Coping Mechanisms for Managing or Relieving Stress in the Wake, or in Fear, of Job Loss (4-Part Series) -- Part III: Using The Time to Your Advantage

While you certainly did not want, and probably did not expect, to be laid off or between jobs, there are certain things that you can and should do now that you have the time. Not only will doing these things help you to present for your next career opportunity at your best, but there is the added bonus of helping you to feel better about yourself, thereby decreasing your levels of stress. The following are some examples of actions that should be taken during this period:

· USE THE TIME WISELY. Think about all the people, places, and things you may have neglected or overlooked in recent years, and use this time to reconnect with people and to tackle some of those projects. You will feel better for having done so, will feel a sense of connectedness which is important at this time when many are tempted to isolate themselves. This will also give you a sense of accomplishment whenever you complete a task. As an added benefit, you never know from where your next opportunity will come. One of those people you reconnect with may prove useful in helping you to determine next steps, to come up with contacts that you may not have thought of, or may have some great ideas or avenues for you to pursue or incorporate in your job search. You never know.

· WORK TOWARDS A NEW AND IMPROVED (AND MORE MARKETABLE) YOU. Take courses, learn new skills, update and hone old skills, in an effort to reevaluate what it is you want to do next (i.e., do you want to continue what you’ve been doing, or have you been secretly yearning, but putting off, doing something else). In the same way that the ABA Recession Recovery Teleconference series is offered free of charge, there have been numerous other offerings in recent months advertising free online courses aimed at helping people to produce better resumes and cover letters, state and local bar association programs designed to assist in assessing one’s marketability and putting together a career development plan, committees dealing with transition issues for lawyers, etc. Check out the ABA website, but also the websites of your state and local bar associations, as well as running a web search for webinars, and other free teleconferences and podcasts.

· KEEP TO A ROUTINE. No matter what, get up and do something aimed at helping you in your job search every day. At the end of every day, make a list or schedule of things to accomplish the next day, and tell someone what it is you intend to do. Somehow saying it aloud helps to give you a sense of accountability. You want to keep up a routine so you don’t feel as if you are aimlessly wandering from day to day, but instead have purpose.

· COMMIT IT TO PAPER. Identify and write down the largest sources of your stress. For many, this is financial. If this is the case, as an initial step, review the spending habits of yourself and your family and think of ways in which you can begin to cut costs. Once written, investigate ways in which to alleviate some of the financial stress and begin to look into them (i.e., with respect to mortgage issues, there are a number of repayment and other programs now available to assist in this effort, and a host of nonprofit entities ready to talk to you about them. With respect to credit card payments, some companies will entertain lowering your interest rates, so it’s worth it to call and ask. There are also reputable credit counseling companies out there to assist you.)

· EAT HEALTHY, EXERCISE MORE, AND LAUGH MUCH! It sounds basic, but it’s important to remember to take care of yourself. You need all your synapses firing at full throttle, and they won’t be able to if you aren’t getting enough rest or exercise, and are eating junk. It is especially important to avoid turning to self-destructive attempts at relieving stress, such as: drinking, drugging, gambling, smoking, and emotional eating, to name a few. Also, it’s been said that the mere act of laughing in and of itself has stress relieving properties. So, read a funny book, go to the movies and opt for a comedy, hang out with your friends who are the most upbeat and funny (and thus, less likely to bring you down).

Even with these coping mechanisms, you may still need professional help with getting through your stressful situation, which may seem overwhelming and all encompassing. THERE IS NO SHAME IN GETTING OR SEEKING HELP, SO PLEASE DO SEEK PROFESSIONAL ASSISTANCE WHEN SUCH STRESS, OR ISSUES SUCH AS ANXIETY, DEPRESSION, SUBSTANCE ABUSE, OR OTHER TROUBLING BEHAVIORS PERSIST. For assistance, please contact us at Lawyers Concerned for Lawyers, Inc. (31 Milk Street, Suite 810, Boston, MA , (617) 482-9600, email@lclma.org, or visit our website at http://www.lclma.org/). Help can also be accessed through your: healthcare provider; local hospital; psychologist, psychiatrist, social worker, clinician or other mental health professional; or community healthcare center.See our web site Resource Page for a list of relevant stress resources.

