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									Lawyers Concerned for Lawyers
     of Pennsylvania, Inc.

  “The Gift of Stress”
    Lawyers’ Confidential Helpline
     24 hours ● 7 days ● holidays
              LCL Helpline Services

•   Free referral to a healthcare professional
•   Free evaluation / initial counseling session
•   Free information and self-help literature
•   Peer support (LCL lawyer volunteers)
•   Lawyer-only 12-step recovery meetings
•   LCL staff support (with your permission)
     Our services are discrete and confidential.
       You incur no obligation by calling LCL.

• The General Sources of Stress

• The Dynamics of the Stress Response

• Personal Stress Factors

• Practical Approaches to Stress

• The Gift
              Living Triggers Stress

     All of our experiences, both good and bad,
             can trigger a stress reaction.

•   Marriage and Family
•   Career, Work and Office
•   Health and Lifestyle
•   Finances
               Marriage and Family

•   Getting married; extended families
•   Pregnancy; birth or adoption of a child
•   Spouse begins or stops work
•   Hectic family schedule; household duties
•   Family reunions; visiting in-laws
•   Marital arguments, separation or divorce
•   Illness, injury or death within the family
•   Son or daughter leaving home
             Career, Work and Office

•   Begin new job or position; career change
•   Increased responsibilities
•   Long work hours
•   Trouble with supervisors, colleagues, staff
•   Complex or difficult cases or clients
•   Difficult opposing counsel and judges
•   Downsizing – loss of job or demotion
•   Retirement
               Health and Lifestyle

•   Personal injury or illness; allergies
•   Unhealthy sleep, diet or exercise routine
•   Work no longer enjoyable or rewarding
•   Too much work; too many obligations
•   Isolated – minimal social life or friendships
•   Not enough work; lack self validation
•   Too much social life – neglect your duties

•   Spend more than you earn
•   Large debts (loans, credit cards)
•   Unexpected medical expenses
•   Unexpected repairs to house or car
•   Children’s tuition
•   No retirement savings
•   Illness or disability – income reduced
•   Change in employment – income reduced
                What is Stress?

• A personal (subjective) reaction to our
  physical and emotional environment.

• Two individuals subjected to the same
  stimulus may react differently.

• An individual’s reaction to the same stimulus
  may vary from day to day.
         Why Do We React Differently?

•   Genetic influence on the mind and body
•   Past trauma (emotional, physical, sexual)
•   How we were raised (nurturing; beliefs)
•   Our current health (injury, illness, Rx)
•   Our current life style (work, family, fun)
•   Diet, sleep and exercise
•   Use of alcohol or other intoxicants

• Each of us has a “set point”:
  → breathing
  → heart rate
  → production of hormones & chemicals
• A real or perceived threat or challenge triggers
  an increase in these 3 activities which return
  to normal once the threat or challenge is
  addressed, resolved or otherwise “accepted”.
               The Stress Response

    The amygdala (or sentinel) and the
    hippocampus (site of emotional memory)
    alert you to a perceived risk of harm:
•   Physical
•   Emotional
•   Financial
•   Social standing
•   Control (over one’s life or livelihood, etc.)
            Fight, Flight or Freeze

• Your body goes on alert in anticipation of
  having to fight or flee, or, you may freeze and
  wait for the perceived threat to pass.

• Once the threat or challenge is “over”, your
  body returns to normal.

• This adaptation to our environment is called
          The Brain and Body in Action

•   ACTH – adrenocorticotropichormone
•   Adrenaline and cortisol
•   Blood diverted to the muscles
•   Digestion slows or stops;
•   Fats & sugars released; cholesterol rises
•   Blood enzyme promotes clotting
•   Blood pressure elevates; vessels constrict
•   Heart rate and breathing increase
               Genetic Factors

• “BDNF” (brain-derived neurotrophic factor)
  strengthens neural connections in the
  hippocampus and enhances the growth of
  neurons that respond to serotonin (i.e.,
  “neuronal plasticity”)

