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Mindfulness Techniques: Creating Resilience to Stress For Lawyers

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Mindfulness Techniques: Creating Resilience to Stress For Lawyers

It’s no secret that lawyers work in high stress environments. Long hours, client expectations, competition, lack of boundaries, and many more factors can take a toll on lawyer well being and productivity. Join Dr. Elizabeth Eckhardt, Director of the Nassau County Bar Association’s Lawyer Assistance Program, and attorney Carolyn Wolf, a family-focused mental healthcare practitioner, for a practical course designed to provide lawyers with tips and techniques for controlling and reducing stress at work.

Transcript

Good afternoon, everybody. This is a program that we'll be presenting called Mindfulness Techniques Creating Resilience to Stress for Lawyers. Um, I'd like to introduce myself. My name is Carolyn Reinach Wolf. I'm an executive partner and director of our unique mental health law practice at Abrams Fensterman. It's located in New York. Although we do consulting across the country, it's the only practice of its kind. And our job is to work with families and professionals and organizations to help them navigate through the very complicated and not always helpful mental health, legal system, clinical system and so on. My co-presenter is Elizabeth Eckhardt. She's the director of the Nassau County Bar Association Lawyer Assistance Program here in New York. And I am very happy to have her joining in this presentation to talk about the issues of lawyer stress. Particularly after the Covid 19 pandemic and to present some of the issues that we all face as attorneys as well as to present some areas of practice in the mental health space in order to help us deal with those stressful issues. Stress in the practice of law. So according to a 2017 survey, which was done by the American Bar Association Working Group, it showed that 21% of lawyers reported problematic alcohol use and 28% reported depression. Now, of course, as we all know, there is a connection between alcohol use and result in depression. Also, we have to keep in mind that much of the networking and out and programs that we present do in and of themselves include the use of alcohol. When we go out to dinner with colleagues or with potential clients, when we hold meetings or seminars, often there is alcohol that is provided. So the the area itself does actually encourage the use or present to us the use of alcohol and again, result in depression is not a surprise to anyone. In 2021, the National Task Force on Lawyer Well-Being reported that 60% of lawyers surveyed reported increased stress levels and 50% reported increased anxiety. And of course, since the Covid 19 pandemic, we have been seeing this across the board lawyers, their families, children, school aged children up through graduate school, adults were seeing a big increase in stress levels across the board. In October 2021, the New York State Bar Association Task Force on Attorney Well-Being issued its own report finding that 37% of lawyers reported a mental health related problem or concern in the last three years. So the year certainly before the pandemic, the years during the pandemic and the years following the pandemic has shown a significant increase in mental health related problems and issues. Next slide. Um, why lawyers in particular are at risk. Well, lawyers, as we all know, are generally less likely to seek support or help. We deal with a tremendous amount of workplace stress. Workload, long hours. Those of us who work in an area having to do with life and death issues or day to day conflict issues also experience stress really as a result of the cases that we handle. We are all faced with confidentiality concerns, the stigma of mental health and mental health, issues of substance use disorder also put lawyers at risk because they're less inclined to talk about it, seek help and so on. The competition that we face in the practice of law, many of us have maladaptive perfectionism, learning to address that in a way that is helpful and supportive is a challenge for many of us who have worked in this field a long time. It's the adversarial nature of our work. We are problem solvers. And as all of us know, there are times when we just can't solve the problems for clients. This creates a certain amount of stress for us and anxiety, again, as we seek perfection and the ability to solve everyone's problems. Of course, we all also know that is not reality. We have vicarious trauma. Those of us who work in fields where we have clients who are experiencing firsthand trauma themselves, we actually take on some of that trauma very often frequent exposure to alcohol consumption, as I said, at networking events and other such events or programs that we frequent encourages and allows for the use of alcohol consumption. Next slide, please. So what is the impact on attorney well being? Well, a survey by the New York State Bar Association Task Force on attorney well being found that the greatest barriers to attorney well being are lack of boundaries regarding downtime or never off. And we saw this a lot during the Covid 19 pandemic. There was much talk about how through the use of Zoom and teams and other online sources that because we weren't leaving our homes, going into the workplace, finishing our workday, coming back home, there was really an overlap between work and home. And more and more lawyers in particular because of the virtual nature of the practice as happened during the pandemic, many of the attorneys were more and more experiencing this lack of boundary regarding downtime or never being off one area of our lives bled into the next, so to speak. And we were working at all different times and nights and weekends, often because we could. I'm also client expectations and demands. Again, going back to the issue of wanting to solve everyone's problems, being perfectionists in the nature of our work, managing client expectations and demands becomes a part of that. And I can tell you that certainly in our mental health law practice, client expectations is one of the most challenging areas we face. Being able to say to clients, We can do this for you or we can't do this for you. The law doesn't provide for this, or the law provides for that being reality based and meeting clients where they are, but also managing their expectations for perfection for the correct answer, for the ability to solve every one of their problems. That creates a wellspring of stress and anxiety for attorneys. And then, of course, there are the financial pressures in the business of law, whether we're in private practice and have to pay the bills, whether we're in our firm and have to bring in new business or have billable hours and anything in between creates a fair amount of financial pressures while in conjunction with the actual practice of a legal the legal profession. Next slide, please. So how stress can impact an attorney's practice of law? Well, studies have shown that there are a variety of stressors that impact how we manage in our law practices. Procrastination. There are those who get so overwhelmed that we can't. Move forward in any area of practice. And so we put things off or we move them to the side of our desk or we put them under other papers and we perseverate and we think about it, but we procrastinate on actually getting to it and working through the challenges, the stress of frequently adjourned meetings and cases, the idea that our day doesn't go the way we thought it would go. And we see this a lot in my area of practice. Given the nature of law practice, often there are multiple attorneys involved in a case. So yes, we frequently have to face meetings that are adjourned because people