Ms. Walcott presented this and other material in a program entitled, “Staying Positive in a Down Economy: Beyond The Group Hug” (June 30, 2009), which was part of the ABA’s Recession Recovery Teleconference Series. A download and course materials for this program are available online at http://www.abanet.org/cle/programs/nosearch/tspdmo.html.

Coping Mechanisms for Managing or Relieving Stress in the Wake, or in Fear, of Job Loss (4-Part Series) -- Part II: Shifting One's Perception

Losing a job, for whatever reason, is a life-altering event on many different levels –familial, professional, financial, behavioral, social (etc.) –and affects people in many different ways. For most, however, there are certain experiences that should be simply taken as givens:

1. There will be some degree of worry and/or stress.

2. There will be some level of interest in knowing who is (and is not) going through a similar experience.

3. There will be some people in your life who –for whatever reason –feel the need to constantly update you on how much worse things are than you thought. (I’ve lovingly dubbed these people naysayers, voices of doom, and town criers.)

4. There will be a point in time, however brief, when you experience self-doubt, lowered self-esteem and/or decreased self-confidence.

5. At some point, it will take more of an effort than usual to keep up the social and professional relationships you had when employed, and to continue in your professional extracurricular activities.

In moderation, all of these experiences are completely normal and to be expected given the circumstances (i.e., job loss). It is only when they get in the way of moving forward towards accomplishing your goals that it becomes a problem. The following are some examples of self-defeating actions which should be avoided at all costs:

· WORRYIN’ NEVER CHANGED ANYTHING, SO DON’T GET STUCK ON THE WORRY TRAIN. If you have a lot of free time with nothing to do, that also gives you a lot of time within which to stress or worry. Fretting, worrying, and being stressed or anxious are all normal. There’s nothing wrong with doing any of those things, for a time. Just don’t get stuck there – it’s self-defeating.

· STEER CLEAR OF NAYSAYERS, VOICES OF DOOM, & TOWN CRIERS. While there is certainly comfort in knowing that you are far from alone in this situation, be careful not to spend all of your time dwelling on the negative, as opposed to working towards a goal. Avoid those people who can’t seem to talk about anything other than the state of the economy, lawyer layoffs, unemployment, firm closings, decreases in available jobs, and the like. While I am in no way suggesting that you should avoid discussing what happened to you, I am cautioning against not being able to move beyond it. Also, there will always be those people who tell you all the reasons why you can’t do something, instead of supporting you in your efforts to make an attempt to accomplish your goal. Avoid such naysayers and surround yourself with supportive people.

· DON’T BECOME A SLAVE TO THE MEDIA. This serves no useful purpose other than to stress you out and keep you coming back for more. The media is more likely to give reports focused on the bleak, tragic, downtrodden, and hopeless (from its skewed perspective), than the positive, successful, hopeful, and victorious. That’s just the way it is. While you should absolutely keep abreast of what’s going on around you and what opportunities may lay out there for you, you can accomplish this by quickly skimming your media outlets for this information.

· ACCEPT THE SITUATION, BUT DON’T BE LABELED BY IT. It goes without saying that being unemployed is quite a humbling experience. Use it as a life lesson –absolutely –and if you come out wiser and stronger for it, then you have come out the victor. However, remember that being laid off doesn’t define who you are, or what you’re about. Indeed, it is no reflection whatsoever of your value. Nor is it an indictment of your worth. It’s merely a temporary place called unemployment, which you’ll soon depart.

· DON’T BE M.I.A. Very important: Make sure people know where you are and how to contact you! Often people give their work addresses to bar associations and others as their preferred contact method. After leaving a place of employment, however, they forget to update the bar associations with their new contact information, so they no longer receive notifications of any relevant and/or free course, program, and other bar association offerings. You don’t want to stop getting this information –stay connected. Be sure to also update your alumni offices (law school, college) of your whereabouts because some of them are offering programs as well.

