15 Apr 2015

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Wealth, Power & Celebrity: Towards a New Cultural Competency

Sticky Post By main On April 15, 2015 With No Comments

This article first appeared on www.rehabs.com

The other night I came across a YouTube video from the Jon Stewart Show[1] where he mocked of the phenomenon known as Sudden Wealth Syndrome. In the video, a “reporter” conducted an interview of the two clinicians whose research in treating people of wealth led the concept. During the interview, the reporter made the clinicians look like fools and lampooned them for being concerned with the emotional well being of people of wealth.

While I understand comedy can be biting, I was disturbed by the mean spirited nature of the piece and the insensitivity it showed to the full range of human experience. Essentially, the piece maintained that people of wealth are not deserving of compassionate clinical care; and that the two clinicians who devoted their time and talent to understanding the very real phenomenon of Sudden Wealth Syndrome[2] are in the crass conclusion of the reporter- “dick heads.”

With all due respect to Jon Stewart’s wit and charisma, I strongly disagree with his conclusion. In my opinion, everyone regardless of his or her place on the wealth, power and celebrity spectrum deserves culturally and clinically competent care. Unfortunately, too few of these patients actually get it.

Like other minority groups, people of wealth and celebrity operate in a distinctly unique world where they face distinctly unique problems. Central to this experience are deeply entrenched power dynamics that keep them trapped in destructive mental health and addictive cycles. But most people, and many clinicians, fail to fully understand and effectively address these systemically based cycles. In their minds, wealth and celebrity are goals to strive for and imbue the holder with omnipotent and enviable control over their lives. They resent the power these people hold and label them as “whiney” and “self absorbed” if they reveal their vulnerability- vulnerability that comes from being fully human in a chaotic and uncertain world.

Case Study

Jason*, was 42 when he came to see me for treatment. A super star in the world of finance, he grew up the youngest of three boys in an aspirational Jewish family. His father, the only son of Russian immigrant parents, suffered from untreated alcoholism and bounced from one failed business to another. In an attempt to bring financial stability to the family, Jason’s mother took a job in the handbag department of Neiman Marcus in Beverly Hills. She resented the fact that she had to serve the very people she longed to be and hated her job. Instead of receiving a legacy of unconditional love and support from his parents, Jason inherited his father’s alcoholism and his mother’s anxiety fueled aspirations. “I learned from an early age that poor was bad. In my family, money and success was love.” Smart, charismatic and manipulative, Jason did exceptionally well in school and learned the ropes at a prestigious Wall Street firm. A short time later, he opened up his own hedge fund where he realized financial success beyond his wildest dreams. But like many people who aren’t emotionally and culturally equipped to deal with the financial windfall that came with his success, Jason found himself paralyzed by anxiety over his new identity in the world. “I was much more comfortable wanting to be rich,” he admitted after several intense and challenging sessions. “Now that I am really rich, I feel lost and alone.” To manage his emotional discomfort, Jason drank cases and cases of expensive red wine, utilized the services of “women of a certain commercial interest” (escorts), bought garages full of finicky sports cars that he never drove, a townhouse in Manhattan’s West Village, a beach house in East Hampton, a ski house in Aspen and villa for the “shoulder season” on the island of St. Barth’s. He came into treatment, not on his on volition, but rather through the demands of his wife who found in his phone a trail of infidelities and betrayals.

Treatment

In order to deliver effective mental health and addiction treatment services, clinicians must address their patients in the entirety of their being. This includes a host of features including their socio-economic status. Typically, clinicians are trained (as was I in both my MA and PhD programs) to be highly sensitive to minority populations who exist in positions of powerlessness. But nowhere along this academic path is attention paid to minorities who occupy positions of power. But power, especially the power that comes from wealth be it suddenly acquired or acquired over time, fuels a host of mental health and addictive disorders.

We see this most visibly in the lives of celebrities. But for every celebrity whose struggles are splashed about like pigs blood in the tabloids, Internet and nightly news, there are legions of others who struggle under the radar with the intense power of their wealth. Sure it might be a problem that you wish you had, but there’s no denying that it’s a problem none the less- and a problem that deserves to be treated with clinically and culturally competent care.