• Low levels of BDNF (genetic cause or the
  result of too much stress) may contribute to
  neuronal atrophy and cognitive decline.
               Early Life Trauma

• Flawed BDNF genes may create biological
  vulnerability for low tolerance to stress.
• When combined with an early life trauma (or
  series of trauma) it may sensitize a person to
  permanently over react to environmental
  pressures triggering the “stress response”.
• Experiments show a link between early
  trauma and elevated stress hormones.
               Later Life Trauma

• Any serious physical, emotional or sexual
  assault or experience

• Post-traumatic stress syndrome

• Can be set off by any sensual stimuli (sight,
  sound, touch, smell, taste) that triggers the
  amygdala and hippocampus
                Injury and Illness

•   Pain and discomfort
•   Difficulty sleeping
•   Effects of medication
•   Reduced or lost mobility and functioning
•   Difficulty thinking and making decisions
•   Loss of motivation
•   Alcoholism, other addictions
                    Life Style

•   Long work hours without enough “R&R”
•   Poor diet
•   Insufficient sleep
•   Not enough exercise
•   Misuse of alcohol or other intoxicants
•   Over extended financially
•   Neglecting personal or family needs
•   Conflicts with values or belief system
          Destructive Self-Belief Systems

•   Less than perfection = total failure
•   1 poor performance → a future of failures
•   Focus on 1 negative & ignore the positive
•   Positives don’t count
•   Negative reading of other’s minds
•   Negative fortune telling (it will turn out badly)
•   Magnifying their success and minimizing yours
•   Negative feelings = truth (despite the facts)
•   I am responsible for all that goes wrong
          Quick Recap – Stress Factors

•   Genetic
•   Early and later life trauma
•   Upbringing and family of origin issues
•   Self-defeating beliefs
•   Health, illness and injuries
•   Responsibilities: work, family & community
•   Life style
•   Diet, sleep and exercise
     Some Stress Is Good!

A natural reaction to life that can:
   ●     protect us
   ●     motivate us

         We stay safe.
          We achieve.
      We do good things.
 We feel good about ourselves.
           Too Much Stress Is Harmful

•   Critical / analytical thinking skills impaired
•   Indecisive, forgetful, confused, emotional
•   Problems sleeping
•   Changes to our diet and eating habits
•   Loss of energy and enthusiasm
•   Pervasive negative outlook
•   Disillusionment, feeling trapped
         Problems at Work and Home

•   Marital / communication problems
•   Withdraw from friends and family
•   Lowered productivity - can’t complete work
•   Declining competency
•   Problems with colleagues and clients
•   Financial problems
•   Separation & divorce
•   Ethics and malpractice
      A Downhill Slide into Depression?

You do not like how you feel or act but you
• are unsure why you feel & act that way, or
• you don’t know how to change, or
• you have tried to change but it didn’t work.
Negativity undermines all efforts to change:
• feelings of unworthiness, self-loathing, guilt,
  helplessness and hopelessness.
Lawyers lead all professions in Depression.
         Due Diligence – Get the Facts

Start with self-discovery and self-awareness
• Physical illness or injury
• Mental illness or injury
• Cognitive distortions
• Prescription and over the counter drugs
• Use of alcohol
• 3 pillars of good health (sleep, diet, exercise)
          Identify Health Problems

• Family history of illness or vulnerabilities
• Family of origin issues
• Current health: allergies, diabetes, thyroid,
  high blood pressure, pain, headaches…
• Depression ….. Mood Swings …. Bi-polar
• Adverse drug interaction (Rx & OTC)
• Substance abuse or addiction
             Identify Other Concerns

•   Workaholism? No personal / family life?
•   Can’t say ‘no’ when asked to help?
•   Too busy to help someone in need?
•   Unhealthy lifestyle (diet sleep, exercise)?
•   Behaviors conflict with value system?
•   Worrier? Perfectionist? Overly Critical?
•   Can’t start? Can’t finish?
•   Angry and resentful? Self-pity?
                  “Smart” Planning

