IDENTIFYING THE ALCOHOLIC LAWYER
by Jonathan Goodliffe (email@example.com)
This paper is provided by SolCare, which gives health support and advice for Solicitors on alcohol problems, depression, stress and drugs. SolCare may be contacted at PO Box 6, Porthmadog, Gwynnedd, LL49 9ZE, United Kingdom. Tel: 01766 512222. E-Mail: firstname.lastname@example.org.
Stress, depression and alcoholism
SolCare was founded in February 1997. It is a charity funded by the Law Society and the Solicitors' Indemnity Fund. It has a full time co-ordinator, Barry Pritchard, supported by trustees and a network of volunteers. Its purpose is to help solicitors and their staff who are impaired by alcohol and/or drug abuse, stress, depression and similar conditions, and to prevent health, family and professional problems which often develop from these conditions.
These conditions are closely linked to each other. A lawyer may be addicted to alcohol or drugs or both. Alcoholism often generates symptoms and behaviour patterns which are similar to those generated by addiction to many other drugs. A stressful working environment may lead to heavy drinking. Heavy drinking will also create problems which in turn will lead to still more stress.
On the positive side, a depressive personality may sometimes be an asset for a lawyer, since it may help him to anticipate the worst and thus to be better prepared for problems, when they arise. On the other hand it can paralyse his ability to function professionally.
A lawyer suffering from endogenous depression, or depression caused by his problems,
may resort to drinking. In so doing he may aggravate his problems, first because alcohol
is a depressive drug and secondly because the problems generated by his drinking will give
him more to be depressed about(1). Many patients
seeking medical help are given a dual diagnosis of depression and alcohol dependence.
Bipolar affective disorder, or "manic depression", mimics many of the symptoms
Most doctors receive little training in the treatment of addiction. Some see it merely as a symptom which will disappear if the primary condition is treated. "Patients and therapists are as prone as researchers interviewing alcoholics after the fact to fall victim to the retrospective illusion, that is the view that most alcoholics have been severely disturbed or depressed from the very beginning. The resultant interpretation of heavy drinking as a form of self-medication facilitates collusion with the patient's denial that drinking is a serious problem in its own right"(3).
Other doctors hardly regard alcoholism as a medical problem at all. They expect their patients to conquer it by will power and Valium.
These factors, combined with the social stigma attached to alcoholism, often lead to incorrect diagnoses and, for instance, to the prescription of anti-depressive drugs for patients whose primary problem is alcohol. Patients with conditions which may be alcohol related will not necessarily be asked about their drinking.
Even the most experienced doctor, and indeed any professional person, seeking to help an alcoholic patient or client, faces considerable challenges, since the alcoholic will generally lie about the amount of his drinking and blame his problems on everything and everyone except his addiction. In so doing he is not being deliberately dishonest: he simply cannot face up to reality. The family, friends and colleagues of the alcoholic often share the same "denial". They facilitate his drinking and help him to avoid the natural consequences of his behaviour. This attitude is sometimes described as "co-dependency".
Responsibility of colleagues
The primary responsibility for identifying lawyer alcoholism lies, therefore, with the profession itself, which is in the best position to identify the behavioural signs of addiction and perhaps has the most to lose, especially financially, if the problem is ignored. Certainly no sober lawyer has the right to expect that his alcoholic colleague will seek or get the appropriate medical advice, or, even if he does, that he will take any notice of it, since whatever the chaos that surrounds him, the alcoholic will not accept that there is a problem with his drinking. The sober colleague cannot rely on the alcoholic's spouse or family to take the initiative. Nor is the fact, if such be the case, that alcoholism is caused by stress or depression, a reason for ignoring its potential consequences.
This article describes typical symptoms and behaviour patterns of alcoholic lawyers. Much of what is said applies to other addictions, including addictions to prescription drugs, although drugs such as cocaine, heroin and marijuana have yet to make the same impact in the British legal profession as they have done in North America. The alcoholic is referred to as "he", but women may also be affected. There are still more male than female alcoholics, but the prevalence among the latter is increasing(4).
