Fragile Power: Why Having Everything Is Never Enough

Let’s talk family enterprise explores global ideas, concepts and models that help family enterprise advisors better serve their family clients brought to you by family enterprise Canada. All views Information and opinions expressed during this podcast are solely those of the individuals involved and do not necessarily represent those a family enterprise Canada.

0:31
Hello, and welcome to another episode of The let’s talk family enterprise. Podcast. My name is Steve Legler. It’s great to be your host once again. This month we’re looking at some complex subjects that we haven’t dealt with very often here. And I get to interview someone I’ve really been looking forward to speaking with since I read his book a few years ago. Our guest is Dr. Paul hookah. Meyer, a clinical and consulting psychotherapist who works with individuals and families all over the world. He also holds a doctorate in law and an MA in clinical psychology with a focus on family dynamics. The book I mentioned is titled fragile power. Why having everything is never enough lessons from treating the wealthy and famous. I read it a few years ago and just listen to the audio version recently to get ready for this episode. We’ve got lots to discuss. So let’s welcome our guests and kick things off Dr. Paul hook Amaya. Thanks for joining us today. Welcome to the let’s talk family enterprise podcast.

1:29
Thank you Steve, thanks for you for having me. And thank you for the innovative work you’re doing in the family governance space.

1:35
Okay, so you know books and their titles and especially the secondary title why having everything is never enough that is really intriguing and engaging. So I wanted to start there and can you just give us a little bit of, of what inspired that particular subtitle and where that might take us today?

1:57
I wish I could claim complete credit for it. But it really came from my editor who and we were working on the manuscript for a number of years and we were trying to focus on a subtitle and her understanding of the book was that at the heart of the population with whom I work, people who live in the world in positions of extraordinary abundance, material abundance, but in emotional scarcity really resonated with her and this notion of living in a world where the world feels and looks at you like you have everything that they would ever want and yet you still live in a place of emotional scarcity was something that had a deep resonance with her and subsequently had a deep resonance with me and so we decided that that would be the subtitle of the book.

2:45
Interesting. Okay, so, the main audience for this podcast are the family enterprise advisors who have taken the FBA program. And so we try to, you know, target our content towards them. And so a lot of us work with all sorts of successful people who have typically a successful family enterprise, and a blood of different issues come up, and we’re often not sure how to deal with them. And so you’ve treated a lot of people with addiction issues and mental health issues and I know that my colleagues who have taken this program off and when we start to hear about those issues, that’s where we sort of get scared and say, Oh, this is out of my depth. And so I’m hoping that you can help shed some light on what we might do in those kinds of situations. At least at first to like, do no harm but also not pretend that what we’re hearing about isn’t happening.

3:42
Yeah, I think that that’s such an insightful place to look at the work that what I deal with on a daily basis is behavioral health issues as you mentioned, addictive disorders, relational disorders, mental health disorders. It’s a qualitative realm. And the professionals who graduated from this program typically focus on the quantitative aspect of a family’s wealth and they know you we all know intuitively because we’re human beings and because we’re all existing relationships that that there’s a whole other side of wealth and a lot of our colleagues have talked very eloquently about health as wealth and the holistic notion of wealth and working in the realm of quantitative wealth, right, you can add it up at the end of the day, what’s the net worth of my client? That tends to be linear and tidy? This other bit, the behavioral health issues related to behavioral health are not exist in the qualitative realm and they tend to be nonlinear, and very messy. And so what I recommend to my colleagues who I work with in your field, is that recognizing that these issues exist, and that they are part of a family’s holistic well being, and that if you’re holding yourself out as a full service firm, that it’s helpful for you to have a basic understanding of the issues that most impact you have the families that you’re working with in a disruptive way in recognizing your limitations and that just as you will have other professionals in your ecosystem, you have accountants, you have estate lawyers in your ecosystem. That it’s important to have behavioral health experts in your Echo system as well. A person who’s credentialed whose license who’s highly vetted, who is able to hold the enormity of this experience and contain it in a way that moves the family in a reparative direction. So it’s basically expanding your Echo system to have a trusted, vetted, professional who can come in and help out with these issues, which by the way, are highly disruptive, to a family’s quantitative financial well being

5:58
right so you’re speaking I think, mostly to the converted because one of the things that we learn in the program is the interdependent or the team, the multidisciplinary team. And so often, it’s a lot of interdisciplinary between people on people who work on the quantitative side, and learning that well, there’s some qualitative stuff that they may need to bring in is something that we’re exposed to but like I said earlier, when it gets to severe issues, that’s where people feel they’re out of their depth, but what you’re pointing out is that we need to make contacts with people and start to include these people because we will see these issues more and more.

