Q: Coming from a blue-collar family in a small Southern town, I
have some pride in having managed to find my way to a good college
near home, and now to entering a prestigious Boston-area law
school. Although I'm doing OK academically, it's been a bumpy road
emotionally. I have been getting panicky at unexpected times and
places, always kind of on guard and jumpy (not new for me, but more
intense). I've also been losing sleep because of a lot from
nightmares related to some bad memories that also pop into my head
during the day, even in class. The most disconcerting thing was a
few occasions when I was sitting in my apartment and suddenly it
was a couple of hours later than I thought and I couldn't account
for the time that passed. I know that some of this may be related
to the fact that I was abused by one of my teachers as a kid, but I
don't see why it should be bothering me more now, and I don't know
whom to talk to or what to do about it - not really that close with anyone.
A: You are describing some of the key symptoms of Post-Traumatic
Stress Disorder.
That does not mean for sure that this is the problem - you'd
need a thorough clinical assessment - but since you report a
history of abuse, it's a distinct possibility. People with PTSD are
often subject to intrusive and disturbing memories (which can feel
like re-living rather than just remembering), including in the form
of nightmares, and to dissociation (various forms of the experience
of being mentally removed from oneself, one of which is "losing
time"). Such individuals typically avoid thoughts or stimuli that
remind them of the trauma, and may also avoid close relationships
and assume a stance of "hyper-vigilance."
Avoidance and dissociation are in fact effective measures for
self-protection during a period when someone is in danger or
subject to trauma, whether through something like sexual or
physical abuse or experiences such as witnessing horrific events.
But these automatic maneuvers can also create problems when, months
or years later, the danger has passed but the trauma continues to
feel very present. In your case, the fact that you have moved far
from the physical location of the abuse may have somehow allowed
some of the related feelings and fears to emerge.
Certainly, it is an appropriate time for you to get some
professional help, and if you come for a clinical evaluation at LCL
we will assist you in finding appropriate resources. Psychotherapy
with a mental health clinician trained and experienced in trauma is
a place to start. It will probably not be brief treatment, but it
will be good for you to have someone to talk to and with whom you
can build trust. Nowadays, there are several different kinds of
therapeutic techniques that have evolved for PTSD; we can review
those with you as part of the referral process, and can also
discuss the potential role of medications of various sorts
(especially the ones without addictive potential) that, while not
curative, can reduce the intensity of post-
traumatic symptoms.
PTSD is also something to take into account in planning your
career as a lawyer. You may (or may not) find that certain kinds of
work (e.g., involving direct contact with distressing family or
criminal circumstances) tend to trigger trauma-based reactions. On
the other hand, work that is related to such matters, but a bit
further removed from direct exposure may feel meaningful. Whatever choices you make, it is helpful to remain
cognizant of the psychological context of your career choices. As
you gradually move toward both symptom reduction and a level of
healing from your abusive experiences, you can find your own best
ways to find greater professional and personal fulfillment.
Dr. Jeff Fortgang is a licensed psychologist and licensed
alcohol and drug counselor on staff at Lawyers Concerned for Lawyers of Massachusetts, where he and his colleagues provide
confidential consultation to lawyers and law students, and offer presentations on subjects related to the lives
of lawyers. Q&A questions are either actual letters/emails or paraphrased and disguised concerns expressed by
individuals seeking LCL's assistance.