have conflicts in their schedule cases that you are all set up and spent hours preparing for having them adjourned or moved to other dates. All of this creates a certain amount of stress and challenges in the practice of law. Also on return calls and emails to clients, adversaries, or the courts. Because of the Internet, because of the use of email, everything is here and now right away. And I'm sure all of us have that feeling about. I sent you an email. Why am I not getting an answer back in the next two minutes? Again, client expectations. I sent you an email at 901 and I haven't heard from you back at 905. All of this creates more stress for the attorneys. The client stress often spills over into the attorney stress adversaries and their expectations. I sent you an email. I sent you a text. I left a message. Why am I not hearing back from you in the last 10s? And in addition, courts themselves are overwhelmed with the backlog since the Covid pandemic. Often there are turnover in staff at the courthouse. Different judges have different expectations or protocols for emails or for letters or for phone calls. All of that, of course, does impact on an attorney's level of stress. Escrow difficulties. We all know that the ethical rules regarding escrow accounts is sacrosanct. That is one of the most slam dunk type of cases for attorneys to lose their license or be suspended from the practice of law. We all know or should know that escrow accounts, as I said, are sacrosanct. Not to be touched unless it's related directly to a client matter. But often attorneys who are experiencing difficulties, whether they be financial or psychiatric or psychological, sometimes have the urge to go into these accounts in order to obtain money. And as we know, it's very dangerous thing for us to do. Emerging difficulties with personal and professional relationships, people changing jobs, firms going in and out, firms changing managing partners, moving about, whatever it might be. These are also stressors that attorneys face when they're practicing in the legal profession. Impaired cognition due to self-medication with alcohol or drugs. A very big challenge. And for those attorneys who are on prescribed medication, as we know in my field, use of alcohol or drugs that are not prescribed certainly can impair the use of the prescribed medications, can be contraindicated and often present a very challenging situation medically and mental health wise for attorneys who are using drugs and alcohol in order to self-medicate through whatever depression, anxiety, other mental health challenges they might have. Um, in addition, thrill seeking for distraction or a rush. Unfortunately, we've seen an increase in the use of not only drugs and alcohol, but other types of of addiction, sexual sex addiction, gambling, for example. Sometimes attorneys look to these in order to have a diversion or a distraction from the issues that they're facing in their legal practices. Next slide, please. The risk of oops. The risk of substance use and impact on the practice of law. So giving up or missing important social, occupational or recreational activities because of substance use is certainly a risk. When attorneys are faced with the ongoing use of drugs or alcohol. Another risk faced by attorneys who have these types of challenges are repeated use of these substances, even when it puts them in danger. Continuing to use even when the attorney knows they have a physical or psychological problem that would have caused or made worse by the substance use. Again, this also goes back to the issue of asking for help or having insight into having a problem and seek to address it and solve the problem rather than keeping it under the rug or quiet and just continuing the use of these substances, needing more of the substance to get the effect that you want. So goes to tolerance level. The more use, the more your body builds up a tolerance for the alcohol or the drugs, the more that happens, the more you want higher levels of drugs or increased use of alcohol. It becomes this never ending cause and effect, ultimately possibly leading to serious complications as a result of the use of drugs or alcohol, the development of withdrawal symptoms which can be relieved by taking more of the substance. Again, the challenge of having insight into when it becomes problematic or when it impairs your ability to practice. And the idea of getting help for this increased use. But of course, with that increased use comes the development of withdrawal symptoms. Very important for attorneys to keep in mind that they can turn to mental health professionals to address the possible withdrawal, seek to get clean from these substances and move on in a healthier way in terms of how their practice continues. Next slide. So the New York Rules of Professional Conduct and the ABA model rules of professional conduct. Well, for example, New York has rule 101, which talks about competence. A lawyer needs to provide competent representation to a client, and it is defined by requiring the legal knowledge, skill, thoroughness and preparation reasonably necessary for that representation. Again, the use of substances can impair that competency as it's put out in the rule and can interfere with the thoroughness and preparation reasonably necessary for that representation. A lawyer shall not handle a legal matter that the lawyer knows or should know that the person is not competent to handle without associating with a lawyer who is competent to handle it. That goes to insight the ability to know that you have a problem, that you have not dealt with that problem, that the use of illicit substances interferes with your ability to practice law and to provide the most competent practice or representation to a client. That lack of insight can lead to continued use of these substances and impair an attorney's not only cognitive ability but also impair the ability to seek help and to be able to go into detox or rehab in order to address the issue and to recover from it. See, of Rule 101, a lawyer shall not intentionally fail to seek the objections of the client through reasonably available means permitted by law and these rules or prejudice or damage the client during the course of the representation. So it's very important for attorneys to know your individual state law and compare those to the ABA model rules which will govern every state attorney's practice of law. Next slide. Diligence. So that rule point one, point three talks about how a lawyer shall act with reasonable diligence and promptness in representing a client. We know that the use of illicit substances can impair a lawyer's ability to act with reasonable diligence and promptness. As we've just talked about, the idea of cognitive compromise, promptness versus procrastination, all of these tied into the use of substances that are detrimental to an attorney in the practice of law. A lawyer shall not neglect a legal matter, shall not intentionally fail to carry out a contract of employment or a retainer entered into with a client for professional services. Again, as we've talked about, the use of drugs and alcohol, other types of medications can impair the ability of a lawyer to negligently or not negligently provide legal representation, can impair the ability to carry out the contract of employment or the retainer agreement into which the attorney and the client have entered into to provide professional services. As I've said previously, insight into those challenges and the ability to move past that in order to seek assistance and help for the addiction or for the illicit use goes a long way towards bringing the attorney back into line of proper practice. Again, you want to know your state law and compare it to the model Rule 1.3. Model Rule 1.3. Comment two talks about how a