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Cognitive Wellness for Lawyers: Creating a CBT Toolkit

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Cognitive Wellness for Lawyers: Creating a CBT Toolkit

Cognitive wellness is critical to lawyers’ long-term success. Negative mindsets, perfectionism, and anxiety can contribute to declines in cognitive wellness. When these declines in cognitive wellness impair your ability to effectively practice law, you may be violating your professional obligations. In this course, Dr. Patti McCartney introduces participants to Cognitive Behavioral Therapy (CBT)-based methods for sharpening cognitive tools. Attendees will learn how this rational approach to reframing challenges can help you distinguish yourself in the management of cases and professional conflicts.

Transcript

- [Dr. McCartney] Hi everyone, my name is Dr. Patti McCartney. I am a board-certified naturopathic doctor, an animal naturopathic doctor, a cognitive wellness coach, and most importantly for today's topic, I am a licensed Texas attorney. I'm also the founder of the Lawyer-Doctor.net, which is a cognitive wellness platform where I offer micro coaching and videos as well as additional resources. So today I'm excited about talking on one of my favorite topics, which is cognitive wellness. Specifically for today's presentation, it's gonna focus on cognitive wellness for lawyers creating a CBT Toolkit. Now, if you're not familiar with what CBT stands for, I'll be explaining that in just a moment, but let's go over some of the learning objectives. And that is understanding the importance of cognitive wellness for lawyers, recognizing the different types of cognitive distortions, and how they can negatively impact our ability to practice and effectively represent clients, as well as implementing CBT methodologies that will increase cognitive wellness and benefit the practice of law. Understanding lawyer cognition. So most of us understand the term of cognition, but I've included explanation and description here, that term cognition refers to the learning and memory. And learning is of course, we know the ability to acquire new information such as performing legal research, or familiarizing yourself with the facts of a client's case. Memory refers to the storing ability of the information, and to use it for future purposes. This is a lawyer's ability to recite case law or present an argument at a hearing. And then neurons are the nerve cells that communicate information throughout a lawyer's brain. The brain comprises of approximately 100 billion neurons that make up networks. Neurons are also responsible for transmitting and for the uptake of the neurotransmitters, which are chemicals that relay information through the brain cells. I know that's a little bit of a science-y technical description, but just so you understand the importance of the cognitive aspects of who we are and how much we rely on our cognition as lawyers. Our professional obligations, before we go further, let me just go ahead and cover those. As lawyers, we understand what our obligations and responsibilities are, and we also recognize that these are the minimum standards for our practice. And of course, we always strive to do more and reach a higher level of professionalism, but the standard and the minimum requirement is that we provide competent representation to our clients, and that the competent representation means that we exhibit the legal knowledge, the skill thoroughness, and preparation reasonably necessary to our representation. The reason I've included this is because it's hard to measure up to that level of exhibiting the legal knowledge, and skill, and thoroughness if we're not maintaining our cognitive health. If our cognitive wellness is suffering, I would argue that we're finding it hard to meet that level. And then the lawyer-client relationship, a lawyer shall act with reasonable diligence and promptness in representing a client. Again, if you're not cognitively sharp, if you're not at your best, it's going to be hard to have the level of diligence you need to thoroughly and zealously represent your client, or at least I would argue that could be the case. Then ABA model rule 1.16.a.2, which requires that we withdraw from representation if our physical or mental condition materially impairs the lawyer's ability to represent the client. Now, without getting off into what materially means, or an examination of this model rule, which is outside the scope of this presentation. I do wanna highlight the fact that it does say physical or mental condition. In the end, we have to be our own best advocate, we have to be our own best doctor, and yes, we have to be our own best judge as far as what our abilities are and if we're able to fulfill those obligations for our clients. Nobody wants to be on the wrong end of a disciplinary complaint because we fail to apply these standards to ourselves. As lawyers, this requirement makes it all the more important that we devote the necessary time and attention to prevent and resolve cognitive issues as they become noticeable to us, and before they become problematic. So also we understand that we're in a profession that is a cognitive profession. We can't do our jobs if we're not able to think, analyze, interpret. Those are all functions and skillsets that our clients pay us for, they rely on us to fulfill. So because it's a cognitive-based profession, I would argue it's critical that we take whatever steps necessary to maintain our cognitive wellness. Obviously, these standards can apply if you're already at a place where your cognitive wellness is at issue, but I hope you can apply this information and walk away from this presentation, or step away, or shut it off, whatever the case may be with a better sense of proactive measures you can take. And that's one of the factors that I find so interesting about CBT, and why it is so effective for lawyers. So as promised, now's the time to define what CBT is, and get a better understanding of how it can be so effective in assisting lawyers. CBT, not to be confused with CBD, which is the cannabis oil. CBT is Cognitive Behavior Therapy, and it is one of the most recognized and effective therapies for lawyer mental wellness, and you'll see why as we continue in the course. CBT focuses on the unhealthy thoughts that we may have, our belief systems, our attitudes, even our biases. And it equips us with the necessary tools to help us reframe our thoughts into healthier and more realistic thoughts, feelings, emotions, and even moods. One of the reasons CBT is so successful is that it is short-term is problem-oriented and it incorporates an intensive approach through talk therapy. The history of CBT, Cognitive Behavioral Therapy is rooted in the concepts of Aaron Beck. He is the founder of cognitive therapy and Albert, I'm sorry, and Albert Ellis, the founder of Rational Emotive Behavioral Therapy. And CBT was created in response to the more traditional forms of psychoanalysis adopted by Sigmund Freud and Carl Young, and the realization that there was more to be done in the development of psychology and with regard to assisting individuals with everyday issues, stress, anxiety, depression, those were really the motivating factors for Beck