The Phenomenology and Dynamics of Wealth Shame: Between Moral Responsibility and Moral Masochism

Elizabeth, the Unlevel Playing Field, and Wealth Shame

Elizabeth, a bright and thoughtful woman in her mid-twenties, came from generations of wealth. Both of her parents were attorneys working in their private firm, but they had also started out from money. Elizabeth had attended an elite private grade school in the Midwest, where all the students were, in Elizabeth’s words, “rich” or “super-rich.” She did extremely well academically. Her excellence at school was important for her self-esteem because she felt her high-achieving parents expected it, though it seems there were other emotional incentives for her to excel academically that I will not address. After high school, Elizabeth attended a prestigious liberal arts college. It was only then that she started to feel shame about her wealth. In her sessions with me, Elizabeth talked a great deal about the playing field. She felt tormented by her sudden discovery in college that the playing field was not level between her and some of her peers who came from lower-middle-class or poor families. These peers were bright and hardworking, but, unlike her, they had to overcome many socioeconomic hurdles. How could she evaluate her real intellectual capacity, and take pride in it, when the playing field was not level, she often asked me. Elizabeth worried that people would join her in dismissing her academic achievements once they became aware of her affluence. She imagined them saying, “Oh, she’s doing well in college because she had the advantage of having been educated at the best schools in the country and she doesn’t have to worry about paying for college tuition or budgeting meals.” Currently at work, she felt undeserving of a paid fellowship she was considering because a coworker had also applied. The coworker was an immigrant and thus, Elizabeth thought, more deserving.

Elizabeth was masterful at feeling shame. Going to a party with her friends meant she was shallow; eating dessert meant she was greedy; taking a short break from a work project meant she was lazy. And the list went on. After a few years of working in therapy on challenging her shame about emotional needs and claiming her right to ordinary pleasures, Elizabeth described how much she had enjoyed a conference where she met new friends and felt comfortable being herself despite her usual anxiety in social settings. Immediately after she told me how much she enjoyed the workshop, she started crying while reporting that since her return from the conference she had felt tortured with shame about her privilege. It turned out that Elizabeth had recently met the janitor at her parents’ law firm. This encounter made her reflect on the janitor’s hard life and financial struggles in contrast to her family’s luxurious lifestyle. I validated her empathy toward the janitor and her distress about the socioeconomic injustice and asked her whether she envisioned using her empathy to inform her interest in social activism, an interest she had talked about. I felt some unease about the possibility of coming across as yet another adult telling her what she should do. I also felt cautious about reducing the cause of her distress to economic inequity because Elizabeth had a tendency to undo any positive feeling she experienced. Was wealth shame being used to undo her pride and joy in the new experience of feeling socially at ease? I pointed out the immediate shift in her affect from pleasure to shame and invited her to explore it with me. We started to understand how wealth shame was sometimes for her a default setting to feel bad about herself when feeling bad was a necessary protection, a defense, against feeling desire or pleasure. For Elizabeth, pleasure threatened the bond with her parents, who taught her that every minute in life should be productive and that relaxation was allowed only after sweating through a hard task.

I felt moved by Elizabeth’s sensitivity to economic inequality and her empathy for less fortunate students and colleagues. I too could imagine their trials. I also understood Elizabeth’s concerns about what these classmates/colleagues might feel in her presence: envy, anger, resentment. What Elizabeth did not seem to imagine was the possibility of their own class shame or that they might idealize her. Like Elizabeth, I had attended a prestigious university, for both undergraduate and medical school education. I was fortunate that a Lebanese organization made this opportunity available to low-income students. I imagined that if I were her classmate I would have admired her and envied her not for her material wealth but for her social and educational capital. My imagining helped me access her fear of envy, which was not easy for her to talk about. (Below I will address fear of envy as it relates to wealth shame.)

As I sat with Elizabeth, the world of material deprivation, as hard as it is, sometimes felt to me more merciful than that of wealth. I often felt the urge to reassure her that she was indeed deserving, though the questions she raised were complex and required more than simple reassurance. It hurt me to see her so tortured by her shame. Her trust in sharing her unbearable shame with me also touched me. On occasions when she was able to enjoy feared activities, I felt happy for her, like a mother delighted to see her daughter take on the world.

Elizabeth often dismissed any attention to the transference, even when hints of it seemed to show up, as when she felt her immigrant coworker was more deserving of a fellowship than she was. She told me that her coworker came from a poor family. My being an immigrant, with an obvious accent, however, reminded her, she told me when I asked about this, of her wealthy Arab peers in college, the only Arabs she had known. I also think that my being a professional woman with white skin and straight hair might give the impression of my being well assimilated and less “other.” On the few occasions when Elizabeth allowed direct exploration of the transference, she emphasized that she could not imagine that I, or anyone, could like her because she did not feel likable. I understood this assumption as a reflection of her belief in being inherently flawed and of insecure attachment rather than the result of a class dynamic between us. For Elizabeth, my being a child and adult psychiatrist in my own private practice, in a predominantly affluent neighborhood, meant that we shared a similar class status, similar to that of her parents in their private law firm. Her assumption that I came from a wealthy Arab background also seemed to be at least in part an idealization. She had occasionally expressed her wish to keep me idealized, which I understood to be a function of her difficulty in accepting negative feelings toward me as an attachment figure.

How to understand Elizabeth’s wealth shame? Before I delve into my understanding of it, I will take a detour to explore the psychoanalytic community’s relationship to class, the range of countertransference feelings we might experience, including my own, and the way in which they might shape the therapeutic process.

Psychoanalysts’ Troubled Relationship with Class

Honest reflections about money and social class are often generally avoided in psychotherapy sessions and psychoanalytic circles. In “On Beginning the Treatment,” Freud (1913) observes how “money matters are treated by civilized people in the same way as sexual matters—with the same inconsistency, prudishness and hypocrisy” (p. 131). However, it seems we psychoanalysts have been able to talk about sexual matters much more openly and with more depth than we have been able to discuss money and class matters. Glen Gabbard (personal communication, June 2016) considers money to be “the dirtiest subject in psychoanalysis, even dirtier than sex.” Class, of course, has to do not only with money but—primarily— with privilege and power. Capital also includes social, educational, cultural, and political access. Although one finds several psychoanalytic papers and books on money, the social context of these issues, such as patients’ and analysts’ experiences with socioeconomic class, how class shapes our psychic landscapes, has received much less attention. (In addition to the works cited in what follows, also of note are Bandini 2011; Krueger 1986; and Whitman-Raymond 2009.)