lawyer's workload must be controlled so that each matter can be handled. Competency. Again talks about workload. The attorney's ability to prioritize, not to procrastinate, to take on matters that they believe they can handle competently and efficiently in order to provide the best legal representation for our clients. I'm. Comment three talks about how no professional shortcoming is more widely resented than procrastination. Again, goes to expectations, goes to efficiency, goes to court deadlines and adversarial deadlines that we all are stressed about and need to meet as we progress in our client matters. A client's interests often can be adversely affected by the passage of time or the change of conditions. Unreasonable delay can cause a client needless anxiety and undermine the confidence in the lawyer's trustworthiness. Of course, that goes without saying. As attorneys, one of the major stresses I believe we face is the use of deadlines and the passage of time. A change in conditions which we need to roll with. It's part of our practice. But there are times where use of substances can impair our ability to keep to our calendar to make sure we have calendared any changes that might come in the way of scheduling court conferences, trials and so on. So very important client and attorney needs to keep a clear mind in order to address those stressors that basically are part of our everyday practice. Next slide. Rule 1.4 talks about communication. A lawyer shall promptly inform the client of decisions or circumstances with respect to the client's giving consent or withholding consent for certain actions by the Attorney. Any information required by court rule or other law to be communicated to a client, and any material developments in the matter, including settlement or plea offers. We don't want the use of any sort of substances and result in symptoms such as depression, anxiety and so on, as we've talked about before, impairing our ability to communicate back and forth with a client. We need to reasonably consult with the client by the means by which the client's objectives are to be accomplished. Keep the client reasonably informed, promptly comply with the client's reasonable requests for information, and so on. Again, we want to make sure that we are not impaired in any way in order to fulfill those requirements that are set out by the rules of professional conduct. A lawyer also needs to explain a matter to the extent reasonably necessary to permit the client to make informed decisions regarding the representation. As I've said previously, know your state law and compare it to the ABA Rule 1.4. Next slide, please. Rule 1.15 is preserving identity of funds, property of others and a fiduciary responsibility, co-mingling and misappropriation of client funds or property maintenance of bank accounts, record keeping, examination of records. As we noted previously, an attorney acting in this forum is a fiduciary and must not misappropriate such misappropriate such funds or property or co-mingle such funds or property. Again, that goes to the financial pressures that attorneys are often faced with, in addition to other types of practice where we may be obtaining client funds that need to go into our escrow accounts. Financial pressures, other cognitive decline or challenges can make this somewhat of a challenge in making sure that we keep the appropriate financial records, don't co-mingle funds and so on. The rule also talks about how a lawyer needs to promptly notify a client or a third person of the receipt of those funds. Identify and label these. Maintain complete records. We want to make sure we are clear headed or that our support staff are well trained and understanding of that record keeping. We need to render appropriate accounts to the client or a third party regarding these and promptly pay or deliver to the client or third person as requested by the client. Again, the use of funds depending on your area of practice, whatever financial reporting there are and are required by that level of practice, we have to be very cognizant of what those requirements are and clearheaded and organized if we're going to practice in that area and take on that responsibility. And of course, as I'm sure we're all familiar with the disciplinary action that can result as not following these rules. If a lawyer who does not maintain and keep the accounts and records as specified or who does not produce such record can be deemed in violation of these rules and subject to disciplinary proceedings as appropriate. Um, last slide, please. Or next jump in here. I think this is me, if I'm not mistaken. Did we slip? Um, yeah, I just wanted to say that these are services for lawyers to address mental health and substance use concerns. The international lawyers and Alcoholics Anonymous, New York State Bar Association. Every county in New York, as in other states, have lawyer assistance programs with Doctor, which Dr. Eckhart will talk more about, and how these services are provided free of charge and pursuant to, um, pursuant to the rules that govern them in each state. And now I will turn it over to Elizabeth Eckert to talk about self care and tips for managing the stress that we've talked about so far. Thank you. Regarding the services that are available, each state typically has a lawyer assistance program. I'm in New York. It's a little bit different. We have three separate lawyer assistance programs that the directors of these programs are licensed mental health professionals, so they're able to provide direct services to lawyers in need. Confidentiality in New York is protected by all agents of the lap program, including members of the Lawyer Assistance Committee. There is on the ABA website, there is a page for the Commission on Lawyer Assistance Programs that has contact information for each of the lawyer assistance programs across the country. So some of the reason why we had chosen to call this real time professional self care tips is because often we've done presentations in the past. The Lawyer Assistance program does several types of presentations, including many well being presentations that talk about mindfulness. There's a large portion of the lawyers that I've spoken to who have kind of said, you know, we need to demystify what mindfulness is and what well-being is and what wellness is, because there's this perception that you have to be able to go and meditate, you know, for an hour or take a walk in the woods. I mean, things that some lawyers feel are really prohibitive in the field of law when you're working all day and you're, you know, you're struggling to even take a lunch break. So we really made an effort to come up with suggestions and strategies that can be used real time for lawyers who are busy that actually can be beneficial on several different levels. So here's some things you can do in your office. Take breaks throughout the day. It doesn't matter whether you walk to the bathroom and walk and visit with some people who might be in your office. Walk outside. Of course, on a nice day is a good thing to do, but it doesn't have to be an hour. It doesn't have to be. You know, this set time every day. It's really just about moving and distracting yourself a little bit from your screen stretch at your desk. In the slides ahead. I actually have pictures of the stress stretches that have been deemed to be most useful in an office setting. Meditate if you can do it. It's not a bad idea to try to do it. There are lots of resources available on YouTube, on Netflix, where they have very short meditations that are kind of guided meditations that you can look at and actually find that are not that intrusive. Take computer breaks and screen time breaks, and it's recommended that every two hours of computer use you take a rest. Now, that doesn't