I was interviewed by Jay Coulter on the Conquer Worry show. Listen to this Podcast.
The Depression Epidemic in the Legal Profession
Dan’s Latest Top 10 Book Recommendations on Stress, Stress-Management and Anxiety
Over the years, I’ve read too many books to count about stress, anxiety, and depression. Like most people, I’m always looking for tips and clues about how to handle things better.
Some of these books have turned out to be real stinkers. Others, retreads of books and articles that have said the same things over and over again.
I have found some gems, though. Books that have something original to say, or are well-written.
I’ve found that the most useful ones make me want to read them further after the first 25-pages, or so. Good rule of thumb.
I hope you find help, hope, and insight between their pages.
Manage Your Time to Reduce Your Stress: A Handbook for the Overworked, Overscheduled, and Overwhelmed — Rita Emmett
The title of this book grabbed my attention because it seemed to capture so much more than just stress management. Stress management is truly about managing being overworked, overscheduled, and overwhelmed.
According to the author, the key is not time management but “stuff management — taking control of all those tasks to do, people to see, commitments and obligations to fulfill. Mismanagement of all that “to-do” stuff is what leads to stress. Emmett combines quick, easy-to-digest tips and infectious good humor to give readers positive ways to handle stress and their overly busy lives.
You can also check out her website for other helpful tips and ideas.
Monkey Mind: A Memoir on Anxiety — Daniel Smith
I first read about Smith’s book in a New York Times article called “Panic Buttons“. This memoir on stress and anxiety is not only informative and insightful, it’s well-written and funny.
The long list of things that, over the years, have made Daniel Smith nervous includes sex, death, work, water, food, air travel, disease, amateur theater, people he’s related to and people he’s not related to, so the prospect of a book review probably wouldn’t seem like a very big deal to him. Or would it?
This fleet, exhausting memoir, is an attempt to grapple with a lifetime of anxiety: to locate its causes, describe its effects and possibly identify a cure. Or, if not a cure, at least a temporary cessation of the worry that’s been plaguing him since his youth.
Check out his website, The Monkey Mind Chronicles, for more interesting stuff.
Hardwiring Happiness: The New Brain Science of Contentment, Calm, and Confidence — Rick Hanson
Rick Hanson, Ph.D. is a neuropsychologist and best-selling New York Times author.
Hardwiring Happiness lays out a simple method that uses the hidden power of everyday experiences to build new neural structures full of happiness, love, confidence, and peace.
In an interview discussing the book, he states:
“So, how do you get good things—such as resilience, self-worth, or love—into your brain? These inner strengths are grown mainly from positive experiences. Unfortunately, to help our ancestors survive, the brain evolved a negativity bias that makes it less adept at learning from positive experiences but efficient at learning from negative ones. In effect, it’s like Velcro for the bad but Teflon for the good.
This built-in negativity bias makes us extra stressed, worried, irritated, and blue. Plus it creates a kind of bottleneck in the brain that makes it hard to gain any lasting value from our experiences, which is disheartening and the central weakness in personal development, mindfulness training, and psychotherapy”.
Check out his website for more information about the book and his suggestions.
Why Zebras Don’t Get Ulcers: An Updated Guide to Stress, Stress-Related Diseases and Coping – Robert Sapolsky, Ph.D.
Why don’t zebras get ulcers–or heart disease, clinical anxiety, diabetes and other chronic diseases–when people do?
In a fascinating that looks at the science of stress, Stanford biologist Robert Sapolsky presents an intriguing case, that people develop such diseases partly because our bodies aren’t designed for the constant stresses of a modern-day life – – like sitting in daily traffic jams or racing through e-mails, texting and running to pick up our kids after a tough day at work. Rather, humans seem more built for the kind of short-term stress faced by a zebra–like outrunning a lion.
This book is a primer about stress, stress-related disease, and the mechanisms of coping with stress. How is it that our bodies can adapt to some stressful emergencies, while other ones make us sick? Why are some of us especially vulnerable to stress-related diseases and what does that have to do with our personalities?”
