louisiana rules of professional conduct - schedschd.ws/hosted_files/miemanagers2017/15/professional...

4/3/2017

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J.E. Buddy Stockwell III, JD, CCI Executive Director

Judges & Lawyers Assistance Program, Inc. (985) 778‐0571

[email protected] www.louisianajlap.com

All Rights Reserved 2017

In This Self‐Care Presentation:

PART ONE:

Lawyers’ Problems

PART TWO:

Health Care Solutions

PART ONE:

Lawyer Self‐Care

Problems and Challenges

Louisiana Rules of Professional Conduct Rule 1.1 Competence

Rule 1.1 (a) Competence

A lawyer shall provide competent representation to a client. Competent representation requires the legal knowledge, skill, thoroughness and preparation reasonably necessary for the representation.

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California Rules of Professional Conduct Rule 3‐110 Failing to Act Competently

Rule 3‐110 Section (B) Competence

For purposes of this rule, "competence" in any legal service shall mean to apply the 1) diligence, 2) learning and skill, and 3) mental, emotional, and physical ability reasonably necessary for the performance of such service.

Clinical Therapists: Self‐Care Code

Universal Right to Wellness : Every helper, regardless of her or his role oremployer, has a right to wellness associated with self care.

Physical Rest and Nourishment: Every helper deserves restful sleep andphysical separation from work that sustains them in their work role.

Emotional Rest and Nourishment : Every helper deserves emotional andspiritual renewal both in and outside the work context.

Sustenance Modulation: Every helper must utilize self restraint with regard towhat and how much they consume (e.g., food, drink, drugs, stimulation) since itcan compromise their competence as a helper.

Source National Association of Social Workers NC

Lawyers and Judges Self‐Care Code (unwritten)

Be Brave!

(and simply endure stress, anxiety, or other health issues)

Lawyers Are Perfectly Negative = Higher Risk

Lawyers depend on two primary traits:

1) Perfectionism: practicing law is excessively detail‐oriented and mistakes are not tolerated

2) Pessimism: lawyers are hired to always look out for what can go wrong

“Lawyers learn to see problems everywhere, even when they don't exist. And they start to perceive threats as if they are life‐or‐death matters. That's the very definition of anxiety.”

How lawyers can avoid burnout and debilitating anxietyBY LESLIE A. GORDON 2015ABA JOURNAL

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Impact of Self‐Care Neglect

Profound effects that can reduce Executive Functioning:

• obsessive thoughts

• feelings of inadequacy

• difficulty concentrating

• a sense of worry and impending danger

• sleep disturbances

• heart palpitations

• sweating, fatigue and muscle tension

Lawyers’ and Social Workers’ Challenges

• Transference (unconscious redirection of feelings; one person to another)

• Compassion Fatigue (domestic and criminal work)

• Vicarious Traumatization (clients’ trauma becomes yours too: CF)

• High income requires high stress and long hours (the Golden Handcuffs)

• Little or no control over clients’ outcomes

• Recognition/appreciation not always commensurate with skills and effort

• Unrealistically demanding, disturbed, or even threatening clients

• Paperwork demands

• Long hours that include evenings, weekends and sometimes holidays

The Craftiness of Compassion Fatigue

Empathy is not a choice:

• Empathy is involuntary: a shared emotion that is hardwired into the brain

• You experience the experiences of clients

• You endure those same experiences and emotions

• Mirror Neurons and Monkey‐See‐Monkey‐Do

• Intrusive images/painful emotions =actual mental representations =fear response

• “Fight or Flight” switch stuck “ON”

The Craftiness of Compassion Fatigue, Cont’d

How is your outlook on life?

• The world is a ________place.

• Life is _______.

• I am ______as a human being.

• I want to change ________about my job.

• I want to change ______about myself.

• Most often I feel ___________.

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Primary assumptions pre‐Compassion Fatigue

• The World is Benevolent

• The World is Meaningful

• The Self is Worthy


Effects of long term exposure to traumatic material:

• Shattered assumptions about basic beliefs in our world for safety, security, trust, justice

• The world is not a good place; there is no meaning; pessimism, depression, irritability, sickness

• Heightened awareness of vulnerability and the fragility of life: increased anxiety and anger

Unhealthy Coping Strategies

Maladaptive coping behaviors by lawyers seeking some control:

• Self‐medicating with alcohol and other substances.

