Friday, July 10, 2009

ON LAWYER SUICIDES

The recurrent issue of lawyer suicide has come to the fore recently with reports that lawyers at three prominent firms have taken their lives since December. In subsequent months, there has been a flurry of correspondence as to what kinds of programs can be offered to target the problem. The prevalence of unhappy lawyers, and the very high incidence of depression in the profession are, of course, not new findings. Despite repeated calls for humanizing and balancing the lives of attorneys, there seems to have been no way to stem the tide of ever-increasing stress, the emphasis on billables and bottom lines for those who work in large firms and the difficulties making ends meet for many sole practitioners and small firms. I see so many lawyers who wish they could find another way to make a living but feel trapped; it is always a refreshing counterpoint to visit with some of my college buddies who went into the law and are enjoying themselves.

Feeling trapped, of course, can readily lead to both depressed mood and suicidal thinking (an exit), especially for people who are predisposed, either biologically or psychologically, to depression. The risk is heightened in the presence of a disinhibiting substance (most commonly alcohol) and/or access to a gun (particularly lethal in response to an impulse).

The programs being contemplated may be very helpful in addressing the needs of the grieving survivors – those of us who have lost a colleague, friend, family member, or client to suicide. The normal sense of grief is, in these cases, often compounded by such feelings as guilt (“What could I have done?”), anger (“How dare he choose to take himself away from his friends, family, etc?”), and even fear of contagion (“He seemed no different from me… Will this happen to me, too?”). In addition, when a loss seems to come from out of the blue, it is difficult not to become more vigilant, seeing the world as a place where dire events can strike us without warning. Fortunately, for most of us these emotions fade over time as we gain perspective and talk it over with others, but if not, it’s a good idea to talk it over with a therapist.

Brief prevention programs, on the other hand, seem not to be very effective in reducing rates of suicide – no more than those one-shot high school drug education assemblies made a long-term difference in who would eventually use or develop an addiction. What is likely to make more of a difference are long-term, ongoing factors. To what extent does an individual feel connected to, cared about, and accepted by a community – of friends, coworkers, fellow congregants, etc.? To what extent do lawyers allow themselves to become overwhelmed with burdens (cases, finances, home life, etc.) and tell no one, because of a perceived need to always appear in control? And although in many cases we see no advance warning of a suicide, do we make ourselves available to listen when something seems amiss with a colleague, or do we feel that acknowledging human frailty on the job would be a faux pas?

These kinds of factors probably make a great difference in the path toward (or away from) the sense of entrapment or despair. Listening is a powerful antidote to the sense of aloneness and isolation, but it’s hard to come by nowadays. Primary care physicians, back in the days when they were known as “general practitioners,” had time to listen. Managed care, combined with the cost of maintaining their desired lifestyle, has made it almost impossible for physicians to take time with patients, as you may have noticed last time you went to the doctor.

Fortunately, the vast majority of lawyers, even the many who may have fleeting thoughts of suicide, never reach the point of readiness to take their lives. But at the lawyer assistance program, we often wish that people had come to see us sooner – before the onset of severe symptoms or the license suspension or the daunting pile of unopened mail or the drunk-driving arrest. People tend to put off reaching out for help, a feature especially prominent in lawyers (and also doctors) – those who feel they should be the “knowers” and not the “needers.” [Lawyer assistance programs, however, are not emergency services; if the danger of harmful action is imminent, the appropriate resource is an emergency room, or if slightly less imminent, a suicide hotline – shown for each state at suicide hotlines.com.]

I feel particularly heartened when a lawyer comes to LCL accompanied by one or two friends/colleagues who have prevailed upon him or her to see me for assessment. There is no need for the concerned party to diagnose the problem – just to recognize that something is wrong and to not turn away. Sometimes, of course, the colleagues are partners in a firm seeking to avoid losing a valuable lawyer – and that’s certainly a good idea. But at other times the only motivation is friendship and human concern, motivation of a higher order. Although some individuals, whose covert agenda is to avoid change, find ways to give lip service and evade my further attention and recommendations, some actually grab the lifeline and embark on a path toward health.