumination tends to dominate in social phobias and can create nausea and a level of tension destroying an ability to experience any quality of life. It’s a feature of anxiety, which seems to be entirely neuro-biologically driven. In this circumstance what lawyers usually worry about, their day-to-day concerns, are less significant in driving the anxiety than the omni-presence of worry itself. The brain just goes on humming away. To deal with this issue, the therapist focuses not on the origins of any particular worry, but on worry itself. It’s as if the ruminating brain is like a person with a food addiction who can’t slow down and stop eating.
Here are some suggestions for dealing with ways to eliminate the rumination. The first method is for the therapist to help teach the lawyer how to simply turn off the worry process. There are specific techniques for doing this which are ways to create the concept of a cleared space in the mind. Another, which is often used in Al Anon, is the idea of a “God box”. Worrisome thoughts are written on a piece of paper and then ritually placed in a box and turned over to one’s Higher Power. Other similar rituals may be used with the goal of giving the ruminating mind a chance to rest and calm down.
Another approach a therapist may use is persistent interruption of the worrying itself. In this technique, lawyers learn how, once the worrying starts, to interrupt it. This method requires persistence, but is very effective. A third method used by therapists is to set aside a specific time to do the worrying and get into whatever the basis for the worry is as effectively and deeply as possible. It is sort of like, well, let’s worry real good, but only once. Surprisingly, a relatively short period of time can often be used – five to ten minutes for the worry session – to be a sufficient way to focus on the problem, and then in turn, stop it.
A fourth method has to do with learning how to plan rather than to worry. Planning is a way to try to put the psyche at ease about what is going to occur in the future, since anxiety often is a generalized fear about the future. Many times worry occurs when there is no planning. A short circuit to prevent worry is good planning which includes contingency plans for when things don’t go the way they might be wanted. The basic tools of good planning such as specificity and concreteness may be taught to the lawyer. Or, the lawyer may be shown how to use such tools in his personal life that he already uses in his professional life. Often this can be a way to break the cycle.
As you can see, there are many different approaches to deal with the uncomfortableness of anxiety. As technology speeds up the practice of law, we are much more subject to the possibility of anxiety in our work life. Many of the techniques suggested here are just good techniques to have to promote one’s mental health generally and prevent anxiety. A good therapist can help a lawyer understand the exact nature of his or her anxiety and help provide the type of learning and feedback on the application of proven techniques to reduce it. Most worriers have found that they can get a great degree of relief if they actively seek good therapeutic help, rather than just continue to worry about their worrying.
– by Don Carroll
The North Carolina Lawyer Assistance Program is a confidential program of assistance for all North Carolina lawyers. The Lawyer Assistance Program has two outreaches: PALS and FRIENDS. PALS addresses alcoholism and other addiction; FRIENDS depression and other mental health problems.Tags: anxiety, coping with anxiety, lawyer Posted by