Even with these coping mechanisms, you may still need professional help with getting through your stressful situation, which may seem overwhelming and all encompassing. THERE IS NO SHAME IN GETTING OR SEEKING HELP, SO PLEASE DO SEEK PROFESSIONAL ASSISTANCE WHEN SUCH STRESS, OR ISSUES SUCH AS ANXIETY, DEPRESSION, SUBSTANCE ABUSE, OR OTHER TROUBLING BEHAVIORS PERSIST. For assistance, please contact us at Lawyers Concerned for Lawyers, Inc. (31 Milk Street, Suite 810, Boston, MA , (617) 482-9600, email@lclma.org, or visit our website at http://www.lclma.org/). Help can also be accessed through your: healthcare provider; local hospital; psychologist, psychiatrist, social worker, clinician or other mental health professional; or community healthcare center.See our web site Resource Page for a list of relevant stress resources.

Ms. Walcott presented this and other material in a program entitled, “Staying Positive in a Down Economy: Beyond The Group Hug” (June 30, 2009), which was part of the ABA’s Recession Recovery Teleconference Series. A download and course materials for this program are available online at http://www.abanet.org/cle/programs/nosearch/tspdmo.html.

Coping Mechanisms for Managing or Relieving Stress in the Wake, or in Fear, of Job Loss (4-Part Series) -- Part I: Shifting One's Perception

Almost everyone has a friend or family member who is contending with a layoff, between jobs, or who fears the same may be in their future. There is cold comfort in knowing that one is in the good company of others who share a similar fate, not by virtue of personal or professional shortcomings, but by an economy that has failed them. Even so, such a life-altering event can affect all dimensions of one’s life: finances, for sure, but also family and social relationships, self-esteem and self-confidence, energy, thought processes, and daily routines formerly structured and organized by work schedules. Losing a job, or delayed success in finding a job, is no small thing.
While stress in moderate amounts, or when adequately managed, provides motivation and drive, that is not the case when the stress is in excess. Stress has been described in the simplest of terms as resulting from the way in which one interprets and reacts to events. Accordingly, a person who changes her perception of a situation in a positive direction should, in turn, experience a decrease in stress. The following are suggestions for assisting in this perception shift, and ultimately for managing and relieving stress:
· THIS TOO SHALL PASS. Chances are you’ve been through worse times, and survived darker periods in your life, so keep it all in perspective. Reflect on some of those periods when you thought you just couldn’t make it through, and recall that in spite of everything, you did. You’re a survivor! The ability to cope or deal with adversity is not new to you. You’ve coped and adapted before in a myriad of situations, whether involving yourself or others –including clients! What would you do and advise if a client came to you with this situation? What would you say? It’s important to remember that transitions in whatever form are a natural part of our lifecycle, requiring adaptability and often, the ability to reinvent oneself. Some examples of life events triggering some form of reinvention include: becoming a new parent, divorce, dealing with a major illness (yours or that of someone close to you), having your child go off to college for the first time (empty nest syndrome), relocating to a new country/state/city/town, etc. No matter your situation, remember that things could always be a lot worse.

· CELEBRATE YOU! Reflect on all of your past accomplishments and significant experiences and milestones. Make a list of the things of which you are most proud and grateful. (i.e., birth of a child, wedding day, trial victory, high praise or compliments from colleagues on your delivery of a masterful argument, 1st time finishing a 5K race, watching your child take his/her first steps, the first time you hear your child say “dada” or “mama,” finally reaching the mountain top during a long and arduous climb, losing that final 5 pounds, graduating from college and law school, passing the bar exam, etc.). This should help to put things in perspective and remind you of just how great you are and how much you’ve achieved. Also, it will help you to remember that in the large scheme of things, this is but a blip on the radar. Whenever you feel yourself heading back towards the worry train, remember this list.

· FLIP THE SCRIPT! Rather than think of this as the worst thing that could have ever happened to you, flip the script and look at it as an incredible opportunity. Use the time to reevaluate where you are, both professionally and personally. In terms of the professional, are you doing what it is you really want to do? Too often, we become complacent in our day-to-day lives and forget about some of our dreams and goals. This is a perfect opportunity for you to reexamine your priorities and to take stock of where you are, and where you‘d like to be.