Our community’s disavowal of class seems multidetermined by our profession’s privileged class position, the nature of our helping profession, the American cultural narrative, and the role that class consciousness, or its lack, plays in that narrative. Lynne Layton (2006) reminds us that to be capable of being aware of class hierarchy and its attendant affects, the analyst has to be in touch with “a great deal of anxiety about being contaminated by poverty, of getting too close to need” (p. 62). The analyst also has to face difficult feelings inherent in a culture stratified by class: shame (e.g., about needing), guilt (e.g., about having more than others, surpassing peers, siblings, or parents in wealth), contempt (of “the other” class), envy, greed, and doubts about self-worth (Dimen 1994; Layton 2006). Contributing to analysts’ difficulty acknowledging need is that many of us are drawn to our profession by personal psychologies marked by a heightened sense of precocious caregiving and denial of need. Moreover, while we may love our work, we also need to make a living doing it. Money “as a universal medium of exchange” (Dimen 1994, p. 89) tends to commodify our work, eliminating the differences between, say, a kitchen sink and a therapeutic relationship built on trust and love. Money becomes degrading and a signifier for hate: “in the psychoanalytic contact, the contradiction between money and love can be resolved only if we transform it into the paradox between love and hate” (Dimen 1994, p. 94).

Until recently, countertransference, which includes the analyst’s vulnerabilities, was considered an impediment to treatment. This, too, contributed to an unwillingness to acknowledge need within the analyst. As part of this stance, American psychoanalysis was resolutely apolitical and acultural until the mid-1990s. It is worth noting here a shift in the demographics of psychoanalysts over the past three decades marked by the entry into the field of more socioeconomically marginalized groups—women, nonpsychiatrists, people of color, gender nonnormative individuals, and non-European immigrants. It may not be surprising that in the last three decades most of the psychoanalytic papers on social class and on the socioeconomic and political underpinnings of the psyche have been written by women, nonpsychiatrists, or analysts from lower socioeconomic backgrounds. Also, rising economic inequalities affect analysts, who may feel pressured to charge higher fees in order to make a living; this may have contributed to the growing psychoanalytic interest in writing about class. In parallel, and perhaps not independent of this demographic shift, psychoanalytic theory has evolved from one-person psychology to intersubjectivity, bringing an increasing appreciation of social context.

Our psychoanalytic blindness to class is also required by the “American dream.” Class hierarchy and financial inequality give the lie to the myth that anybody can climb the wealth ladder in America. Acknowledging and discussing the shame and guilt that may accompany wealth and upward mobility risks shattering another aspect of the dream: that upward mobility is a conflict-free, albeit hard, journey with an invariably happy ending. The clinical observations I will present suggest the contrary and seem to echo clinical reports by others (Corpt 2013; Holmes 2006; Josephs 2004; Layton 2014; Ryan 2006). Layton (2006) has proposed that “the psychic cost of class mobility might be chronic low-grade depression or manic denial of need” (p. 63).

Countertransference and Wealth Shame

Unacknowledged discomfort with class can interfere with our ability as analysts to appreciate, let alone address, our patients’ class-related experiences, or the attendant feelings, fantasies, inhibitions, and actions. This discomfort can show up in a range of countertransferential permutations ranging from full blindness to our patients’ class relationship—with pathways in the patient’s mind never to be traveled—to destructive enactments of envy, contempt, or idealization of our patients’ class affiliation.

Analysts who experience wealth shame but have not faced it, or who dismiss as defensive any conversation about financial inequality, may shy from recognizing wealth shame in their patients. Those of us who have grown up in working-class or poor families may struggle with poverty shame and mistakenly believe that only the poor (or the affluent who have been poor) feel shame, and thus might dismiss our patients’ shame about being wealthy. Analysts working with wealthier patients may idealize, or become envious or contemptuous of, the privilege that accompanies wealth (Wahl 1974). Analysts may also feel a sense of vicarious pride in having wealthier patients, as if their patients’ wealth somehow makes the patient—and the analyst—more important. In his paper on how affluence in the patient or analyst impacts the therapist-patient relationship, Josephs (2004) summons the courage to share feeling “more elite myself in being the analyst of a person with such a social pedigree” (p. 403).

Analysts’ countertransferences (at times unconscious) toward their patient’s class status can drive them to unethical behavior. Wahl (1974) describes his encounters with a few colleagues who breached the confidentiality of their celebrity patients by boasting about them, evidently in order to experience vicarious fame. A former colleague googled a wealthy patient he was seeing in therapy out of curiosity to estimate his patient’s wealth. He proceeded to tell me with great glee that his patient’s home, located in an expensive neighborhood, was worth millions.

Although my awareness of class preceded my psychoanalytic training and clinical work, it deepened every time class emerged in the therapeutic dialogue. I felt that every time I helped my patients become more aware of their relationship to class, and face their wealth shame and the defenses around it, layer after layer of my own relationship to class, and my class injuries, were unveiled. This unveiling in turn helped deepen my work with my patients around class matters. To illustrate my point, I will share a clinical encounter with my patient Christopher, a prosperous artist in his late twenties. Christopher led an upper-middle-class lifestyle, thanks to a well-paying job and an inheritance. During his treatment I made the decision to stop accepting insurance in my private practice. ² When I shared with Christopher my decision to stop accepting insurance, which would take effect nine months later, he replied: “I feel mad that you will not take insurance. I understand the reason and I feel I already got a great deal, but I still feel mad and sad about the change. Having to think about money, how and why I use money, brings up charged feelings.” His charged feelings were multidetermined; he felt understandable anger at my changing the “frame” and bringing the love/money paradox to the foreground. Do I love him because of his money? Am I taking advantage of his wealth? Growing up, he had often heard warnings of such things.

One day Christopher came to his session and asked whether it would be okay with me if he came once a week, instead of three or four times, after I stopped accepting insurance; he was concerned, he said, that he could not afford to pay. (His insurance would still reimburse him for most of my fee.) I said I would work with him once a week if that’s what he wanted. I added that it would be good for us to explore how this process would go for him. That night I had a dream. In it, Christopher reported to me a text exchange with his mother, in which he was sarcastic toward her. In the dream I wondered about the dilemma of whether to bring up Christopher’s sarcasm and explore it with him. I tried to draw his attention to his sarcasm, but he was dismissive, and I felt guilty about having brought it up. As he was leaving my office, I saw a shadow of something lurking in the dark hallway, but couldn’t mention this to Christopher because I worried he would think I was saying something crazy. After Christopher left the hallway, a stranger entered my office and tried to kill me. I was able to control the intruder while I tried to scream for help, but I realized that Christopher was too far away and could not hear me. End of dream.