•   Schedule a “physical examination”.
•   Rx and OTC drug / supplements “audit”.
•   Need an “emotional health” checkup?
•   Need a career or job reality check?
•   Write out your goals and how to reach them.
•   Be realistic. No dramatic changes.
•   Discuss your plan with an objective friend.
•   Start with small, doable changes. Easy does it.
•   Be patient and persistent. Be flexible.
                   Into Action

•   3 Pillars of Good Health
•   Confronting Negative Thinking
•   Working Smart
•   Setting and Keeping Boundaries
•   Time Shifting
           3 Pillars of Good Health

• Sleep – 7 to 8 hours, more if you are ill or
  stressed; avoid sleeping pills – address the
  cause not the symptoms.

• Diet – don’t skip meals; avoid heavy dinners;
  health considerations; vitamins and

• Exercise – do something....
        What Do You Value Most?

□   A meaning-full job / career
□   Spending time with your family
□   Pursuing interests outside the law
□   Helping others
□   Honesty in your dealings with others
□   The Golden Rule
□   Peace of mind
            Are Your Values Being Met?

                              Yes/No   If not, why not?

A meaning-full job / career

Spending time with family

Pursuing outside interests

Helping others


The Golden Rule

Peace of mind
       Confronting Negative Thinking

• Are you in the grip of HALT?
• Identify negative thinking and feelings
  ■ Worry and Perfectionism
  ■ Anger and Resentment
  ■ Low Self Esteem
• Substitute valid positive thoughts & actions
• Look for the potential within the problem
• Respond (not react) to negative situations

Our physical and emotional states affect our
  body chemistry:
• Hungry
• Angry
• Lonely
• Tired
A combination of 2 or more can reduce our
  ability to cope with stressful situations.
           Analyzing Your Worries

1. Get the facts:
  –   What is the problem?
  –   What is the cause of the problem?
  –   What are the possible solutions?
  –   What is the best solution?
2. Weigh carefully all the facts.
3. Make an informed decision / action plan.
4. Take appropriate action
            An Experiment in Worrying

•   Write down your Top 10 Worry List.
•   Put it aside for 2 weeks. What happened?
•   Make a new list.
•   Delete worries that probably won’t happen.
•   Delete those you can’t do anything about.
•   Take appropriate action on those you can.
•   Still worried? What is the worse that can happen?
    Prepare yourself for it. Can you survive it? Work on
    accepting what you cannot control.
           A Few More Tips on Worry

•   Live in “day-tight compartments”.
•   Avoid “fortune telling” the future.
•   Don’t engage in mind reading.
•   Let go of the past.
•   Focus on what you need to do today.
•   Work smart as well as hard.
•   HALT
•   Relax (e.g., time shifting, breathe, walk)

□    Are you always unsatisfied with your work
  product or that of others?
□    Do you procrastinate?
□    Does one mistake or flaw = failure?
→ Set realistic expectations for yourself &
  others based upon available resources.
→ “If it’s worth doing……………………..
     ……………….it’s worth doing poorly!”

• Respond – don’t react; wait 48-72 hours?
• Ask yourself “Why am I angry?” Feeling threatened:
  embarrassed, financial insecurity, authority
• Don’t take it personally.
• What do you want to accomplish?
• Will an angry reaction help or hurt you?
• What is the other party’s objective, or, concerns?
• Is there a WIN-WIN option?

