Dr. Sandra Betancourt, PHD, MCAP, ICADC, CMHP – CLINICAL DIRECTOR
In her book, “The Golden Ghetto: The Psychology of Affluence,” Jesse H. O’Neill defines the phenomenon of affluenza as the development of “an unhealthy or dysfunctional relationship with money that manifests in behaviors and emotions like shame, anger, hoarding and all manner of addictive disorders.” From this information and other research with this population, we understand a rupture that emphasizes money and wealth in some individuals. This relationship to money creates a detachment from their emotional and spiritual development, producing deterioration of the self and sense of well-being.
In his book, “The American Paradox: Spiritual Hunger in an Age of Plenty,” David G. Myers stated, “The more people strive for extrinsic goals such as money, the more numerous their problems and the less robust their well-being.” Treatment with this population focuses on developing a sense of safety and self-acceptance regardless of materialistic things, allowing them to establish a new relationship with wealth and power to understand their addiction better.
A significant piece for the staff is looking into our own biases and countertransference. Questions like, “What are my views about money, power, and wealth?” and statements like, “I wish I had their problems” are some of the ones we as clinicians explore during our work to treat these patients effectively. This is a critical component of successful work with this population. Our clinical work helps these patients by emphasizing their less obvious losses and consequences, such as the loss of dignity, intimacy, and mental and emotional deterioration. The clinician’s work resides greatly in helping the patients make shifts from a materialistic perspective to a life of spiritual meaning, purpose, and social connectedness.
We find several approaches helpful and significant, within a framework of Motivational Interviewing and the 12 Steps of Alcoholics Anonymous, which provide the positive social connectedness and spiritual and emotional base that our patients need. Some examples of the approaches are: Acceptance and Commitment Therapy (ACT) to develop psychological flexibility and living life according to a chosen value system; Dialectical Behavior Therapy (DBT) to help patients increase their ability to be present emotionally, as well as to develop a distress tolerance; and Cognitive Behavioral Therapy (CBT) to assist patients in challenging distorted cognitions concerning wealth and power, which might impact their recovery.
For instance, messages like “wealth and or power equal happiness” and “wealth and power equal love” and “money can cure addiction” are some of the deep-rooted thoughts we help the patient identify and challenge as they sustain their addiction and overall despair. Schema and attachment work, along with Eye Movement Desensitization and Reprocessing (EMDR), can be extremely helpful in allowing these patients to heal from trauma and develop more insight into their addictive and emotional patterns.
Summarizing, executives and wealthy individuals with substance use disorder can recover if they have the right environment and apply effective strategies from the beginning of treatment. This population thrives when we are authentic and compassionate with them, motivating change from a false and distorted sense of self towards a more genuine and purposeful individual outlook.