6:45
When we are and if you are a full service firm and you’re holding yourself as a full service professional, that these are issues that have a very direct impact on the well being of a family enterprise.

6:59
So recognizing, like you said, the first thing is to recognize that these issues are there, understand our limitations, and then have a network of people that we need to be able to reach out to help support us with that.

7:12
And that’s exactly right. And so, you know, just not being afraid of the issues and and if it comes up in a family to be able to say, you know, Joe or Susie this is a really tricky issue, and these are complicated issues. And I think that we need to talk to some professionals about getting some help in this area. I have a list of three vetted professionals who I know and perhaps together or you independently can have a conversation with them, invest them just like you would in any investment, right. You have to do due diligence on the person and on the professional.

7:46
Also one of the ways that we can add value for our clients is to be someone who helps to identify for them and help them vet and bring in the kind of resources that they need. But in order to do that, we need to do some of our homework in advance and start to scope out and start to contact these kinds of people. If like you said, we want to be seen as full service. Exactly. You talk about the three traits that a lot of successful people have that make them maybe more challenging to serve. And I think their isolation suspicion and hyper agency, can you take us through that in a few minutes just to help because I really had resonated with me that you know, a lot of us deal with people that are a little more difficult than the average person to try to convince up things because they’re already successful. And so they look at the world a little bit differently.

8:43
Sure. So my work, I approached my work through the lens of cultural competency, and if we know that we’re dealing with a minority population, which we are and particularly with this population, the minority is defined in terms of their quantitative wealth. So we’re dealing with the top 10% the top 1%, the top zero 0.1%. So we know the quantitatively they exist in the world in the position of a minority, in contrast to other minority groups, to whom cultural competency in the realm of behavioral health has been created. Those individuals exist in the mind not in minorities in positions of powerlessness. So if we think historically, typical clinical formulations, feminist theory, there’s a lot of good work that’s been done with queer populations in terms of their positions as minorities in positions of powerlessness, the population that we are privileged to work with, exist in the world, as a minority in positions of power by virtue of a number of features, be their wealth, be their family name, be in their position at the top of a corporate ladder. And so the field of Behavioral Health has done a very poor job in terms of developing cultural competency with these individuals. My work focuses specifically on a minority group of people who exist in positions of power and I did my PhD research on ultra high net worth identity so how people have wealth manifest their identities. interpersonally which means how they view themselves, what’s their level of motivation? What’s their self concept? What’s their self esteem? interpersonally how does that identity impact their relationship with the significant people in their lives, be that their family members be that they’re their service providers? And then the last one is social culturally, right? Because we know that nobody exists in isolation and the dominant cultural zeitgeist. The ethos that exists around people of wealth is very important in the consideration of how they view themselves and how they exist in the world. And so part of that research was that I identified three distinct cultural markers of this particular population. And as you you listed off those three cultural markers are isolation suspiciousness of outsiders, and hyper agency. So let’s just take a minute to go through each one of them. The first is isolation. So we know that people of wealth exist in a very isolated world. And there’s a lot of data around that and this is particularly relevant in terms of entrepreneurs, so people, first generation individuals who have made their wealth isolation is very hard baked into the entrepreneurial mindset, but it also exists for this particular population. They live very secluded, and they don’t fly commercial, they fly private. They’re not going to go on a Disney cruise, they’re going to charter their own yacht. They’re not going to go to the hospital emergency room. They’re going to have a concierge doctor who probably will come to them. You know, many of our clients live in gated communities behind another set of gates and so they exist removed from the general flow of the world. And the second one is suspiciousness of outsiders because as a minority group as a tribe, as you will they exist a tribal right. And this is not unique to this particular population that all minorities, there’s a tribal component to that right. And so when we think about what a tribe is a tribe is a group of people who orient around common interests and against a common foe. And so this particular minority group like other minority groups, there’s a tribal component to it and then the third is this construct and this is unique to this particular population. The other two, not so much. But this last construct this notion of hype or agency, is the capacity to construct your world to avoid discomfort. It relates to the first doesn’t know. So I’m not going to stand in the queue. At the airport. I’m going to fly private. I’m not going to wait in line. I’m not going to go to a bank, right, I mean, I’m not going to do any of this. I have people who do all of these things for me so that my wealth and my power is used to remove friction from my life. And so these are the three distinct cultural markers of this particular population. And then, if you’d like, you know, if I’m happy to address any of that treatment has some thoughts on that, and then we can talk about how those relate to the delivery of psychotherapeutic services.