· THINK BABY STEPS OR SMALL, ACHIEVABLE GOALS –NOT LEAPS AND BOUNDS. When trying to lose weight, it is usually ill-advised to think in terms of how much you wish to lose all at once (i.e., 100 pounds). Instead, if you break down how much you want to lose into smaller, incremental portions (i.e., 10- or 20-pound increments), and then tackle it piece by piece, it’s much less daunting. This also allows you to enjoy periods of achievement throughout and it prevents you from having to wait a long time to celebrate an accomplishment. The same should be true of finding your next employment opportunity. If you break it up into small achievable goals, then it allows you to maintain momentum.

· BEEN THERE, DONE THAT. Try to remember that we, as a profession and as a nation, have weathered storms just like this one in the past, and we always get through it, just like we will this time. Nothing lasts forever –not even the current state of affairs.

Even with these coping mechanisms, you may still need professional help with getting through your stressful situation, which may seem overwhelming and all encompassing. THERE IS NO SHAME IN GETTING OR SEEKING HELP, SO PLEASE DO SEEK PROFESSIONAL ASSISTANCE WHEN SUCH STRESS, OR ISSUES SUCH AS ANXIETY, DEPRESSION, SUBSTANCE ABUSE, OR OTHER TROUBLING BEHAVIORS PERSIST. For assistance, please contact us at Lawyers Concerned for Lawyers, Inc. (31 Milk Street, Suite 810, Boston, MA , (617) 482-9600, email@lclma.org, or visit our website at http://www.lclma.org/). Help can also be accessed through your: healthcare provider; local hospital; psychologist, psychiatrist, social worker, clinician or other mental health professional; or community healthcare center.

See our web site Resource Page for a list of relevant stress resources.

Ms. Walcott presented this and other material in a program entitled, “Staying Positive in a Down Economy: Beyond The Group Hug” (June 30, 2009), which was part of the ABA’s Recession Recovery Teleconference Series. A download and course materials for this program are available online at http://www.abanet.org/cle/programs/nosearch/tspdmo.html.

Parity Time

The world of health insurance and managed care is confusing, especially when it comes to mental or behavioral health coverage (interchangeable terms), even for the lawyers who compose our clientele at LCL. In fact, assistance in searching for adequate and covered treatment is one of the key reasons that lawyers come to LCL rather than seek help on their own. Right now, things are changing in mental health insurance coverage (largely for the better), though few consumers are up to date on these changes (which some insurers have not seemed eager to mention, e.g., in their on-line benefits information).

Mental health coverage has long been the “stepchild” of health insurance, partly because it is more difficult to evaluate or define these conditions with precision, or to determine a specific optimal treatment plan. That very vagueness has served as an excuse for inadequate coverage. When I was first licensed as a psychologist in 1981, before managed care, most people in Massachusetts had an old-fashioned Blue Cross Blue Shield policy. By law, those policies covered up to $500 a year in mental health coverage. Believe it or not (partly because, even then, the insurer gave itself a discount), that was enough for at least 10 sessions. Nowadays, coverage is generally defined by number of services (which helps accommodate inflation), and most people have HMOs, which require “pre-authorization” before subscribers can actually utilize these benefits.

In one form or another, insurers have set fairly arbitrary maximums in mental health coverage, even while there were no such maximums for coverage of most physical health conditions. Sick as you might be, even with severe mental illness, once you had used up your maximum for the year (or, occasionally, your lifetime), you were on your own. In 2000, more or less concurrently with a number of other states, Massachusetts passed its first Mental Health Parity law, which removed predetermined maximums from coverage for psychiatric conditions seen as largely biological in nature. These were:
♦ Schizophrenia
♦ Schizoaffective Disorder
♦ Major Depression
♦ Bipolar Disorder
♦ Psychotic Disorders
♦ Delirium and Dementia
♦ Obsessive-Compulsive Disorder
♦ Panic Disorder
♦ “Affective Disorders” (defined slightly differently by different insurers)

In addition, the 2000 law stipulated that, for most other conditions, the maximum number of outpatient visits per year could not be fewer than 24 for adults (thus every Massachusetts-based insurer began covering 24 visits), with no limits for children. Excluded from the law entirely were alcohol and drug dependence, which are often covered up to just 8 sessions per year. (I am not focusing, here, on the maximums for inpatient hospital stays, since those are virtually always kept extremely brief regardless of stated maximums.) It always seemed very curious to me that alcohol and substance dependence were handled this way, since the biological aspects of those behavioral disorders are so central.