After reflecting on my dream and my most recent session with Christopher, I felt surprised and frustrated with myself for having dealt with his request so concretely. What was I avoiding by not exploring his decision? I think the intruder in my dream represented the deadly outcome of my collusion with Christopher’s avoidance, which threatened “to kill” my analytic function and his treatment. I realized that, like Christopher, I did not want to face my conflicts about money and class as they pertained to his treatment. I did not want to be perceived as greedy, uncaring, or exploiting his wealth. ³ I also did not want to face Christopher’s anger and attack—his sarcasm in the dream—about my decision not to accept insurance; I felt anxious about my wish to increase my income and having to face my own shame/guilt about upward mobility. While I felt relief and joy in the comfort and the new possibilities afforded by economic prosperity, I also felt guilty about leaving the poor ones behind: relatives, friends, and neighbors who did not have the good fortune to make the upward transition. In the process of working on my countertransference with Christopher and other patients during that period in my private practice, I realized that my initial surprise about the existence of wealth shame was in part a defense against feeling it myself.

It is worth noting here a cultural force that contributed to my ambivalence about money and increasing my income: the way Lebanese culture approaches money matters. Here’s an example. Let’s say I consult an electrician to do work in my home. When the work is completed, I ask the workman how much he wants to be paid. He may tell me “baddi salemtek!” meaning “I want you to have good health!” “No, seriously,” I say. He may reply, “metel ma bitreedi,” meaning “pay me as you wish.” “Well, that’s nice,” I say, “but you should tell me your fee.” He may reply “mish baynetna,” meaning, “I am not going to let this issue get between us.” We continue to argue until he proposes a number and we go from there. This example shows, on the one hand, a wonderful aspect of Lebanese culture, which represents prioritizing relationships, generosity, and the art of give-and-take. But it also reveals a shadowy side of the way the Lebanese handle money: monetary transactions tend to be vague and wishy-washy. This lack of transparency may create space for manipulation, intimidation, and shame about money.

After further work on my dream about Christopher and my countertransference, I decided to explore with him why he felt he could not afford coming more frequently, despite his abundant financial means. I told him that continuing to meet three to four times a week would be crucial to exploring and managing his recurrent despair and suicidality. What emerged, as we explored in more depth his conflicts about money and affluence, was not only wealth shame but also the deprivation and difficulties with attachment that he had experienced in his family of origin—both, paradoxically, exacerbated by their wealth. These themes had come up in my conversations with many of my wealthy patients, which I discuss below.

The Phenomenology of Wealth Shame

Some of the affluent adults I have worked with over the years in psychotherapy and psychoanalysis came from families with intergenerational wealth. Others had parents from middle-class backgrounds who had created (or increased) their wealth through careers in medicine, law, or the corporate world. A few patients had parents who rose from extreme poverty to the ranks of the “one percent.” Other patients had themselves transitioned from working-class beginnings to the upper middle class. Despite similarities in my patients’ experience of wealth shame, differences in their familial class backgrounds seem to have particularized their experience of shame. I will highlight these differences where appropriate, though the wealth shame I describe here relates mainly to patients born into wealth. The extent of their affluence—the exact figures regarding yearly income and assets—was often undisclosed or unknown even to my patients. A few estimated their families’ assets to be worth millions; still, the exact numbers remained elusive. This secrecy surrounding financial numbers, even among wealthy family members themselves, is quite common (O’Neill 1997; Sherman 2017).

Almost all my wealthy patients, their backgrounds notwithstanding, experienced an uncomfortable relationship with their wealth. This discomfort did not always involve shame about wealth. One patient in his fifties took pleasure in driving luxurious cars and wearing expensive clothes. He told me that without this luxurious facade, he was “worth nothing.” Although my patient did not feel ashamed about his wealth, he felt ashamed about the way he used wealth to cover up his intense feelings of worthlessness.

The majority of my prosperous patients, however, in particular college students and young adults, struggled with intense shame about their wealth. Some of my patients hid their wealth from peers and friends. They avoided any mention of personal historical details that might betray their family’s wealth, such as living in expensive neighborhoods, having attended an expensive private school, or having parents with high-paying jobs (or parents with low-paying jobs who by dint of their inheritance maintained an upper-class lifestyle). Others bought their clothes from thrift stores in order to blend in. All of my wealthy college student and young adult patients felt undeserving of their family’s affluence because they had not earned it themselves, regardless of whether their parents had inherited their wealth or earned it themselves through hard work.

Socioeconomic and Cultural Contexts of Wealth Shame

As I noted at the ouset, contemporary wealth shame has developed in the context of the exponential growth of economic disparities, starting in the late 1970s when the United States adopted neoliberal policies such as the deregulation of markets. ⁴ Neoliberalism ⁵ is an ideology promoting free markets and untrammeled individual liberty. Its philosophy, based on social Darwinism, is to let the markets run their course unregulated and to let people use these markets freely. This ensures that individuals get what they “deserve” (Monbiot 2016). Such ideology dismisses the importance of the fact that the playing field is not level. Success and failure are seen as the exclusive responsibility of the individual. The individual is also meant to be striving at all times toward productivity, which is viewed as the primary measure of worthiness. My patient Elizabeth’s expectation that every minute should be productive is an illustration of neoliberal principles common, though not exclusive, to contemporary upper-middle-class and upper-class families. In neoliberalism, the concepts of interdependence and community are not taken into account or are viewed as irrelevant or as signs of weakness, though networking is an essential element in neoliberal entrepreneurship.

It was during the recession of 2008 that the terms “wealth shame” and “luxury shame” began to emerge in the American (and British) media, amid growing awareness of the vast disparity between rich and poor (Kirwan-Taylor 2011; Llewellyn-Smith 2013; Roberts 2008). ⁶ An example is to be found in the business section of Newsweek in late November 2008. “Across America’s upper strata, rich folk like [the multimillionaire Michael] Hirtenstein are experiencing an unfamiliar emotion: luxury shame. . . . [Hirtenstein] says . . . I could walk downstairs now and buy a Ferrari. . . . But all of my friends are hurting. I don’t feel like buying random toys” (Roberts 2008). What Hirtenstein meant by random toys involved buying multimillion-dollar homes, which he loved to collect.

The media attributed this new trend of wealth shame to the 2008 recession. I suspect that additional factors, as well, activated wealth shame, especially among wealthy college students and young adults. The two factors I will address are the de-isolation of wealthy students on college campuses and social activism.

In the past, wealthy students were more insulated, surrounded primarily by those of similar background; however, thanks to student loans and scholarships, wealthy students increasingly share campus life at prestigious schools with lower-middle-class and working-class peers. For example, a number of Ivy League universities started implementing a policy of “zero family contribution.” If a student from a low-income family could get in, the school would pick up the full tab. Princeton adopted this policy in 1998, Harvard in 2004, and Yale in 2005 (Foster 2015). On its website in February 2018, Harvard stated that 20 percent of its students came from households whose total annual income was less than $65,000. Families at this level of income were not expected to pay for tuition, room, or board. At Brown University (2018) this figure was 35 percent for the school year 2015–2016.