in creating CBT. And he identified thoughts that he referred to as being quote, "Automatic thoughts," unquote, which were responsible for the negative thoughts that individuals have about themselves, their future, and the world around them. By recognizing these thoughts, Beck was able to assist his patients in replacing the destructive views with the thoughts that were more realistic and affirming. I put the automatic thoughts in quotes because that's an actual foundational belief and foundational principle of CBT. So core concepts of CBT for lawyers, as an evidence-based form of talk therapy, which all lawyers should love because it's talking, and we're so strong on communication, we understand the value of communication, so I think that makes CBT all the more of a perfect fit. But there are some key concepts or principles of CBT, which should be considered. CBT incorporates goals and targets for problem-solving. CBT concentrates on the present rather than dissecting the problem's origins. We've all seen the movies where someone's laying on the couch, and the psychologist or the psychoanalyst is saying, "Tell me about your childhood, let's go back in time." That's not how CBT works, CBT deals with real-life present situations. It takes the individual where they're at, which is great because we live in an ever evolving, fast-paced world where the stresses are continually mounting and changing for us, especially within the legal profession. And so it's incredibly beneficial to have a tool like CBT that can adapt with us. And also CBT is limited in duration, so we're talking 12 to 20 sessions if you're doing it in a formal sense. We're gonna explore some self-help aspects of CBT shortly, but either way, this is a form of therapy that's intended to be short-term. It's not, again, like those stereotypical mental health therapies where individuals are going for months or years on end where it seems like they never advance, and they never complete their therapy. That's not the way CBT is working. And frankly, we need something that adapts more to our lifestyles. And before I go on to why CBT is beneficial for lawyers, let me just say one of the reasons I'm passionate about this for lawyers, and one of the factors in creating this presentation and how grateful I am for Quimbee in wanting to offer it in their library or catalog of courses, is because of the mental distress that the profession is facing. And we've known about that level of distress, or we've known about problems with regard to mental health issues in the profession for more than three decades. And although some measures have been taken, clearly by the statistics, we continue to see year after year, not enough work has been done. And so I am so passionate about helping lawyers and making tools available to them, that fit their life and their schedules, and work with them and help compliment their lifestyles. As a naturopathic doctor, naturopathic medicine is a form of complimentary and alternative medicine CAM for short. So I am always looking for ways to add complimentary information, and advising, and educating lawyers on tools that can help them succeed because in the end, we're all in this together and we want the profession to succeed and excel, and we want each individual lawyer to succeed and excel. So that's just an explanation of why I love this topic so much, and why I'm excited to bring it to you. So without further ado, why CBT is beneficial for lawyers? Unlike many therapies as we just discussed, CBT is rational and it's practical in its application, those are qualities that lawyers love, right? I mean that's who we are, we're rational thinkers, and we are problem solvers. And those factors make it ideal for lawyers, and again, for our cognitive wellness. The process is based on a goal-oriented approach that addresses problems that stress lawyers out on a daily basis and disrupts their ability to function in an optimal manner. Some of these are problems we may not even be aware of, but again, my training is on proactive and preventative medicine, and proactive and preventative care and strategies, and that's what I wanna bring to you. So if you're saying, "Well, I don't need therapy." Great, awesome, hopefully we can keep it that way. And perhaps something you learn here will make you feel even more secure and confident in your mental wellness. And mental wellness is an area that you can never say, "I've licked this, I don't need any more tips, "I don't need any more help, I've got this. "I don't have to give it a thought." Not in our profession as we know. Again, the statistics don't lie, they show that this is an ongoing struggle. And as I've said in a recent presentation, I would much rather help lawyers love the profession than rather give them another reason to leave the profession. Our profession thrives if we stay in and make it better than it was when we entered the profession. So key principles of CBT. What we think affects how we act and feel. And what this basically means is what our thoughts are and what our perceptions are, are going to determine how we act, our actions and our feelings, our emotions. Also what we do affects how we think and feel, so we may think our actions have no relationship to our thoughts, but that's just not true. So the actions we take are impacting, it's this relationship of how each aspect of our life, our wellbeing, and our cognitive health impacts another area. And finally, what we feel, in other words, our emotions affect how we think and act. So you may not feel or believe that if you're having a bad day or a rotten mood that it's going to impact your ability to do your job, or how you act toward a client, or a supervisor, a partner, or opposing counsel, even a judge. But it does, most of us can relate and go back and understand that there are times where we've felt horrible. Either we were sick, or we were stuck in traffic, or we had a horrible morning. and without realizing it, we're bringing that into the rest of our day, and we're allowing that to impact the way we think. So if you're having a bad day, that could actually sway the way you're interpreting the facts of a case, or the way you're responding to a client, or the way you're responding to opposing counsel on a case. And so understanding this relationship just helps us have a better handle on the areas we can take control, which as lawyers we love to do. We can take control of the situation and these aspects and the various ways they interact before they get out of hand. We'll explore this a little further as the course goes on. Okay, lawyer know thyself. And I entitled this slide in this way basically to indicate the importance of understanding ourselves, knowing ourselves. And if you read this and you're saying, the importance of strengthening your self-image. Well, most lawyers have a strong self-image. Yes and no. So the image that you're reflecting to the public may seem strong and solid, and lawyers may seem cocky and confident, and even arrogant in some cases and at some points to some people. And that may be the overall perception of who we are, but we all have our hangups, we all have our insecurities, and without realizing it, we bring those into the way we respond professionally and personally, so they actually affect the way