Sapolsky, a neuroscientist, concludes with a hopeful chapter, titled “Managing Stress.” Although he doesn’t subscribe to the school of thought that hope cures all disease, Sapolsky highlights the studies that suggest we do have some control over stress-related ailments, based on how we perceive the stress and the kinds of social support we have.
Full Catastrophe Living: Using the Wisdom of Your Body and Mind to Face Stress, Pain, and Illness – John Kabat-Zinn, M.D.
As a busy lawyer, I was immediately attracted to the title Full Catastrophe Living. It literally leapt of the bookshelf and cracked me on the head. Who doesn’t live a life so jammed with stuff to do that it feels like a catastrophe?
Chronic stress saps our energy, undermining our health, and making us more vulnerable to anxiety, depression, and disease. The heart of the book is based on Kabat-Zinn’s renowned mindfulness-based stress reduction program at the University at Massachusetts Medical Center.
The author takes the phrase “full catastrophe living” from book and movie “Zorba the Greek”. If you’ve never seen it, an Englishman Basil – – who is half-Greek – – inherits a run down mine in a small Greek town. To help him restore it, he hires a local character named Zorba to be the foreman of the local laborers. Zorba, full of the zest of a life truly lived, is asked by Basil, “Do you have a family?” Zorba responds “Wife, children, house – – the full catastrophe!!!”
Undoing Perpetual Stress: The Missing Connection Between Depression, Anxiety and 21st Century Illness – Richard O’Connor, Ph.D.
Author of my favorite book on depression, “Undoing Depression”, Richard O’Connor, Ph.D., has written another simply brilliant book on the consequences of “perpetual” stress in our lives – the alarming and escalating rates of clinical anxiety and depression. This was the first book I read that made clear to me the connection between stress, anxiety, and depression. It formed the basis for my blog on the topic How Stress and Anxiety Become Depression. The human nervous system was never meant to handle this many stressors. It’s as if the circuit breakers in our brains are blown by too much stress running through our brain’s circuitry. This book is a perfect fit if you want to learn a lot about the brain and physiology of stress – I found it fascinating. If you’re looking for a quick read and pick-me-up, this isn’t it. Check out his website.
A Mindfulness-Based Stress Reduction Workbook — Bob Stahl
The author writes that the key to maintaining balance is responding to stress not with frustration and self-criticism, but with mindful, nonjudgemental awareness of our bodies and minds.
This book employs some of the same mindfulness strategies discussed in Full Catastrophe Living but does it in the format of a workbook. I find this format very helpful because it’s practical and gives me exercises to do to put into practice mindfulness to reduce my daily stress load.
The 10 Best-Ever Anxiety Management Techniques – Margaret Wehrenberg, Ph.D.
Medication, once considered the treatment of choice, is losing favor as more and more sufferers complain of unpleasant side effects and its temporary, quick-fix nature. Now, thanks to a flood of fresh neurobiology research and insights into the anatomy of the anxious brain, effective, practical strategies have emerged allowing us to manage day-to-day anxiety on our own without medication. Addressing physical, emotional, and behavioral symptoms, Margaret Wehrenberg, Ph.D., a leading mental health clinician, draws on basic brain science to highlight the top ten anxiety-defeating tips. Everything from breathing techniques to cognitive control and self-talk are included. I really like that the 10 chapters are highly readable and short. Dr. Wehrenberg is also a frequent blogger at the Psychology Today website. Here’s one of her blogs, The One-Two Punch of Negativity and Fear.
