Psychotherapy Case Study

Case #1

Some years ago a man in his twenties, who I will call Roger, came to me for treatment. His concern was that he was about to graduate from an MBA program, and he was conflicted over whether to seek a high stress but highly remunerated job or a lifestyle job that would somewhat pay less.

We started the treatment with my trying to help him express the pros & cons of each possible choice. But, before long the underlying conflict began to be revealed.

This man grew up in a family where the mother was the main breadwinner and the father worked at a poorly paid and low prestige job. This was in stark contrast to the other families he knew where the men were successful and the main breadwinners. Roger had felt ashamed of his father and, because he loved him, he felt guilty for feeling ashamed.

He believed that if he made a lot of money he would be humiliating his father, a possibility he abhorred, at least consciously.

Another part of the conflict resulted from his father's defensive expression of disdain for anyone who was very interested in money, as shallow and materialistic. Roger feared that if he took a high paying job his father would disapprove of him and, because he partly identified with his father's values, he might agree with his father's judgment

A related issue was that he saw the role of breadwinner as masculine, but it was his mother who was the breadwinner. He seemed to have some confusion over what it meant to be masculine. If he made a lot of money he would be like other fathers in his neighborhood. But he would also be more like his mother than his father.

There were all sorts of issues reflected in Roger's concerns. There were his unconscious wish to best and to humiliate his father and his reluctance to do so. There were superego issues related to his sense of what was good or bad with regard to focusing on money. There were gender identity issues. There were issues of reality and fantasy regarding what he would do to his father if he were to make a lot of money and what this would do to his relationship to his father.

All of these issues had been sub-conscious at the beginning of treatment. Over time, through our discussions, they were brought into consciousness and he was able to resolve them. He was able to test reality and realize that his father would be ok and would still love him if he were to make a lot of money. He was able to recognize that his sense of masculinity did not have to be tied to how much money he made. Roger was enabled to choose a challenging, and reasonably well remunerated position, which suited his emotional and financial needs.


Case #2

Roger (name changed), a thirty something corporate employee, caused his own suffering through his efforts to become rich and famous. He came to see me, devastated because he had lost his girlfriend and had also become isolated from his friends.

A big part of the reason for this was that he was very disappointed that he had not achieved the salary level that he thought he should have reached by this time in his life. And so, outside of his day job, he had become so obsessed with working on an entrepreneurial project, which he hoped would make him rich and famous, that he no longer had time for friends or other enjoyments.

He had moved in with his girlfriend and was letting her pay the rent, while he invested whatever money he made in this project. He had assumed that she would be happy to share in his dream and would want to spend her life with him. Once he had put this into words he could see what he had been doing. He realized how isolated he made himself and he moaned, "How could I have become so greedy that I forgot about my friends and didn't pay attention to what my girlfriend needed?"

Although, in the course of therapy, Sandy didn't give up this project, or the dream of becoming rich and famous, he became less obsessed by them and, with time, he began to change. With a bit of encouragement from me, he began reaching out to the friends he had been ignoring and he started allowing time in his life for recreation. This encouragement was meant to help him find both pleasure and social connection to counteract his misery. When he started dating women again Sandy didn't assume they would want the same things from a relationship that he did. And began asking what they wanted. This did not automatically make him happier. He complained to me that the women he was meeting were all looking for a man to support them financially rather than sharing this responsibility. I was able to help him recognize, however, that not all women would be like the ones he was meeting and I suggested that he engage in activities that he would enjoy, were he could meet women who shared some of his interests.

One of the things, I pointed out to him was that he found the project on which he was working, inherently interesting and it provided an opportunity for him to express his creativity in a way that his day job did not. It might or might not lead to his becoming wealthy, as he hoped it would, but focusing on an activity he enjoyed and that was good at made him happier than focusing on becoming rich. He accepted this viewpoint and began to talk about his entrepreneurial activities as an interesting learning process through which he was becoming more and more competent.

As part of the treatment we did, of course, explore Sandy's history. His cousin and many of the kids he went to school with came from wealthier families than his own. He was never part of the in-crowd and, at times, he felt demeaned by his cousin. His father was stingy, although he did use money to make bad investments. When it came time for Sandy to go to college, his father would not pay for him to go to the school of his choice, so Sandy had to go to a state school, which he resented.

In elementary and high school Sandy wasn't a good student and thought he was not as smart as others. The one thing he was good at, and for which he got his father's approval, was thinking up schemes to make money. He would be the first one out shoveling snow for his neighbors. He designed a T shirt that his school mates bought. He bought an old boat, learned how to fix it up, and sold it at a profit. So we can see that Sandy was trying to repeat a pattern of success when, as an adult, he started an entrepreneurial project hoping to be successful.

What also became clear was that Sandy's desire to become rich and famous was a reaction against his feelings of rejection by his wealthier and more popular cousin and schoolmates. This reaction involved a revenge fantasy in which he would become so much richer and more well know than them, that they would now have to admire Sandy and to feel as envious of him as he had of them. By being able to recall and to tell me about the emotional traumas associated with money, their sting was diminished. And, by making the changes described above, Sandy was already creating a richer life, without having made a penny more than he had previously.