To be effectively delivered, mental health and addiction services that are provided to people of wealth and celebrity must address the powerful role money plays in their psyche and in their relationships. To be comprehensive, this analysis needs to occur on the following five areas of the patient’s life:

The sociocultural framework in which they live: This includes the dominant cultural view of wealth and the zeitgeist surrounding money. In America, and other capitalistic countries like Eastern Europe, wealth is seen as an aspirational goal and a panacea that can solve all problems. At the same time, we are living in a time of great wealth disparity, hostility and mistrust towards people of wealth. This schizophrenic view of wealth, wherein it’s simultaneously idolized and demonized, causes people on all levels of the economic spectrum to view one another with mistrust and distain.
Their family of origin: Just as we track mental health and addiction issues inter-generationally, we can also see how money is used in families as a reward or a vehicle to control. We can also look for compulsive spending, poor boundaries around money, bankruptcies and other financial events that impact a patient’s sense of place in the world.
The inter-personal relationships in their lives: Money can be an energetic that is used to control and manipulate, to foster unnatural dependencies and serve as a substitute for intimate connections and emotional nurturance.
The intra-personal relationship they have with their selves: Everyone has an internal dialogue and self-concept. For many, notions of external success are used to measure one’s sense of self and value in the world. This leads to a destructive “I am what I own” mentality.
The psychotherapeutic relationship the patient has with his or her clinician: The typical clinician has not been trained in dealing relationally with a person of wealth. As a result, they either deny they’re impacted by money or use their wealthy patients to fuel their own narcissistic ego. In addition, many people of wealth are accustomed to being in charge of their relationships and either consciously or unconsciously intimidate their clinicians to avoid being therapeutically challenged.

In applying these five factors to the case study cited above, we can see how Jason’s drive to succeed was fueled from a position of pathology and weakness rather than from a place of strength and self-actualization. Rather than acquiring his wealth in a way that could contribute to his development as a fully functioning adult, he remained stuck as the little boy who desperately craved the love and approval of his mother.

His mother in turn, didn’t have an outlet to constructively process her disappoint over her husband’s failure to achieve success in America, the land of opportunity and abundance. In her chronic state of anxiety, she passed on to Jason a legacy of uncertainty and fear. But perhaps the biggest tragedy in this family system is Jason’s father who came into a new and foreign land that valued material possessions over strong family bounds, biologically wired for addiction, with absolutely no understanding of his disease or tools to deal with it.

So it was only natural that Jason from the tender age of 12 resolved to transcend his economic class, save his family and earn the love and respect of not just his parents, but the also the world around him. Instead of finding peace of mind and a secure sense of place in the world, however, Jason discovered the platinum trophy he sacrificed so much to acquire was cold, hard and insatiable; and that behind the curtain of his American Dream was the wizard of his addictions, pulling strings and forcing him to betray his self and those who loved him.

To recover, Jason had to get a holistic perspective on his motives and drives, his emotional and biological makeup, and his relational patterns. He had to tease out those aspects of his self that were exceptional and harness them in constructive rather than destructive ways. Central to this process was Jason’s need to see how wealth, power and external success should be used to upholster the high performance jet he had become instead of being the fuel that propelled it on dangerous and destructive missions.

The good news was that in addition to inheriting challenges from his cultural, genetic and psychic environment, Jason also inherited incredible strengths. These included a strong middle class work ethic, a keen mind, a healthy and physically robust body, the drive to become a better person, solid family values and a willingness to change. With the proper clinical care and psychotherapeutic interventions, Jason’s prognosis was optimistic and promising.

Conclusion

There’s no denying that material wealth and the comforts it brings are worthy goals to strive for. Used properly, money and the power inherent in it can provide a person with heightened sense of safety and security. It buys higher quality food, safer cars and homes, leisure and access to a full range of quality educational and healthcare options. But let’s not pretend that money and the effort expended to acquire and maintain it don’t also hold the power to enslave, because they do. Therefore, it’s critical when seeking help for mental health and addictive disorders that all patients, regardless of their place on the economic spectrum, look at the role money’s power plays in their lives and the full price of the external success they strive for.

[1] http://thedailyshow.cc.com/videos/yv18fb/sudden-wealth-syndrome

[2] http://www.mmcinstitute.com/about-2/sudden-wealth-syndrome/

08 Aug 2012

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50 Shades of Grey: What Men Can Get From Reading It.