• Food disorders

• Gym Anorexia

• Unhealthy Sexual Behaviors

• Compulsive Video Gaming

• Hair Pulling

• Isolation and withdrawal from friends and family

• “Stuffing” feelings and ignoring mental health concerns

2016 Study: “The Prevalence Of Substance Use and Other Mental Health Concerns Among American Attorneys”

By: Patrick Krill, JD, LLM; Ryan Johnson, MA; Linda Albert, MSSW

Published in Journal of Addiction Medicine: January/February 2016

19 states participated via voluntary, online confidential ABA survey

All Louisiana lawyers were invited to participate in the study

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Substance Use Screening per Survey

Alcohol Use Disorders Identification Test (AUDIT)

10‐item self‐report instrument

Screens potential for severe alcohol use disorder

Alcohol Use Findings– AUDIT

20.6% scored at a level consistent with hazardous drinking and possible alcohol dependence (severe alcohol use disorder)

Men (25.1%) vs. Women (15.5%)

Professionals aged 30 or younger had the highest rates (31.9%)

Higher rates were also found for those at the junior (31.1%) or senior associate (26.1%) level compared with other firm positions

AUDIT‐C: How Often? Daily? Ever 6 or More?

First 3 AUDIT questions: quantity and frequency of alcohol use

Younger lawyers demonstrated significantly higher AUDIT‐C

Higher rate of women (39.5%) than men (33.7%)

36.4% of lawyers screened positive in 2016

15% of physicians and surgeons screened positive in 2012

0%

5%

10%

15%

20%

25%

30%

35%

40%

Doctors Lawyers

AUDIT ‐C

AUDIT C: Doctors vs. Lawyers

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I’m too busy to think about ME or anything except what is in front of me . . .

Self‐Care and Self‐Reflection

Basic Healthy Habits

Lawyers "intellectually know" the foundations of a healthy lifestyle:

• 8 Hours of Sleep

• Healthy Diet

• Daily Meditation to find an “Off Switch”

• Aerobic Exercise at least 3 times per week

Why Lawyers Resist Basic Healthy Habits

Attorneys routinely sacrifice healthy habits, claiming there is no time:

• Employer’s demands for billable hours

• Clients’ demands on top of employer’s demands

• Lack of control over calendar and scheduling

• Misconception that excessive self‐sacrifice is required (began in law school)

• Allowing demands of practicing law to dictate time left for friends and family

• The demands of law can’t be controlled, only perfectionism in law can be

• Wanting to appear tough and invincible

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Comparing Corporate Cultures as to Coping

Legal Profession:

“Suck it Up” and don’t ever speak about fear/pressure/anxiety of practice

Show no human vulnerabilities and refuse to acknowledge them

Win at all cost; mental health is secondary; poor life/work boundaries

Medical/Therapeutic professions:

Recognize real mental health risks from fear/stress/anxiety due to practice

Acknowledge that effective self‐care is critical to sustaining mental health

Set hard boundaries for balance and protect time for personal life and health

Comparing Corporate Cultures

Legal Profession:


Medical/Therapeutic Professions:


Legal Profession: “While relaxing . . . I’ll ponder how to . . . ”

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Comparing Corporate CulturesMedical/Therapeutic Professions: Encouraged to hit the “Pause Button” Duty to Self: Honest Self‐Assessment

PART TWO:

Mental Health Self‐Care

Practices and Solutions

The Practice of Law and Mindfulness

Lawyers, due to the nature of their work:

• Spend large amounts of their time focusing keenly on solving puzzles of the past and crafting plans and predictions on the future

• Spend little or no time recognizing, appreciating, and accepting the actual “present moment” of their immediate surroundings

• “Thinking” is central to our trade and “Lawyer Minds” are polished tools

• But we are still primarily human Beings and not human Thinkings

• Mindfulness in simple terms, is a practice that allows us to suspend thinking and focus purely on our true physical Being in the present moment

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The Practice of Law and Mindfulness

The Paradox:

• Lawyers experience high rates of stress and anxiety

• An effective approach to reducing anxiety is mindfulness and meditation

• Mindfulness and meditation require scheduling time periods on a routine basis wherein you stop ruminating, analyzing, judging and predicting and instead surrender all analytical and judgmental thought and focus on Being

• Lawyers are typically uncomfortable at first because their professional self‐worth rests upon tremendous dedication in the realm of complex Thinking

• Lawyers tend to believe that only thinking is an effective tool to deal with any issue and it is implausible that NOT thinking can help solve a problem

What Mindfulness is NOT

Is it some touchy‐feely, hippie‐dippy, wimpy‐trippy, freaky‐fad? NO.

Is it therapy for “sissies” who can’t handle their business? NO.

Does it require me to wear funny clothes or burn incense? NO.

