Dec 23

For those in recovery, especially new recovery, the holidays can bring increased risk of relapse.*  AA provides a wonderful extra resource at this time of year:  the “Alkathon,” a very long, ongoing meeting welcoming walk-ins at any time with a sober, encouraging embrace.  Click here for a link to the Boston-area list of alkathons for both Xmas and New Year’s. (Scroll down to Page 3.)

*Watch out, too, for the post-holiday relapse phenomenon, that goes something like this.  “I got through the holidays; the danger is past, and now I deserve…..”

Sep 27

 

LCL attends Harvard Wellness Fair

I was pleased during my recent visit to Harvard Law School Wellness Fair to be able to speak with so many students about how Lawyers Concerned for Lawyers (“LCL”) exists to help lawyers, judges and law students.  Although many students were not aware of LCL and its mission, they were certainly attentive when I explained the services provided by LCL.  As can be found at the students’ tab, LCL is here to help students learn to cope with common issues like stress and procrastination, and successfully overcome more difficult issues such as mental health issues, substance abuse or alcoholism.  LCL’s clinicians are experienced and helpful, and our recovery meetings are welcoming to law students.  Moreover, Harvard Law students need not travel far for a recovery meeting, because there is a LCL recovery meeting at the law school.  In addition to LCL resources, Harvard Law School also provides helpful information at its HLS Wellness blog

I not only enjoyed meeting with the law students, but I also had the pleasure of meeting a fascinating individual traveling through life.  Samuel Jay Keyser, Professor of Linguistics (Emeritus), took the time, as he strolled towards his office at MIT, took time to stop and chat.  He was also kind enough to introduce me to his blog, The Reluctant Traveler.  Included in his wide ranging discussions about travel, are two posts pertinent to Harvard Law School, justice and judgment, My Favorite Spot.  Thank you, John Safer and the related Releasing the Sword in the Stone, September 15, 2013 Not surprisingly, given Professor Keyser’s profession, the posts were educational and thoughtful in discussing issues of justice and judgment.  For me, however, the power of the posts was that his discussion would not have been possible but for the author’s willingness to slow down, to contemplate that which was about him, to allow curiosity room to explore, and to give himself time to understand.  As a result, blobs became objects from which lessons could be learned.  Go ahead, slow down and read Professor Keyser’s posts.     

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Mar 21

More than 20 years after Managed Care aggressively changed the world of health insurance, for better or worse, many people still believe that they are covered for “rehab” of the sort that they see Dr. Drew providing on cable TV.  I still have fond memories of the days when it was a fairly simple matter, when meeting with an alcoholic or addict whose personal and family life was in disarray, to get him or her a bed at places like Spofford Hall or Edgehill Newport – these were perhaps the premier rehab facilities in New England, and neither of them survived the advent of managed care.  I must admit a 28-day (inpatient) rehab was “overkill” for some of these cases, but at the time, that was the default clinical approach, and when an addiction counselor spoke of “treatment,” it usually referred to that type of program.

For years now, with the exception of a couple of nationwide insurance plans (which seem to cover facilities largely in Florida) as well as specially configured union plans for individuals such as pilots and pro athletes, health insurance covers very little in the way of inpatient treatment – generally limited to medically necessary detox (only when necessary to mitigate withdrawal symptoms).  Sometimes it is possible to get insurance to cover a subsequent couple of weeks in a “partial hospital” or “intensive outpatient” program (consisting typically of 3 to 5 clinic visits per week, each lasting from about 2 hours to about 6 hours), and in a few places one can also arrange to reside on site while attending a partial hospital program – these approaches are much less costly than rehabs, and provide a diluted version of some of the same benefits.

A more traditional rehab will cost over $30,000 for a month’s stay; do not expect your Blue Cross, Tufts, Harvard Pilgrim, etc. policy to cover it.  There are programs that cost somewhat less (e.g., with reduced lengths of stay or staffs consisting mainly of counselors with less in the way of medical care).  And if a person needs a sobriety-oriented residence as a next stage of recovery, there is also a 2-tiered world – very comfortable accommodations for those who can afford to spend well over $1000 a week, or relatively rough [but sometimes life-saving] halfway house environments (with long waiting lists) for those without wealth.  (More to come at a later date.)

Jeff Fortgang, PhD, LADC-I

Feb 01

Many years ago when I was first trained as a clinical psychologist, patients’ interest in self-help books was often viewed as a cheap substitute for psychotherapy, and their requests for book recommendations was sometimes deemed a form of resistance to therapy.  In my own memory it was the world of alcoholism treatment, and then the 1980s explosion of interest in adult children of alcoholics, that opened the door to what is sometimes called “biblio-therapy”.