Sticky Post By main On August 8, 2012 With No Comments

This posting by Dr. Paul Hokemeyer first appeared on the Dr. Oz website

By Paul Hokemeyer, PhD, JD
I just finished reading 50 Shades of Grey. For most of you, the book needs no introduction. It’s a hot and steamy novel that’s been a topic of conversation among women of all ages for some time now. Some of you, however, may be late to the game. If you fall into this second category, chances are you’re a woman who’s been in a coma or a man who thinks the book is “silly” and irrelevant to you.

For all the men who think 50 Shades is silly or irrelevant, I challenge your beliefs. There’s an enormous amount you can learn in its 514 pages about yourself as a sexual being and your role as a romantic partner to the woman in your life.

I also have to confess that in regard to the book, I was both late to the game and a skeptic. I’d heard about the book from nearly all of my female friends and was taken by their reaction. Without exception, the women found the book mesmerizing, wildly entertaining and incredibly erotic. What struck me most about this reaction was how it remained consistent among women of all ages, socio-economic classes and even sexual orientations. I overheard 20-year-old women giggling about it on the train, my lesbian colleague couldn’t put it down, and my 50-something-year-old Ivy League educated neighbor described it as “porn” that she found “absolutely delicious.” Finally, after one of my female friends insisted, “Paul you must read this book. It’s full of psychological stuff that you’ll find fascinating,” I decided to take the plunge and see what all the estrogen-fueled hype was about.

After devouring the book over a long weekend, I was pleased with the results of my “psychological study.” Through it, I gained great insight into what women want out of men and how we can be better lovers. For the sake of brevity, I’ve outlined what I learned in the bullet points below:
Women need to feel valued: Men often take their female partners for granted. This is especially true when the couple has been together for a while. Men need to stay attentive to the details of their partner’s lives and consciously value them as human beings.
It’s okay for men to be vulnerable and sensitive: Women love men for their strengths and for their vulnerabilities. By sharing their emotional vulnerabilities, men will strengthen their romantic relationships.
Sex is an important communication tool in a relationship: Sex is not a mechanical act. It’s a way partners communicate their desires for and respect of one another.
Sex is a whole lot more than penetration: Women want romance. Know that the journey is more important than the destination. Slow down and enjoy the scenery along the way.
Intimacy demands trust: At the heart of romantic relationships is an intimacy that is borne of trust. Women must be able to trust their men. This requires their men to be trustworthy.
While 50 Shades has a great sexual content, it also has great insight to enable men to be better partners, lovers and friends to their romantic partners. It’s a book that’s entertaining and enlightening, sexy and stimulating. Most importantly, it’s a book that need not be reserved for women only. Men can learn a great deal from it’s content. I certainly did.

03 Jun 2012

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50 Shades of Grey

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Is ‘Fifty Shades’ poorly written? Who really cares?

“I think that women are giving other women permission to read it and get in touch with their sexuality,” says Dr. Paul Hokemeyer, a marriage and family therapist who is a frequent guest on The Dr. Oz Show. “And there’s something very normalizing about that.”

By EMILY J. MINORPalm Beach Post Staff Writer

Updated: 5:49 p.m. Wednesday, May 30, 2012

Posted: 5:48 p.m. Wednesday, May 30, 2012

My favorite side effect from the Fifty Shades books is probably the little story singer John Mayer told on Late Night with Jimmy Fallon.

Whether it’s true or not, who knows? But Mayer says he took the first book, Fifty Shades of Grey, and actually sang a page to a woman, a possible bed partner, in an attempt to get her all ready for the sack.

Oh Anastasia. Your alabaster skin is so hot.

Who doesn’t love a little romance resulting from all this Fifty Shades madness?

Well, that and the fact that I now know what a spreader bar is, and it’s not something farmers use for fertilizing the fields.

The first time I heard about this phenom series, a trilogy – I hesitate to use the word “threesome” – was only about a month or so ago. I’m a late bloomer, a considerate understatement now that I am deep in the third book, Fifty Shades Freed, and starting to realizing what’s going on in American bedrooms.

And dining rooms. And automobiles. And boat houses.

And it’s not Saturday-night sex with a bottle of Astroglide.

There we were, my schoolteacher friend and me, barreling down Interstate 95 to attend a sporting event involving a bat, a ball, and beer, and she was screaming, and I mean screaming, as she weaved her car with the broken speedometer through fellow travelers, some of them probably Fifty Shades readers and therefore technically unfit for driving in that they were presumedly still a bit weak in the knees from Chapter 21 in the second book, Fifty Shades Darker.

