1. 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

2. 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

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

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

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

6. 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

7. 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)

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

9. 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

10. 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

11. 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

12. 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

13. 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

16. “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