we do our jobs. Your self-perception has more to do with the way you respond, and think, and act than you realize. So if you're having an area of your life or a mindset that is negative for whatever reason, it's important that you know that's impacting your day and it's impacting your duties to your client, and even perhaps your ability to perform due diligence in a particular case. But either way, having a strong self-perception is an important step toward having the best days possible and doing the best job you're able to do. In self-actualization, again, we think we know ourselves and our habits, and our behaviors, and our biases, but lawyers are often so busy solving everybody else's problems. Lawyers are similar to doctors in that sense, we're always focusing on others, solving their problems, helping them, pleasing those we work for, whether it be a supervisor, or a partner, or your clients. And because of that, you can lose sight of what your thoughts are, what your actions are, how you're responding, how you're doing. And that's where self-actualization really comes in as well as self-disclosure. And this is being able to again, admit to yourself and to others where you may be struggling, or where you may have a weakness that you feel needs to be addressed or something to be resolved. Again, these are all helpful tips, they're all meant to be proactive and preventative so that no one is on the other end of a grievance, or a complaint, or a dissatisfied client, or partner, or whomever it is that may be affected. CBT Lawyer Tools. So again, CBT is based on a combination of different cognitive and behavioral therapies. And is an umbrella term, so if you hear the term CBT, it can mean one type of quote, unquote "Therapy," or it can be an umbrella term that refers to different concepts. And those concepts can include Dialectical Behavior Therapy, DBT, Acceptance and Commitment Therapy, ACT, Mindfulness-Based Cognitive Therapy. So most of us understand what mindfulness is. Mindfulness is actually a form of CBT, or let me say, there is a form called mindful CBT that is more in touch with the mindful aspects, the contemplative aspects of cognitive wellness. We'll be touching on that briefly, but the core of that topic is outside the scope of this presentation as are the other courses listed. I just included those or the other, I'm sorry, the other areas of CBT listed, I included those just to give you a thorough understanding. Obviously this is a huge topic, let me preface my presentation here by saying there's no way I can properly address all the aspects of CBT. So it's going to be brief and just a overview of what's involved in CBT, and how it can benefit lawyers. This is a topic I explore at length on my website, my platform, and also through coaching and so forth. So if you need additional information, or would like additional information, or have any questions, please feel free to use the contact information at the back of the presentation to reach out and ask me any questions, or again, feel free to check out my platform if you want other information. But for purposes of today and going through this now, let's explore further the rational approach and why that's so appealing to lawyers. We are rational thinkers, we understand the value of a rational approach. And again, that's one of the many reasons that I think CBT is so beneficial. We do love being problem solvers as we just discussed, and if we can solve our own problems, then we're better equipped to solve others' problems, right? So being able to address those problems either before they arise, or once they arise will make us better at our jobs. It makes us better people in general, it makes us better in our personal lives, but certainly better in our professional lives as well. So CBT focuses on confronting and resolving problems, utilizing, again, the rational approach. And it is very structured, it provides specific skillsets to help us in tackling those challenges, those thoughts, those negative biases that we may have and breaking through and disrupting those. But it's also flexible enough to be adapted to be person and problem specific. So there are general approaches to CBT, which are great for self-help tools, but there are also specific personalized approaches which, again, can be used in a collaborative model as well as through self-help. As you're working through some of the exercises, you're able to reflect on your personal thoughts and your personal mindsets, and work through those. So mindsets, we understand that mindsets are how we express our foundational beliefs when interacting with other people, with the public, with jurors, if you're a trial lawyer, with clients, so forth. In our day-to-day practice, our mindsets are what shaped the way we perceive clients, coworkers, opposing counsel, and even the cases or matters we're working on. There's so much research and there has been so much evidence gathered and studies that reflect the importance of understanding the connection between our perception and what is our reality. As lawyers, we understand this, I mean, especially if you practice an area of law where you're deposing clients or deposing witnesses. And in law school we all understood how going through the cases, two witnesses can be at the same place at the same time and have completely different stories. And we've always heard the truth, there's his story, her story, and then the truth. And it's not necessarily that one person is lying, or misremembering, it's that our perceptions shape our understanding. They shape the way we hear things, they shape the way we see things. We understand that as lawyers, but we're not always great about applying that to ourselves and recognizing that it's okay as lawyers that we see different aspects of the same fact pattern. You're not always going to agree with another attorney who may be working on a same case with you or a same fact pattern. And often opposing counsel are just as convinced that their client is right and their facts are exactly on point, and they're going to be able to prevail for their client just as you are sure you can do that for yours. And again, a lot of that could be based on perception as much as anything else because we bring our perception with us. It's not like a tie that you put on, or a dress, or or a coat, it's something that's with you. Now, there are things that we can help with as far as altering those perceptions where they may be skewed but nevertheless, our perceptions are ours, we own them and because we own them, we can take control over them. So if our perceptions are off, that gives us an opportunity to utilize the tools to reshape those. Okay, if our mindsets are fixed and negative, they do hinder our ability to successfully analyze our relationships and our work in an effective manner. So again, we all know the lawyer whose mind is made up, no matter what facts you introduce, no matter what scenario you explain, no matter what case law you may present, that lawyer's mind is fixed, it is just locked in. And that can be good in representing your client, but it can also be a very negative point when it comes to being open to having a full understanding of the case. And again, this isn't just the way we practice law, but it's our mindsets that we carry