Choosing the right psychologist or therapist can be daunting. Look carefully at the psychologist's or therapist's credentials. As in any area of medicine, someone that says they can do everything, may not be the right person for you. I specialize in stress and anxiety disorders, which sometimes present as depression. It is of course important that the psychologist makes you feel comfortable, but also keep in mind that therapy is about change and making changes in our lives can have uncomfortable moments.
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Attorneys must deal with the same stressors as the rest of us. Balancing work, family, financial pressures, raising children, dating, marriage, divorce, and surviving Thanksgiving dinner in the age of Trumpian politics. But attorneys also have several special stressors, and some of the stressors that most of us need to deal with, often get handed to attorneys on steroids. Let’s look at the stress in attorney’s lives and some tips for self care.
First, attorneys are often competitive by nature and work in a competitive environment. This is more obviously the case for litigators, who are modern gladiators, using paper, pen and their verbal arguments as their swords and shields. The fight hormones and fight brain and nervous system mechanisms exist in order to get us through fights and are in our basic DNA. But turning them on for the courtroom battle, means that attorneys are switching on their fight and flight mechanisms, and may have difficulty turning them off. Cortisol and other stress hormones enable our fight, but when they stay in the system chronically, they have destructive impact on our health, sleep, and mood. Second, attorneys often work long hours and may work on difficult life issues where they are witness to life tragedy. This not only adds stress, it may take a toll on exercise, and encourage grabbing fast food, or too many restaurant meetings. Add to this, attorneys may take their work home in their heads, even if they leave their briefcase at work or undisturbed in their home office. They “work” cases in their heads, go over details of what they did, what upset them, and what they may have missed. In our electronic world, we can add to this surfing the web late at night, checking emails, and responding to work issues late into the night or early in the morn. For many of us, our smart phone is the first thing we check in the morning, the last thing we check at night, and even the thing we check in the middle of the night. Another way that attorneys may take work home is by bringing their adversarial training and experience home to their families. No one benefits from an adversarial stance on the home front. It is the wrong way to be a spouse, partner, friend, or parent. Indeed, this is worse if you are very good at it, as it is a kind of unfair fighting. As an attorney you have been trained to win arguments, and other family members haven’t. So, you are a trained fighter and they are amateurs. Indeed, the very idea that you should “win” arguments at home is the wrong attitude. You should be an advocate for your partner, spouse, friend, children…anyone you care about. You should be looking to see how they can “win” first and foremost and how the whole family, or both friends can “win” together. Sleep can be a big problem for attorneys. Like any busy person, attorneys might not exercise, often sits sedentary at a desk for hours, and has a lot on their minds. Add to this the adversarial aspect of legal work, and you have a formula for poor sleep. Sleep research shows that we need about 7 to 8 hours a sleep per night. It does not matter if you can perform on less, as many people can, but this takes a toll on physical health and mood. Poor sleep is associated with anxiety, depression, anger, heart disease, weight gain, and diabetes. Genetically, we are endowed with a certain number of hours of being awake. We don’t yet know how to read those genetics, but nevertheless you can use your waking hours as you like. In other words, sleep less and you will live less years. Poor sleep makes us edgy, agitated, and more prone to anger and depression. If we have something going on with our physical health it interferes with healing and makes for greater pain. And then we sleep even less. When we don’t get enough sleep, our bodies get a signal to slow metabolism, and so we burn calories more slowly, leading to weight gain with the same number of ingested calories. Poor sleep also becomes a habit, leading to chronic insomnia and shortened sleep patterns. These can be very difficult to break. Given the high stress in many attorneys’ lives, it is no wonder that some might turn to alcohol or even drugs. Alcohol and drug use are all too common among attorneys. How much is too much? The National Institute on Alcohol Abuse and Alcoholism (NIAA) instruct that for women, low-risk drinking is defined as no more than 3 drinks on any single day and no more than 7 drinks per week. For men, it is defined as no more than 4 drinks on any single day and no more than 14 drinks per week. Prior to driving, 2 drinks may be 2 too many. And of course if you double the alcohol in the glass, that already counts as 2 drinks! Even if you drink less than this, 2 drinks can disturb sleep, which means you may not have a drinking problem, but you may have more impaired sleep. Tips for Lowering Stress
Finally, if stress, depression, anxiety, agitation, anger, or poor sleep are weighing on you and not very temporary states, seek help. Psychologists and other mental health professionals have effective tools to help you, as long as you have a commitment to change. If depression or anxiety are really severe, seeing a psychiatrist for medication, who might also bring in a psychologist, is imperative. Psychotherapy can be somewhat costly in terms of both time and money, but your marriage, family, children, and your quality of life are worth the investment. I have had the privilege of working with several attorneys at the end of their lives, and I assure you none said, “I wish I had worked more.” If they have any regrets, they are about not living life fully and not enjoying work-life balance. While I wish you long life, the perspective of how one would see one’s life looking back can help us see what is truly important in our lives.
