Dear Patrick:

I recently heard you give a talk where you referenced the “functioning alcoholic” mindset in the legal profession, and why that term is an oxymoron. In my 20-plus years in the profession I have worked at several law firms that were densely populated with attorneys who fit that bill, and my question is why would they stop drinking if they are indeed high functioning?

Ellen in Los Angeles

Dear Ellen:

It's a great question, and one that I would need 10 pages to fully address. I'll spare you the glazed eyes and instead just touch upon my four top reasons why “functional alcoholism” is nothing more than a lie we like to tell ourselves—a fabricated construct often deployed to buoy rationalization in the face of nagging doubt.

First, however, a quick point of clarification. Not everybody who is a problem drinker needs to stop drinking, at least not permanently. There seems to be a lot of confusion around this point, with many people having the dichotomous understanding that you either are a problem drinker and should stop altogether, or you are not a problem drinker and therefore shouldn't. Few things in life are that straightforward—this issue included.

It may surprise you to learn that many people who qualify as “problem drinkers” (a term that includes alcohol abuse) don't necessarily need to pursue abstinence as their initial goal. (Pause for sighs of relief) What they need to do is drink far less, and be able to sustain that change over the long term. If they are unable to successfully do so, then it would be clearer that they may need to quit altogether.

Now, back to why so-called functioning alcoholics are kidding themselves:

1. Their health and well-being are greatly diminished. The connection between excessive alcohol consumption and physical disease is indisputably well-established for everyone (heart and liver disease, cancer, stroke, hypertension and so on), and the American Bar Association/Hazelden Betty Ford study that I led clearly demonstrated the link between problem drinking and mental health problems among lawyers specifically.

In that study, those who screened positive as problem drinkers also had significantly higher levels of mental health distress than their less-thirsty peers, while those who fell in the normal range for mental health symptoms also endorsed far fewer problem-drinking behaviors.

For some people, problem drinking may develop as a maladaptive coping mechanism aimed at alleviating their mental health symptoms. Unfortunately, drinking your depression and anxiety away doesn't work, and what you end up with is an attempt at self-medication that comes served with a side of self-defeat. For others, their depression or anxiety could actually be caused or exacerbated by their drinking, meaning the cost of their alcohol habit is a lot higher than what's showing up on their monthly Amex statement.

2. Problem drinking is often progressive, and serious consequences are inevitable for some. While it's true that some people can live an entire adult life with an undiagnosed alcohol problem and generally steer clear of visible disaster, unaddressed problem drinking tends to be progressive for most others. An eventual loss of control—sometimes gradual, sometimes abrupt—is in the cards for many attorneys who might be “functioning alcoholics” today. It doesn't take clinical expertise to understand that most late-stage or “full-blown” alcoholics didn't start out that way, and that they were once just heavy drinkers.

3. Their functioning is actually suboptimal. Not gonna lie, many problem-drinking attorneys can perform at a reasonably high level for many years, at least outwardly. But if you peel back the curtain a bit, you'll see that they're not performing at nearly the level they could be in the absence of their booze shackle. Habitual problem drinking is bad for the one thing lawyers need most—their brains. Working memory, mental flexibility, attention, decision-making, problem solving, processing speed, motivation and planning abilities are all handicapped by drinking too much, and the brain of a “functional alcoholic” will need to work much harder than it otherwise would to achieve the same result.

In tennis, it's called running around your backhand, and it's what many hard-drinking lawyers find themselves doing on a regular basis: compensating for a weakness. At a time when competition in many sectors of the legal profession has never been stiffer, having your potential stunted by your drinking is as irrational for lawyers themselves as it is for the firms who employ them.

4. They have a heightened risk profile. As stated, things don't always go immediately south for problem-drinking attorneys, especially because they are so adept at compensating for and concealing the impacts of their unhealthy lifestyle. When things do go bad, however, they can go very bad. From the obvious risks like poor performance, loss of clients, and malpractice, to the less-obvious risks such as the insane amount of time their firm might have to spend dealing with the issue, or the emotional and psychological impacts on colleagues, it is hard to overstate just how much embryonic volatility might be stuffed into that baggage a problem drinker is carrying around.

So, to recap: Functional alcoholism is a myth, and what you're really talking about is nothing more than a high-maintenance deferment on consequences. The sooner a problem drinker comes to that realization, the less damage they're likely to do to themselves or others.

Have a question? Send it to [email protected], and I'll see you back here in two weeks.

Patrick R. Krill is the founder of Krill Strategies, a behavioral health consulting firm focused exclusively on the legal industry. Go to www.prkrill.com for more information.