American democracy has become an oligarchy. A 2014 study conducted by Northwestern and Princeton researchers concluded that the powerful wealthy elite substantially determine government policies while ordinary citizens have little impact. By lobbying on Capital Hill for the passage of self-serving legislation, the rich dictate political agendas. What has resulted is an unprecedented disparity of wealth and environmental pillage actuated by unrestrained privilege. An Oxfam Global Inequality report indicates that the top percentile of earners holds more wealth than the rest of the world combined.
Epidemiologists are scientists who analyze the patterns and causes of health and disease in populations. It’s no surprise that they have long documented the devastating impact of poverty and inequality on social cohesion and population health. Epidemiologists report that stress related to unemployment and economic inequality can result in everything from obesity to increase in suicide rates, infant mortality, psychiatric illness, and addictive disorders. Research from Layola University linked the Great Recession of 2008 to a significant increase in major depression. Another study of the 2008 recession (2013, British Medical Journal) proclaimed a 3.3% increase in the number of suicides among working age men around the world.
Examining current circumstances, we are confronted with more than 146 million Americans classified as “low income,” more than 100 million Americans enrolled in at least one federal welfare program, and tragically, an all time high in child homelessness. Governmental looting of pensions and savings has begun, devastating retirees and their surviving spouses while corporate moguls earn 380x more than the average wage earner. Minimum wage is not commensurate with inflation. Fiscal corruption is exonerated and in fact encouraged. We are stuck with a broken and corrupt healthcare industry. Given the government’s track record it is ignorant to think the absurdly wealthy will be justly taxed, in conjunction with not increasing or even decreasing taxes on the middle and working classes.
As to be expected, psychotherapists are encountering the myriad repercussions of fear, panic, and disillusionment rooted in pervasive economic strife. Corporate Stockholm Syndrome, a psychological phenomenon in which employees feel pathologically beholden to their abusive employer, has become a frequent concern in therapy sessions. Clients feel trapped in a corporate culture infused with ambient terror. They are sent the message that non-compliance will result in merciless demotions and terminations, resulting in mortifying subjugation and impaired volition. Dreams deferred by the economy are replaced with strategies of subsistence and endurance.
Along with the tribulations of despotic work environments, psychotherapy clients are sharing about the vicissitudes of rising costs in child-care and an antiquated maternity leave system. With only 13 percent of American workers having access to paid family leave through their employers, clients are reporting spending as much on monthly daycare costs for their infant as they are on rent. Sadly, the United States is one of just three countries in the world that doesn’t guarantee paid time off for new mothers. In NYC where I maintain a private practice, the cost of living, is double the national average and taxes are among the highest in the country. Hence, sessions are rife with survival fears and financial anxiety. Simultaneously, health insurance benefits have outrageous deductibles and high premiums. People clearly need treatment during these difficult times, but economic strain and little to no insurance coverage often undermines that pursuit.
Although psychotherapists are discerning the myriad ways in which economic and political realities are affectively infiltrating the therapeutic dyad, navigating this terrain is replete with complexity. Session time may need to be spent processing the adjustment of fees and schedules. Perceived or real class differences may penetrate transference/counter-transference dynamics. Most notably, shifting the therapeutic work from comprehensive abstract processing to custodial issues pertaining to housing, employment and medical needs may necessitate suspending creative and psycho-spiritual inclinations for the sake of unyielding practicality. Clearly, Abraham Maslow’s assertion that one must satisfy basic biological and physiological needs before progressing on to aspire towards self-actualization, is a premise clinicians will indeed depend on as economic trends continue to decline.