mean then switch from your computer to your phone. That's a screen, too. So it's actually a break and a rest for your eyes and your mind. That's important. There's headaches and other things that come with extended computer use, with lack of breaks create the habit of focusing on a point in the distance every 20 minutes or so. So even when you're not taking a break, if you can remember to kind of look away from the screen a little bit. Hold regular meetings with your team. So when I see this, I think about the importance of. In particular the lawyers who work in settings that are high stress settings. There's an epidemic really of secondary and vicarious trauma in certain types of law. So immigration law is a very big one, especially here in New York City. And we're working with the Office of Mental Health and the governor's office, the mayor's office to present education and outreach to supervisors who work with lawyers who are on the front lines working with immigration. There's so much to be concerned about with that, because with vicarious or secondary trauma, oftentimes we unconsciously begin to become indifferent to our clients because we are protecting ourselves from the pain of hearing these stories over and over again. So it's very important to do things in these settings, especially where you have regular meetings with your team to see how each other is doing, review caseloads and strategize about how you can make it so that each lawyer has. Varying degrees of trauma on their caseload. Discuss different strategies. Strategies on doing that and offer resources and coping skills. Some of the other things that happen in these high stress areas of law is isolation. So oftentimes lawyers feel like they'll stay at work longer because it's really only their colleagues understand what they're going through. So then they tend to isolate from their friends and family. And oftentimes that causes even more disruption in their life because one of the highest one of the most important things that are reported when people do surveys on quality of life is in fact your support systems and your close relationships. So oftentimes we alienate ourselves from the things that are most important to us to stay healthy. Now, these techniques and these suggestions are for any firm and any setting in particular for those where there is a high level of stress. It's important to work together, Bring your staff together. We live in a time where we often don't even see our colleagues sometimes anymore. With people working still from home or in a hybrid setting. What we're learning is that some regularity of face to face time is very helpful for morale and it's helpful for the building, a sense of camaraderie among your staff. So overall, it's important to look at and recognize what your own stressors are. I think Carolyn had mentioned earlier that for some people it's very hard to set boundaries. So they go into their work with a sense of being able to accommodate a lot of things and return calls quickly. And they don't necessarily remember that they set the expectation of their clients early on in their process with them. So if you know that you might end up having difficulties with boundaries, then you might wait before you call or return your phone calls at the end of the day so that clients expect that you're not going to be able to respond to their, you know, emails or calls right away. We kind of set the tone for what people expect from us. So that's very important. Know if you're feeling if you're not feeling well, know what your baseline is, know when you're feeling more stressed than usual. And then address that. Find ways of coping with that depression anxiety. If you're feeling more fatigued, if you're having more trouble sleeping than normally, if you're feeling indifferent, if you're starting to have less sensitivity to your clients or to your colleagues or people around you, we spend a lot of time with our colleagues, sometimes more time than we do with our family. So we're in a position where we can actually not only, you know, recognize what's going on for ourselves, but we may be more likely to recognize when our colleague is going through something because all of a sudden they're not responding the way that they typically do. They're not as jovial or they're not. They're a little less well kept. Their appearance is changing. They're more isolating or they're more irritable or they're more likely to lash out and we can approach them. It's difficult to do that, but there are ways to gently do that. And there are tips that I receive calls all the time from colleagues, family members, you know, saying, I'm really concerned about this lawyer. I don't feel comfortable talking to him or her directly. And we reach out and we say, someone contacted us and they're concerned about you. And this is the this is the help that we can provide you through lap. And so that's not uncommon, but it's important to be aware of that. Be realistic about what you can accomplish in your practice. Use discernment. It often feels when when lawyers come to the lawyer assistance program for help, that there is a sense that they have to take every client, especially in solo or small practices. There might be this sense that they really can't afford to not take a case. But typically when you kind of branch out and look at the big picture, some of the cases really end up being more stressful to deal with than they are helpful for you. So being using some discernment is also important. And organize your day, create and adhere as close as possible to a routine. Stay in touch with families, friends, colleagues, religious supports and cultural supports also have a purpose outside of work. People, when they talk about quality of life, will often say what brings them quality of life. Second, and in addition to the importance of support systems, is actually feeling that they have a purpose and that that purpose extends beyond just their career. Exercise and sleep. We know how important those things are. There's a reason why sleep deprivation is a form of torture, because it affects your ability to concentrate. It affects your ability to retain information. It affects your ability to keep yourself, um, measured and in line and emotionally regulated. So what is mindfulness? Mindfulness is a practice that's aimed at helping us cultivate moment to moment awareness of ourselves in our environment. So most of the time we are not really present the ability to stay in the present moment and to focus our thoughts on what's happening in the here and now. It's our ability not to think about the past or the future, but instead observe what's happening in the moment. Right now I am in a room reading my slides to you and giving you some anecdotes as well. I'm fine. I do have things that I'm worried about that have happened in the past and things that I am concerned may happen in the future. Most of the time those are the things that are occupying our lives and we're not necessarily aware that most of the time in this very moment we're okay. When we practice being okay mindfully, we're actually more prepared when things do happen, when we're our thoughts are racing and we're regretting things that happened in the past and we're anticipating anxiety and things happening in the future, we're existing at a heightened state of of hypervigilance, and that actually affects our ability to perform as well as we really could otherwise. So does mindfulness really help? So there is some science behind mindfulness. What the studies have shown is that it counters habituation. And what habituation is, is this tendency to stop paying attention to new information in our environment. We're not necessarily aware that somebody just came into the room and they're a person that might be a good person to talk to about