The Psychic Cost off Inflation

Shrinks and despair over the shrinking dollar

Joseph P., a technical writer in Manhattan, dropped out of psychotherapy last year to save the $45 weekly fee. Even with that extra spending money, Joseph went into debt, and his psychological condition worsened. Now he is back with the same psychotherapist, going twice a week at $60 per session,* and almost $1,200 behind in his payments. Says he: "I thought therapy was a middle-class frill I could give up to meet inflation. But the economy is so bad I can't get through the week without therapy."

According to many psychotherapists, the nation's economic woes are beginning to have a heavy impact on their practice. One common report: the pressures of inflation are sending many marginally stable patients over the brink. Says Alan Gruber, a psychologist at Social Counselling Associates in Hanover, Mass.: "The people we see would ordinarily be able to cope, but with inflation, they can't cope now. It is just too much." Adds Cleveland Psychotherapist Jack Wiggins: "We're seeing a cumulative effect. When financial problems are added to internal problems, they tend to overwhelm people." St. Louis Psychologist Norman Matulef reports that patients are now more pessimistic, worried about their own competence and obsessed with money. "Inflation seems to connect more directly with personal dynamics," he says. "It's bad enough for those in the 'normal neurotic' range. For those with more primitive organization in their personalities, it is even more frightening."

One sign of the times is that therapists are resigned to talking more and more about money in sessions with troubled patients. "It used to be that 5% of our conversation concerned economic worries," says Los Angeles Psychologist James W. Gottfurcht. "Now it is 10% to 20%." Some therapists have even taken on the role of financial adviser to their patients. Says Manhattan Psychologist Salvatore Didato: "I spend many more hours than I'd like to trying to help people find jobs, readjust their careers and find ways of making more money." Therapist Margaret Nichols of Atlanta is willing to work out basic budget plans for patients. Says she: "I will do a very reality-oriented kind of assessment. If they need more, I refer them to an accountant."

The first signs of inflation stress are marital spats, increased pessimism, and the growing fear among many men that they are not competent enough to survive the economic rollercoaster. Detroit Psychiatrist Victor Cruz says that it is not unusual for a working man, after being laid off for six months, to seek help for sexual impotence. Says Cruz: "The initial complaint takes the form of sexual insecurity, but the problem is often more related to the lack of being able to provide financially for a wife or girlfriend."

Many therapists report that the nation's political and social drift encourages patients to think that their personal lives are just as uncontrollable. "To improve, a patient has to develop a sense of the future, and that is very hard now," says Manhattan Psychologist Donald Kaplan. "Now the environment ratifies a patient's own inability to experience a sense of the future." Says Psychologist Gruber: "People feel things are beyond their control, in the hands of the Government or OPEC."

There are those who believe that while economic troubles may add to stress, they rarely produce mental illness. Says Boston Psychiatrist Barry Gault: "There is a lot of evidence that real adversity--London in the blitz, for example--is a tonic. Financial concerns make people damned unhappy, but not mentally ill." But M. Harvey Brenner, a Johns Hopkins medical sociologist who has spent the past 15 years studying the relationship of the economy to physical and mental health, disagrees. While he concedes that money problems alone do not produce illness, they can exacerbate it in a patient who is vulnerable for other reasons. That point is illustrated by Brenner's data, some of it gathered for his 1973 book, Mental Illness and the Economy. During the period 1841-1967, whenever unemployment rose, the number of admissions to state mental hospitals rose too. So did suicides and deaths from heart ailments. Concludes Brenner: "There is no reason to believe the phenomenon will not repeat itself."

*Fees for a therapy session vary widely, roughly from $15 to $100 per hour, depending on the locality and reputation of the therapist. In Manhattan, the average session cost $45 to $50 three years ago, $60 to $75 today.

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