Add in “Legal Professional” and you have The Perfect Storm SHAME and STIGMA Add in “Legal Professional” and you have The Perfect Storm Stephen M. Delisi, MD Hazelden Betty Ford Foundation

STIGMA FEAR SHAME Law culture concerns Long hours Meticulous adherence to high standards Client dinners and business generation High stress Lack of control High job dissatisfaction Isolation at work Highly competitive – at times adversarial Hush-hush mindset STIGMA FEAR More likely to have intimate partners who also have substance use disorders SHAME

CHARACTER TRAITS OF EXCEPTIONAL LEGAL PROFESSIONALS Capable Reliable Analytical Intelligent Sensitive Kind Caring Giving Dedicated Perfectionistic

CHARACTER TRAITS OF LEGAL PROFESSIONALS WITH MH/SUD Capable Reliable Analytical Intelligent Sensitive Kind Caring Giving Dedicated Perfectionistic

The Treatment Gap Most people in need of treatment do not receive it

Barriers to Receiving Treatment SHAME Barriers to Receiving Treatment Misinformation about addiction and co-occurring dx Negative attitudes about addiction and mental illness Privacy concerns Insufficient insurance coverage Lack of information on how to get help Limited availability of treatment in some areas Insufficient social support Negative perceptions of the treatment process Legal barriers STIGMA

Internalized Stigma Leads one to be filled with Shame (SHAMEFUL) RELATIONSHIP BETWEEN STIGMA & SHAME Internalized Stigma (SELF-STIGMA) Leads one to be filled with Shame (SHAMEFUL)

VICIOUS CYCLE SHAME Addiction or Depression Self-stigma overdose/ Social stigma Self-stigma SHAME Structural stigma Addiction or Depression overdose/ suicide

SHAME Shame leaves us feeling unlovable and disconnected from others. “In the absence of connection and the absence of love and belonging, there’s always suffering.” LONELINESS Brené Brown, 2017

SHAME RESILIENCE “Shame cannot survive being spoken. The moment we reach out and share with others our shame, shame cannot hold on.” Be willing to LISTEN. Create a safe space for people to speak. COMPASSION and GRACE Brené Brown

Know That Treatment Works  Educate So, what can WE do?  Pay Attention  Reach Out  Provide Support DO NOT need to hit bottom – NOTICE – Many times people are RELIEVED that someone noticed and cared. Treatment works, there hope, but you need to create a culture and safe space for attorneys in crisis to seek treatment and gain hope (culture change comes from the top). Know That Treatment Works  Educate

COMPASSION HOPE GRACE Treatment Works! Specialized legal professionals group Staff aware of legal culture and workplace Attend “Bar None” lawyers AA meeting (MN State Bar Assoc. Office) Visited by attorneys and judges in recovery Teleconference with lawyer’s assistance program Tailored assignments HOPE LAPs in 48 states and the D.C. Treatment works, there hope, but create culture and safe space for attorneys in crisis to seek treatment and gain hope. GRACE

Stephen M. Delisi SDelisi@hazeldenbettyford.org (651) 213-4848 None of us got where we are solely by pulling ourselves up by our bootstraps. We got here because somebody bent down and helped us pick up our boots. Thurgood Marshall

“Unspoken shame is the most dangerous form of shame.” The 1, 2, 3 of Shame We all have it Nobody wants to talk about it. The less you talk about it the more you have it. Brené Brown, 2017