13:23
Well, what interested me was the way when you explained it, how they seem to be so self reinforcing all three of them. Right? As you isolate yourself more, you become more and more suspicious of people outside because you’re not used to having them close. And now you want to control things more because you are suspicious about people so they all they all work together. But can you help us now then so all of us who have clients like this, and they might not all have their own private jets, but they’re somewhere in the upper echelon? And so you know, developing trust with them is always key. And then we sometimes get suspicious for them upbringing in other outsiders and so I’m thinking about when we have clients who need specialized services, like somebody needs to go into rehab, and we want to refer them to someone, but you talk about the fact that there’s like a whole industry around the whole luxury rehab model. And I wonder how that fits with the three traits you were talking about?

14:28
Yeah, very distinctly. And it also relates to the framework within which I analyze my data the last bit being the cultural construct of the world that we live in and the zeitgeist around people of wealth and we live in a world where wealth is viewed in a binary and people have a very conflicted view of wealth is simultaneously idolized, demonize people of wealth, right, right. They want to be them desperately and then they hate though, right? They love the data shows that that’s dependent upon people’s understanding of how the wealth was made and the service that was provided. So Oprah Winfrey because she touches a lot of people’s lives in a very warm way. We don’t really disdain her as much as we would disdain a Bernie Madoff or somebody like that in financial services industry. So that’s that bit in terms of quality care. Again, my work is focused on cultural competence and clinically effective care. So if we think about this three distinct cultural markers, isolation suspiciousness of outsiders, hyper agency and we look at the way typical treatment is set up even a psychotherapeutic relationship, right. So somebody is in psychic pain and they need to go to a therapist to engage in talk therapy, or they need to go to their their family physician, or their psychiatrist to get some kind of psycho pharmacological intervention antidepressant. We’re asking that person to come out of their isolation to trust somebody who’s outside of their social class, and to tolerate discomfort while they talk about their vulnerabilities. So

16:03
every single order because you’re going

16:07
exactly right. And so so if we think about that, in the individual psychotherapeutic setting, I mean, just to have somebody go come forward, and to say, look, I’m gonna I’m suffering from depression and I’m suffering from anxiety and it’s been feared my relationship the vulnerability inherent in that is extraordinary. And when you live in the world in a position of power, and the world is projecting upon you, and you hit your handle and you’re responsible for the livelihood of hundreds, 1000s of people, it’s a tall order. So the clinician needs to be able to earn the trust of the patient who’s coming forward to and that’s a felt experience, right? That’s not something that’s promised. That’s something that has to be manifested in the clinician. If we look at it in terms of the if we take that and we expand that we have so much just talks try to kind of talk some brass tacks. So let’s just say classic case. We have a 55 year old wife who’s married to a wealthy first generation wealth holder and She twisted her ankle playing tennis and becomes addicted to Oxycontin, right. And so now she has an addictive disorder. And so there’s an enormous amount of shame. There’s an enormous amount of stigma because now she’s like, this can be viewed as a drug. And so we need to make sure that we meet her in a way that’s what’s called an ego syntonic environment, which means we need her in a place of respect and that mirrors back how she perceives herself in the world. Without stigmatizing her. So where do we send her for treatment? So we tried to you know, we tried to work with her outpatient and to try to get her into a detox and to get her some medical interventions, but it’s not going to work. We need to stick her we need to put her into treatment. So we need to look at what the basics of treatment is. And treatment is essentially residential treatment as a frame. We have a patient outside in the world, causing disruption to themselves and others so we need to get them out of that environment and put them in a safe contained frame. 90 days is ideal, because empirically we know that we are neural networks, our brain can takes 90 days for them to achieve a new state of equilibrium, which is what we want to do with her because her brain is wired Perfect. Now she has is craving dopamine, right? It’s all about rushes and we need to get her stabilized. So there is value in terms of residential care in terms of getting patients out of a destructive frame into a highly structured, safe contained frame where they can detox. But what’s happened in the residential treatment community is that because of managed care where the margins have been squeezed almost zero for residential treatment facilities, treatment facilities have been able to say, oh, boy, there’s really great margins in private pay patients and so we can charge 90,000 100,000 There’s clinics in Switzerland that charge 250,000 euros a month for treatments, essentially, what are they doing? They’re just providing this frame and so they tend they look at the patient as a profit. I like when they look at them as like a higher return on investment as opposed to a human being who deserves culturally competent, clinically. excellent care. Is this like de facto across the board? No, there are some programs that do have that are are aware of the unique cultural needs of this particular population and do provide those services, but it’s a tricky bit and you have to be so careful in terms of picking the facility in terms of knowing who the clinical team is, knowing if they’re a for profit or nonprofit if they’re a for profit, or they’re going to ask the patient for donation. After they you know, sometimes I’ve heard of patients being asked for donations during their treatment stay. That that’s unethical, and that’s not acceptable. So you have to be very diligent and this is why it’s important to do your due diligence, right? And to have somebody who is managing the case and who’s overseeing the case and making sure that they’re not going to start talking to the patient about extending their care, like in the first two weeks of treatment, because they want to you know, like these, and by the way, there has been a proliferation of these facilities and there’s too many beds for patients and so it’s a highly competitive space. And you just need to make sure that that there’s a value proposition in terms of the residential care. And just