something. We don't even see them. Sometimes we don't see things that are going on around us, new information that can actually help us in the situations that we're struggling with. Mindfulness reduces our mind from wandering off and it improves our problem solving. Again, we're more prepared when we're in the moment. If we're not thinking about things that have happened in the past or thinking about things that are going to happen in the future. It helps the brain to be less reactive to stressors and we recover better from stress when we do experience it. Mindfulness practices help with anxiety. And this particular study, and there's more than one with different degrees of. Different different degrees of experimental studies. So some of the studies have small numbers of participants and some have larger. But these studies show that mindfulness practices can help with anxiety, as well as using a standardized drug treatment with fewer side effects. So it's certainly something to consider when we understand that it's not this big, life altering need to go to a silent retreat for three weeks in order to get the benefits from it. So in addition, mindfulness helps relationships. It enhances our compassion for ourself and others and enhances our likelihood to help others when we're not. In a hypervigilant state of worry. We're more inclined to be be aware of what the people around us are going through. We're more likely to be able to actively listen when which means that we're actively hearing our clients, our loved ones struggles, what they're really going through. We're not using our time thinking about how quick we're going to get out of the room, thinking about how we're going to defend ourselves and what we're going to say next. It allows us to be present in a way that is otherwise more difficult. We recover from conflict faster. We're less likely to act impulsively. We may. It actually makes breaks, breakups and divorces easier, in part because of what I was saying about being less defensive, less impulsive, less likely to fall into the fight or flight response when we feel agitated or threatened. It gives us better relationship with our kids for the same reasons. Practicing mindfulness can reduce psychological bias. It it reduces cognitive dissonance because so often we are kind of so wrapped up in. Trying to feel okay ourselves that we're quick to dismiss the people around us. Mindfulness probably reduces what they call sunk cost bias, which is our tendency to stay invested in a losing venture or proposition, kind of doing the same thing over and over again and hoping for a different response, which many of you know is the definition, in fact, of insanity. So The New York Times published an article last year, and it was called The Art of Breathing. And they talked about three different breathing exercises to reduce stress, stress and improve health. So you can look this article up. And what they first do is an interactive exercise where they time your breathing. So during a period of time, I think it's one minute you count the number of full breaths you take and then depending on how many breaths you take, it will tell you kind of the healthiness of your breathing and it falls into, you know, X number of categories depending on the number of breathwork. So it's something that you might want to look into just to try. But they have come up with three different types of breathing that have proven effective that if you can do it in the moment, that this is very helpful for you in in bringing balance and they're good for different things. So the four for eight breathing exercise is if you're particularly feeling anxious or scared. Several studies have found that purposefully extending your exhale to last longer than your inhale. It slows your heart rate and brings down your blood pressure. But you have to do it three or more times. So basically. And I often do do these right with a hand on your belly. If any of you have ever seen a baby breathing or sleeping when a baby sleeps, you'll notice that their stomach rises when they inhale. And then it releases and it rises. Most people, when they're in a state of anxiety or even when they're not, they're just rushing through their day. They their breathing is kind of from the chest up. In fact, they pretty much exist from the chest up. They breathe heavy from their chest is rapidly rising and falling. Their diaphragm is nowhere in the picture. So what we do in these breathing exercises is take one of our hands and put it on our belly so that you can actually help yourself to feel your belly extending when you when you inhale. So if you inhale for a count of four. Hold it for a count of four. And then breathe out for a count of eight. You're breathing in through your nose, holding and then breathing out through your mouth for a count of eight, just trying to let go as much oxygen as you can before you take the next breath. If you do that three or more times, you should see a difference in those areas. The next. So the next method of breathing that has been found to be helpful is actually taken from yoga and it's called alternate nostril breathing. So why is this helpful? It. The right nostril is connected to your sympathetic nervous system which controls your fight or flight. The left nostril is connected to the more calm parasympathetic system. So even if this doesn't necessarily scientifically help, what we do know is that concentrating on switching between nostrils helps you tune out racing thoughts and help you focus on the moment because you have to be present in order to do that. That said, this has been something that has been done in yoga and found to be very helpful for a very long time. So how do we do this? Using your thumb and your ring finger, you close your right nostril. You breathe in through your left nostril for a count of four, and then you use your ring finger to close your left nostril and you breathe it out from your right nostril for a count of four. And you do that 3 to 5 times. Again, these are efforts to bring you to the moment. They don't take an extensive amount of time and they work. So the this form of breathing is helps to actually improve energy and cognitive focus. So as it says it, the US, US Navy SEALs use this technique to prepare for trainings and even before combat because it can enhance your cognitive focus. So what do you do with one hand on your belly and one hand on your chest? You breathe in for a count of four. You hold for a count of five four. You breathe out for a count of four, and you hold again for a count of four. So it's for four different kinds of things. For a count of four, breathe in for four, hold for four, exhale for four, and then hold again for four. So this as mentioned earlier, stretching is very important. These kinds of stretches you can do right in your chair. The spinal twist. You can do it right there. Just grab the back of your chair and turn so that you can turn as far as you can to the back of the room. And the open chest stretch. Oftentimes when I see people who are anxious or when people describe how they feel when they're feeling anxious, it's like their shoulders are pressed forward and their body is kind of compact. These are kind of help you to expand so that you can actually take the breath more. Your shoulders go back, you become more engaged with your environment and you're more present. You're more likely to be able to register information. You're also more likely to get up and take a break and maybe take a walk because you're no longer hunkered down, you know, in this confined body posture. So there are different stretches for stress release, rotational neck stress. And you really are our neck, you know, is kind of takes on a lot of our. Ah, somatic stress. So if I'm feeling stress, a lot of people feel it in your