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Guest Post: Live Deliberately

(Today's post is a guest post by longtime reader Matty P. If you would like to guest write for us, please check out our guest post guidelines. We look forward to publishing reader posts on future Thursdays.)

We stepped cautiously through the door at the behest of an Orange County Sheriff. Our patient, a fifteen year-old girl who took a razor blade to her wrists, walked down the stairs to our gurney with pressure dressings on her forearms, teary-eyed. We wheeled her out of the multimillion dollar home on the gurney, past the BMW her father bought her for her upcoming sweet sixteen birthday party, and loaded her into the ambulance so she could be evaluated for her wounds and depression.

I struggled to understand this phenomenon for a long time, wondering about kids or adults who have more than we even aspire to have are depressed and attempt to kill themselves. EMT’s working for minimum wage, I’ve noticed, find it particularly difficult to grasp. “Like their life was so hard,” we would say bitterly.

Why is it that America has little more than five percent of the population controlling more than thirty percent of household wealth, but has a higher rate of depression than any other country? The most reasonable hypothesis would seem to confirm the adage that money cannot buy happiness. In fact, is seems money only buys discord.

Abraham Maslow suggested human beings have a hierarchy of needs. At the most basic are the biological: food, water, air, etc. Following in that pyramid are needs of security, belonging, self-esteem, and finally self-actualization. When one level is attained, a human being struggles with ensuring the next. For example; a person is unlikely to worry about finding a permanent shelter if that person cannot guarantee a steady supply of nourishment. In the case of my patient, once food and safety are ensured, she struggled to fulfill higher level and more abstract needs such as belonging and self-esteem.

Maslow’s theory has evolved and my explanation is of course overly simplified. But the core concept remains the same: humans long to fill needs in accordance with what they have and what they do not. Happiness is then a counter cultural abstraction of faith and value, rather than the ownership and property. Complexity of thought rather than of trappings and lifestyle.

My patient’s life was full of everything money could buy, yet it wasn’t enough. Entanglement in the material, investing in our culture of more and better and faster as the means of happiness only revealed her wanting; her own solitude and disconnection. As for me, though at the time I lacked an understanding with what made her attempt to kill herself, I was happy with something simple. I was just happy that she didn’t succeed.

five comments


I know that psychoanalysis is no longer in vogue and that quick short term therapies (drugs) are what are in style today – demanded by changes in insurance along with the American wish for a quick fix.

Have you read the Nanny Diaries? It’s actually not just good chick-lit, airplane reading. It showcases a wealthy family with a young boy who suffers an excess of nannies who the mother dismisses as soon as her jealousy gets in the way. Meanwhile, the mother can barely touch her child, lest he dirty her clothes. The child has every material thing he could want but not the love and affection of his parents.

My father, a psychiatrist and psychoanalyst, had very wealthy patients who’s lives were similarly absent of real warmth and affection although they sometimes had a succession of nannies. He would never give up their names. But the patterns were the same.

My father, himself, was raised by a politician (former Mayor of Cincinnati) who left him and his siblings along with psychotic, abusive mother. His brother became schizophrenic in his early twenties (schizophrenia is about 50 percent genetic and 50 percent environmental), his sister committed suicide and my father became a psychiatrist and analyst. He was depressed much of my early life but his profession helped him survive by helping others when he could not protect himself as a child.

So his own personal experience of growing up in an unusual although not wealthy family (he actually died poor)helped him understand the psychodynamics of growing up wealthy without real love. Those psychodynamics vary with each individual but there is often a theme and that theme is neglect in the most profound way that has little to do with material wealth.

Fortunately, not every wealthy family suffers emotional deprivation and abuse. But it’s not money alone that leads to a higher rate of depression, it’s something more insidious and culturally complex.

Love and affection (and all that means- like parental recognition that a child is not a narcissistic extension of themselves ) early in life (and later as well) helps create a child with a solid sense of who they are, an integrated sense that they are worth loving and can themselves love, a strong ego and superego, a sense of the world and their actions in it as meaningful, and the ability to have loving relationships with other people.

I must admit I wish it were that simple. If so then we could call for the redistribution of wealth to solve depression in the U.S.


I think that in the US we conflate materialism with happiness. That coupled with an increasing isolated existence (Ipods, Iphones, Ipads) tears away at our natural need for human interaction. Clinton would probably say that we need to resurrect the idea of the village.

The Hindus say that the fastest way to good Karma is by living a humble, minimalist life.

Jesus preached that we should give away our worldly possessions if we want to find peace.


Love your post. I forgot to note in the my last one that the stats on wealth and depression are probably not correct. When something appears amok among the rich, it’s often labeled psychiatric. When something appears amok among the poor, it’s frequently labeled criminal.

Great comments both, I thank you. From the religious perspective, in the Gospel, Christ warns of the danger money and material things more than any other topic.

Interesting topic! I am sure this is only one piece of the complicated puzzle, but I would love to see some studies done to determine how much marketing contributes to people perceiving themselves as unhappy. Ads are now everywhere, not just on tv, radio and billboards, but now plastered all over Dodger Stadium, on the floor of my grocery store, covering 5 stories of office building off the 405 freeway so I can see it from miles away, bringing me free access to hulu or latimes.com, sponsoring events, and on and on. A lot of marketing is designed to instill in you a sense of need that can be alleviated with fill-in-the-blank-w/-product-or-service here. Are we now overloaded with the subliminal message that we don’t have enough? We aren’t good enough? We’re missing out? I wonder …