in through our personal life too. And so we don't wanna be so fixed on a fact pattern or so fixed on a principle, or a personal value that we may have or a personal belief. And I'm not talking core values and core beliefs, I'm not talking about like spiritual, or foundational values, or beliefs. I'm talking about other values and beliefs that without realizing it are determining our response, and affecting the way we respond, or the way we hear our clients, or the way we hear other attorneys in addressing a particular case. So I hope that explanation helps a little in the reference here to fixed and negative. And I reference this point so often in my CLEs because there is a general view that lawyers should be pessimistic by nature, and the more pessimistic, the more successful. And I disagree with that generalization, I disagree with that characterization that lawyers are or should be negative or pessimistic. I do believe a healthy skepticism is beneficial for us as lawyers because it helps us see both sides. And most lawyers can see both sides, but we do know those that get locked into a particular case or argument and that's a tendency any of us can have. But we don't want to bring our negative perception to the point to where we're missing the forest for the trees, so to speak. So again, I hope that helps explain it a little bit further, or adds a little bit more clarity on the way that we're affecting, and our mindsets are affecting the way we practice law. And the good news is that we are able to control and change these because again, our thoughts are ours and our actions are ours. So let's explore CBT for perfectionistic lawyers, talking about control. This is where it goes awry, this is where control can get out of control, so to speak. This is where we're trying to control so much, but we don't realize these are aspirations and goals that we can't possibly control. Okay, perfectionistic lawyers, that may sound like a contradiction just in terms of who we are as lawyers. I don't frankly know a lawyer who is not a perfectionist, simply because I feel like we've developed that mindset and that perspective coming through law school, passing the bar, entering into the profession. So that being said, perfectionism is good as long as it's healthy and adaptive. When it becomes based on unrealistic standards, then it's no longer healthy and it can become problematic. So CBT for perfectionistic lawyers refocuses the cognitive biases, and it realigns unrealistic beliefs and perceptions. The problem with perfectionism is when it becomes unrealistic and it's not just, "I'm gonna do my best on this case, "I'm gonna put forth my best argument." If you're an estate planning attorney, "I'm going to develop the best estate plan for my client. "I'm going to present the best options "that he or she can choose from "in designing the estate plan "that best meets his or her goals." It's going beyond that and it's setting a standard that is impossible. So therapy for perfectionistic lawyers focuses on identifying and altering the cognitive and behavioral aspects of the problem rather than those that caused or contributed the problem. And in CBT there's a model called SMART, it's implementing the SMART goals. And SMART stands for specific, measurable, attainable, relevant, and time-bound. These are the factors that we use to try and help focus in and hone in on the problems that are resulting in the perfectionistic behavior. Again, not to hinder or prevent us from being our best, but allowing us the room and the freedom to do our best without setting standards that are unattainable. So let's explore this a little bit further by looking at the destructive consequences of perfection among lawyers. And if you've listened or taken any of my other courses, and this may be familiar to you, whenever I talk on perfectionism, I use this example simply because it's nationally known, and it's so powerful in the heart-wrenching nature of a lawyer whose perfectionism was so far outside of reality that it caused devastating effects, not just for his outcome, but for those who loved him and for the world at large, for the world at large who could have benefited from having his life continue on. So Gabriel McConnell was a bankruptcy lawyer, and he was also a partner at Sidley Austin's Los Angeles office. And he worked on various high profile bankruptcy cases, he had undergone a lot of transition professionally with partners retiring. He had a mentor who left the firm, and because of that a lot of extra work had been placed on him. And rather than reaching out for help, or too afraid to say anything, he instead continued to push himself and apply his efforts more and more in his work. There was a major bankruptcy for a mattress company that he was involved in, and he actually felt that after the bankruptcy had been filed in, once the case was concluded, he would be fired from his job when in actuality he was highly praised and very well recognized for the efforts he had completed, and achieved in the filing and in the bankruptcy case. And I relate this fact also is one Sunday night, shortly before the events at issue, McConnell called his wife, who was also a lawyer, Joanna Litt. And told her that he felt like his body was shutting down, he was working late, he had worked all day Sunday and he felt like his body was starting to fail him. So of course, like any spouse would do, she went and picked him up and wanted to take him to the emergency room. And he told her, "You know, if I go to the ER, "this will end my legal career." I can't tell you how that saddens me, and how heartbreaking I find it to be that any of us would think that seeking help, when we are so run down because of our job duties, and our occupation in general, that that we're afraid to get the help we need for fear of losing our job. But that's what can happen when we become maladaptive in our perfectionistic goals. And sadly, his wife just did not understand at that point, as most spouses wouldn't, if they weren't familiar with the signs. Most people around him wouldn't have recognized, and that's another reason why mental wellness among lawyers is such an important topic. And anyway, on Sunday, October 14th, 2018, McConnell received an email according to his wife, he kissed her goodbye, left her at home, drove to his office parking lot, put a gun to his head, and shot himself. Again, heart-wrenching in its details and such a cautionary tale for us as lawyers and the importance of getting help. Following his death, his wife started researching to try and explore what could have happened that led her husband, who was so brilliant and successful at what he did, to feel like he had no other option but to commit suicide. And she discovered the concept of, or the condition known as maladaptive perfectionism, and slowly recognize the signs and symptoms she had observed in her husband. And maladaptive perfectionism, again, it's this unhealthy form of perfectionism based on standards so high they're impossible to attain, and they result in feelings of shame, self-doubt, feelings of inadequacy, and they lead to extreme anxiety. I actually have a presentation on perfectionism that explores it in more depth, but I feel like it is important to address this in any context involving lawyer