A lawyer-turned-psychiatrist who now treats troubled attorneys quotes from Dante Alighieri's "Inferno" to explain the private hell of men and women the public sees as accomplished and capable professionals:

In the middle of our life's way/
I found myself in a wood so dark/
I could not tell where the straight path lay.

The doctor, Elizabeth Tillinghast, suggests that such malaise especially impacts small-firm attorneys and solo practitioners, who tend to become more personally involved with their clients and are more immediately affected by financial crises.

As a consequence, said Tillinghast, who has been a psychiatrist since 1997, these lawyers can become "overwhelmed, to the point of paralysis."

She added, "They may feel that their personal lives are empty, that somehow they're missing pleasure and purpose, that they're on a treadmill going nowhere."

Solos and small-firm lawyers, said Tillinghast, who was an associate at Skadden, Arps, Slate, Meagher & Flom until she began medical studies, "deal with situations that contain more human drama than is seen at the big firms. They feel as if they're helping their clients make the most of their lives. Which is being a good advocate, but it's also something more: It's being an ally."

She added, "They feel very drawn to clients, and lose track of the professional framework."

Then there is the matter of a bad economy.

The current crisis, said Dr. Tillinghast, a faculty member at Columbia University Medical Center and Weill Medical College at Cornell University, is "a second 9/11" in which lawyers are "worried about generating money, collecting money and holding on to their jobs."

Martin E.P. Seligman, a professor of psychology at the University of Pennsylvania, discovered a great irony in his research of happiness versus unhappiness among professionals.

Contrary to optimism as a principal factor of success in most walks of life, Seligman wrote in a medical journal, "Pessimism is seen as a plus among lawyers because seeing troubles as pervasive and permanent is a component of what the law profession deems prudence."

He added, "A prudent perspective enables a good lawyer to see every conceivable snare and catastrophe that might occur in any transaction. The ability to anticipate the whole range of problems and betrayals that non-lawyers are blind to is highly adaptive for the practicing lawyer who can, by so doing, help his clients defend against these far-fetched eventualities. ... Unfortunately, though, a trait that makes you good at your profession does not always make you a happy human being."

Indeed, U.S. Supreme Court Justice Benjamin N. Cardozo famously remarked to nonlawyer friends at the height of the Great Depression in 1933, "I fear that happiness isn't in my line."

Tillinghast said a psychiatrist who "gets it" about lawyers can help them deal with demons that come with the territory. Among these are a work ethic -- operating in comparative isolation for solos and small-firm attorneys, and often on overdrive -- and the misery of money, compounded at the moment by the biggest economic mess since Cardozo's day.

"Making money is one of the major forms of competition in our society," said Tillinghast in explaining the traditional and potentially negative view of finance.

"It can shake up relationships, or threaten them -- for instance, sons working for their fathers in small family firms," she said. "Making money is associated with being masculine, being powerful or virile."

She added, "That can worry women. If women make too much money, they might feel too masculine -- or aggressive. Or they might make their husbands feel uneasy or insecure."

For men and women, said Tillinghast, losing money is "a huge blow, a shock to the system. People feel as if their legs have been knocked out from under them."

But she suggests a more positive thought pattern.

"Money can also be a way of expressing intimacy and connection with people. Men paying tuition for their kids, for instance, are connecting. Women making money are providing for their families," she said.

As for the practical matter of collecting from slow-paying clients, Tillinghast urges lawyers to recognize that they are frequently "so anxious about talking money that they leave things murky," resulting in client uncertainty about timely payment. Again, she said, the answer lies in careful maintenance of a professional framework that should underlie client relationships.

Lawyers do not enter the profession in order to be unhappy, the doctor said. To the contrary, "people go into law because it's a prestigious field. You can get gratification from pleasing people. If you do very well, the law brings you acclaim. You're loved because you can achieve."

On the other hand, she said, "In some ways, the law leaves you vulnerable. It requires diligent, hard-working people. It requires a work ethic that, for some, becomes a sort of slave master. When that happens, people can't let themselves off the hook. They think they have to put joy aside."

When the inevitable crash occurs, said Tillinghast, a lawyer is "embarrassed because lawyers are so used to being successful and capable. It's hard to feel stumped or thwarted. But lawyers can overcome embarrassment by understanding that psychiatry is a resource like any other resource."

She added, "A psychiatrist can help you strengthen your game, not diminish you."

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