Given students’ physical proximity on campus and in the classroom, affluent students have direct exposure to the huge economic disparities between themselves and their less fortunate fellows. This is the reality my patient Elizabeth discovered upon entering college.

Another factor leading to wealth shame might be the rise of social activism on college campuses. In the 1960s and 1970s, campus activism focused on civil rights and the war in Vietnam. A critique of capitalism was folded into much of the activism of the time. However, the disparity of wealth has increased so dramatically over the past four decades that activism has correspondingly come to focus more pointedly on the close relationship between Washington and Wall Street. The Occupy Wall Street movement in 2011 exemplified this shift in activism. Some college professors have even incorporated the social activism movement focused on wealth disparity in their curricula, participating, for example, in campus teach-ins (Buckley 2012). While some of my wealthy student patients spoke of conversations on campus and on social media as important to their awakening to socioeconomic reality, they experienced some of the statements made in these conversations as shaming and hostile toward them. They read and listened to statements vilifying rich students as “rich brats who always had it easy and never worked at anything.” My patients experienced this stereotyping as dehumanizing them and delegitimizing their emotional suffering. One of my wealthy patients, Amanda, once told me, “I am in the one percent but I hate Wall Street. The activist students don’t understand that not all rich kids had it easy,” referring to her history of emotional deprivation and a long-standing struggle with severe anxiety and depression. Amanda, like some of my other affluent student patients, felt trapped. She did not want to be a rich kid blind to the plight of the poor; but she felt too scared to become an activist and take the risk, if she spoke honestly about her background, of being perceived as a spoiled rich brat. Her fear and shame isolated her from campus politics despite her interest in social activism.

Wealth Shame as Ethically Responsible

Many of the wealthy young adult patients I have seen over the years were like Elizabeth and Amanda. They spoke of their awareness of social injustice. They refused to pursue lucrative careers in finance and the corporate sector despite financial temptations and, for some, despite family pressure. They felt pained by the fact that some kids, through no fault of their own, were born into poverty and were deprived of basic opportunities to lead successful and comfortable lives. John Sedgwick (2008) aptly conceptualized it in Rich Kids, where he wrote, “Rich kids soon recognize the miserable truth: for them to be so extraordinarily rich, others must be poor” (p. 106).

Silvan Tomkins and others have conceptualized shame as a pro-social affect (Sedgwick and Frank 1995). For example, if for a moment in a relationship we treat the other with cruelty or indifference, shame (like guilt) arises as an affect to inhibit further mistreatment for the sake of protecting the relationship and helping us repair the wrong we have done. I conceptualize some aspects of wealth shame as pro-social in this same way. It can be an ethical response to an often unjust economic system that favors the affluent.

Unlike some psychoanalysts, but in accord with others (e.g., Aron and Starr 2013), I dispute the idea that shame is a less mature affective experience than guilt. Developmental research suggests that both shame and guilt have “their own developmental trajectory”; each has “lower and higher developmental forms” (Aron and Starr 2013, p. 61). Shame does not have to “mature” into guilt to be reparative. Michael Lewis, a developmental researcher, eloquently described the important role that shame assumes in moral responsibility: “I don’t want to live in a society in which people are not ashamed about the things they do because shame makes sure that the person stops what they are ashamed about doing—there is a collapse—while with guilt it doesn’t [make the person stop]” (Carveth et al. 2007). Mary Watkins (2018) distinguishes between what she terms “deserved” and “undeserved” shame:

we experience undeserved shame when we are treated shamefully by others and internalize the shame, as in situations of rape and racist diminishment [I would add here shame that results from parental intrusion, humiliation, emotional neglect, or other forms of maltreatment]. Deserved shame . . . grows as we treat others with disregard, violating our own standards. Deserved shame can accrue to an individual and also to a group in which we have membership. In the latter case, it can possibly be the start of a pathway to collective remorse and reparation

[p. 26].

For my wealthy patients, guilt is often linked to shame. For example, one of my patients, the daughter of immigrant working-class parents, chose to use disposable income to travel for pleasure rather than help a sibling who was struggling financially. She felt guilty about this decision, but also ashamed about her desire for more comfort and luxury in her life, for being “greedy” rather than “generous.” Generosity toward family and friends in need was highly valued in her immigrant community. The internalized injunction to be generous was conflictual for my patient, leading her to both defy it and then to feel guilt and shame for having done so. Moreover, those who are born into wealth tend to experience wealth as a stigmatizing birthmark. In The Golden Ghetto, Jessie O’Neill (1997), the granddaughter of Charles Wilson, former president of General Motors and Secretary of Defense in the Eisenhower administration, describes her own experiences with wealth shame and the conflation of guilt and shame: “The inheritor hasn’t ‘done’ anything, and therefore there is no absolution. Their only crime is one of being” (p. 143).

Wealth Shame as Moral Masochism

It would be simplistic and inaccurate, however, to think of wealth shame only as an ethical response to the social injustice of economic inequality. Sometimes my patients’ wealth shame was an offshoot of a pervasive pattern of shame and an extremely harsh superego. My patients felt ashamed about their wealth because they felt they did not deserve anything, period. They believed they did not deserve love, care, or money, let alone wealth. One of my wealthy patients often described himself as “garbage.” Oddly, this is reminiscent of the pejorative term “white trash,” applied to poor white people. In this pervasive shame pattern, wealth might become the hanger on which shame could rest, as was often the case with Elizabeth.

Some of the determinants of pervasive shame for my affluent patients were similar to those leading to shame in my patients with less wealth. Some of my patients, for example, had emotionally unavailable parents who had themselves suffered emotional deprivation and trauma. But pervasive shame was often directly related to wealth.

The Paradox of Privilege: The Dual Self

What has been called the “paradox of privilege” refers to an aspect of shame experienced in the context of wealth—how affluent individuals feel it would be inappropriate to have relational needs or to feel negative emotions while having been provided so much privilege (Duffell 2000). In my clinical experience, the wealthy often conclude that something must be really wrong with them if they feel emotional needs. They must be ungrateful and bad. Some of my wealthy patients felt ashamed about being in therapy because they believed they had no right to suffer given all the material resources their families possessed.

Belonging to a privileged class while not feeling significant oneself can create a painful true self / false self dichotomy (Neil Altman, personal communication, February 2018). Some of my patients felt that the tutoring they had received while in school—not because of learning problems but to enhance their grades and SAT scores in order to get into elite colleges—and the internships and jobs they pursued, thanks to their parents’ connections, made their achievements feel fraudulent and created a sense of themselves as fraudulent. John Sedgwick (1985), a writer born into wealth, wonders, “Still, the question lingers: how much of me is my money, and how much of me is me?” (p. 18).

