A common taboo for clients and therapists
Why do many clients avoid talking about money issues in therapy?
Some clients have asked recently about a temporary revision of fees because of their own financial hardship due to the pandemic. In some ways this is a simple question, but the answer is not always so straightforward, and needs to be carefully considered. What meaning does my reply have for this client, and how does it affect the therapeutic relationship? On what basis am I making this decision? Are there transference and countertransference issues involved? And how comfortable am I in general in discussing clients’ financial issues?
When you reflect on your own family of origin (and/or your current family), how openly were money, earnings, debt and concerns discussed among family members? Did the culture you grew up in support openness or a more private approach to finances? Family of origin and cultural attitudes influence how comfortable clients are with raising financial worries in therapy.
Shame is another significant factor – people can feel immense embarrassment over their monetary losses and poor financial skills. Along with shame comes the fear of the therapist’s judgement, which may also deter clients from disclosure.
Clients and therapists can also make assumptions about what is a ‘legitimate issue’ to bring to therapy and what is perhaps an irrelevant problem, a ‘side-track’ or considered ‘defensive’. So too, previous therapists may have suggested to a client that talking about certain topics is outside the realm of therapy. The client may be understandably anxious about raising money problems as a result.
Resistance is common in therapy, and clients may regard changing long, ingrained financial patterns too difficult to change so they don’t bring it up, or fear that their therapist will ‘push for change’ when they, the client, find it too difficult or too painful to make the changes.
What gets in the way of therapists raising or pursuing financial issues with their clients?
The therapist may find themselves discomforted by the client’s financial fears, which trigger the therapist’s own problems and fears around their own financial circumstances. The therapist may seek to reduce their own anxiety by quickly moving off the topic, which subsequently sends the message that money problems are not appropriate to discuss in therapy.
My accountant legally can’t give me financial advice other than that directly related to tax – if they can’t, how can I possibly offer my client anything?
Therapists may decide that they don’t have sufficient knowledge and skills to help their clients with financial issues. The error is to assume that it is knowledge/advice on finances that is required, rather than framing it as an area of difficulty for the client to be explored as with any other issue. The therapist could instead explore the issues around the financial concerns. What are the behavioural patterns, fears, conflicts, emotions associated with money, spending/saving habits etc.? Taking this route as with any other client concern may offer relief, benefit and change for the client.
The therapist (like the client) may see enquiring about behavioural patterns and accompanying emotions related to money as a violation of cultural norms, and thereby invading or intruding into the client’s private space. Related to this is a theoretical belief in the ‘client-centred’ approach where the therapist waits for the client to introduce the issues and topics for exploration. The client, on the other hand, may regard this as confirmation that money issues are indeed ‘taboo’.
How to introduce the topic of money with clients
Therapists should introduce the topic naturally, and/or as it occurs. What do you do when the client fails to pay for their session, asks for a discount or extended time to pay their outstanding fees? These are opportunities to further explore with the client if there are financial issues they may wish to discuss, and how extensive they are. What are their concerns about their financial situation? As with any sensitive area, of course, the therapist needs to be gentle with the exploration.
The topic can also be approached as part of a parallel process/discussion. For example, a relatively new client began to talk about wasting time and how they don’t spend their time wisely. I asked if that pattern was only a concern around spending time. His head went down, and to my surprise, he began to tear up. He looked back at me, hesitated, and slowly explained, “No, I have always been ashamed of how foolishly I spend my money, and then don’t have it for things I really want.” Then, almost in a whisper, “I’ve never talked about this with anyone – I’m always too ashamed.”
Looking for ambivalence and conflict
Nancy (all names are changed and responses paraphrased) begins to talk about how she won’t be able to come for a few weeks because she and her partner (Jo) are going on holiday. I ask where she is going, and she pauses. Then after a minute or so she explains, “I can’t make up my mind – one resort is so expensive but beautiful, the other much more affordable, but a bit run-down – I just can’t decide. And besides, I‘ll probably be paying for Jo as well; she never contributes anything!”
I asked if she was feeling ambivalent about spending money on herself, and this quickly moved to us exploring themes of deserving and self-worth. In the next session, she spoke about how conflicted she was regarding paying for Jo: “Shouldn’t I be pleased to be able to be generous to someone I love? But I also resent that I am so taken for granted and always have to pay for her. I am ashamed to say this, but I would love it if someone paid for me for a change!”
Delving into the issues surrounding Nancy’s initial money-driven concerns allowed these ambivalences, conflicts and emerging resentments to be explored in greater depth.
The miracle question
I have found it useful as a therapist to pose the following question to clients: “If, while you are asleep tonight, a miracle occurred and this financial problem you mentioned was solved, what would be different for you when you wake up? How would you know the problem had been solved?”
One client told me with a huge grin on his face, “I would be credit card debt-free, and I would feel such relief, I could dance on the ceiling!” I then asked, “And how would someone close to you know the miracle had occurred – what would they notice?” (He had informed me earlier that his wife was feeling stressed by the amount of debt and was nagging him to reduce it significantly.) He explained that his wife would see how much more relaxed he was around her and was no longer discussing money problems with her. We went on to discuss what steps he could take to reduce the debt in an active way, with the hope that he could experience the possible outcomes he had just described.
A framework for thinking about the therapy and money taboo
- Explore the client’s attitude, beliefs, emotions and cultural determinants associated with money.
- Review issues of self-worth via deprivation/indulgence etc. reflected in patterns and attitudes towards money.
- Is the person/couple able to meet their core physical, social, emotional and attachment needs adequately through their financial behaviours?
- How do spending patterns reflect issues of power and control over self and others?
- Are financial patterns in or out of control? Do they benefit or harm the person(s) involved?
It is unethical for psychologists to offer treatment in areas where they do not have the necessary training and competence; but if they don’t explore the area(s) of difficulty sufficiently to make that decision (maybe with a supervisor or peer), therapists may choose to avoid the topic or prematurely stop treatment and refer elsewhere. Yet, this could be a major disservice to our clients because they may well have money problems that significantly impact on their lives and wellbeing, and/or interfere with life being as fulfilling as possible.
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