Things Might Go Terribly, Horribly Wrong: A Guide to Life Liberated from Anxiety – Troy DuFrene
This book approaches the problem of anxiety a little differently than most. Instead of trying to help you overcome or reduce feelings of anxiety, it will help you climb inside these feelings, sit in that place, and see what it would be like to have anxiety and still make room in your life to breathe and rest and live, really and truly live, in a way that matters to you. This approach is based upon a research-supported form of psychotherapy called Acceptance and Commitment Therapy, also known as ACT which starts with the assumption that the normal condition of human existence is suffering and struggle, ACT works by first encouraging individuals to accept their lives as they are in the here and now. This acceptance is an antidote to the problem of avoidance, which ACT views as among the greatest risk factors for unnecessary suffering and poor mental health
The Worry Cure – Robert L. Leahy
For “highly worried people,” or those who suffer from the “what-if disease,” this book presents a systematic, accessible self-help guide to gaining control over debilitating anxiety. Leahy is an expert in changing thought processes, and he walks worriers step-by-step through problems in the way they think, with pointers on how to change these biases. The author then outlines a seven-step worry-reduction plan (remember, I love plans!) beginning with identifying productive and unproductive worry, progressing to improving skills for accepting reality, challenging worried thinking and learning to harness unpleasant emotions such as fear or anger.
Self-Coaching: The Powerful Guide to Beat Anxiety – Joseph J. Luciani, Ph.D.
This is a good book for those who don’t want to see a therapist or, if they do, need extra doses of encouragement and practice to overcome their stress and anxiety. The author advises readers to identify themselves as specific personality types (e.g., “Worrywarts,” “Hedgehogs,” “Perfectionists”) and then gives specific instructions on how to change the particular thought patterns associated with this type of personality. So many people who struggle with anxiety never got what they needed while growing up – – enough love, encouragement, and affirmation. Lacking these core experiences, we develop can develop particular maladaptive strategies to cope with people and situations that push our buttons. This is the only book that I’ve read that pairs specific coping recommendations with particular personality types.
What books would you recommend? Hit the comment button and submit your favorites.
If you are interested in talking to Dan about CLE eligible trainings he offers law firms, call him at (716) 913-6309 or via our contact form. One-on-one coaching is also available for lawyers who need individualized attention. Go to Dan’s website Yourdepressioncoach.com to download his free book and schedule a consultation.
Are Lawyers Worry Warts?
Lawyers don’t have problems, they have catastrophes. Many lawyers feel that the problems that afflict the average person are manageable in comparison to the big decisions with big consequences they must shoulder every day. “My friends just don’t understand the burdens I carry in my job”, one lawyer told me. “I worry constantly and can’t turn it off.”
Another seasoned attorney related:
I always thought I was a worrier. I’d feel keyed up and unable to relax. At times it would come and go, and at times it would be constant. It could go on for days. I’d have terrible sleeping problems. There were times I’d wake up wired in the middle of the night. I had trouble concentrating, even reading the newspaper or a novel. Sometimes I’d feel a little lightheaded. My heart would race or pound. And that would make me worry more.
According to psychologist Jim Taylor, not all worry is bad:
Worrying is obviously not a pleasant emotion, but it is actually an essential, normal, and instinctive emotion that has been hard-wired into humans to help us survive since we rose out of the primordial muck. We worry about something because we perceive it as a threat to our existence and worry causes us to focus on it and protect ourselves from that threat. Back in the prehistoric days, carefree cave people, though probably a very fun bunch, were killed by hostile tribes or eaten by wild animals because they didn’t worry about or focus on the potential threats. Cave people who worried, though probably not the life of the party, survived these threats and passed their genes on to future generations. So, worry has been keeping us alive as a species since the dawn of humankind.
Worry is as much a part of lawyers’ lives as bagels and briefcases. I think most lawyers think of worrying as an occupational hazard of the professon, as much as an electrical lineman does about working at great heights around high voltage cable lines.
But worry can go on for too long and go to far. If it grinds on too long, it can became a type of disfunctional anxiety; a condition that is incapacitating.
What’s the difference between worry and anxiety? Psychologist Tara Bennett Goleman offers up this useful distinction:
A right-size dose of worry can mobilize us to meet a challenge well. But the tipping point from apt concern to the anxious mode is reached when added anxiety does not lead to constructive action. From that point on, we just stew in our worries. People caught in the anxious mode can feel overwhelmed, needy, fragile, and emotionally helpless, or have deep self-doubt.