A child’s agency may also feel hijacked when well-meaning parents use their connections or financial resources to get their child out of trouble or to quickly fix a child’s conflict without allowing the child the opportunity to figure out and resolve the situation independently. Amanda, a wealthy twenty-two-year-old college student, had struggled with pervasive feelings of emptiness and fraudulence. As we explored these feelings, one particular memory kept emerging. At twenty, Amanda had arrived late for an internship interview because she had slept in. The interview was canceled and Amanda was asked to reschedule for another day. While waiting for the secretary to reschedule the interview, Amanda texted her parents just to let them know what happened. Without telling her, her parents immediately used their connections and got her an interview that same day with the same staff member who had canceled the interview. Although relieved that she did not have to reschedule, Amanda felt angry with her parents for having hijacked her sense of responsibility. Amanda told me this story a few times. During the second repetition, I was surprised to realize that I had forgotten many of the details from the first telling. Such forgetting is uncharacteristic of me. I then realized that I had felt dismissive of her concern, thinking, “Doesn’t she know how burdensome life can be without resources and connections?” I began to wonder whether my envy of her family’s resources had interfered with my ability to remember this story. My envy, heretofore unconscious, made it impossible for me to empathize with her wish to claim her agency and her anger when that wish was inadvertently denied by overprotective parents. It was only after Amanda repeated the story, and after I became aware of my envy, that we were able to think deeply not only about her anger but also about her belief that she was incompetent. Her parents’ quick intervention meant to her that they did not believe she could manage on her own and that she too should doubt her ability to do so.

Class Shame in the Upwardly Mobile

Feelings of fraudulence in those born wealthy seem to resemble, though in a different way, feelings expressed by my upwardly mobile patients from poor or working-class backgrounds. While my patients born into affluence felt that their cultural achievements—success at work or in academia—hid an inner emptiness, some of my upwardly mobile professional patients from poor or working-class backgrounds described feeling fraudulent for lacking the cultural foundation—or cultural tastes— of a middle- or upper-class upbringing. Their newly acquired higher class status felt illegitimate. Wealthy patients from poor backgrounds may struggle with double shame about both poverty and wealth. One of my patients, Dorothy, a successful attorney who was born poor, had recurrent dreams in which she was attempting to sign up to enter elementary school as an adult, as if she were trying to build an educational foundation she felt was missing.

This sense of “lack,” a source of considerable shame in Dorothy, was, of course, familiar to me. For a few years, I had a recurrent dream in which I was visiting one of my old childhood neighborhoods looking for a girl named Rita. In reality, Rita was one of my close childhood friends and lived across the street. Although smart and vibrant, Rita had struggled academically. In the absence of resources in her mediocre school and her working-class family, she dropped out of school. At the time I was accepted to medical school in my early twenties, Rita was working in a small clothing store, engaged to be married to a man who worked at a local factory. The Rita I was looking for in my dreams was the friend I had left behind in poverty who could not use the educational ticket to get out. I also think that Rita was my younger self, the impoverished, “uneducated” self I had left behind, dissociated and shameful until I was ready to go and find her, face my shame about her and claim her. In a similar way, I felt, my patient Dorothy had to face her shame about her own “uneducated Rita.” Her desperately trying to sign up to an elementary school was an attempt at undoing her shame: if only she could get a “good education” she would not feel so ashamed. After years of working together on her shame, naming it and challenging it, Dorothy had a dream in which she was again trying to sign up for a good elementary school; but she had an epiphany (in the dream) that she did not need to go to elementary school: she was already an attorney and she had already passed the bar exam. This marked the end of Dorothy’s elementary school dreams.

Shame, “Old Money,” and Emotional Deprivation

Wealthy patients—in particular those who come from “old money” with a tradition of assigning childcare primarily to nannies—may associate wealth with emotional deprivation. “Money allowed my mother and my father to ‘buy out’ of parenting,” writes O’Neill (1997), “leaving me . . . abandoned in the ‘care’ of a series of servants with little beyond a paycheck invested in our relationship” (p. 9). Another source of emotional deprivation some of my patients experienced, in the context of their wealth, involved being sent to a boarding school against their wishes—to maintain a long-held family tradition—leaving them with the belief that their longings for intimacy were forbidden and thus shameful. Wealth thus became, according to my patients, the symbol of an embarrassing family reality, a reality depleted of emotions and love. One of my adult patients was left as a young infant in the care of a nanny while his parents went on safari in Africa for three months. A colleague’s patient spoke of the family tradition of having the kids stay with their nannies on a different floor of the home when the parents needed to relax after work. A friend told about her parents, who traveled first class on airplanes while the children stayed with the nanny in economy. It was as if the economic disparities of the outside world were replicated within the household. The children were treated as if they belonged to a lower class.

Pervasive Shame in First-Generation Inheritors

A different dynamic seemed at play for the first generation of inheritors. These are the children of the founding parent, generally the father, who had made the leap from poverty to wealth. These fathers seemed highly intelligent, extremely ambitious, well disciplined, and hardworking. My patients whose fathers had made such a leap felt immensely inadequate in their quest for a career, and a life they could claim as their own. The shadow of their larger-than-life father figure was too haunting to allow any success to matter.

Juliette, an intelligent Yale graduate in her early forties, had wandered most of her adult life between different careers, as a music teacher, a writer, and an artist. Despite her success in these careers, Juliette considered herself a failure. For her there was only one template for success: her father’s hard journey from extreme poverty to the ranks of the one percent, leading one of the most successful tech companies at the time. Juliette’s father had let her know that he expected her to become a Nobel laureate or a famous astronaut. This had left her with the feeling that what mattered most in life was perfect performance and that her essence was not important and, thus, shameful. This expectation that the child should match or exceed the founding parent’s achievement may not be as explicitly communicated as in Juliette’s case; yet the child may still feel the heavy weight of comparable expectations.

Wealth Shame as an Emotional Inheritance

It is worth mentioning here that almost all the parents of my wealthy patients appeared themselves to have experienced shame about their wealth, whether they had inherited it or amassed it themselves. It could be said that my patients inherited not only their parents’ wealth but also their shame about it. A clinical vignette illustrates my observation.