20:53
like all the other service providers who are around these families, everyone is looking at them as, as a cash cow in some kind of way. And if we have that trusted relationship with them, we have to make sure we’re honoring that and bringing in only people that really are qualified to be dealing with them. And at the same time, though, you talk about the fact that we really need to take the time to get to know them and treat them as individuals as opposed to another person staying in a bed with a high profit margin.

21:24
That’s right. You know, this to me and to you and I know you and I know your work. It’s a handshake business, and so you can start looking around online in terms of finding a treatment facility online. They’re really slick, and you just need to know which and you need to know who the clinical team is, and you need to know what their credentials are, how long they’ve been with the program. There are a lot of questions that need to be asked.

21:50
Right? And so these wealthy people you talk a little bit about you know, how these people are wealthy and people admire them and they’re held in disdain at the same time. And so these people and they have, like you said, 1000s of people who work for them who depend on them, and yet, they do have issues of vulnerability and self worth and then another one that that we hear about, or we think about when we talk about these kinds of clients narcissism, and I know that’s one that comes up a lot in our industry where people I have a colleague who told me I never deal with founders anymore because they’re all a bunch of narcissists. And I think that’s probably more of a generalization than is necessary. But can you just shed a little bit about some of these different manifestations of what we see in some of our clients and how we might find better ways to deal with those instances?

22:42
Yeah, sure. So empirically, we know that people on higher income brackets suffer at higher rates than the general population from narcissistic personality disorders and narcissistic personality traits. We need to understand the etiology, we need to understand the root causes of narcissism and so narcissism is a result of an ego injury that occurred early in the person’s developmental life, somebody whose trust they depended upon and care they needed a trade. Now, the level of the betrayal can vary. It can be a huge betrayal or it can be a small betrayal. This is all dependent upon the individual’s central nervous system and so you know, everybody in the field of behavioral health or most people want like what’s the silver bullet? What’s What’s the one thing is it nature is it nurture and sorry to break the news, but it’s not one thing. It’s somebody launches. A good colleague of mine always says what it’s a bouquet. It’s a combination of all of the above. And so, what could constitute a betrayal to one person would not constitute betrayal to another person, depending upon their genetic makeup project, depending upon the vulnerability of their central nervous the sensitivity of their central nervous system so early in the person’s developmental path, somebody who’s carrying protection they need to betrayed them. The message that they internalize because they’re very smart was that people are unsafe, and so I will not trust people and I will not allow myself to be vulnerable. What is safe, external markers of success are safe money. In particular, one of the dominant cultural messages that we have about money is that it buys security. And look, it does. I mean, let’s not pretend that money doesn’t allow us to live in the safest neighborhoods. It the healthiest foods drive the safest cars, etc, and so forth. What happens is that it gets the wind when that gets turned way up. And so vulnerability. Intimacy is something to be avoided at all costs, and I will build a castle around myself literally and figuratively, to protect myself from vulnerability. And so when you have professionals who come to help them, they’re always going to not always but they’re part of their personality construct if Firm narcissism is the need to feel superior and so they have a tendency to engage in things like gaslighting, right? So to make your reality seem like it’s not true there can be very manipulative. There’s something called the narcissistic cycle of abuse that when the narcissist feels threatened, they turn it around and become the victim and by becoming the victim, they regained their power. It’s a very challenging population to work with, because they’re constantly testing that what they’re doing is they’re testing they’re testing. Are you trustworthy? Can you handle the enormity of my experience? And look, my hat’s off to your colleague for recognizing her his limitations in terms of their ability to work with this particular population? It’s not for everybody. And so so being able to successfully negotiate a narcissistic relationship with a client requires It’s a dance. It’s an art form that needs to be grounded in empirical data. So like everything that we do the work the field of behavioral health, one of the challenges is that there’s a lot of opinions and there’s a lot of experts who are not credentialed and who are have like Instagram followers and the work that I do and I know the work that you do is based on empirical data, so we need to ground ourselves in the empirical data, we need to understand the root causes of narcissism from an empirical standpoint, there’s a lot of really good research about positive example as a clinician who’s done a lot of great work around narcissism and upper upper echelons of our society. And then the art form comes in being able to negotiate that and being able to establish what I call a reparative. Alliance, a therapeutic alliance with your client, so that you can you can work within that challenge those challenges and being able to negotiate them in a way that moves the client and the client system and clients families. In a reparative direction towards increments better. The other thing with narcissism is that this notion that the narcissist will change, I let go of that, because while the edges of narcissism can be softened, it’s like a pickle. You know, what’s a narcissism kind of always narcissist and so progress can certainly be made and insights can be gained. You have to work with it. And by the way, if you have a huge ego, you’re not going to be able to work with the narcissist