What’s new is that, as of this past July 1, Mass. state law has added four more diagnoses (including chemical addictions) to the list of those covered without a hard-and-fast maximum:
♦ Alcohol/Drug Abuse and Dependence
♦ Eating Disorders
♦ Post-Traumatic Stress Disorder
♦ Autism.

This state law does not apply to (a) self-insured plans [where the money that pays the claims comes directly from the employer], (b) MassHealth, or (c) Medicare.

There is also a new federal parity law coming down the pike. It was actually bundled with the measure congress passed late in the Bush term to permit the massive bailout of financial institutions (in this case the “pork” going toward what I regard as a good cause). As of January 2010,

♦ No plan is required to offer mental health coverage, but if it does (which is mandatory in Massachusetts), the coverage for all legitimate mental health diagnoses must be equivalent to coverage for medical/surgical procedures.
♦ It applies even to self-insured plans, but excludes employers with no more than 50 employees.

When the state and federal laws are in conflict, the more consumer-friendly one generally applies.

Two caveats:
(1) Who can say how Health Care Reform (which I support in principle) may ultimately be worded, and whether, as some kind of trade-off, it will override these legislative measures. In any case, I assume it will not take effect before 2011.
(2) Despite the removal of automatic maximums, the insurers will continue to require pre-authorization—that is, HMOs will cover only those services that they have determined are “medically necessary” for an individual. That is a very slippery concept when it comes to mood and behavior problems. In truth, even with reform or with a “public option,” some kind of mechanism is needed to prevent wasteful spending on unnecessary health care. I do wish, however, that someone would come up with a better means of accomplishing that purpose than the cumbersome,(unpaid) time-consuming, and privacy-reducing forms that providers and their patients/clients often face.

In any case, if you are in need of assistance, now is a good time to look for the right therapist. LCL can help with that process if you are a Massachusetts lawyer, law student, or judge, or a family member of people in those categories. Understand that LCL itself does not use your health insurance – our primary service is to evaluate and refer (not to provide ongoing therapy), and is funded through lawyers’ annual licensing fees. We do, and must, take your health insurance into account in the process of our efforts to refer you for further services.

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Update Feb 2010: You may have noticed that we are not hearing anything about the federal parity law from our insurance providers. As a provider, I can tell you that when I look up new patients' eligibility on-line, there are still references to the 24-session/year maximum for diagnoses not on the Massachusetts list of parity diagnoses.

Based on some web searching, it seems that, although in one sense the federal parity law is already in effect, in another sense it is still in a non-final, feedback-gathering phase until July 1 -- so that may be the point at which it will really kick in.

In addition, while most interpreters of the law see it as applying to all mental health diagnoses (thus not just the ones that Massachusetts has deemed parity-worthy), some commentaries note that this only applies to coverage of conditions included in the plan. Although I have seen no evidence of this as yet, it seems possible that an insurance company could decide, for example, that they do not cover substance absue at all, or that they do not cover adjustment disorders at all. My impression is that they could get away with that gambit, because the law only states that whatever is covered must be covered equivalently to medical/surgical conditions, and that providing no coverage whatsoever, for a given condition, gets around that requirement. We'll see. In either case, we should be beyond the 24-session limit that is probably still being shown in your insurance provider's information packet. Caveat: I am a psychologist and not a lawyer or policy expert. My only expertise is that I've been dealing with health insurance claims, authorizations, and limitations (though a series of changes) since 1981 as a working clinician, and that I've taken the time to look up this information extensively on line.

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.

Hello and Welcome.

We, the staff of Lawyers Concerned for Lawyers of Massachusetts, look forward to finding ways to increase our usefulness to the legal community through the medium of blogging.

At this location, you will begin to see a series of observational and informational postings about the human side of lawyering from the perspective of non-lawyers who have interviewed hundreds of lawyers over the years, usually for the purpose of assessing problems that are impeding their functioning (professionally or personally or both). We are excited about adding this means of communication to our existing toolbox, which includes, for example, the many articles and resources posted on our web site, our many types of presentations, our newsletter, and our Q&A column featured in Mass. Bar Association Lawyers Journal.