Oliver, a twenty-five-year-old man with intergenerational wealth, had struggled with intense shame about his affluence, particularly about spending his trust fund, even for basic self-care needs. As we explored his wealth shame, Oliver recalled that discussions of money, trust funds, or inheritance were taboo in his family. He had many memories of parental anger or avoidance whenever the subject arose. Oliver’s mother had grown up in extreme luxury and equally extreme emotional deprivation. She lost both parents in a car accident when she was in her early thirties, which left her with a large inheritance. Oliver was a young child at the time. It was then that his mother established a trust fund for him. During our sessions, when we explored the family’s dynamic around wealth and inheritance, Oliver could suddenly feel his mother’s ambivalence about her inheritance; her shame about benefiting from her parents’ tragic death and her shame about using their money after suffering emotionally at their hands. His mother later told him that she also experienced sadness and anger over the inheritance—sadness for having lost her parents and anger at how material wealth had replaced love when she was growing up.

Wealth Shame as a Defense

I have described so far the phenomenology and dynamics of wealth shame as a primary affect, reflecting either moral responsibility or moral masochism. In my clinical experience, wealth shame has also seemed at times to function as a defense against other feelings deemed more dangerous by the individual.

Earlier I described my encounter with Elizabeth in which it emerged that her wealth shame served as a defense against feeling pleasure and pride. This need to defend against pleasure is often overdetermined: for example, one may feel undeserving and identify with cultural and family norms that emphasize what I call “earned pleasure”—enjoyment allowed only following a productive day, a purposeful activity, or a perfect performance—rather than ordinary pleasures in lounging, strolling, eating a delicious meal, meeting with friends, and the like.

Fear of being envied sometimes emerged during my explorations of wealth shame. For example, Oliver felt ashamed about paying for therapy despite his abundant financial resources. When we explored his shame, it turned out he feared his friends’ discovering that he was paying for therapy out of pocket. He felt terrified of their potential envy. For Oliver, envy implied the threat of being attacked by the envious other. It was therefore deemed safer to feel ashamed about wealth than to acknowledge the possible envy and negative judgment of others. What’s there to envy if it’s shameful, and no fun, to be wealthy?

Another defensive function of wealth shame, which might take years to identify, is to obscure feelings of superiority. We view shame as the underside of narcissism, but grandiosity, or fear of grandiosity, can also present as the underside of shame, perpetuating a vicious cycle of superiority and shame. Some of my wealthy patients felt both ashamed about their wealth and special because of it. They enjoyed special treatment at country clubs and expensive resorts. They understood and appreciated the power of money.

Janet, a college professor in her early thirties, with transgenerational wealth, complained in one of her sessions about her husband’s “limited knowledge.” Janet proceeded to explain why she felt better than her husband, how she had always considered upper-class individuals like herself to be superior because of their high education, social etiquette, and good table manners. This echoed Coco Chanel’s reported statement that luxury is not the opposite of poverty; it is “the opposite of vulgarity” (cited in Roberts 2008).

Janet’s statement surprised me. It surprised her too. She soon confessed feeling ashamed about it. Janet was a compassionate woman who had often expressed discomfort, including shame, about belonging to the upper class, which she experienced as snobbish and oblivious to economic disparities. Also, Janet’s husband was intelligent and well educated, by her own report, and his parents were successful lawyers. As Janet was talking about her sense of superiority, I noticed myself cringe, feeling repulsed. I thought my reaction had to do with my shame, recalling how I used to feel, perhaps still felt at the time, ashamed about my “lack of education.” I also wasn’t sure if I would meet Janet’s expectations of table etiquette. I felt sorry for her husband. It was only after the session ended that it occurred to me that my sense of revulsion might also have been about seeing myself in Janet: on occasions I too felt (embarrassingly) judgmental toward people from lower classes who did not follow what I considered proper social etiquette and how my judgment of them was a defense against my own poverty shame.

Sitting with Janet at that moment, all I could do amid my feeling shame and revulsion was to summon my curiosity, inviting Janet to explore with me her sentiment of superiority. She started to hear echoes of her parents’ frequent disparagement of immigrants and those from the lower classes. One particular memory stood out for her. She recalled how her parents would make long detours in order to avoid driving through working-class neighborhoods in the city where she grew up. She had also been taught that even people like her husband, who were well off but did not come from old money, were not her equals. Janet dismissed my attempt at exploring possible transference implications (my being an immigrant, for example, and her parents’ disparagement of immigrants). A moment later in the session, Janet realized how wealth also provided emotional safety, something she could fall back on when feeling inadequate about herself, which she often felt (here lay her underlying shame, which I was made to feel earlier in the session). She told me that at least she could feel superior to other people in her wealth. Joanna Ryan (2006) similarly notes how middle-class and upper-class individuals “use . . . class as a defence, to create an illusion of superiority and false confidence, warding off fears of failure and inadequacy” (p. 60) and creating a field of inferiority/superiority and contempt in the transference-countertransference. My difficulty with Janet’s condescension seems to resemble the countertransference struggles Janice Lieberman (2012) describes in her encounters with affluent patients in whom envy and greed predominate while shame and guilt are nonexistent or perhaps unconscious (Blum 2012).

Wealth Shame, Self-Esteem, and Financial Inequity

Janet’s reliance on her affluence to feel good about herself, despite her misgivings about financial inequity, became, however, another source of shame. This echoes Neil Altman’s observation that wealthy liberals feel guilty not simply for “having too much” but even more so because “they don’t want” to give up what they have (Altman et al. 2006, p. 175). Similarly, Andrew Samuels (2001) held workshops in which he explored participants’ feelings about money and wealth inequality. He observes how participants expressed concerns about inequity while at the same time they did not want to give up their wealth, noting “it is very difficult for well-meaning people to admit openly how much they love inequality of wealth” (p. 153). He adds that this love of inequality might on occasion border on sadism. For example, in one of the workshop activities, Samuels asked participants to talk about the most shameful thing they would do if they had a lot of money. “A professor of philosophy at one workshop in the United States said this: ‘Well, if I had unlimited funds, I’d buy thousands of acres of skiing land at Aspen and fence it off so nobody could use it. . . . And I’d hire the US Marine Corps to machine-gun anyone who came near.’ He burst into tears and told us about his tycoon father and the relationship he had had with him and so on and so forth” (pp. 155–156).

This conflict between self-interest and a sense of one’s ethical responsibility toward the common good is well depicted by Josephs (2004). He describes his patients of wealthy backgrounds who espoused progressive, egalitarian ideals in their youth and pursued successful careers in the helping professions, which secured them a modest middle-class living, significantly less affluent than the milieu in which they grew up. In middle age, they often became self-critical for not having pursued more lucrative careers like finance or corporate law as their peers did. “Thus their self-esteem was held hostage between a normative standard of affluence that shamed them for their materially modest lifestyles and their self-condemnation for their frustrated but forbidden longing to ‘sell-out’ for greater material affluence” (p. 397). It is not clear whether Josephs’s patients desired more money or only felt that they ought to desire and make it to satisfy their parents’ and society’s expectations of them, or longed for material affluence as compensation for underlying low self-esteem, as did Janet.

