I’m a Therapist: 6 Problems I See Wealthy People Struggle With the Most

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There is a common conceit among those of us who are not wealthy that wealthy people have it easier than we do. We’re not wrong. Wealthy people generally do have it easier, in so many important ways. They have more freedoms, more access. Things that should be financially manageable for all of us — like going to the dentist, raising healthy kids, going to college and retiring — can be pretty painless for them, whereas the rest of us have to penny pinch and make sacrifices. Would we rather have our Netflix and Starbucks or our bus fare? Wealthy people don’t have to choose. 

But wealthy people do, like every single one of us, have problems — problems that really weigh on their minds, hearts and lives. Their problems may not be as dire as the possibility of homelessness or the inability to pay for your pet’s surgery without going into credit card debt, but they’re still cumbersome and challenging. What are some of the most common problems wealthy people face — and how are they treated?

Isolation and Mistrust

“A philanthropist I’ll refer to as M. told me she struggled to distinguish genuine friendships from those drawn by her fortune,” said Shebna N. Osanmoh I, PMHNP-BC, psychiatric nurse practitioner at Savant Care. “Invitations to dinners or requests for ‘networking’ felt transactional and she rarely felt she could confide in anyone without an agenda.”

It makes sense that someone boasting wealth could feel this way. Those of us who have yet to make our millions are often hearing about how we should network with people we want to be like — people who’ve made “it” — and “it” often means millions. To help M and other clients suffering from this sense of isolation and mistrust, Osanmoh combines evidence-based modalities with sensitivity to the unique context of affluence, working to build genuine trust and confidentiality. 

“Early on I prioritize creating a space where clients know they won’t be ‘pitched’ to or judged for their financial status,” Osanmoh said. “This often means meeting off-site rather than in a glitzy office and reinforcing strict privacy boundaries.

“Together we explore what matters beyond money — whether it’s creative expression, mentoring others or meaningful philanthropy.” 

For those feeling exploited, as M might in social situations, Osanmoh coaches negotiation skills and helps map out trusted circles. 

“M created a ‘friendship covenant’ — clear guidelines around how and when people could contact her, which quickly revealed who valued her presence versus her wallet,” Osanmoh said. 

Guilt 

Stacey Ross, a mental health specialist at Addiction Resource, sees a lot of guilt among people she works with. Guilt about having problems they feel bad about.

“Wealthy individuals tend to feel ashamed about being anxious or depressed,” Ross said. “They’ll say, ‘I have it all, why feel this way?’ But hurting is hurting. I remind them that emotions don’t discriminate by checking their account balances. I get them to let go of judgment about their own emotions.”

Identity Crisis

Are you lower class? Lower middle class? Middle class? Upper middle class? We usually have an answer to these questions, or think we do, and that’s a problem in itself, because when we begin to identify with who we are in terms of our income and net worth, we risk losing aspects of our identity that are more grounding, more real and, frankly, more important. 

Vikas Keshri, clinical director, social worker and psychotherapist at Bloom Clinical Care Counselling and Therapy Services, often sees wealthy patients going through an identity crisis. 

“The net worth of an individual may become ‘one’ with their perceived self-value,” he told GOBankingRates. “Clients may ask themselves, ‘Am I being loved for who I am or for how much I have?’ Financial success tends to gain more respect from society compared to other forms of ‘identity’ (ex., profession, hobbies, religion, values, etc).” 

Keshri believes the key coping mechanism for people struggling with this problem is for them to define their identity outside materialistic means. They should look at their relationships, their creativity and personal growth.  

Paranoia  

Always feel like somebody’s watching you? A lot of wealthy people do. Perhaps they feel like all that money puts a target on their backs for bad actors. 

“Being very conspicuous as a rich individual creates clear vulnerability,” Keshri said.

Keshri recommended that people who feel paranoid because they are obviously wealthy practice grounding techniques such as mindfulness with a licensed therapist who is trained in that modality. 

“Try risk-assessment drills, cognitive behavioral therapy, and determine what’s in your control versus what isn’t to distinguish between actual danger and perceived danger,” Keshri said. “This can also help individuals navigate those negative, anxious feelings and help the person create an actionable plan.”

Decision Paralysis

If you don’t have much money, you often don’t have much choice. If you want to stay afloat, you need to live in a modest home in an unglamorous area and possibly rent instead of own. Your kids need to go to public school. You don’t need to decide whether you’re going to Bora Bora or St. Barts because you can’t afford to go to either. Wealthy people usually have the luxury of choice, and this can lead to decision paralysis. 

“Too much choice (where to reside, what car to buy, which school to send kids to, etc.) results in decision paralysis,” Keshri said. “Money removes most natural financial constraints, making choices more challenging.”

To help patients cope with decision paralysis, Keshri encourages them to adopt “decision filters” such as making decisions in accordance with their primary values to reduce the mental overload.

Fear of Losing It All

Finally, wealthy people often struggle with a pronounced fear of loss. They have a lot to lose, after all, when it comes to things like stocks, real estate and material possessions. 

“The higher your financial altitude, the farther you can theoretically fall,” Keshri said. “The fear can also be, ‘I don’t want to go back to how things were before,’ and the ‘fall’ could be entering the past stage of their life (typically their struggle phase).” 

Keshri works with patients who are experiencing fear of loss to redefine security by diversifying not only financially but also emotionally. Additionally, if you’re wealthy and scared you soon won’t be, surround yourself with people who have held positions of wealth for a longer time than you and have, in one sense or another, been through bad times before and clearly come out fine.

Sources

• Shebna N. Osanmoh I, Savant Care
• Stacey Ross, Addiction Resource
• Vikas Keshri, Bloom Clinical Care Counselling and Therapy Services

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