wellness because it is such a critical topic, and it's one that too many lawyers tend to fall into without realizing that the push to be more, to be better, to be the best, to strive more, to earn more, to do more, to build more, all of that can get quickly out of control, and mount, and mount, and mount to a point to where it breaks us if we don't stop it, if we don't seek help. I don't want to know that there's another lawyer that is at Gabriel McConnell's stage. And truly one of the saddest parts, I've included a link here to check out the article, how "Big Law Killed my Husband," and it was written by Joanna Litt. I believe it was written just a month or two after her husband's death. And it's raw, and poignant, and very informative, and certainly something I would encourage every lawyer to read. Again, if for nothing else, but just an awareness that if this isn't you, it could be the next lawyer in your firm or the opposing attorney that you're dealing with or a friend you've known from law school. So it is beneficial for all of us as lawyers to be aware of this. And again, one of the saddest parts of this story is when Joanna told her husband, "Look, why don't you just, why don't you resign? "We can sell our home," which she loved. "But we can move off, we can take a break, "we can go do something else, let's just disengage." And he said, "I could never do that. "I could never leave my clients, "I could never leave a case." And sadly, the disconnect was so great for him that the only option was to commit suicide in the parking garage of his employer rather than actually resign from the firm, or withdraw from a case that was causing, or contributing to such inner turmoil. So again, this is something I'm passionate about, I hope you can hear that, and I wanna encourage all lawyers to be aware of this because none of us should feel like we have no other alternative to, but to reach this point, and I believe I read a statistic yesterday that in 1996 lawyers actually surpassed dentists for the first time in committing suicide. That is not a statistic any of us wanna know, or own, or contribute to. Creating a collaborative CBT plan. So one of the successes of CBT is its collaboration. You get to work with someone else, and help talk through some of the issues, get feedback. We understand as lawyers collaboration is a big part of what we do, whether we're collaborating with another lawyer or we're collaborating with our clients, we understand collaboration is an important part for us seeing the whole picture in developing a case, or an estate plan if you're an estate planning lawyer. I was an estates and trust lawyers for many years, so I don't wanna leave out that sector of the profession. If you don't practice in a area that takes you to court, if you don't go to probate hearings or so forth, and you're just conducting most of your work in your office or now remotely, I wanna make sure to include you because whatever the aspect of your profession or your practice is, I'm sorry, whatever the aspect of your practice is, there is collaboration involved in some form, and that's one of the strengths of CBT is the ability to collaborate between a client and a coach to address and resolve the root cause issues behind the stress, anxiety, and even depression. CBT was actually created in response to addressing depression specifically, and then more generally anxiety, stress as the interplay is so great among these different mindsets and these different conditions and mental health issues. Okay, CBT also is effective though because it offers principles and exercises that are successfully used as self-help tools. So there are worksheets you can download, there are exercises you can complete individually, which can help you succeed as well if you're not comfortable in doing an actual CBT program with a coach. Let me say one of the benefits for CBT is because it is offered so frequently in a coaching format in addition to being offered as a therapy through traditional psychologists, psychotherapists. Because of that, lawyers like anonymity, and so often lawyers are afraid, "Oh, if I tell somebody I need help, "it's going to come back to bite me, "my malpractice carrier may find out. The bills may show, the invoices that may reflect that I've needed help, how is this going to come back? Just like McConnell was afraid, going to the ER would negatively impact his profession. One of the greatest reasons lawyers refrain from seeking help is because of the fear of being discovered, or it having a negative impact on their career. I will tell you, my platform is set up where there is no reporting to firms or malpractice carriers. Those who go on, whether it's a firm or sign up directly are handled in a coaching format. And because of that, it's wellness coaching, it's not psychological therapy. So hopefully that will encourage you or someone you know who may think that CBT or some other form of wellness coaching is beneficial. I'm sure there are other coaches who offer the same or a similar format, I'm just giving mine as an example to let you know that there are options available for you without the need of fearing any kind of reprisal or discovery of a mental health issue. And that's important for lawyers to know. Okay, CBT and Lawyer Anxiety. As I mentioned, anxiety is one of the topics that's actually touched on in under the umbrella of services where CBT really shines. And the reason is because it is so successful in addressing the anxiety by disrupting the core issues that are causing the anxiety, Sometimes we know what's making us anxious, other times we don't. And that's where it's beneficial to drill down and in some cases look more specifically, and other times it's standing back and getting that 30,000 foot perspective on what thoughts and mindsets are creating the anxiety. Once we know, we can disrupt them, we can resolve them, and we can break that rumination cycle. It's interesting, I was interviewing an attorney who is now in the natural wellness field and works as part of a very well-known, established natural wellness practice and after I interviewed her, she made the comment about wanting to go over a statement she made because she was so afraid that she may have misspoke on one statement. And I told her, "Well, that is a perfect example "of how we as lawyers ruminate, "our minds are just trained to that." But we can't shut it off sometimes and we need to. So if you find yourself ruminating over something over and over again, if not addressed, that will lead to anxiety. And that can create additional issues as we've seen, so you wanna know how to break those up, how to disrupt those thoughts, and convert them into something more positive. CBT is very successful at that. Also, anxiety can appear as avoidance, which is a maladaptive behavior. We were talking about maladaptive perfectionism within the confines of anxiety, avoidance is a maladaptive symptom of having anxiety or can be a maladaptive symptom of anxiety, and it can deprive you of the opportunity to work through, to address the source of the anxiety. So often we learn by what we work through. And we know that as lawyers, the more we work through a fact pattern, or develop a pleading, or emotion or a brief, or put together scenarios, or interview