Janet’s conflict, and that of Josephs’s patients, about giving up privilege might represent an understandable human desire for beauty and comfort: who does not desire a beautiful home and a relaxing vacation? However, these conflicts also highlight an important cultural hallmark in capitalist, particularly neoliberal, societies in which self-esteem tends to be significantly regulated by affluence. Layton (2014) well describes the experience of some of my wealthy patients whose “demands for special treatment . . . mask longings to feel valued as something more than an investment for future yield [based on their awareness of having been loved not just for who they are but for the return they can bring on their parents’ investment in them], something more than homo entrepreneur” (p. 471). There are psychoanalysts who justify the high expense of psychoanalytic treatment by presenting it as a financial investment—that by having their neuroses attenuated, patients become more successful and will make more money. In fact, Freud (1913) argues that patients of the middle classes “have made a good bargain” when they pursue psychoanalytic treatment because of “the increase of efficiency and earning capacity which results from a successfully completed analysis”; thus, he argues further, the expense of their treatment would be “excessive only in appearance” (p. 133). Although this may prove to be true, my point here is to highlight this tendency in capitalist society to measure people’s value by their “earning capacity.”

Clinical Implications

As we sit with our patients, how do we listen for references to social injustice or wealth inequality whose reverberations are experienced across the socioeconomic divide? We don’t hear statements that, consciously or unconsciously, we don’t want to listen for. As I hope to have shown, social class and financial inequality raise uncomfortable questions that we all, analysts and patients alike, would rather keep hidden. I believe there is no shortcut to trying to open ourselves to the anxieties, sadness, and perhaps despair inherent in the unwelcome reality of inequality. Such feelings might be more bearable, however, if they are not suffered alone but shared with colleagues in the broader psychoanalytic community, particularly if that community takes a serious look at the role of social class in development and psychoanalytic treatment.

The stories of my affluent patients are often not so different from those of my patients who are poor or belong to the working class. At the same time, at the end of the day, the wealthy go home to material comfort while the poor often go home to significant material deprivation. For that matter, affluent people have the resources to seek psychotherapy and to work on their shame. The odds against poor and working-class individuals being able to do this are tremendous. Psychoanalysis, an expensive treatment, is a poignant example of this issue.

Psychoanalytic acknowledgment, let alone discussion, of economic inequality, beyond its intrapsychic and interpersonal symbolism, may be seen as inviting the political into the consulting room. This invitation has generated debates in psychoanalytic circles. Some have expressed legitimate concern about how this may impact neutrality or intrude on the patient or turn psychotherapy into a didactic, shaming, or superego-driven encounter (for a thorough review of these debates, see Aibel 2018). Layton makes a strong statement in favor of including sociopolitical questions in psychoanalytic treatment: “If part of my job is to attend to [my patient’s] development as a citizen who recognizes his implication in the suffering of others, . . . then I need to listen carefully for moments where the conflict [i.e., of self as autonomously sufficient vs. self as interdependently embedded in society] emerges and might be further explored” (cited in Aibel 2018, p. 77). In a similar vein, Hanna Segal (1995) refutes accusations of eschewing neutrality when we address sociopolitical injustices. She warns us not to confuse neutrality with “being neutered”: psychoanalysts, she argues, “are entitled, and indeed ethically bound, to make known our views about the [sociopolitical] dangers we foresee” (p. 204). It is not clear to me whether Segal made her views known inside the consulting room or only in her writings and presentations with colleagues.

I propose that it is ethically and clinically important when encountering wealth shame in our consulting rooms that we depathologize and honor the aspects of that shame that maintain moral responsibility. Because of our field’s general conceptualization of shame as “pathological” (Carveth et al. 2007), therapists may approach wealth shame as something to overcome or challenge rather than to own, face, and use as a moral compass. For example, a new wave of “money therapists” or “wealth therapists” accompanied the rise of young professionals who made a sudden move to extreme wealth from the Silicon Valley tech boom or the finance sector. Riete Oord’s BBC documentary Affluenza (2000) featured these “money therapists” helping their clients “overcome feelings of guilt” about their sudden wealth. Overcoming guilt and shame might involve becoming desensitized to them, as in challenging one’s preexisting “faulty” assumptions about wealth. Some of these therapists caution affluent individuals against using guilt and shame to guide their decisions about philanthropy (O’Neill 1997, p. 144).

In thinking about the ethical versus the “pathological” aspects of shame, it may prove useful to apply Watkins’s distinction between “deserved” and “undeserved” shame. What indeed need to be challenged are those aspects of wealth shame related to undeserved shame about emotional and relational needs: the need to be heard, seen, and loved and the right to a good, enjoyable life lived with dignity not contingent on achievement or productivity. What also need to be challenged are the manic defenses our patients might use to protect themselves from feeling their needs—denial of dependency, the omnipotence of self-reliance—and the cruelty with which they may treat themselves should their needs leak through these defenses (Peltz 2006). Recognizing or honoring the deserved, or ethical, aspect of wealth shame involves facing it, which means to claim it, to speak about it, and to challenge its tendency to pull us back into our cocoons. It also involves exploring with our patients what they might want to do with their ethical concerns about economic disparity, how they might have imagined using it as a signal or compass for socially responsible actions, as I briefly noted in my discussion of Elizabeth (see also detailed illustrations of such discussions in Hollander and Gutwill 2006).

It’s important to note that shame, deserved or undeserved, may feel too painful to admit even to ourselves. Collectively or individually, we often erect protective walls in order not to feel it. While my patients were able to speak of their wealth shame, many of the affluent participants Sherman (2017) interviewed for her sociological study of affluence felt uncomfortable admitting, or talking about, their shame and guilt. Some of them even identified themselves as “middle-class” or simply “in the middle” (pp. 30, 34) in order to deny altogether their wealth and their guilt about it. One interviewee, for example, with a yearly income of 2.5 million dollars, a house in the Hamptons, and a child in private school in Manhattan, did not consider herself affluent because, unlike what she considered her truly affluent friends, she did not travel on private jets (Sherman 2017). In their efforts to avoid their shame, wealthy people may insulate themselves in gated communities and associate only with others of similar socioeconomic status. Segal (1995) speaks of yet another collective defense the wealthy may use against their “guilt about [their] destructive greed or ambition” (p. 195): how they might project their guilt and destructiveness onto the poor, “creating a red monster of communism or the black-and-red monster amongst depressed coloured populations” (p. 195). This projection of guilt might also account for the tendency to blame the poor for their poverty. The nature of shame and the social defenses we build against it—repression, denial, and projection—make it difficult to hold honest communal discussions about economic inequality.