Needy? Fragile? Deep Self-doubt? Lawyers? To many, that wouldn’t describe most lawyers they know. Lawyers need clients and their firms to think that they are strong and confident and, sometimes, even cocky and arrogant. Clients and firms pay them to stand up and be tough when inside, a lawyer riddled with anxiety, feels like falling apart.
Over the long haul, this way of life, this “cost of doing business”, is draining. But many lawyers feel like they have no choice. But when it comes down to it, they really do. And most lawyers know, deep down, that it is a bad one.
As author Corrie Ten Boom wrote, “Worry does not empty tomorrow of its sorrows. It empties today of its strength.” Can lawyers get to the point in their lives where they see their anxiousness as a choice?
What are your experiences with worry and anxiety in your law practice?
The Worrier Warrior: Working with Depression through Brain Training
Frank walked into my office and said, “I was in therapy for 15 years, know my ‘issues’ inside and out, but I’m still taking an anti-depressant and an anti-anxiety med when I have to do any major presentation at the firm. It’s like my baseline is off. It’s great for being a lawyer. I’m always hyper-vigilant—looking out for the next danger, working very hard to stay on top of everything. But when I get into bed at night, my mind is racing and I feel this sinking feeling. Still, after all this therapy. What can you do for me?”
Frank doesn’t have a motivation problem, or a lack of insight problem. Frank has a brain problem.
Frank had come into my office after having done research into the benefits of neurofeedback for depression and anxiety. I see clients like Frank everyday and I call them my “Worrier Warriors”. Their nervous systems are in a state of ‘activation’ where the flight/fight/freeze brain is always in go-mode. And he’s right—it serves a law firm well. These brains are habitually trained to be on the watch for danger. Add a good analytic mind to that mix and you’ll have a highly successful lawyer who protects his or her clients well, but at a high cost of health and happiness.
We’ve come a long way in our understanding of the brain and brain functioning in producing the symptoms we call anxiety and depression. In the mental health field we used to think of them as ‘mind’ problems, but now we’ve come to understand that they are also brain problems.
We all know we are ‘creatures of habit’ but what that really means is that the brain is prone to habituated rather than fresh responses. The brain functions to be most efficient and effective in use of its energy to protect and maintain the body. The flaw in this system design is that the brain becomes efficient by using cues to approximate the present situation and then uses an old response pattern, which leads to misperceptions of the present moment and less than appropriate responses. We’ve all seen someone “lose it” and respond with an angry outburst when the situation warranted concern or a firm voice.
A dramatic and sad illustration of this principle is the war vet who comes home with Post Traumatic Stress Disorder (PTSD) from his years of service. As a soldier he has been trained to respond to danger with ‘fight’ response. But now he is home from the war and is walking down his hometown street when a car backfires. The brain is habituated to “loud sound equals danger” and the vet’s brain goes into fight mode—yelling, pushes someone or becomes highly irritable and later starts a fight with a loved one.
An important piece of information to know about the part of the brain that operates the fight/flight response: it does not take orders from anyone. It is a part of the brain that needs to be able to respond in milliseconds, so it doesn’t take in information from other, more rational and analytic parts of the brain. As a result you could say to yourself, “I really shouldn’t get angry and fly off the handle.” But the part of the brain that decides that action, acts without input from our rational, willful self. It takes in sensory input and then makes a snap decision.
Why are lawyers so prone to anxiety, depression and anger outbursts? Their brains are habituated to the flight/flight/freeze response (anger/anxiety/depression) response. For whatever reason, and their could be many, they experienced a threat or threats at some point in their lives that were significant enough to habituate the brain to being in this activation mode. A quick way to find out if you are is to ask yourself this question, and answer quickly without thinking: Is the world a safe place? If the answer is ‘no’ then chances are your brain is habituated to thinking that you are in danger when you aren’t. It makes you a perfect candidate to become a lawyer where you always have to be thinking about what the risks are in any situation. Or to be an ENT or an emergency room doctor. Your brain is habituated to perceive risk.