Things have certainly changed, and now, according to a study by psychologists at the University of Scranton, 85% of psychologists polled found that their patients/clients reported benefitting from self-help books, and 57% said the same of autobiographies.  Reviewing these results recently in The Register Report, a periodical for psychologists, the researchers had provided a list of the top 50 self-help books and top 50 autobiographies for issues including grief, depression, bipolar disorder, substance abuse, and more.  [Unfortunately they have taken down these pages since this blog was originally composed, but if you need ideas feel free to call Dr. Fortgang at LCL.]

Jeff Fortgang, PhD

Jan 14

As a clinician at LCL, I recurrently have the opportunity to meet lawyers who present with exceptional academic backgrounds, who have excelled in their careers, and who have shown impressive vision and determination in their professional lives.  Even so, the matters bringing them to me are reminders that depression, addiction, attention deficit, anxiety, and the like are equal-opportunity problems, and that these individuals are no more immune from them than those whose backgrounds are less extraordinary.

One reason for that is the fact that different parts of our brains are, in some respects, at war with one another.  Rationality, decision-making, goal-directedness, etc. are functions that seem to go on mainly in the prefrontal cortex, a part of the cerebrum that is uniquely evolved in humans, and we’d like to think that we employ our cognitive capacities to control our lives.  But the fact is that much of our behavior is affected strongly by the limbic system, where we find the influence of emotion and reward.

Lawyers seek to live professionally in the prefrontal cortex, which is essential in the practice of law.  But they are human beings as well, and subject to the powerful behavioral impact of feelings (whether or not these are acknowledged) and reward states (such as those that can be unnaturally elevated by alcohol and other drugs of abuse).   Thus, we find highly intelligent, accomplished individuals, who have tried to apply their reasoning skills to problems of emotion or addictive behavior only to see these difficulties worsen.

We all have to recognize that there is much of life over which we have little or no control, and that when it comes to those parts of our experience we will probably benefit most from (a) acceptance of our human limitations and (b) willingness to make honest connections to others as sources of help.

Jeff Fortgang, PhD

Dec 10

Here we are at the time of year when we are occasionally reminded to be grateful (perhaps superseded, these days, by reminders that true fulfillment requires cars, jewelry, or smartphones).  And of course the recommendation for an “attitude of gratitude” has long been a prominent recommendation for a sane way of life in 12-step groups.  All very nice, but what does it offer the hard-headed professional, such as a lawyer well trained in finding the holes in any argument?

Now there is a growing body of systematic psychological inquiry into “the grateful disposition,” notably in the lab of UC Davis professor Robert Emmons, author of books such as The Psychology of Gratitude (Oxford University Press).  He has found, for example, that people who kept gratitude journals reported fewer physical complaints, made more progress toward personal goals, and were more attentive, optimistic, generous, and energized.

Dr. Emmons’ colleagues/collaborators in the field of gratitude include Michael McCullough, PhD of University of Miami and Jo-Ann Tsang, PhD of Baylor University.  If you’d like to self-administer the Gratitude Questionnaire (GQ-6) that they developed, you can link to it here and then find scoring instructions here.