Finally, I would emphasize that honoring the deserved aspect of wealth shame is not equivalent to intentional shaming, a sociopolitical tool so common today. Purposeful shaming, however understandable, tends to foreclose curiosity, learning, and creating space for growth. Watkins (2018) invites us to ask, “When will [shaming] bring about desired aims, and when will it destructively backfire?” (p. 33). I have been on psychoanalytic listservs and discussion groups (online and in person) in which some members take it upon themselves to police participants through name-calling and the like when participants might have presented a novel perspective in a debate, made a simple mistake, or revealed a blind spot—and who among us is free of racist, sexist, classist or other prejudiced blind spots? It is important to invite participants whose words reveal a blind spot to reflect on their lack of awareness of prejudice or privilege. However, intentionally shaming or moralizing to the participant almost always shuts down any dialogue. But even as we challenge such shaming tactics, we need to own and face up to the shame that they evoke, in order for conversations about inequality and social injustice to continue.

Writing about Class

Here I would like to share my experience of writing this paper, as the ambivalence and charged feelings that surround class discussions were to some extent present in me as I wrote. I thought a great deal about whether and how much of my class history I would disclose. The particularities of my class positions and experiences—which I have outlined above—do matter. To simply say that I come from a low-income, working-class, or lower-middle-class family of fluctuating financial means would have been insufficient in locating my experience. At the same time, how much should I disclose without turning the paper into an autobiographical essay? My sense of freedom about disclosing my class origins has not been expanded by the approach of the psychoanalytic community to class and money. Years ago, for example, I participated in a group discussion of a psychoanalytic paper in which the author, a psychoanalyst of working-class background, explored the role socioeconomic class played in the formation of her psychoanalytic identity. She wrote that within the psychoanalytic community she had experienced a minimization of the significance of class and economic inequality and a condescending attitude toward working-class and poor people. I liked her paper and admired the author’s courage and thoughtfulness in exploring these issues. During the group discussion, however, a participant commented that the author’s observations ought not be considered “objective” because they might have originated in her shame over her working-class origins and her envy of the more privileged. In writing this paper, I wondered whether, if I revealed that I had struggled with poverty, readers would similarly dismiss my observations on wealth shame. Do such observations need to come from an analyst with a privileged background in order to be taken seriously? Indeed, presentations I have given, using some of the material included here, have elicited shaming remarks dismissive of its “objective” validity. Recently a senior analyst shared with me that colleagues of her generation from working-class families often did not feel comfortable talking about their class origins until after they retired. Elizabeth Corpt (2013) similarly reports that she knows analysts who experience difficulty in disclosing their working-class history.

In the process of writing, I have wondered how my patients might feel should they read my paper. A few of them, as it is common nowadays, have researched me online (either before or during their therapy) and come across a certain publication of mine. Would their reading it collapse or expand the therapeutic space? For example, would it make an affluent patient feel more or less comfortable talking with me about their relationship to wealth? Would a working-class patient feel threatened to know that I “made it” against difficult odds or feel encouraged by my affinity with the struggles of working-class folks or perhaps feel both? Would it deter prospective patients from making their first call if they learned that social class would be a welcome guest in our sessions? What do you, my readers, feel having read so far? When my patients who read the publication in question shared with me their experiences, our conversations proved useful. I hope that should my patients choose to share with me that they have read this paper our conversations too would deepen our work.

My conflicts about disclosure led me to write an earlier version of this paper that emerged truncated, with a brief mention of my guilt about upward mobility but not much else about my background. This version enacted the very dynamic I aimed to address in the paper: here lay my own conflict about discussing my experience with class.

Aside from my conflicts about disclosure, I also debated how to emphasize the seriousness and urgency of wealth inequality—and our ethical responsibility—while keeping a psychoanalytic stance that invites the reader’s curiosity and willingness to delve deeply into this charged topic. I did not want to moralize or police the reader.

Despite these challenges and risks, writing and presenting on wealth shame have offered me the space to reflect on and feel through difficult aspects of my relationship with class inside the consulting room and outside in ways that have enriched my clinical sensibility. Having found other analysts’ clinical writing helpful when I struggled in my own work—through an impasse or an enactment—I hope, likewise, that my reflections on class and wealth shame will be useful to colleagues facing the issues I discuss here, and that this will make the risk of writing worth having taken.

Conclusion

I have described the complexity of wealth shame, its sociopolitical, intergenerational, familial, and intrapsychic roots. I have also discussed the multiple functions of wealth shame as a key signal affect in moral responsibility in the face of economic disparity, as a manifestation of a pervasive shame pattern, and as a defense against pleasure, pride, feelings of superiority, and the fear of being envied. I have proposed that our approach and interventions in the consulting room ought to mirror this complexity. We need to challenge the aspects of wealth shame related to expressing emotional and relational needs and to the desire that those needs be met. We also need to acknowledge the ethical aspect of the shame and the importance of facing it—rather than challenging it—and using it as a moral compass.

I have argued that our capacity as psychoanalysts to identify and examine wealth shame hinges on our own consciousness of class hierarchy, the ways in which this hierarchy shapes our psyches and those of our patients, and the inequities it creates. We expand our awareness when we examine our individual relationships to class and when we collectively situate our psychoanalytic theories in the context of social class, perhaps in line with recent efforts at “decolonizing” psychoanalytic theories and practices and bringing race and gender to the cultural foreground.

I believe it is important that we analysts acknowledge our privileged status and the fact that by and large those we serve are themselves privileged. In 1918 Freud saw value in psychotherapy for all, including those who could not afford to pay a fee: “it is possible to foresee that at some time or other the conscience of society will awake and remind it that the poor man should have just as much right to assistance for his mind as he now has to the life-saving help offered by surgery. . . . Such treatments will be free. It may be a long time before the State comes to see these duties as urgent. . . . Probably these institutions [which will provide psychoanalytic treatment to the poor] will first be started by private charity. . . . But, whatever form this psychotherapy for the people may take . . . its most effective and most important ingredients will assuredly remain those borrowed from strict and untendentious psycho-analysis” (pp. 167–168; emphasis added). It is staggering that a hundred years after Freud made that statement, health care is still far from equitable, even for basic medical needs. This inequity requires collective political activism beyond the confines of our consulting rooms. In the meantime, we live in a neoliberal American economy which lacks adequate social provisions—health care, college education, pensions—many of which we must secure on our own. We psychoanalysts might want to collectively consider how we can make a decent living and also see patients with modest incomes or no income at all. This question needs to be individually considered, but it is a question confronting us all.