UNMASKING WEALTH’S HIDDEN WOUNDS
We had the honor of interviewing esteemed psychiatrists and psychoanalysts Thomas Franklin, M.D. and Marina Nikhinson, M.D. of MindWork Group, a private practice that treats older adolescents and adults, provides clinical supervision, psychiatric consultation, executive coaching, and organizational consulting. Both Dr. Franklin and Dr. Nikhinson have taken care of an international cadre of patients, including business owners, political leaders, and Fortune 100 executives in their private practice and at the prestigious Retreat at Sheppard Pratt Hospital.
Ultra-high-net-worth individuals navigate complex psychological challenges, from generational trauma to struggles with identity, purpose, and relationships. In this interview, Franklin and Nikhinson discuss the mental health complexities of wealth, the impact on family dynamics, and the importance of expert psychiatric care. They offer insights into common struggles among inheritors, barriers to seeking treatment, and strategies for fostering resilience and emotional well-being in high-net-worth families.
What unique psychological challenges do UHNW individuals face?
There are often high rates of psychological and emotional neglect passed down through multiple generations, leading to anxiety, depression and substance use disorders. Young family members are often insulated from their peers and larger peer groups, through highly privileged school settings or highly structured activities which leads to social isolation and loneliness.
We also commonly see issues around generativity — a feeling that one’s life has purpose and meaning. If people don’t have to work to support themselves then what are they doing and why? On the other hand, excessive pressure to perform and maintain the family wealth can lead to despair and inability to find joy in the work and being productive. Lack of motivation to build skills and knowledge, fear of not measuring up to other successful family members, and premature financial security often lead to feelings of emptiness and shame despite acknowledging immense privilege.
How does extreme wealth impact mental well-being?
Interestingly, rates of severe mental illness are just as high in extremely wealthy cohorts as they are in the general population. Wealth doesn’t insulate one from disabling mental health concerns. Anxiety, stress, and psychological suffering are quite high in this cohort; often accompanied by shame that despite having financial resources they remain anxious and insecure. Our culture often associates extreme wealth with happiness which leaves UHNW individuals feeling lonely, misunderstood, isolated and guilty that they are not able to feel satisfied in their life despite wealth. Difficulties with secure attachments and healthy relationships further deepen this isolation.
What are common mental health challenges among second- and third-generation wealth inheritors?
The second and third generation wealth inheritors often struggle with the consequences of neglect and insulation in their childhood with high rates of depression and substance use. The second generation cohort has often missed the opportunity to learn effective parenting and secure attachment in their childhood and this leads to difficulties with their own adult relationships and children. They also lack agency to build their own lives since a lot has been done for them or on their behalf. They often feel like their lives are run by the family business or the family wealth. We see the consequences of intergenerational trauma of extreme wealth in these families where there is a real chasm between the high-earning first generation and the resentful, suffering third generation. Intergenerational dynamics are often such that there is a lot of anger about feeling ungrateful and privileged coming from all sides of the family. The second or third generation patients we are working with have not had the opportunity to make sense of the feelings they have about their family wealth. This confusion, lack of knowledge about what their financial future looks like and lack of spending boundaries leads to the fortune being lost often within three to four generations.
How does extreme wealth affect interpersonal relationships?
Often wealthy people, especially young people, buy “friendships” by paying for everything in their friend group. This gets them attention and a social circle certainly. During that life stage, attention and privileged connections feel like an adequate substitute for genuine relationships. As a result, they often miss out on trusting, intimate relationships that don’t offer an immediate gain, the kind of a relationship that will be the cornerstone of health and happiness down the road. With these dynamics, it’s hard for these individuals to know who likes them for their personal qualities rather than their wealth, and they often have pathological doubt about all of their relationships. They can sometimes attract a cadre of hangers on and develop a whole payroll of people who unknowingly or maliciously take advantage of them.
When the source of wealth is a family business and the success of family relationships depends on the success of the business, dynamics will become fraught, with communication and relationships becoming censored to protect the wealth. Marital relationships are often strained; the pressure to make things work or to avoid conflict leads to a lot of dysfunction.
How can UHNW individuals maintain a sense of normalcy in relationships?
This task can be very difficult, especially if the individual came into a UHNW family and culture at birth. The key element to maintaining normalcy and shaping healthy emotional connections is seeing money as an important aspect to life but not the main one. Wealth can become someone’s only identity. Joining or developing a community that is less dependent on someone’s wealth identity is essential. Developing interests, taking appropriate healthy risks, identifying activities that feel purposeful and lead to connection with others who have the same purpose are all ways to feel more grounded and connected in the world. Learning new skills, finding opportunities to learn from failure, taking care of the body and the mind by avoiding substance use and engaging in healthy physical activities can all help to avoid the Gilded Cage, which is very real.
What are the barriers UHNW individuals face in seeking mental health support?
Good mental health care is hard to find at any price these days. Recognizing the indicators of real quality as opposed to frills and expensive comforts is difficult. The main problem however lies in lack of awareness that the problem is serious and severe. Money covers up disability quite often. When seeking out care, education and training of practitioners actually matters. Time spent with a capable expert team as they get to know the patient and confidence that they will take time together to bring forth all of their expertise is critical to achieving the best results in treatment.
How can wealth advisors and family offices support mental health?
Psychiatric and psychological disability and substance use disorders are the biggest risks to family wealth — its accumulation, retention, and growth. Be proactive about identifying problems in the family matrix. Identify the need for good treatment at the earliest stages possible; stay clear-eyed and honest about the reality of the situation which wealth often hides. Every family office and wealth advisor should proactively engage trusted consultants that have networks of top mental health professionals. Just getting someone an appointment isn’t enough for serious issues. It’s better to have them take a few weeks or months to have a comprehensive evaluation and treatment experience at a reputable center.
At Wellworth, we understand the profound intersection of wealth and well-being, supporting ultra-high-net-worth individuals and their families as they navigate complex mental health challenges. From generational trauma to struggles with identity, purpose, and relationships, these challenges often remain unseen and unspoken.