Later articles will discuss possible strategies for confronting and helping the alcoholic, dealing with the problems created by his behaviour, and helping him to return to the profession once he has received appropriate help and treatment.
Professional signs of alcoholism
The following bullet points describe behaviour which may sometimes indicate other conditions. However when a number of these patterns persist over a long period, alcoholism is the most probable explanation.
Appearance and health
He will probably look unwell. He may put on weight (or lose it if he is depressed). His eyes may be bloodshot and his face florid (women may disguise these symptoms with makeup). He may neglect regular exercise and will in any event have less mental and physical energy. Alcohol and drug addiction often go together with heavy smoking.
He may appear unkempt and may be neglecting personal hygiene (this is perhaps more likely to affect men than women). He may be wearing a lot of aftershave, or have been sucking peppermint, to disguise the smell of alcohol. Women will achieve the same result with perfume.
He may be suffering from a physical condition which is alcohol related, a fact which may not be apparent to his doctor. Physical complaints which are alcohol related include liver cirrhosis, hepatitis, pancreatitis, cancer of the larynx, pharynx, oesophagus and pancreas, cardiomyopathy, anaemia, vitamin deficiency, tremors, digestive/bowel problems, dental problems and peripheral neurititis (not being able to feel one's fingers and toes).
A common feature of alcoholism, which often reinforces "denial", is the alcoholic blackout. The alcoholic drinks so much that when he wakes up the following morning he "blacks out" on a substantial period the night before and cannot remember it. Serious crimes are often committed in blackout. A solicitor may, for instance, make the same telephone call twice, or not remember drawing £10,000 from client account or why he did it.
When alcoholics are misdiagnosed, they are often prescribed tranquilisers or anti-depressants, which, when combined with alcohol, may aggravate their symptoms.
There are psychoses resulting from chronic alcoholism: delirium tremens (including
shakes, sweats and horrors), Korsakoff's syndrome and alcoholic dementia (wet brain),
auditory alcoholic hallucinosis (hearing of derogatory voices), and pathological alcoholic
A male alcoholic's family, especially his wife, may be very loyal and defensive of him (secretaries often react in the same way). A woman's family is less likely to be so loyal. Ultimately, however, the alcoholic's behaviour, if unchecked, will usually lead to family breakdown and divorce.
Young children may be very upset by the unhappiness caused by the alcoholism, resulting in problems at school, truancy, juvenile crime, aggressive or tearful behaviour, and bed wetting. Older children may follow their parent's example by getting onto drugs or drink themselves.
The spouse of an alcoholic will feel the impact of his drinking. If she is herself a
lawyer her own practice will suffer. She may get depressed, have difficulty concentrating,
have frequent absences from work and lose her own professional commitment.
This is the first in a series of articles. The second discusses strategies for helping the alcoholic lawyer and coping with the consequences of his behaviour. The third discusses how to help him to return to practice after treatment. The full series is available for download from the World Wide Web at http://dspace.dial.pipex.com/jgoodliffe/??
Jonathan Goodliff is a solicitor and trustee of SolCare.
SolCare can be contacted at PO Box 6, Porthmadog DO, Gwynedd LL49 9ZE, telephone number 01766 512222.
1. 1 Most research papers seem to support the view that alcohol is the "horse" rather than the "cart": Vaillant, GE "Is alcoholism more often the cause or the result of depression", Harvard Rev Psychiatry 1993; 1-2:94; Schuckit, M. A. et al. "One year incidence rate of major depression and other psychiatric disorders in 239 alcoholic men" Addiction 1994;89: p.441
2. 2 "Alcohol and mental illness: cause or effect", Glass and Marshall, in "International Handbook of Addiction Behaviour", Glass, 1991.
3. 3 Lindström, "Managing Alcoholism", 1992, page 77.
4. 4 "Gender and Alcohol: individual and social perspectives" RW and SC Wilsnack, 1997.
5. 5 There is convincing research evidence that heavy alcohol consumption impairs cognitive functioning in complex tasks, and not just, for instance, in driving a vehicle or in manual labour: Steufert et al. "Alcohol and complex functioning" Journal of Applied Social Psychology, 1993 23-11: p.847.