neck. That's why in shoulders, that's why you go for a neck massage and that's why you do these types of exercises because you're trying to hold that brain up. So even the National Institutes of Health say that tensing up in your neck can trigger a tension headache to keep healthy flexation in your neck and to let go of tightness simply and effectively doing that next stretch which targets the muscles in the back of your neck. So bring your test, your chin down to your chest and rotate your chin toward your armpit. If you need more, place the hand on the back of your head and actually slightly push your head forward so that you feel that stretch. As we know, sleep is one of the building blocks for maintaining physical and mental health. Healthy habits include exercising regularly, getting out in sunlight, drinking less alcohol and caffeine close to bedtime. Try to stay on some type of sleep routine. Try not to look at your electronics 30 to 60 minutes before bed. If you can indulge in one of these short guided images and they'll be at the end in the slides in the future. At the end of this program are some links to different programs that have different kinds of meditations for different purposes. One of them is sleep. Yoga is known to reduce stress because it promotes relaxation, in large part because of the breathing conscious breathing throughout the exercises. It creates mental clarity and calmness. It increases body awareness. It relieves chronic stress and stress patterns. It relaxes the mind and sharpens attention and focus. So and I'll show you these so you can see them. There's seven specific of the very of the many yoga poses. Seven of them have been shown to reduce stress quickly. The first of those is just the standing forward bend. The cat cow pose. So this you're kind of doing, you inhale and you exhale as you shift from from arching your back to then leaning forward. Easy pose. Just kind of sitting. Head to knee. That stretch is a stretch. That's helpful, of course. And the bridge pose. And the corpse prose. That's a lovely name. But it's really just laying with your with your legs hip width apart. And your arms facing up. Child's pose. A lot of times we carry stress in our hips. This stretch helps to release some of that. Tai chi is another tradition. It's an ancient Chinese tradition that's practiced. And basically what it is, is graceful forms of exercises. It's a series of movements that are performed in a slow, focused manner, accompanied by deep breathing. Tai chi decreases stress, anxiety and depression improves mood, improves aerobic capacity, increases energy and stamina, improves flexibility, balance and agility, Muscle strength and definition. It enhances quality of sleep. Improves your immune system, lowers blood pressure, improves joint pain. Improves symptoms of congestive heart failure. Overall well-being. And as your balance improves and your coordination improves and your flexibility improves, of course, you're less likely to fall. So Headspace is a program that offers what we had been mentioning earlier, which all different kinds of meditations, each with a different. A different topic and different amounts of time, usually not more than 20 minutes. I believe that's the longest one, if I'm not mistaken. So how to get started and what is meditation? Then? There is one about letting go how to drop the baggage and how to fall in love with life. How to pause for a minute so that you have gratitude and learn to listen to your mind and your body. They explore the ways that you can be more reflective. How to deal with stress, How to be kind. Had have purpose, had to deal with pain, had to deal with anger. How to achieve your unlimited potential. So I'm going to talk a little bit before we end about the services that the Lawyer Assistance program provides. As mentioned, we are the Nassau County Bar Association Lawyer Assistance Program is one of three programs in the. In the New York in New York State. There's also a program at the New York State Bar Association, and there's a program in the New York City Bar Association. Most many law, many bar associations have committees, lawyers helping lawyers, committees. And they also provide a lot of outreach and education and assistance to lawyers. The difference is that the lawyer assistance program is typically funded, and it's typically run at least in New York State, by a licensed mental health provider that enables those programs to provide direct counseling services, professional counseling services to lawyers, judges, law students and their immediate family members. It's similar to an employee assistance program in that we would provide 3 to 5 direct sessions before we would determine whether or not an outside referral is necessary. And then we have a series of professionals that we work with that we refer clients to. As I mentioned earlier, sometimes we get calls from lawyers who just feeling a little bit stressed. I talk to them once. I never talk to them again. Sometimes we get calls from lawyers, from lawyers who are concerned about other lawyers, and we talk about ways that they can help and perhaps approach their colleagues because these are concerns about cognitive impairment. For example, we want to make sure that lawyers who have had fulfilling careers as lawyers, you know, really leave kind of the profession with with their dignity and their respect. And we want to make sure that that we can help our colleagues to do that if necessary. So those are things that people call us and we talk about. Family members call us because they're concerned about a family member who happens to be a lawyer. Sometimes I talk to people a couple of times and they don't need to go to another facility or another organization. We help lawyers get into treatment programs. We help lawyers get into rehab, substance use or co-occurring rehab programs. We have a lawyer assistance committee which is comprised of lawyers who volunteer their time to help other lawyers in need. Many of the members of the committee are in recovery themselves, and they provide peer support. They bring people to meetings. They they might mentor people and take them out and form connections with them. We have a lawyer retreat once a year for lawyers who are new to recovery so that they can have a opportunity to meet with other lawyers who are struggling and other lawyers who have actually made had enormous quality of life in recovery. We have a monitoring program, which is a diversion program. So oftentimes lawyers who engage in behaviors that threaten their license, like neglecting clients, taking money from escrow, oftentimes there are mitigating circumstances, whether that be substance use, whether that be mental health issues, whether that be going through a divorce and feeling overwhelmed. There are so many reasons why we might behave in ways that we would not typically behave. And the monitoring program is a is a way for us to hopefully work with lawyers to to create coping skills that can demonstrate to grievance or character and fitness that should these issues raise themselves in the future, they have coping mechanisms and the means to avoid engaging in unethical behavior. We do a ton of outreach and education to law firms, law schools and. Other legal departments to prevent the use of medication for self self-soothing, so to speak, and the use of drugs, alcohol, or the increase in mental health that comes from stress. And we do interventions oftentimes where we will work with family members to intervene with a colleague or a friend or a family member struggling with substance use. This is our contact information. Um, feel free to reach out if there are any issues or questions you have. And if in your state you're not able to reach the program, I'd be happy to assist you in doing that. Thank you.