witnesses, whatever the case may be in your particular practice, that reveals so much to us and we're able to put pieces together and see what fits and what doesn't fit. Well, it's the same with regard to our anxiety in addressing the source of the anxiety and being able to disrupt it, then we've gained by acknowledging that and being able to work through it, break that ruminating thought process, and come out on the other end of that exercise, not just healthier, but free of whatever is looping over and over in our mind that's trying to distract us from being our best and our most effective. Okay, I'm gonna talk briefly about the ABC model, which is a core model of cognitive behavior therapy and that affects the way lawyers think and practice. The ABC model can serve as a successful problem-solving tool for lawyers because it focuses on A, which stands for activating or triggering event. Again, you can't address what you don't know, so if you are not aware of what's actually activating the stress or activating the anxiety, the ABC model helps you recognize or identify the activating event, or whatever it is that is triggering the stress or anxiety. B, beliefs such as the thoughts you have when the activating event happens. You may not realize that every time something happens that you have an automatic knee jerk response, and you respond through behaving in a certain way. And again, we are so busy focusing on others that sometimes we can miss these behaviors, and thoughts, and beliefs, and triggering events in ourselves. So it's important that we're able to address those. Also consequences, this encompasses our feelings and behaviors in responses, in response to the beliefs. And consequences can be divided into two parts, your actions and your emotions. So again, it's all tied together. As lawyers, we like to think that we're very steady and even kill, we're passionate when we need to be on behalf of our clients to zealously represent them. But the rest of the time we're able to keep our emotions in check, and to a large degree we are, but the downfall can come in failing to recognize what those emotions are, or where they come from, or how to properly address them. If they're are own emotions that are dictating the way we respond and the way we do our job. Hopefully all of this is clicking for you. Again, if I'm losing you at any point or any of this you want more information of, please feel free to reach out. Okay, confronting lawyer cognitive distortions. And we've already touched on this briefly, but again, we're in a profession that is rooted in conflict and challenges. Our ability to confront those is instrumental in the way we practice, but because we're so busy doing that for others and we often fail to apply the same standards in the same analysis to ourselves, it's important that we recognize that we do have distortions, and especially if you're feeling stress, anxiety, the ruminating thoughts, even depression, knowing that you can reach the thought process behind that is so empowering and I hope you feel that it is something worth pursuing because those distortions are literally coloring the way you see the world, they're filtering your relationships, they're changing the way that you're perceiving the world. We all have filters that we carry with us every day. If those filters are unhappy or I'm sorry, if those filters are unhealthy, then they can distort our reality. And in being able to take control over those, break and disrupt those distortions, and reshape them into something positive, again, is very empowering. And as I mentioned, I get the fact that we as lawyers like being in control, we like being able to control fact patterns, and scenarios, and cases to positive outcomes. However, we should also take that same approach to controlling the negative aspects of our thought process, knowing that we can reshape those into something more positive and more beneficial. One of the ways we can do this is through writing, and I have information here, but let me just summarize this by saying, it's a very helpful exercise, if you're having negative thoughts, or you're feeling stressed or anxious to either grab your iPhone, open it up to notes and talk out whatever is negative, say it in a negative term. And then rethink it, reshape it, and challenge yourself to now say it in positive terms. Type it out on a keyboard, for those who actually like writing things out, write it out and first the negative, then really apply your analytical skills and flip that into something positive, however you can, whatever you come up with, put it in a positive context. We do that all the time as lawyers for others. Do it for yourself you will be amazed how it changes the way you think, and you feel, and your perception also talking it out. There is no benefit to just being able to talk out whatever is bothering you, whether it's talking into your phone if nobody is around, or you don't feel like sharing, or it's talking to a colleague, a family member, someone you trust that you can confide in. Just have that release, it's very therapeutic, just talking it out. And then thinking it through as you talk or after you talk it out. Also laugh it off. Laughter can interrupt a cycle such as fear, it is tremendously beneficial, it promotes relaxation, it lowers your cortisol which is your stress hormone. It alters your breathing, it calms it down. And to do this, consider reading jokes or memes, watching funny videos or even, you know, comedies on TV, or your iPad or your computer. Anything that just help you laugh it off, have that release. It's like a pressure cooker where the valve is released where that steam can come out through laughter, so that's very beneficial. Again, taking control, and another way to do this, as I mentioned, is you can create a record on your phone. You can just dictate it, it doesn't have to be written, it can be audio, it can be in any form. Having a growth mindset, knowing what your goals are, never lose sight of what your goals are, and don't let anybody take them from you, stay focused on those, and use those as your roadmap in guiding you. And if you find your strength from your goals, again, that may be a time to look into positive therapies such as CBT. So the key takeaways that I hope you've gained from this are that CBT is problem-focused and goal-oriented. Lawyers are skilled in reframing facts for our clients, and we should do no less for ourselves. When it comes to our thought patterns, we have more control than we realize. Our cognitive behavior is extremely, or cognitive behavior as a form of therapy is extremely lawyer-friendly in that it is rational and evidence-based, and our cognitive wellness should be a priority for all of us. Just as a final word, I wanna thank you so much for giving me the opportunity to present to you today, and I hope if there is one thing here that can help you or another lawyer feel a little bit more satisfied in your work, a little bit happier in your life, or a little bit healthier, I am so grateful for the opportunity. My goal is never to minimize any mental health condition, but just to provide some information and education about valuable resources. Again, feel free to reach out and contact me if you have any questions. Until next time, take care and be well.