27:48
correct Yeah. They’re very useful stuff out what one thing you mentioned earlier about how you were dealing with a minority population. And one of the most fascinating things I got out of your book was the fact that you actually went to the other end of the continuum and worked with minorities in the power less area and I just, if you could just talk about how what happens at one end of the bell curve, actually is informative to at the higher end of the bell curve of wealth and power as well as I find that fascinating.

28:26
Yeah, sure. I started my career, you know, as a lawyer and I worked with some ultra high net worth families and I decided I saw some technology in those systems and decided to go back to school and I did a master’s degree in clinical psychology and I didn’t think I would practice psychotherapy. But as part of this program, I had to do an internship and I did another free clinic in Hollywood working with HIV positive transgendered sex workers, people who live in the margins of society and extraordinary positions of extraordinary powerlessness. And then I was working, as I mentioned, as a concierge lawyer with Ultra Uber High Net Worth families and I saw that while the externals of these people’s lives were quite different, the internal constructs were the same hyperactive central nervous systems, insecure attachments, trauma, in their background in the field of Behavioral Health have done a good job of working with people who live in the world in positions of powerlessness, and not positions of power. And we think about those two sides of the economic bell curve right? We have cultural stereotypes that define them in pejorative ways, right? If we think about poor people, we can call them entitled, we think about rich people, we call them entitled, we think about poor people, we can call them lazy. Everything about rich people, we can say that they’re lazy. So there’s a lot of similarities between the two populations and you know, Steve, I still work on those dos sides of the scalp provider. I work in the realm of philanthropy, in providing direct clinical services and culturally competent care to minority populations who exist in the world in positions of powerlessness. So I think that and I work as a clinician in the realm of behavioral health to people who live in the world in positions of power by by virtue of their wealth. So I’m still very much engaged in those two sides of the economic bell curve. And I think that from a political from necessarily from a social justice standpoint, that of golf, you know, we all know that the gulf between the haves and have nots, it’s not getting better, it’s getting worse. We haven’t this this notion of a top down where, you know, the rich people need to provide need to fix the poor people that hasn’t worked. And so I feel that behavioral health is a connector that the behavioral health, mental health issues of mental health are a wonderful way to connect people all races all gender of all social classes, together in in the vulnerability of being human. And so that’s why I intentionally work as a clinician with people who live in positions of wealth and then I work as a philanthropist with people who live in the world and poverty human is another stigmatized minorities.

31:12
So you exercise those muscles and hone your craft on both ends. What you learn in one end helps you with the other fascinating. All this has been fascinating. Unfortunately, we’ve got to start to wrap things up. So as usual, we always end with the two final questions. of all our guests. So I need to ask you for First of all, a book recommendation, something that you’ve read, that you’d like others to know about. And then we’ll finish with one last thing, which is one piece of advice from one experienced advisor who works with families to others who are also working with families. So can we start with a book recommendation, please?

31:49
Yeah, I mean, my book recommendation is an old classic. It’s going to be the Alchemist by puck. Well, I mean, I think it’s a genius book. It’s a book that I come back to probably once every five years. A simple, beautiful tale that it’s just full of wonderful insights about being human and being in this journey of life and celebrating the existence of being alive on a daily basis and appreciating where you are and and making the most of it.

32:18
Excellent. I’ve heard of that book. I have not read it. Now. I have a reason to go and pick it up. And one last thing then so one piece of advice from someone who works with this population, to others who some of whom are still newer adding something that you can leave us with metal. One piece of advice for all of us please

32:38
be kind and generous for the sake of being kind and generous.

32:41
Oh, wow. For the sake of being kind and generous, I love it. Wow. Dr. Paul, thank you so much, again for joining us and sharing your expertise with our audience. Steve, it’s

32:54
a pleasure and I appreciate the quality and the care that you bring to the work so thank you.

33:00
Thank you listeners. If you have not already subscribed, please do so make sure you never miss any of these monthly episodes. Thanks again for joining us. I’m Steve Legler. Until next time,

33:13
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