Presenter(s)

CWJ
Carolyn Wolf, JD
Executive Partner
Abrams Fensterman, LLP
EEP
Elizabeth Eckhardt, PhD
Director
Nassau County Bar Association Lawyer Assistance Program

Credit information

Jurisdiction
Credits
Available until
Status
Alabama
    Pending
    Alaska
    • 1.0 ethics
    September 21, 2025 at 11:59PM HST Available
    Arizona
    • 1.0 professional responsibility
    September 21, 2025 at 11:59PM HST Available
    Arkansas
    • 1.0 ethics
    September 21, 2025 at 11:59PM HST Approved
    California
    • 1.0 competence issues
    September 21, 2025 at 11:59PM HST Approved
    Colorado
      Pending
      Connecticut
      • 1.0 ethics
      September 21, 2025 at 11:59PM HST Available
      Delaware
        Pending
        District of Columbia
          Not Offered
          Florida
            Pending
            Georgia
            • 1.0 ethics
            Unavailable
            Guam
            • 1.0 ethics
            September 21, 2025 at 11:59PM HST Available
            Hawaii
            • 1.0 ethics
            September 21, 2025 at 11:59PM HST Approved
            Idaho
              Pending
              Illinois
              • 1.0 professional responsibility
              September 29, 2025 at 11:59PM HST Approved
              Indiana
              • 1.0 general
              December 31, 2024 at 11:59PM HST Approved
              Iowa
              • 1.0 attorney wellness
              January 10, 2025 at 11:59PM HST Approved
              Kansas
                Pending
                Kentucky
                  Pending
                  Louisiana
                    Pending
                    Maine
                      Pending
                      Maryland
                        Not Offered
                        Massachusetts
                          Not Offered
                          Michigan
                            Not Offered
                            Minnesota
                              Pending
                              Mississippi
                                Pending
                                Missouri
                                  Pending
                                  Montana
                                    Pending
                                    Nebraska
                                      Pending
                                      Nevada
                                      • 1.0 ethics
                                      December 31, 2026 at 11:59PM HST Approved
                                      New Hampshire
                                      • 1.0 ethics
                                      September 21, 2025 at 11:59PM HST Available
                                      New Jersey
                                      • 1.2 general
                                      September 26, 2024 at 11:59PM HST Approved
                                      New Mexico
                                        Pending
                                        New York
                                        • 1.0 ethics
                                        September 21, 2025 at 11:59PM HST Available
                                        North Carolina
                                        • 1.0 substance abuse
                                        February 28, 2025 at 11:59PM HST Approved
                                        North Dakota
                                        • 1.0 ethics
                                        September 21, 2025 at 11:59PM HST Approved
                                        Ohio
                                        • 1.0 professional conduct
                                        December 31, 2024 at 11:59PM HST Approved
                                        Oklahoma
                                          Pending
                                          Oregon
                                            Pending
                                            Pennsylvania
                                            • 1.0 general
                                            January 16, 2026 at 11:59PM HST Approved
                                            Puerto Rico
                                              Pending
                                              Rhode Island
                                                Pending
                                                South Carolina
                                                  Pending
                                                  South Dakota
                                                    Pending
                                                    Tennessee
                                                    • 1.0 ethics
                                                    September 25, 2024 at 11:59PM HST Approved
                                                    Texas
                                                    • 1.0 ethics
                                                    September 30, 2024 at 11:59PM HST Approved
                                                    Utah
                                                      Pending
                                                      Vermont
                                                      • 1.0 ethics
                                                      September 21, 2025 at 11:59PM HST Available
                                                      Virginia
                                                        Not Eligible
                                                        Virgin Islands
                                                        • 1.0 ethics
                                                        September 21, 2025 at 11:59PM HST Available
                                                        Washington
                                                          Pending
                                                          West Virginia
                                                            Not Eligible
                                                            Wisconsin
                                                              Not Eligible
                                                              Wyoming
                                                                Pending
                                                                Credits
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                                                                  Status
                                                                  Pending
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                                                                  • 1.0 ethics
                                                                  Available until