OH MY GOD, she was bellowing. YOU HAVE TO READ THEM.

And I think teachers should be obeyed, much like Anastasia Steele obeys Christian Grey, unless she wants to be spanked.

There’s a lot of high-brow grousing going on right now about the series – written by a British TV executive, first launched as Internet fan fiction – that is, fantasy chapters about existing books and existing characters – and then snatched up by Random House because of the following author E L James had established online. Apparently there is a widespread literary opinion that the books – a continuing story about a young woman, a recent college grad, who falls in love with an ultra-wealthy businessman who is “fifty shades” of messed up because of his crack-addicted birth mother – are poorly written.

But I hadn’t noticed.

Erotica has been around since the dawn of time. Have you watched HBO’s Game of Thrones? My mother used to keep a tame version stashed under her bed. Remember those old True Story magazines? But what’s so different about the Fifty Shades series, I think, is how everyone’s talking about it.

Indeed, Hokemeyer speaks the truth. We’re not hiding our copies in the T-shirt drawer or under the bed. Women are reading Fifty Shades books on airplanes and in waiting rooms and while standing in line at the grocery.

In just six weeks, the series sold 10 million copies – which begs the obvious question:

Just how horny are we?

“Here’s what I think,” says Dr. Maureen Whelihan, a West Palm Beach OB/GYN who is considered a leading national expert in sexual medicine.

“I think people, especially people in long-term relationships, they don’t believe they’re horny. They don’t believe they have the drive. So when they read these books, there’s that intense dopamine surge that gets women aroused and they get a little validation that they’re not broken.”

On these matters, I completely trust Whelihan, who through the years has collected women’s intimate sexual stories, everything from bedroom practices to libido levels, then teamed up with a writer to put the stories in a book.

Yes, this is a woman who knows her sex and I’m betting Maureen Whelihan was all hip about bondage, discipline, sadism, masochism back when I still thought BDSM was the airport code for Boulder, with an extra letter thrown in for good measure.

Like maybe a clue about my cute luggage, or something?

Sex and money are two funny things in our lives. They pretty much rule how we live, from happiness to contentment to physical fulfillment, yet we don’t talk about them much. Nowadays, though, we all seem to have gone a bit haywire. Well, I should speak only for myself – a grown woman who recently started yelling “Fifty Shades, baby,” after a few mojitos.

“I really just think these books are permission-giving for women to talk to their girlfriends and to talk to other people,” Whelihan says.

And her recommendation to all the John Mayers out there?

“Don’t send her to the girls’ book club,” Whelihan says. “Read her the book. Give her a glass of wine.

“I assure you there will be frequent breaks.”

And who doesn’t want that?

25 May 2012

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Left for a Younger Woman?

Sticky Post By main On May 25, 2012 With No Comments

Left for a Younger Woman? 5 Steps to Thrive

By Paul Hokemeyer, PhD, JD

One of the most devastating things that can happen to a woman is to be cheated on or left for a younger woman. It’s insulting, it’s humiliating, and it’s infuriating. In my clinical and personal experience, the women who’ve faced this situation feel they’ll never get over their pain – but they do. And if they consciously process their betrayal, they come through it stronger, more confident and happier women.

If this happens to you, know you will get through it, too. You’ll feel like you can’t, but you can. Acknowledge it won’t be an easy process. It will require you to recognize painful truths about the men you love and trusted, to manage the shame and judgment you feel from others and to pull yourself from the gutter where you feel you’ve been dumped.

In addition, don’t think your transformation from devastation to resolve will happen overnight. It often takes years and will track the five stages people go through when processing the death of a loved one. These stages include anger, denial, bargaining, depression, and acceptance. Unfortunately, you can’t go from anger to acceptance overnight. There’s a lot of ground you’ll need to cover in between. Give yourself the time and space to trudge it.

And while you’re trudging your road to a higher destiny, use the following five steps to enhance your journey. In them, you can stay on a healing path instead of falling into an emotional trap of self-pity and self-destruction.

1. Your anger is justified: Embrace it! In our society and culture, girls and women are taught that anger is “bad”. Nonsense! Feel your anger and express it in a safe and contained space. Don’t think you can banish anger from your life. It’s real and it’s yours. Get in touch with it and use it constructively. Exercise daily, scream into a pillow or blanket, buy a plastic bat and beat the heck out of an armchair. Discharge your anger OUT, don’t hold it in – or it will consume you.