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During the early dark days of World War II, German U-boats wreaked havoc on U.S. ships bringing vital supplies to our ally Great Britain. Their ships sunk by torpedo, oddly, younger, more fit sailors would more often drown, but older, less-fit sailors would more often survive. Investigating this strange phenomena offered one of the early keys to our modern understanding of resilience.
It seems that younger sailors would give up more easily. But the older sailors had learned an important life lesson: when met by a major stressful challenge, keep trying and don't give up. Even when it might appear hopeless, don't give up hope. As in so much psychological advice, this does not mean that its easy to keep trying and keep rising to the challenge. Life can bring some incredible hardships and sometimes we have brought these on ourselves. But we also have the capacity to "dig deep" and keep up the fight, to change, and to once again thrive. We have the capacity, sometimes with help from friends or family, sometimes with professional help, sometimes with help from a trusted clergy or through prayer, to cope better, go back at the problem, improve our ways of handling internal and external stress. As in my earlier post on "dancing the tango," this often means pushing ourselves to act how we know we should, even before we feel motivated to do so. Actually, we do this all the time. We may listen to our kids or a friend, even when we are tired after a long day at work, or just not in the mood. We go to work when we are feeling like getting back under the covers on a cold, rainy morning. And sometimes, when life has hit us really hard, we need to stay at our daily tasks and routines when we would rather just give up, give in, or move on. So, it's okay to take a break. It is okay to huddle up and regroup. But it's also important to "get back in the game." As in all my posts, if these small "wisdoms" are not enough to turn around your anxiety, depression, OCD symptoms, drinking, or family conflict, it's time to seek professional help. I have often found that patients and clients that come to me, have worked hard to cope on their own, but are ready to engage professional help to aid their journey. Mental health professionals are trained to support you and help you get through difficult times of life. I can be reached at 216-402-3599 or my confidential email: [email protected]. When feeling down or anxious or angry, we often express our mood with our actions. When "down," we tend to isolate ourselves and become more sedentary. When anxious we tend to avoid or act awkwardly. When angry we might become verbally aggressive, make biting remarks, be sarcastic, or yell.
What does this all have to do with "dancing the Tango?" Well, every beginner is awkward when dancing the Tango. So, we dance by mimicry, by putting cut-outs of the dance steps on the floor, by scripting our actions. By acting in a healthy, active, positive manner, our mood often follows. Clinical research shows that mood follows actions. If we get our actions right, our mood often improves. If we act more gently, we become less angry. If we become more active, our depression may decline. If we act more calm, we become more calm. Also, if we "act right," we tend to feel better about ourselves, and our self-esteem improves because we have done something that is hard and met a big challenge. We generally know "how" to act. We know exercise is good, too much alcohol is bad, reaching out to friends is good, isolating ourselves is bad, and so on. In other words, we know what "dancing the tango looks like," even if we aren't very good at it. So, instead of acting in response to your mood, act in response to the script of how you should be acting. Exercise, even if you don't feel like it. Get out with friends, even if you want to binge on TV. Speak up at that meeting at work, even if you feel anxious about expressing your opinion. Act kind to loved ones, or your ex-spouse with whom you share child custody, even if you feel angry. Write the script of how you "should" act, what a positive, healthy day or evening or work meeting would look like, and just act out the script. If this sounds like I am saying this is easy, its not. And that's why I use the Tango metaphor, as dancing the Tango is hard. It takes courage to act in a positive healthy manner when we are not feeling it. As in all my posts, this advice is never a substitute for professional mental health or medical care. If your depression, anxiety, or anger is overwhelming, won't go away, or hurting yourself or your loved ones, speak to your family physician or clergy, or call a mental health professional directly and make an appointment. Changing actions to change mood is part of cognitive behavioral therapy (CBT) and your therapist may use this technique as part of their professional toolbox they have developed with years of training and experience. Summer is a relaxed season and the shining sun and warm weather tends to warm our worries away. So, if Fall brings new pressures, what can we do to keep our more positive summer mood as Fall and Winter come upon us?
