Link Christin, JD, MA, LADC

Most impaired professionals—essentially those individuals who are often licensed, financially successful, autonomous, and have achieved “success” are nevertheless high-functioning and invisible to themselves and others. They are your neighbors, your friends, your colleagues. They live double lives which would make Jason Bourne proud.

As you readers know, addiction of any person is an elusive charade of denial, private logic and anti-social behavior. Family, friends, and peers are eventually driven away. The addict is typically isolated and unwilling to seek or accept help. Multiply this by 10 and I present to you the high-functioning impaired professional.

Who Are They?

He or she protects their career at any cost. They are seldom fazed when personal relationships, health, hobbies, balance, and emotional stability gradually disappear from their lives. Until their disease strips away their defenses, they perform their job without mistakes, slips, or apparent consequences. In their heads a battle rages as their demand for perfectionism wars against the constant obsession to drink or use. But none of this is visible to others.

They look nothing like stereotypical addicts. They and most of their colleagues believe an addict is the person they step over as they enter their office building, operating room, or cockpit. There they are transformed into masters of the universe, convinced that no real addict could do what they do at their job. They also believe they could stop using if necessary if their careers or licenses were at stake.

Even if they sense they need help, they do not want to risk that others may find out they have sought it. Fear of losing their careers or compromising their reputations muscle all objective indicators of their disease aside. In addition, they do not have the time to treat this problem because they believe they are too valuable to their clients or patients or passengers. Others enable them. Often, they have little accountability. So, as long as they act the part, their secrets are safe, and because of the slow progression of the disease, they are commonly able to maintain this charade for years and even decades.

What Do They Look Like?

This gets us to the heart of the issue. They look good—sometimes even better than good. They are invisible until, suddenly, they are not. This is the moment when they begin to miss deadlines and meetings. There are cancellations and postponements, often with different excuses proffered. Mornings are often rough as they arrive at work disheveled, groggy, with little energy and a short fuse. It is not unusual for them to be in a blackout, later forgetting conversations or having difficulty with linear comprehension.

Put into the most concrete terms, by the time the disease has progressed to the point that the professional can no longer sustain peak performance, is the opportunity when the professional, his/her colleagues or family needs to reach out for expert help, especially since the impaired professional may still be unwilling to acknowledge the disease and lack of control.

How to Get Them Help Before it is Too Late

At this juncture, the addict is on the brink of severe consequences. Because of the inevitable progression of the disease, all that awaits is the proverbial “rock bottom.” It is commonly assumed (correctly) that hitting this bottom for the addict or his support system is often the catalyst to seek help. Unfortunately, this is also the later and more irreversible stage of the disease, and when the professional arrives to treatment, his or her addiction, career, health, family situation, or legal status may be in profound distress.

This is precisely why those who are concerned about the impaired professional— before rock bottom— should exercise leverage (i.e., a wife with a husband, a managing partner with a lawyer) to coerce the professional into treatment—preferably residential, where work pressure and family dynamics are removed. This is also the opportunity to retain an interventionist when it will be most valuable. Good interventionists are routinely successful with impaired professionals, especially when they can engage the right team of people to participate in the intervention. And by the way, the professional knows deep down this was coming, and often it is an internal relief. Interestingly, those who arrive at treatment via intervention are just as successful in recovery as those who choose treatment without a nudge.

All of this is easier said than done. The impaired professional, although he is increasingly a danger to himself and others (e.g., driving his children and other children to a soccer game on a Saturday afternoon), is so extraordinarily entrenched in his own denial that he refuses help. He will bargain and delay and cajole for any outcome short of permitting others to treat the addiction. This moment is when the rubber truly hits the road for those pursuing the intervention.

The Road to Recovery

This short piece will not explore the treatment of the professional (an article for another day, especially with the advent of specialty residential tracks for professionals), but will provide these suggestions for this population and successful long-term recovery:

  • The first year of recovery is the most crucial. Recovery comes first, always.
  • Monitoring for alcohol and drugs by a third party greatly increases the rate of recovery (doctors and pilots are routinely compelled to submit to testing).
  • Joining a sobriety support group (such as AA or Smart Recovery) is essential.
  • A gradual return to the professional world is strongly recommended. Whether the professional is returning to a job, looking for another or changing careers, it is important to not “hit the ground running.” It will take time to build a recovery program upon discharge.
  • Remember that there are fewer chances to professionally survive relapses for this person.
  • Consider a “recovery job” for a period of time which is not connected to a career and does not involve taking the job home.
  • Engage with a therapist to assist with underlying issues and problems in recovery.
  • Connect with other professionals in the same field who are in recovery.
  • Do not isolate. This is especially easy to do if alone or not employed. Schedule activities which force you out of the house and involve social interaction.
  • Have a relationship with a psychiatrist for medical help with mental health or addiction issues.
  • Volunteering for a cause you believe in can be helpful, especially because it can take you outside of your own head and moods.
  • Engage in activities which focus your mind on something besides your addiction or life problems: Meditation, yoga, exercise, fishing, golfing, reading, movies, massages, etc.

The good news is once these professionals begin a recovery program they are more successful than most. And better than ever. Everything is possible once the impaired professional can navigate the tricky currents to treatment and recovery.