Is it a fanatical religious thing? NO.

Do I have to adopt certain norms or beliefs? NO.

Are there strict rules I have to follow? NO.

Is it a game I win or lose, or will be graded on? NO.

What Mindfulness IS

A mental state achieved by focusing one's awareness on the present moment, while calmly acknowledging and accepting one's feelings, thoughts, and bodily sensations, used as a

therapeutic technique.

Meditation Specifically for Lawyers

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Why Learn to Meditate?

• Stress and anxiety management: especially good for lawyer‐type stress

• Increasing focus and productivity: an antidote to information overload

• Letting go of unwanted habits: helps combat smoking, overeating, etc.

• Dealing with difficult events: calming, soothing, deeper thought

• Seeking meaning and self‐knowledge: seek reality and avoid self‐deception

From the Book:“The Anxious Lawyer; an 8‐Week Guide to a Joyful and Satisfying Law Practice Through Mindfulness

and Meditation”, Jeena Cho and Karen Gifford 2016 ABA Publishing

What is Meditation

• Meditation is a technique for shifting your focus to the present moment

• Meditation is a tool to help us access and appreciate simply Being

• Meditation allows us to pause our minds and focus on our bodies

• Mediation helps us break out of pessimism and negative habitual thought patterns that may be problematic, and be more optimistic and open to ideas

• Meditation allows us to seek answers and solutions from a perspective other than just thinking and ruminating

Meditation Exercise Right Now

Meditation Exercise:

Get ready to be perfectly still and totally quiet for one minute

Silence cell phones

Sit up straight

No crossed bones; palms up

Close your eyes

Focus on breath

Breathe in: “Present Moment”; Breathe out: “Wonderful Moment”

If thoughts do come in don’t judge, just gently refocus on breathing

How did you do? Go to www.the anxiouslawyer.com for more exercises

Realistic Expectations and Anxiety

What’s your Role as a Lawyer?

To win?

To get the outcome the client desires?

How much control can a lawyer exercise over the case?

60%?

80%?

From the Book:“The Anxious Lawyer; an 8‐Week Guide to a Joyful and Satisfying Law Practice Through Mindfulness and Meditation”, Jeena Cho and Karen Gifford 2016 ABA Publishing

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Realistic Expectations and Anxiety, Cont’d

As a Lawyer Can You Control:

The law?

The facts?

What witnesses say?

What the opposing counsel does?

What the opposing client does?

What your client does?

What the judge or jury does?


Litigation: I’ve Got This . . . No Problem . . .

Realistic Expectations and Anxiety, Cont’d

Expecting to Win, or Even Achieve “Justice” in Every Case:

• An unrealistic yardstick

• Creates negative self‐image

• Creates unnecessary Stress and Anxiety

• Can lead to Depression and other problems

• Client control and setting realistic expectations up‐front can help


Anxiety and Fear versus The Present Moment

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Focusing on The Present Moment (The NOW)

Eckhart Tolle: Can You Ever Stop Thinking, even For a Moment?

“Can you be free of your mind whenever you want to? Have you found the “off” button or are you a “slave” to thinking?”

“Your mind is an instrument, a tool. When a specific task is complete, you lay [the tool] down.”

“I would say that 80 to 90 percent of most people’s thinking is repetitive and useless.”

“If you feel you cannot stop thinking compulsively, it has become an addiction.”

From the Book:The Power or Now, A Guide to Spiritual Enlightenment, Eckhart Tolle New World Library, 1999 and 2004

Everything Happens in the NOW

BEING and Reality in the NOW:

Everything that happens does so NOW, and only in the present moment

We never experience, do, think, or feel anything outside the NOW

Nothing happened in the past, it happened in a former NOW

Nothing happens in the future, it will only happen in a future NOW

The past is a memory of a former NOW; the future is an imagined NOW

Past and future have no reality of their own, there is only the NOW



Fear and Worry:

You are identifying with your mind and thoughts instead of the NOW

Fear and worry come from imagined future situations

A future situation can’t be coped with, it doesn’t exist: it’s a Phantom

Answer: shift focus to the present moment

All you ever have to deal with in life is this moment, the NOW

Ask yourself what problem you have right NOW, not next year, tomorrow, or five minutes from NOW



All coping happens in the NOW:

You can always cope with the NOW; you always have your whole life

The answer, the strength, the right action or the resource will be there when you need it, not before nor after

This does NOT mean you should not prepare for the future as need be, but it means that compulsive thinking, worry and anxiety about a future event serves no purpose


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Stress Management For Lawyers Stress Management For Lawyers

Good Nutrition

Eat: whole grain foods, vegetables, fruits, nuts, beans, fish, poultry, eggs, and plant oils

Avoid: or eat less red meats, butter & margarine, white rice, white bread, potatoes, pasta, sweets, and junk food (potato chips, etc.)

