The Misfortune of the Very Wealthy: Providing Therapy to the Rich

wealthy_2“Let them eat cake.” Marie-Thérèse, wife of Louis XIV

 Issues of entitlement are rampant in the psychotherapy process, and are particularly amplified in those who come from wealth and privilege.

Many of my affluent clients exhibit difficulties with interpersonal responsibility. They are consistently challenged by expectations of reciprocity. Considering another’s needs before one’s own is akin to self-renunciation. They are often miserly with compliments, yet presuming of praise. Selfish, insensitive behavior on their part tends to be justified. Elitism and materialism infiltrate their character, their relationships, and their quality of life in myriad detrimental ways.

 Forming a Therapeutic Alliance with a Privileged Client

Naturally these interpersonal dynamics show up in the relationship between therapist and client. The culture of the rich revolves around a ruling class ideology of hierarchal dominance and self-interest. Hence, a paradigm of collaboration or deference is perceived as loss of control. Accordingly, adhering to the guidelines within the therapeutic frame, meaning the fixed norms and policies structuring the work, is particularly challenging for clients of privilege.

In spite of written and discussed communication concerning contractual policies pertaining to time and fee, last minute cancellations and arbitrary requests to re-schedule are commonplace. Depreciating provocation and power plays may organically pervade the therapeutic bond.

Establishing a therapeutic alliance characterized by mutual respect and trust requires the higher echelon client and clinician to explore the origin of his/her need for control. It involves examining what fuels relentless hedonistic and materialistic pursuits. It requires a willingness to understand the highly competitive world of the very wealthy, the psychological impact of unlimited access to money and resources, dysfunctional generational familial dynamics, and resultant developmental disasters.

 The Psychological Risks of Wealth

Studies show that children from multi-generational wealth and prominence are surprisingly at risk for criminal behavior, eating disorders, and addictive disorders. Studies also indicate that levels of depression and anxiety are considerably higher in affluent youth as compared to low-income teens.

Children from highly affluent homes are often cared for by nannies or housekeepers, or left alone to fend for themselves. While they typically are under extreme pressure to succeed, they often experience isolation from workaholic, troubled parents.

Sent off to boarding school, these children grapple with regimentation and loneliness. In a climate of inadequate adult supervision, incidents of bullying and sexual abuse by staff and students go unreported and unpunished. Devoid of parental supervision and intimacy, these children struggle with self-identity and forming secure attachments.

Paradoxically the constant material gratification and indulgence offers an external locus of control which interferes with the cultivation of basic life skills, such as delayed gratification, learning to compromise, developing frustration tolerance, and forming internal cues of motivation and discipline.

Thayer Willis, family member of Georgia-Pacific Corporation, wrote in Forbes magazine, “The biggest curse of intergenerational wealth for me and many other people is the illusion that you don’t have to do much with your life.” Trust-fund children aren’t required to support themselves. They just need to fulfill an assigned role of status.

Being denied the opportunity to fulfill developmental tasks and experience the ebb and flow of triumph and mistakes breeds the narcissistic expectation that all things should be simply handed over on a silver platter. When a client spends her session having a meltdown over Bergdorf’s not having her Manolo Blahniks in Bordeaux, her immaturity and emptiness is tragically palpable. Her desolation voraciously feeds on wasteful consumption to distract from the source of her brokenness.

The adage is trite but true. Money can’t buy you love. Nor can it buy you psychological health.

For my wealthy clients who courageously undertake the trials and tribulations of working a 9 to 5 job, volunteer in some meaningful capacity, and focus their energies on self realization and creative expression, I applaud you. In the pernicious world of toxic wealth and greed, sometimes humbly stepping down is indeed reaching for higher ground.

Photo courtesy of Jaguar MENA on flickr


The Misfortune of the Very Wealthy: Providing Therapy to the Rich

Rev Sheri Heller, LCSW

Rev. Sheri Heller, LCSW, is a seasoned NYC psychotherapist with 25+ years experience in the addiction and mental health fields. Sheri is also an interfaith minister and playwright, and the founder of The Sistah Tribe - Phoenix Project, a therapeutic theater event for at-risk women and girls in the public sector of NYC. For more information, visit


APA Reference
Heller, R. (2015). The Misfortune of the Very Wealthy: Providing Therapy to the Rich. Psych Central. Retrieved on May 28, 2020, from


Scientifically Reviewed
Last updated: 1 May 2015
Last reviewed: By John M. Grohol, Psy.D. on 1 May 2015
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