Now what to do about this habituated brain? Here are some tips:
- Breath. Seriously. The breath, slow and deep breathing are ways we can “tell” the brain that we are safe and it can go into a state of relaxation and regulation. Slow deep breathing for 5 minutes where you work your way up to counting to 5 on the inhalation and 5 on the exhalation will do wonders to communicate to the brain to come out of flight/flight and into calm awareness (the state of a regulated and balanced brain.)
- Understand: Help yourself by having a good and clear conceptual understanding that your anxiety and depression and anger outbursts are a brain over-reacting, not an accurate assessment of the present moment’s situation. Your brain is reading a newspaper that’s 20 years old and acting as if it’s the here-and-now news.
- Get exercise: I recently had a neurologist tell me that if the positive effects of exercise (increased heart rate 30 mins 5 times a week) were a drug, it would be considered a “miracle drug” and would generate billions of dollars a year in revenue.
- Get enough sleep. Studies are now coming out showing the detrimental effects of chronic sleep deprivation—5 hours a night or less—on the development of chronic conditions.
- Train the brain with neurofeedback. Neurofeedback trains the brain to optimize its functioning through allowing the brain to ‘see’ its unhelpful response patterns. And the brain learns to use the present moment to decide it’s next action rather than using those old habitual response patterns. As a result the trained brain sleeps better, is calmer, is better able to focus, and is more cheerful. And as one client said, “I have the same problems, they just don’t get to me anymore.”
Natalie Baker, MA LMHC, works as a psychotherapist and neurofeedback trainer in private practice in New York City. http://www.neurofeedbackny.com
Anxiety and Exaggerations: Get Relief From Amplifying Possibilities into Catastrophes
Worry, anxiety, stress and panic reflect emotional expressions of catastrophic thinking. Technically, catastrophizing is an exaggerating, irrational, style of dwelling on real or imagined disasters. This is popularly known as painfully blowing things out of proportion. Fortunately, catastrophic thinking is correctable. I’ll emphasize how to do this.
What are the signs of catastrophizing? You unintentionally make a bad situation worse, or create a crisis out of little to nothing. You may chain together worsening possibilities as you sink into a descending cycle of despair. When catastrophic thinking fuses with raw-nerve tension, you’ll have trouble concentrating. You’ll have trouble figuring out what to do. When ongoing, catastrophizing can be a prelude to depression. Combating this thinking helps prevent anxiety-linked depressions.
What does catastrophic thinking feel like? You receive a registered letter from the legal offices of Wiggins and Trust. Before you open it, you assume you are going to be the subject of a ruinous lawsuit and then you dwell on the horrors of the suit. You feel helpless, vulnerable, and overwhelmed. Feeling too tense to open and read the letter, you put it aside. After days of gut-wrenching dread, you can’t take the strain any longer. You open the envelope. You discover that a great aunt willed you her painting of the Grand Canyon.
Are you willing to make necessary changes to combat and neutralize catastrophizing in order to gain the advantage of greater command over yourself and over the controllable events that take place around you? If so, here are sample cognitive, emotive, and behavioral remedies.
First Things First
Let’s get rid of needless blame first. Let’s suppose you blame yourself or others for your emotional turmoil. Paradoxically, by accepting your catastrophizing as an automatic and unpleasant thinking habit, you can quickly shed blame about this whole sorry process. Compared to the blame alternative, tolerance for tension can feel comparatively good.
It’s not your fault that you catastrophize. Like everyone else, you’re wired to catastrophize; otherwise, you wouldn’t be able to learn to do this and then to involuntarily tyrannize yourself in this way. Nevertheless, if you want relief from this form of manufactured misery, it is your responsibility to change course.