Presenter(s)

PM
Patti McCartney
Attorney
DrPattiMcCartney.com

Course materials

Handout

Credit information

Jurisdiction
Credits
Available until
Status
Alabama
    Not Offered
    Alaska
    • 1.0 ethics
    December 29, 2024 at 11:59PM HST Available
    Arizona
    • 1.0 professional responsibility
    December 29, 2024 at 11:59PM HST Available
    Arkansas
    • 1.0 ethics
    December 29, 2024 at 11:59PM HST Approved
    California
    • 1.0 ca competence - wellness
    December 22, 2024 at 11:59PM HST Approved
    Colorado
      Not Offered
      Connecticut
      • 1.0 ethics
      December 29, 2024 at 11:59PM HST Available
      Delaware
        Not Offered
        Florida
        • 1.5 mental illness awareness
        July 31, 2024 at 11:59PM HST Approved
        Georgia
        • 1.0 ethics
        Unavailable
        Guam
        • 1.0 ethics
        December 22, 2024 at 11:59PM HST Available
        Hawaii
          Not Offered
          Idaho
            Not Offered
            Illinois
            • 1.0 mental health/substance abuse
            December 31, 2024 at 11:59PM HST Approved
            Indiana
              Not Offered
              Iowa
                Not Offered
                Kansas
                  Not Offered
                  Kentucky
                    Not Offered
                    Louisiana
                      Not Offered
                      Maine
                        Not Offered
                        Minnesota
                          Not Offered
                          Mississippi
                            Not Offered
                            Missouri
                            • 1.0 general
                            Not Offered
                            Montana
                              Not Offered
                              Nebraska
                              • 1.0 ethics
                              Not Offered
                              Nevada
                              • 1.0 aamh (substance abuse-addiction-mental health)
                              December 31, 2026 at 11:59PM HST Approved
                              New Hampshire
                              • 1.0 ethics
                              December 29, 2024 at 11:59PM HST Available
                              New Jersey
                              • 1.3 general
                              January 16, 2025 at 11:59PM HST Approved
                              New Mexico
                                Not Offered
                                New York
                                • 1.2 ethics
                                December 29, 2024 at 11:59PM HST Available
                                North Carolina
                                  Not Offered
                                  North Dakota
                                  • 1.0 ethics
                                  December 29, 2024 at 11:59PM HST Available
                                  Ohio
                                    Not Offered
                                    Oklahoma
                                    • 1.0 ethics
                                    Not Offered
                                    Oregon
                                      Not Offered
                                      Pennsylvania
                                      • 1.0 ethics
                                      Pending
                                      Puerto Rico
                                        Not Offered
                                        Rhode Island
                                          Not Offered
                                          South Carolina
                                            Not Offered
                                            Tennessee
                                            • 1.05 ethics
                                            Pending
                                            Texas
                                            • 1.0 ethics
                                            Unavailable
                                            Utah
                                              Not Offered
                                              Vermont
                                              • 1.0 attorney wellness
                                              December 29, 2024 at 11:59PM HST Approved
                                              Virginia
                                                Not Offered
                                                Virgin Islands
                                                • 1.0 mental health/substance abuse
                                                December 29, 2024 at 11:59PM HST Available
                                                Washington
                                                • 1.0 personal development & mental health
                                                December 28, 2027 at 11:59PM HST Approved
                                                West Virginia
                                                  Not Offered
                                                  Wisconsin
                                                    Not Offered
                                                    Wyoming
                                                      Not Offered
                                                      Credits
                                                        Available until
                                                        Status
                                                        Not Offered
                                                        Credits
                                                        • 1.0 ethics
                                                        Available until

                                                        December 29, 2024 at 11:59PM HST

                                                        Status
                                                        Available
                                                        Credits
                                                        • 1.0 professional responsibility
                                                        Available until

                                                        December 29, 2024 at 11:59PM HST

                                                        Status
                                                        Available
                                                        Credits
                                                        • 1.0 ethics
                                                        Available until