Jeff Fortgang, PhD

Nov 20

NO LONGER A “HAVE-NOT”
Halfway through my final year of law school I stumbled into the Milk Street office of Lawyers Concerned for Lawyers (“LCL”). I had been mysteriously tumbling down some slippery slope to the bottom. Bruised and battered and homeless after an alcohol-emblazoned domestic violence skirmish, I sat, hands folded neatly in my lap, explaining my crisis to the LCL counselor, Barbara Bowe: I had just awakened “the morning after” with no job, no home, no law degree, no way to finance my legal education, and absolutely zero dignity.
“My chief problem is that I am a HAVE NOT!” I wailed. “ALL of the other law students have family fortunes, or spousal incomes to get them through. MY family couldn’t contribute a dime – NOT A DIME! I SAY – towards my law degree.” Bewailing the fall from the heights of my professional aspirations, I cradled my heavy aching head in my hands and spewed it all out: the struggle to attend college sans parental involvement, the double dose of LSATs, and my crushing Chapter 7 filing. I looked through the ceiling and declared, “The only thing I ever wanted in my life was to be a lawyer!” What I didn’t realize in my haze of self-pity was that last night’s binge might be an itty bitty clue in understanding this avalanche of failure. Inexplicably, but for denial, I was perfectly poised to die a lonely alcoholic death.
Alcoholism and addiction do not discriminate between the illiterate and the post doc. Somewhere between the two, I managed throughout law school to avoid the ER, the detox, the sexual assault office, and jail, and clawed my way along the muddy bottom – until 8 months after that first fateful day at Barbara’s office, and 2 months after I sat for the Bar – when I finally surrendered to the AA program. A progressive 13-year drinking career, combined with law school stress resulted in my hitting the bottom hard, and I realized that I would never be the “one thing I ever wanted to be” unless I started taking care of my brain, my body, and my behavior.
A founding member of LCL introduced himself to me at the first AA meeting I attended. I was moved by his honesty, humility and 30-plus years of sobriety. Suddenly I realized I was not alone. That changed everything! Not that I hadn’t TRIED it before. But, being a rebel from an arch conservative Christian home, I found the whole mention of “God” in the halls of AA to be profoundly annoying. Among my thoughts towards the program was, “They PRAY?! Still just a drunk, but this time, being unequivocally broken, I was willing to try anything. That budding willingness eventually blossomed into FAITH.
Slogging through my first few months of sobriety with the patient guidance of my AA sponsor, I began to recover. A slow and testy immersion into the wash of AA’s 12 Steps brought something akin to relief, including relief from my incessant hollow cry of “not enough.” For the first 32 years of my life I had tried with insane determination to fill that hollow with a future professional identity as lawyer. Lo and behold! The only thing I ever really had was ME. And the only thing I could really change was ME. Attending meetings, working the steps with a sponsor, and fostering supportive relationships with other alcoholics gave me the courage to engage this process. Putting down the bottle and cutting up the credit cards was the first step towards understanding and accepting my emotional needs, which helped me to then begin to discover a truer and more authentic self.
My first year of sobriety was like dawn in the middle of mountains I had driven into at night, unable to see how big they were! I discovered that underneath all my bluffing and lawyerly bravado was a frightening inability to accept certain emotional and practical realities about myself and my life, among them, that earning a regular paycheck is a necessary step in providing for myself. Waking up from that 12-year emotional hangover exposed what appeared to be insurmountable professional obstacles. “Life on life’s terms” had dictated that I graduate law school during the worst employment crisis for new lawyers. I found I myself just another bozo on the student loan crisis bus, buried by fear and financial insecurity, with a student loan debt of $175K and a first year Associate position that paid about $12.00 an hour (before taxes).
LCL has helped me to address work challenges. Barbara connected me to the LOMAP program and Jarred Correia. DING, DING, DING went the bells in my heart! With LOMAP’s help and counsel, I have learned that I can propel myself into a legal practice without flying under someone’s overbearing or exploitive wing. LOMAP offers, in addition to much practical information, a most valuable (to me!) emphasis on self-esteem and personal confidence. Since working with LOMAP, I have tapped into the temporary contract market for new lawyers and am earning reasonable compensation while developing the greatest resource available to new lawyers – a professional network.
Making it as a lawyer in today’s climate requires much more than a J.D. and a license to practice. It demands consistency of purpose, patience, sacrifice, humility, and the ability to dodge disillusionment. I strive toward these objectives through a fellowship with other alcoholic lawyers, and by asking for help -A LOT! I am, of course, still committed to the one thing I always wanted to be, a lawyer.
Despite my missteps, LOMAP has given me the confidence to try. I embrace the process of professional development, and welcome the autonomy and personal responsibility it requires. Happily, Sobriety, and acceptance of my need and desire for healthy, supportive relationships enables me to understand that my life today is much more than just being a lawyer. It is, most importantly, the FAITH that I am not alone as I traverse the peaks and valleys of life “on life’s terms” as it stretches out before me, before all of us.

Nov 16

The International Lawyers in Alcoholics Anonymous (ILAA) now offers online meetings each Monday at 8 pm and 10 pm.  To join ILAA and attend the meetings, anyone who is in recovery and was ever admitted to the Bar can register, log into www.ILAA.org, and click the button on the right hand side of the page for “online meetings.”

Apr 27

A news article in a local Massachusetts newspaper reported the recent arrest of a lawyer late one night for drunk driving, endangerment of two young children in the back seat, and other charges. I glanced at the comments posted by readers in response to this article, and was dismayed by how contemptuous and cruel they were……

Apr 27

[Originally published in our recent newsletter:] My Name is Fred. . . and I am an alcoholic…. I volunteered to share my story here in the hopes that others of our honored profession who are similarly afflicted may catch a glimpse of the wonders of LCL and be encouraged to utilize this incredible resource. …

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