Shaken up

Issue July/August 2017 By Dr. Jeff Fortgang

Q: A week ago, there was a scary incident in the office of my law firm, involving the unexpected appearance of a potentially violent individual related to one of our former clients, who was standing only a few feet from me. Fortunately, no one was injured and the situation was resolved appropriately and fairly quickly. Since then, however, I haven't been the same. Things have felt unreal, and my sleep has been repeatedly interrupted by nightmares. I've been working at home, because I can't quite bring myself to go to the office. Even when I venture out to a store, I feel jumpy, as if anyone I encounter could be dangerous. My closest friend thinks I have post-traumatic stress disorder (PTSD) and need therapy, but I think that's about more serious trauma. Yet, I'm certainly not functioning like my normal self.

A: There are a myriad of ways that the practice of law can bring heightened stress into a lawyer's life. We tend to think about factors such as work pressure, competition, and vicarious traumatization, but there are also situations in which work can involve exposure to actual or potential violence.

You are experiencing some of the symptoms of so-called acute stress disorder (Acute Stress), the term applied to strong reactions that begin shortly after a traumatic event but which often fade within about a month. The symptoms are very similar to those of PTSD, but of briefer duration. Not everyone who experiences Acute Stress will go on to develop PTSD or require professional treatment.

During this anxious period, it's a good idea to try to keep stress levels relatively low, reinforce your supportive connections with friends, family, church, etc., and make sure that you're getting sufficient nutrition and generally taking reasonable care of yourself. It can be helpful to remind yourself that anyone would be shaken by such an experience, and accept that your symptoms are an understandable outgrowth of a frightening experience.

Some people feel better after talking about what they endured, while others do better steering away from the subject for a while - those who care about you should take their cue from you. While you don't want to develop a phobic reaction to the office by avoiding it for too long, it may be helpful to begin your return to the work environment with brief exposure, gradually increasing time there as your comfort level permits. Environments and activities that are familiar and safe can be helpful in coming back to feeling like your usual self, but that does not mean hibernating at home. Some people find short-term use of medications helpful; some blood pressure medications, for example, can reduce reactivity of the autonomic nervous system.

Whether you have actual Acute Stress or something short of that, there is every reason to anticipate that you'll feel progressively better within a few weeks. It might help to come into LCL and review the matter with one of our clinicians; certainly, consider doing so if you're still feeling this way after a month has gone by.

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.