Well, one reason summer is often easier on us stress-wise is that we fill it with activities. When the weather becomes inclement we might curtail our program of fun and meeting up with friends and get stuck behind the T.V. This means that keeping ourselves active can be a potential solution to keeping our stress levels, our depression, and our anxieties at bay. Chicago has about 50 theaters for plays, comedy and improv, and there are websites for half price tickets. Several museums have tours, programs and free days for visits. Many organizations and Churches, Mosques and Synagogues could use tutors or help serving lunches or dinners. Keep your workout routine on course, or start one. Join a health club and take classes where you'll meet others, as well as get a work-out motivated by a pro. "Meet-Up" is on line and has endless activities. I had one client who found a group for others who wanted to meet up and throw Frisbees with others that had multiple large dogs!! There are groups for almost every interest. Go dance at the Drake Hotel, which is free, except for the price of your drink. Take a walk along the lake, and better yet, invite a friend to walk with you. Check out the purchase of a special lamp for light therapy. There is good evidence that it works against seasonal affective disorder(SADS) https://www.webmd.com/depression/depression-sad-diagnosis-treatment#1. These are special lamps, but they are available at rather low cost. By all means, don't increase your alcohol consumption beyond a couple of drinks a day, and less than that may be better yet. Alcohol and most recreational drugs may improve mood for a bit, but than have the opposite impact. They also disturb sleep, which makes us more irritable. As in all my posts, I emphasize, that if the stress, anger, anxiety, or depression doesn't go away, becomes hard to face, or starts to interfere with your life, or if family conflict rises, talk to your family physician or seek the help of a mental health professional. Many clergy are also well-trained to start the conversation with you and if necessary refer you on to a mental health professional. Often, we feel anger or hurt over something someone did to us. This could have been during our childhood, or it could be more recent in a close relationship, or at work. These memories can be the main causes of our anger, depression, or anxiety. They can result in our changing our lives in ways that continue to hurt us and our new relationships. They can be obstacles to new, wonderful opportunities. So, the question is, "Why let them?"
I am not saying it is simple to move on, but it is a must that we do so if we are to enjoy our lives, enjoy new love, sleep well, work productively, and unload the anxiety, anger, and depression we carry. So, here is a thought. If these people hurt you, do you really want them to have that continued power over you? I hope your answer is a resounding and emphatic "No!" and that means you have to set aside what they did and move forward. This does not mean you have to forgive them, and it does not mean you have to forget them or what they did. But it does say, that you need to tell yourself that "I will not be consumed by what they did to me." "I will not let them reach across time and negatively define me." If you feel a need to continue to think about what they did, schedule a couple hours each week to go over it, and perhaps journal your thoughts. But, keep that time for this review and tell yourself that your other hours of the week are for you, your enjoyment, your loves, your passions, your friends, your hobbies, your work.....your life. As in all my posts, these are not substitutes for psychotherapy. And I encourage you to seek the help of your family physician or a mental health professional, if your anxiety, depression, or anger are getting in your way or causing you significant hurt. The above exercise is an essential tool from Cognitive, Behavioral, Therapy (CBT) and one your psychologist, psychiatrist, or social worker might use. It is an exercise I often use for my patients, and quite honestly for myself. We grew up hearing that if you can't sleep, count sheep. Turns out, it is not as silly as it sounds. When we are worried and can't sleep with something on our mind, we keep going over the same worries repetitively. Indeed, we can get really revved up and unable to fall asleep. That's because thinking of worries turns on our fight/flight part of our nervous system. If we need to fight or flee, we don't want to be all relaxed and sleeping.
So, where does counting sheep come into this? Well, sheep are harmless and kind of fluffy and cute. And counting is rhythmic. So, we are doing two things that turn on our rest and relax, parasympathetic nervous system. Now, let's say you don't really want to count sheep, are there any alternatives? Actually, there are. You can imagine a beautiful ocean and make as complete a picture of the ocean in your mind. Then imagine yourself comfortably sitting on the warm sand and count waves. You can even tell yourself with each wave I am more relaxed. Or, you can count your favorite vacation spots. Imagine each one as fully as you can. The other reason that this can offset repetitive thinking about worries is that you are doing two things, imagining and counting, and you are really working on imagining fully. When our minds are doing two things, there's not much room for a third--our worries. Our minds may drift back to worries, and we may have to push ourselves to get back to the pleasure imagining and rhythmic counting. As with any advice like this, if it does not work, and if worries are really troubling you, try sharing them with a friend or loved one, as seeking support can really help reduce our anxiety. And if that doesn't work, it's time to talk to your family physician or a mental health professional who is trained in addressing such problems. Sleep is critical and essential to mental and physical health. Here are some tips from the National Sleep Foundation as well: https://sleepfoundation.org/insomnia/sleep-news/sleep-tips-insomnia-sufferers. Wishing you the blessing of a good night's sleep. www.stress-resilience.com This blog is just to bring some interesting ideas from cognitive psychology to your attention. And some of it, may bring some new insights for you.