Don’t Trip on the Molehills
When apprehension escalates to anxiety, go back to what you were telling yourself when you first started to catastrophize. Map the pattern. You may find a molehill that you made into a mountain. If so, use a flip technique where you turn panicked thinking into an active concern about doing and getting better. Here are four steps in this process:
1. As best you can, suspend judgment about both yourself and the real or presumed catastrophic event.
2. Accept that you, others, and the world are as they are, and no amount of complaining will change that. Nevertheless, you owe it to yourself to change your catastrophizing pattern.
3. Guide yourself, or seek expert help, about how to contain catastrophizing and advance your enlightened interests.
4. Engage in productive activities that can null your failure expectations.
Actively follow these four steps, and you are likely to experience the sort of resilience that springs from your concern to do better. Because you’ll have clearer options, you are less likely to view yourself as vulnerable and helpless. You’ll make better decisions.
We mostly think of catastrophizing as magnifying and dwelling on present problems and anticipating future disasters. However, you can anchor this thinking to a past, present, and future timeline.
1. You anguish over mistakes you made as if these selective recollections stamp the word failure on your forehead. As you extend this dread, you may panic over the possibility of others discovering, criticizing, and condemning you for past faults. However, you are mainly your own worst pain in the rump on this one. You’re better off focusing your attention on what you can do than what you may have done.
2. You look down and see that you are wearing different colored socks. You think that others think that you belong to the poor taste club. You make this event into the worst thing that can happen to you. You think that this error will haunt you forever. You feel mortified, fearful, and vulnerable. (Intentionally wearing off-color socks can help desensitize you to this type error.)
3. You anguish over the possibility of suffering from brain cancer. You feel fatigued. You think this is proof you have cancer. You get up fast from your chair and feel dizzy. You think this is proof you have cancer. You break into tears at the thought that because of this illness you’ll no longer be around to celebrate holidays and special occasions with your family and friends.
Let’s grant that you have made mistakes in the past, that the mismatched socks are a present-moment mistake, and that you have a tendency to jump to conclusions about future possibilities. So what!
The so what intervention helps put catastrophizing into a different perspective. However, you still haven’t put the catastrophizing issue to rest. There is more work to do, including expanding on your so what acceptance thinking. (Instead of exaggerating, you expand you coping capabilities.)
Expand your coping capabilities with a stop and reflect difference technique. For example, distinguish between concerns, calamities, and catastrophizing. Your house catches fire. That’s a calamity. When your reaction is one of concern, you care about what happened—perhaps deeply so. You accept—not like—the situation as it is. On the other hand, catastrophize and you figuratively throw gasoline on the flames. Extinguish these fires by imagining yourself infusing your actions with reasoned choices that propel productive purposes. Take the actions that you imagined.
Here are four examples of actions of acceptance to help you break a catastrophic thinking habit:
1. Acknowledge your tendency to create catastrophic fictions, and refuse to blame yourself for that.
2. Listen to your narrative. What is the story that you are telling yourself that feels so catastrophic? What are the facts and fictions in the story? Are you making a magical and illogical leap from what is possible to what is probable? For example, if you believe that you have an undiagnosed cancer, is this a fiction or a fact? How do you know?
3. Because you believe something catastrophic can happen, doesn’t mean that it will happen. The Mayan Calendar has the world ending on December 21, 2012. Many panic over this possibility. Were the ancient Mayans infallible prophets?
4. The catastrophizing reward system is where you experience a subliminal relief from distress that reinforces the stress that it relieves. When an expected catastrophic event doesn’t happen, or is not as bad as you thought, the relief you feel can reward your negative premonitions, making them more likely to come back. (A reward, such as relief or money, is a reinforcer only if it increases the frequency of the actions that it follows.) Make sure you reinforce your productive and not your dysfunctional reactions. Your awareness of rewards for worry or catastrophizing, can help snuff out these specious rewards.
By Dr Bill Knauss, author of The Cognitive Behavioral Workbook for Anxiety