                                                                  September 21, 2025 at 11:59PM HST

                                                                  Status
                                                                  Available
                                                                  Credits
                                                                  • 1.0 professional responsibility
                                                                  Available until

                                                                  September 21, 2025 at 11:59PM HST

                                                                  Status
                                                                  Available
                                                                  Credits
                                                                  • 1.0 ethics
                                                                  Available until

                                                                  September 21, 2025 at 11:59PM HST

                                                                  Status
                                                                  Approved
                                                                  Credits
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                                                                  Available until

                                                                  September 21, 2025 at 11:59PM HST

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

                                                                    September 21, 2025 at 11:59PM HST

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

                                                                          September 21, 2025 at 11:59PM HST

                                                                          Status
                                                                          Available
                                                                          Credits
                                                                          • 1.0 ethics
                                                                          Available until

                                                                          September 21, 2025 at 11:59PM HST

                                                                          Status
                                                                          Approved
                                                                          Credits
                                                                            Available until
                                                                            Status
                                                                            Pending
                                                                            Credits
                                                                            • 1.0 professional responsibility
                                                                            Available until

                                                                            September 29, 2025 at 11:59PM HST

                                                                            Status
                                                                            Approved
                                                                            Credits
                                                                            • 1.0 general
                                                                            Available until

                                                                            December 31, 2024 at 11:59PM HST

                                                                            Status
                                                                            Approved
                                                                            Credits
                                                                            • 1.0 attorney wellness
                                                                            Available until

                                                                            January 10, 2025 at 11:59PM HST

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

                                                                                                    December 31, 2026 at 11:59PM HST

                                                                                                    Status
                                                                                                    Approved
                                                                                                    Credits
                                                                                                    • 1.0 ethics
                                                                                                    Available until

                                                                                                    September 21, 2025 at 11:59PM HST

                                                                                                    Status
                                                                                                    Available
                                                                                                    Credits
                                                                                                    • 1.2 general
                                                                                                    Available until

                                                                                                    September 26, 2024 at 11:59PM HST

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

                                                                                                      September 21, 2025 at 11:59PM HST

                                                                                                      Status
                                                                                                      Available
                                                                                                      Credits
                                                                                                      • 1.0 substance abuse
                                                                                                      Available until

                                                                                                      February 28, 2025 at 11:59PM HST

                                                                                                      Status
                                                                                                      Approved
                                                                                                      Credits
                                                                                                      • 1.0 ethics
                                                                                                      Available until

                                                                                                      September 21, 2025 at 11:59PM HST

                                                                                                      Status
                                                                                                      Approved
                                                                                                      Credits
                                                                                                      • 1.0 professional conduct
                                                                                                      Available until

                                                                                                      December 31, 2024 at 11:59PM HST

                                                                                                      Status
                                                                                                      Approved
                                                                                                      Credits
                                                                                                        Available until
                                                                                                        Status
                                                                                                        Pending
                                                                                                        Credits
                                                                                                          Available until
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                                                                                                          Pending
                                                                                                          Credits
                                                                                                          • 1.0 general
                                                                                                          Available until

                                                                                                          January 16, 2026 at 11:59PM HST

                                                                                                          Status
                                                                                                          Approved
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                                                                                                                  Pending
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                                                                                                                  • 1.0 ethics
                                                                                                                  Available until

                                                                                                                  September 25, 2024 at 11:59PM HST

                                                                                                                  Status
                                                                                                                  Approved
                                                                                                                  Credits
                                                                                                                  • 1.0 ethics
                                                                                                                  Available until

                                                                                                                  September 30, 2024 at 11:59PM HST

                                                                                                                  Status
                                                                                                                  Approved
                                                                                                                  Credits
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                                                                                                                    Pending
                                                                                                                    Credits
                                                                                                                    • 1.0 ethics
                                                                                                                    Available until

                                                                                                                    September 21, 2025 at 11:59PM HST

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

                                                                                                                      September 21, 2025 at 11:59PM HST

                                                                                                                      Status
                                                                                                                      Available
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