We like to see ourselves as acting rationally and that our behavior follows our clear thinking. The fact is, our behavior is just too complex to be thought through by our conscious thinking. Let's look at an example. When we enter a room at a party, we don't think, "Okay, how should I behave now?" Rather, we just involve ourselves in the goings on. Yet think about how complex being at a party is. This person is not so close, tell her less. This person is a close friend, tell her more. The party is work-related, so drink less. The party is with old friends, so talk about old times. We don't think and decide these thoughts and behaviors, they just sort of come "naturally." How else might this "below the surface thinking" affect us? We are more cautious with people who don't look like us--its a built-in bias left over from our evolution as humans. Research even suggests we are more friendly with a warm cup of coffee in our hand because we find it soothing. John Bargh, a noted Yale psychologist, found that if we are sitting in a hard chair, we are tougher in negotiations. He also found that if we holding a heavy clipboard in an interview, we think the applicant is more serious! Again, we didn't think through those things, they are ways we "think" that comes from below our level of awareness. How is this relevant to our psychological distress or conflicts with others in our lives? Well, once we've created a framework about someone or some others, we create a distorted prism and any new information comes into us through that distortion. We do it politically and we do it with family members. People certainly are prone to do it with their ex-spouses. And we do it with how hard we are on ourselves, harder than we would be with someone we loved. So, perhaps we can step back and be a bit more truly thoughtful, gentle with ourselves and others, ready to take off the distorted prisms we have developed. As in all my posts, these are not meant to in any way be a substitute for psychotherapy and counseling. Rather, they are attempts to share knowledge that psychologists have developed through their research. If you are reading this because you've been feeling a lot of distress, anxiety, or depression, talk to a mental health professional, talk to your family physician--help is out there. www.stress-resilience.com.  Being told to "Count your blessings," when you are hurting can be maddening. "Can't they see I'm sad, anxious, troubled?" But research suggests that counting blessings and expressing gratitude, in your head or in writing, can have value. First, it reminds us that things aren't all black and dark. We tend to overweight the negative and undervalue the positive, especially when we are in a negative spiral, so counting blessings and expressing gratitude counter-balances this natural tendency we have. Second, if your busy counting blessings, you are not going over and over the negative things that are on your mind.
But, what if you find yourself low on blessings? Well, perhaps that's a sign to work on building blessings. Work on friendships, work on our relationship with our children, parents or siblings, work on our marriage. Maybe its time to go back to school, or get that additional work certification. Maybe its time to work on our health, exercise, eat healthier, drink less. Perhaps its time to go back to Church or Synagogue or volunteer to help others, sharing your skills and creating blessings in another's life. If you are stuck and can't seem to turn around your anxiety, depression, or distress, that's when you might want to start a conversation about this with your family physician or look to a psychologist or mental health professional. Many people benefit greatly from psychotherapy and the help a mental health professional can provide getting you on a positive track. The essence of therapy is a positive relationship with a caring professional, identifying where you are undervaluing what you have, and helping you make changes to improve the quality of your life. www.stress-resilience.com Often when we have worries on our mind, troubles, or fears we review them repeatedly. We go over and over what happened, what could happen, or what should have happened. Like a tornado, these thoughts can gain speed and power, and our anxiety accelerates accordingly.
There is some good in our doing this, as our minds are searching for solutions. So, here is a strategy that can help. Schedule a half hour or an hour (at most) a day and write down what occurred, what you fear will occur, and your "solutions." But make that the time for this "work of worry." After a few days, you will usually see that there is nothing new to write down, but if there is write that down. Make this the "worry time," but let the other 23 hours a day be time you don't do this worry. Fill the other time with your work, family time or time with friends, time to seek entertainment, exercise, healthy eating, and healthy sleep. When thoughts or worries pop into your head, tell yourself that you will attend to that during your scheduled worry time, and if true, remind yourself that you've already written that down, so "nothing new there." A psychologist or other mental health professional can help with this, and if trying this exercise on your own leaves you still too anxious, depressed or feeling overwhelmed, it may be time to seek professional help. Nothing in a blog, mine or anyone else's should be seen as psychotherapy or counseling. But from reliable websites we can learn some general principles that apply broadly and can help us out. One such general principle is the importance of preserving or starting healthy routines. Healthy eating, exercise that doesn't overdo your level of conditioning or health, reading a good book, yoga, meditation, visiting with supportive friends or family, can all help ground and stabilize us. Oftentimes when we are in distress we will say, "but I don't feel like doing that." Research suggests that feelings follow behavior, and getting active with healthy behaviors leads to better sleep and better feelings. And speaking of sleep, keeping a positive sleep routine is critical. If you are really not sleeping, I suggest speaking to your physician, as he or she can help with that, as sleep is fundamental to well-being and your health. A psychologist can also help with insomnia, and indeed research shows that psychological treatment of insomnia is often more effective than medication. A poet once said, "Be gentle with yourself," and caring for ourselves is a gentle act.
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Dr. Stevan E. Hobfoll
40+ years experience. Archives
October 2018
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