2. Resist the urge to retaliate. This, of course, will take great resolve and the help of an army of friends and professionals. Your goal is not to “get even” with the cheating spouse. It’s to take charge of your life, reclaim your dignity, and move forward into new love, joy and adventure.

3. Be of service to other women. Yes, I know, this is another one that goes against your impulses. You’ll want to hide out from the world and lick your wounds (or plan your revenge), but these self-focused responses are self-destructive. Instead, focus on how you can be of service to other women who are in pain. Volunteer at a domestic violence center or work with other recovering women. By getting out of your own head, you’ll reclaim your dignity and a place of value in the world.

4. Don’t look to be saved. This is your chance to prove you’re a person of worth and dignity. You have everything you need to heal and grow from this betrayal. Instead of looking for others (and in particular other men) to save you, look for people who can help you hold your pain and devastation. In this regard, the word “hold” means they will be there for you with understanding, compassion and non-judgment. Typically, this is a good psychotherapist, but it may also be a good friend, clergy member or a support group.

5. Track your progress daily. Your healing process will occur in tiny steps, not gigantic leaps. Be mindful of this and ask yourself each and every day if you are working toward the solution or stuck in the problem. When you find yourself stuck in the problem (and you will get stuck there), lovingly pull yourself back to the solution like you’re training a puppy. By focusing on the solution, you’ll ensure the success of your future. Keep a daily journal or write a blog. Years later, when you’ve reclaimed love and lust in your life, you’ll value what you’ve written.

Above all else, never forget you have what it takes to succeed. In my practice, I’ve seen the most seemingly fragile women learn to thrive from the most horrific betrayals. Women are the smartest, most intuitive, loving and insightful people I know and work with. Know that these women are YOU and consciously love yourself through this difficult process.

25 May 2012

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Internet Sex

Sticky Post By main On May 25, 2012 With No Comments

Internet Sex: Is It Ruining Your Relationship?

By Paul Hokemeyer, PhD, JD

Yesterday, I received a call from a friend who lives in a small Wyoming town. She asked if I ever heard of couples whose marriage fell apart because the husband was addicted to Internet sex.

My answer was yes. It’s a problem that’s sweeping the nation, ripping couples apart.

In the past several months, I’ve written about the Internet’s impact on our lives. While the Internet is a force that has the capacity to enrich, it also has the capacity to destroy. One area that’s particularly vulnerable is our romantic relationships and marriages. Since our families and marriages are the backbone of our mental health, we must work diligently to protect them.

A recent study that looked at the impact of online sexual activity found that women and men hold different opinions on this topic (Grov, Gillespie, Royce & Lever, 2011). Not surprisingly, the men in the study felt their online sexual activities were no big deal and enhanced their relationships with their partners. In contrast, the woman in the study felt their sex lives and relationships were damaged as a result of them.

This is certainly consistent with my friend’s experience. The husband was no longer interested in having “live” sex with his wife. Over the course of a year, he had become so stimulated by the “virtual sex” he was having online that sex with his wife no longer appealed to him. In addition, he fell in love with a virtual woman who he refused to give up.

After confronting her husband about his online sexual activities, he refused to give them up. Finally, my friend said enough and filed for divorce. It’s a sad ending to an otherwise happy 17-year marriage.

What can you do if you discover your spouse or romantic partner has an online sexual mate? The following five steps will enable you to sort things out:

1. Don’t be afraid to confront the issue. If you find out your partner is having sex online, address it directly. Tell them you know what they are doing and that it makes you feel violated.

2. It’s okay to think it’s not okay! You don’t have to go along with it. Sex involves your body, mind and spirit. Protect and care for them diligently.

3. Be clear that Internet sex is infidelity and a breach of trust.

4. Find a supportive person who you can trust to talk about it. You don’t need to keep your partner’s infidelity to yourself.

5. Set up a boundary around your partner’s Internet sex that involves consequences if the boundary is violated.

Above all else, remain true to your thoughts and feelings. If something feels “creepy,” it’s because it violates an important part of you. Never jump on a bandwagon if you feel the wagon is heading in the wrong direction. Your self-esteem and integrity are too valuable to let slip away.