• Justified or not, resentments hurt you the
  most….they are toxic to your whole being.
• Try to understand their position, or
• Recognize they are very ill or disturbed.
• Forgive or seek the willingness to forgive.
• Remember, this is for your good health.
• Resentments hurt you the most.
            Improving Relationships

•   Be aware of your rhythm
•   Try to synchronize yourself with others
•   You may need to speed up or slow down
•   When in doubt, slow down
•   Listen and observe
•   Think
•   Communicate (be clear and considerate)
           Improving Communication

• Communicate (clearly state your goals, deadlines,
  expectations, concerns, etc.)
• Stop thinking. Listen carefully to what is said. Restate
  what you think was said. Allow the person to correct
  you. Repeat the process.
• Don’t “react”. Consider what is said but do not take it
  personally. Try to understand their objectives, needs,
  concerns, pressures, etc.
• Respond calmly and slowly. Delay your response if
  you are emotional.
               Low Self Esteem

• List your strengths & accomplishments.
• Learn to spot “automatic” self-put downs:
  ■ I should do better; I should have …..
  ■ I’m responsible (when things go wrong)
  ■ I feel _______, so I must be _______.
• Challenge these thoughts with the truth.
• Stop being a “victim” – identify what changes
  you want to make & get to work.
         Work Smart – Plan & Prioritize

         Write down your long & short term goals.
•   Create “to do list” to reach each goal.
•   Note which items are dependent upon other items
    being completed first.
•   Establish deadlines and priorities.
•   Identify & work on important - urgent items
•   Delegate unimportant & non-urgent items.
•   Get to work. Review & revise plans as needed.
           Set & Keep Boundaries

• Use your new Plans & Priorities with a
  Calendar to establish proper boundaries:
  ▲ First things first….say no to new projects
  that will cause you to miss deadlines or
  interfere with maintaining good physical or
  mental health.
  ▲ Be helpful but not codependent…..if you
  cannot say “no”, ask yourself why?
               Fiscal Responsibility

•   Establish a budget (at work or at home)
•   Live within your means (use best efforts)
•   Identify and plan for periodic expenses
•   Identify and plug spending leaks
•   Refinance when it makes fiscal sense
•   Pay off high interest loans first
•   Pay credit cards in full each month
•   Establish a savings / retirement plan
                      Are You in Balance?
Most Important Areas Suggested      Actual Hours # Hours   # Hours
of Your Life         Weekly Hours                Over      Under

Sleep                 49-56
Exercise              1-10
Relaxation            7-14
Family                20-25
Work                  40-55
Community             1-10

Total Hours in Week   168 hours
            Do Something You Enjoy

•   Hobbies, sports, exercise, yoga
•   Movies, plays and performances
•   Reading, listen to music
•   Prayer and meditation
•   Write or journal
•   Take a nap

         Be grateful, thankful and helpful.
      Spending Time with Your Family

• Before you enter your home, close your eyes,
  breathe slowly and deeply several times, and
  clear your mind of work.
• When you are doing things together as a
  family, leave the cell phone and brief case
  alone. Be “present” not preoccupied.
• Learn to listen, observe and not give advice
  (sometimes even when asked).
                Time Shifting

• Where are you now?
  ■ physically
  ■ mentally
  ■ emotionally
• Get into the “present”.
• Quiet your mind and breathe.
• Practice staying “in the present”.
• Alternate when to push & when to relax.
            The Gift of Stress

          Stress can help you to

identify and change behaviors and attitudes

    thereby allowing you to experience

Happiness, Productivity and Peace of Mind.
            Help Is Readily Available

• Are you anxious or having trouble sleeping?
• Unable to relax without the use of alcohol or other
  mood altering drugs?
• Having problems getting your work completed?
• Lost interest in the things you use to enjoy?
• If you answered ‘yes’ to any of these, why not call
  LCL & schedule a free, confidential and no-obligation
  consultation with a qualified healthcare
      Help is a phone call away. 1-888-999-1941
         Concerned About a Colleague?
                     5 Good Reasons to Call LCL
1.   It could be depression or substance abuse - chronic,
     progressive and destructive illnesses.
2.   We will help you find the best approach to offer assistance
     to your distressed colleague. We know what to do and what
     to say.
3.   Our services are confidential. We do not report to the Office
     of Disciplinary Counsel. See RPC 8.3(c).
4.   Our services are free and non-obligatory.
5.   Recovery offers your colleague a new chance to lead a
     better life – one of hope, happiness and fulfillment.
           Your call to LCL can save a career and a life.

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