                                                        December 29, 2024 at 11:59PM HST

                                                        Status
                                                        Approved
                                                        Credits
                                                        • 1.0 ca competence - wellness
                                                        Available until

                                                        December 22, 2024 at 11:59PM HST

                                                        Status
                                                        Approved
                                                        Credits
                                                          Available until
                                                          Status
                                                          Not Offered
                                                          Credits
                                                          • 1.0 ethics
                                                          Available until

                                                          December 29, 2024 at 11:59PM HST

                                                          Status
                                                          Available
                                                          Credits
                                                            Available until
                                                            Status
                                                            Not Offered
                                                            Credits
                                                            • 1.5 mental illness awareness
                                                            Available until

                                                            July 31, 2024 at 11:59PM HST

                                                            Status
                                                            Approved
                                                            Credits
                                                            • 1.0 ethics
                                                            Available until
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                                                            Unavailable
                                                            Credits
                                                            • 1.0 ethics
                                                            Available until

                                                            December 22, 2024 at 11:59PM HST

                                                            Status
                                                            Available
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                                                              Not Offered
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                                                                Available until
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                                                                Not Offered
                                                                Credits
                                                                • 1.0 mental health/substance abuse
                                                                Available until

                                                                December 31, 2024 at 11:59PM HST

                                                                Status
                                                                Approved
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                                                                  Available until
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                                                                  Not Offered
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                                                                            Status
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                                                                            Credits
                                                                              Available until
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                                                                              Not Offered
                                                                              Credits
                                                                                Available until
                                                                                Status
                                                                                Not Offered
                                                                                Credits
                                                                                • 1.0 general
                                                                                Available until
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                                                                                Not Offered
                                                                                Credits
                                                                                  Available until
                                                                                  Status
                                                                                  Not Offered
                                                                                  Credits
                                                                                  • 1.0 ethics
                                                                                  Available until
                                                                                  Status
                                                                                  Not Offered
                                                                                  Credits
                                                                                  • 1.0 aamh (substance abuse-addiction-mental health)
                                                                                  Available until

                                                                                  December 31, 2026 at 11:59PM HST

                                                                                  Status
                                                                                  Approved
                                                                                  Credits
                                                                                  • 1.0 ethics
                                                                                  Available until

                                                                                  December 29, 2024 at 11:59PM HST

                                                                                  Status
                                                                                  Available
                                                                                  Credits
                                                                                  • 1.3 general
                                                                                  Available until

                                                                                  January 16, 2025 at 11:59PM HST

                                                                                  Status
                                                                                  Approved
                                                                                  Credits
                                                                                    Available until
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                                                                                    Not Offered
                                                                                    Credits
                                                                                    • 1.2 ethics
                                                                                    Available until

                                                                                    December 29, 2024 at 11:59PM HST

                                                                                    Status
                                                                                    Available
                                                                                    Credits
                                                                                      Available until
                                                                                      Status
                                                                                      Not Offered
                                                                                      Credits
                                                                                      • 1.0 ethics
                                                                                      Available until

                                                                                      December 29, 2024 at 11:59PM HST

                                                                                      Status
                                                                                      Available
                                                                                      Credits
                                                                                        Available until
                                                                                        Status
                                                                                        Not Offered
                                                                                        Credits
                                                                                        • 1.0 ethics
                                                                                        Available until
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                                                                                        Not Offered
                                                                                        Credits
                                                                                          Available until
                                                                                          Status
                                                                                          Not Offered
                                                                                          Credits
                                                                                          • 1.0 ethics
                                                                                          Available until
                                                                                          Status
                                                                                          Pending
                                                                                          Credits
                                                                                            Available until
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                                                                                            Not Offered
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                                                                                              Available until
                                                                                              Status
                                                                                              Not Offered
                                                                                              Credits
                                                                                                Available until
                                                                                                Status
                                                                                                Not Offered
                                                                                                Credits
                                                                                                • 1.05 ethics
                                                                                                Available until
                                                                                                Status
                                                                                                Pending
                                                                                                Credits
                                                                                                • 1.0 ethics
                                                                                                Available until
                                                                                                Status
                                                                                                Unavailable
                                                                                                Credits
                                                                                                  Available until
                                                                                                  Status
                                                                                                  Not Offered
                                                                                                  Credits
                                                                                                  • 1.0 attorney wellness
                                                                                                  Available until

                                                                                                  December 29, 2024 at 11:59PM HST

                                                                                                  Status
                                                                                                  Approved
                                                                                                  Credits
                                                                                                    Available until
                                                                                                    Status
                                                                                                    Not Offered
                                                                                                    Credits
                                                                                                    • 1.0 mental health/substance abuse
                                                                                                    Available until

                                                                                                    December 29, 2024 at 11:59PM HST

                                                                                                    Status
                                                                                                    Available
                                                                                                    Credits
                                                                                                    • 1.0 personal development & mental health
                                                                                                    Available until

                                                                                                    December 28, 2027 at 11:59PM HST

                                                                                                    Status
                                                                                                    Approved
                                                                                                    Credits
                                                                                                      Available until
                                                                                                      Status
                                                                                                      Not Offered
                                                                                                      Credits
                                                                                                        Available until
                                                                                                        Status
                                                                                                        Not Offered
                                                                                                        Credits
                                                                                                          Available until
                                                                                                          Status
                                                                                                          Not Offered

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