Take: Daily multi‐vitamin

Alcohol: only in moderation

From the Book:Stress Management for Lawyers, How to Increase Personal & Professional Satisfaction in the Law, Amiram Elwork, Ph.D. Vorkell Group 2007

Stress Management For Lawyers

Exercise for those with a Desk Job (you won’t like the answer)

1. Aerobic exercise (Moderate) one hour per day 6 to 7 days per week

Walking for one hour per day

Running for 30 minutes per day

2. Anaerobic exercise a few minutes every day

Lifting weights or working stretch bands for muscle tone

Can substitute for one‐two of the weekly Aerobics



IF YOU SMOKE

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STOP IT!


Sleep Issues:

• Determine the cause (physical ailment, environmental, substance use)

• Participate in a sleep study

• Avoid stimulants (nicotine, caffeine) a common cause of insomnia

• Avoid alcohol and sleeping pills (may help you fall asleep, but do not foster good sleep and are risky in terms of addiction)

• Proper diet and exercise improves sleep


Don’t be negative about healthy habits . . .

even though it can be very inviting to do so!


Mark Twain:

“The only way to keep your health is to eat what you don’t want, drink what you don’t like, and do what you’d rather not.”


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Redd Foxx:

“Health nuts are going to feel stupid someday, lying up in hospitals dying of nothing . . .”


“If it tastes good,

SPIT IT OUT!”

Jack Lalanne:


Eliminate Habits of Negative Thinking

• Learn to recognize your negative thinking habits

• Negative perceptions of specific individuals or events

• Negative statements about general beliefs, rules, and assumptions

• All categories, past, present and future

• Test thoughts and require evidence that they are not distorted

• In fact, is there any evidence at all to support your thoughts



Example of testing a negative thought:

• “I am going to totally blow this trial”

• How do you KNOW this will happen before the trial even starts?

• How many times have you actually blown a trial before?

• How many times have you said that before but it never happened yet?

• What is a possible truth: I need to prepare a little more because I think my opening statement could be better . . .

Being overwhelmed by negative thought allows insecurities to catastrophize and exaggerate things and you pay an emotional price


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Once a REAL problem has been validated, ask:

• How can I fix this?

• What can I do about it right now?

• What can I do to improve matters?

• How can I solve this problem in the future?

This type of approach gets you out of a negative catastrophe mode and into a positive solution mode.


Summary: The Professional Duty of Self‐Care

Successful lawyers have invested in their law license and practice:

• Tremendous time

• Relentless effort

• Momentous financial investment

• Considerable emotional, mental, and family sacrifices

• All‐in Sunk Costs: law school and then practice development

Resulting in:

• A hard‐won singular self‐image of who they are (a lawyer)

• Self‐expectations of self‐reliance and unshakable resilience

Summary: The Professional Duty of Self‐Care

The Missing Ingredients:

• The skills and knowledge that serve lawyers well in navigating rigors of practicing law are simply not effective in mental health self‐care

• Most lawyers have received little or no professional therapy or training in mental health self‐care

• Many lawyers have difficulty with life/work balance and boundaries

• It takes learned, intentional, and specific health habits to carve‐out and protect one’s daily mental and physical health while also engaging the daily stress and pressure of practicing law

• The legal profession is just awakening to the concept of a Duty of Professional Self‐Care (CA Rules’ new definition of competence”)

Suggested Lawyers and Judges Self‐Care Code

Make these pledges on your own:

Universal right to wellness : Every lawyer and judge has a right to wellness associated with self‐care.

Physical rest and nourishment: Every lawyer and judge deserves restful sleep and physical separation from their practice that sustains them in their practice.

Emotional Rest and nourishment : Every lawyer and judge deserves emotional and spiritual renewal both in and outside the practice context.

Sustenance Modulation Every lawyer and judge must utilize self‐restraint with regard to what and how much they consume (e.g., food, drink, drugs, stimulation) since it can compromise their professional competence and as a helper.

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SEE OUR WEBSITE

louisianajlap.com

Healthy Lawyers at Their Best!

THE GOAL OF JLAP

THANK YOU!

J.E. Buddy Stockwell III, JD, CCI Executive Director JLAP, Inc. (985) 778‐0571 [email protected] www.louisianajlap.com

All Rights Reserved © 2017

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