Money and Psychotherapy

A Guide for Mental Health Professionals

People have always lived in groups that depended on some form of economy for their survival. Those economies have had a great deal to do with shaping their identities and personalities, including their beliefs, attitudes, and behaviors; their personal concerns; and their relationships, which affect their physical and emotional well-being. Not all economies have been based on money; but since its invention in Asia Minor (now part of Turkey) somewhere around 550 to 650 B.C., the importance and influence of money on commerce has spread rapidly around the world (for an in-depth discussion of the nature of money and the impact of its invention on humanity, see Weatherford, 1997). Along with its expanding importance in world economies, money has become an important aspect of interpersonal and internal psychological lives. In America, which is one of the world's most money-centered societies, money's impact on who we are from a psychological perspective, how we relate to others, and our material well-being is compounded.

Considering the power of money to shape the psyches and the lives of people, we must assume that its influence can be either beneficial or highly detrimental. When it has detrimental effects on psychological or interpersonal well-being, it becomes an area of concern and an arena for intervention by therapists. It would, therefore, be logical to expect therapists to be well trained and well versed in how money affects their clients' attitudes, beliefs, behaviors, psychological states, and interpersonal relationships. Therapists should be interested in their clients' relationships to money and how these relationships affect their lives.

Unfortunately, this is very often not the case; discussion about money is taboo in American society. Although there have been recent examples that suggest some loosening of this taboo in social discourse (for example, young adults who are seeking jobs and need information about salaries offered by potential employers or older people who commiserate about the effects of the recent recession), most people would feel very uncomfortable if a stranger at a party asked them how much money they make. Even accountants and financial advisors I have spoken with say that many of their clients are reluctant to reveal their financial circumstances to them. This taboo is a cultural phenomenon; the same kind of question asked in a country such as Norway or Israel would not be considered inappropriate. The "money taboo" has affected both individual therapists and the psychotherapy profession as a whole in ways that inhibit therapists' understanding of money and their ability to enquire about and treat those money-related problems from which their clients suffer (Trachtman, 1999).

One way that the taboo has affected the psychotherapy profession is that it has limited the discussion of money in literature, teaching, and supervision. In the year preceding the publication of this book, I conducted an informal survey of 39 mental health practitioners—one psychiatrist, three psychologists, 33 clinical social workers, and two social work students who had completed their field work and were in the last weeks of their course work. (The data from the social workers and social work students are the basis of an article under review for the Journal of Social Work Education.) I asked whether in their course work or in their clinical supervision, during their graduate training, they had ever heard a substantial presentation or had a discussion about the relationship between money and intrapsychic development and functioning. Not one of these individuals could recall having heard such a presentation or having had such a discussion, and only four (three social workers and one psychologist) could remember having discussed this issue with a supervisor during their graduate training. Perhaps as a result of this lack of training, and the power of the money taboo itself, in the treatment setting, both clients and therapists have colluded in avoiding the exploration of the uncomfortable can of worms we call money. Thus, therapists are short-changed by the profession and by themselves in their in ability to understand money in psychological and interpersonal terms and to be effective in helping the clients deal with its important influence on their lives.

The purpose of this book is to introduce mental health professionals, especially psychotherapists, to the topic of money, to help them understand how money can affect their ability to be effective in their work, and to teach them the basics of how to address money-related issues with their clients. This book will also provide information about some of the problems that clients experience in relation to money and how money affects different clients in differing ways.

Finally, this book does not advocate a particular methodology or theoretical point of view, although some of the examples, being based on my work, will reflect my orientation and style of treatment. It is for all mental health professionals, who are engaged in providing all types of treatment.