[A-List] Psychiatric consequences of the economic debacle - New York Times

[Leighm]

As I was saying, maybe the weak-of-character and morals (not ethics... 
They created their own 'ethics' when the rest of the world's didn't 
profit them), who thought they were the 'strong' because of their 
self-serving hyper-competitiveness and circle jerkish behavioral 
patterns (now, 'circular firing squad'... they eat their own), will drug 
and drink themselves into Central Nervous System oblivion or 
NON-competitive, hopefully non-culturally destructive complacency while 
we work on repairing the global shambles they left in their 
obsessive-compulsive greed driven wake.

With more at the Daily Beast: 
http://www.thedailybeast.com/big-fat-story/2009-01-08/suicides-of-the-crash

FIRST HAND ACCOUNT “I Knew Wall Street Suicides” Charlie Gasparino on 
“the human devastation”
THE CURSE OF MADOFF French Banker Cuts Wrists Failed to recover lost 
$1.4 billion
THE '29 CRASH Wall Street Leapers Black humor greeted rash of high rise 
suicides
SCIENCE OF SUICIDE Former Masters of the Universe An end to success 
causes a precipitous drop in self esteem
MAIN STREET Massive Rise in Mental Problems Mundane money troubles also 
take their toll

The New York Times

December 16, 2008

Mind

A Crisis of Confidence for Masters of the Universe

By RICHARD A. FRIEDMAN, M.D.

Meltdown. Collapse. Depression. Panic. The words would seem to apply 
equally to the global financial crisis and the effect of that crisis on 
the human psyche.

Of course, it is too soon to gauge the true psychiatric consequences of 
the economic debacle; it will be some time before epidemiologists can 
tell us for certain whether depression and suicide are on the rise. But 
there’s no question that the crisis is leaving its mark on individuals, 
especially men.

One patient, a hedge fund analyst, came to me recently in a state of 
great anxiety. “It’s bad, but it might get a lot worse,” I recall him 
saying. The anxiety was expected and appropriate: he had lost a great 
deal of his (and others’) assets, and like the rest of us he had no idea 
where the bottom was. I would have been worried if he hadn’t been anxious.

Over the course of several weeks, with the help of some anti-anxiety 
medication, his panic subsided as he realized that he would most likely 
survive economically.

But then something else emerged. He came in one day looking subdued and 
plopped down in the chair. “I’m over the anxiety, but now I feel like a 
loser.” This from a supremely self-confident guy who was viewed by his 
colleagues as an unstoppable optimist.

He was not clinically depressed: his sleep, appetite, sex drive and 
ability to enjoy himself outside of work were unchanged. This was different.

The problem was that his sense of success and accomplishment was 
intimately tied to his financial status; he did not know how to feel 
competent or good about himself without this external measure of his value.

He wasn’t the only one. Over the last few months, I have seen a group of 
patients, all men, who experienced a near collapse in their self-esteem, 
though none of them were clinically depressed.

Another patient summed it up: “I used to be a master-of-the-universe 
kind of guy, but this cut me down to size.”

I have plenty of female patients who work in finance at high levels, but 
none of them has had this kind of psychological reaction. I can’t 
pretend this is a scientific survey, but I wonder if men are more likely 
than women to respond this way. At the risk of trading in gender 
stereotypes, do men rely disproportionately more on their work for their 
self-esteem than women do? Or are they just more vulnerable to the 
inevitable narcissistic injury that comes with performing poorly or 
losing one’s job?

A different patient was puzzled not by his anxiety about the market, but 
by his total lack of self-confidence. He had always had an easy 
intuitive feel for finance. But in the wake of the market collapse, he 
seriously questioned his knowledge and skill.

Each of these patients experienced a sudden loss of the sense of mastery 
in the face of the financial meltdown and could not gauge their success 
or failure without the only benchmark they knew: a financial profit.

The challenge of maintaining one’s self-esteem without recognition or 
reward is daunting. Chances are that if you are impervious to self-doubt 
and go on feeling good about yourself in the face of failure, you have 
either won the temperamental sweepstakes or you have a real problem 
tolerating bad news.

Of course, the relationship between self-esteem and achievement can be 
circular. Some argue that that the best way to build self-esteem is to 
tell people at every turn how nice, smart and talented they are.

That is probably a bad idea if you think that self-esteem and 
recognition should be the result of accomplishment; you feel good about 
yourself, in part, because you have done something well. On the other 
hand, it is hard to imagine people taking the first step without first 
having some basic notion of self-confidence.

On Wall Street, though, a rising tide lifts many boats and vice versa, 
which means that there are many people who succeed — or fail — through 
no merit or fault of their own.

This observation might ease a sense of personal responsibility for the 
economic crisis, but it was of little comfort to my patients. I think 
this is because for many of them, the previously expanding market gave 
them a sense of power along with something as strong as a drug: thrill.

The human brain is acutely attuned to rewards like money, sex and drugs. 
It turns out that the way a reward is delivered has an enormous impact 
on its strength. Unpredictable rewards produce much larger signals in 
the brain’s reward circuit than anticipated ones. Your reaction to 
situations that are either better or worse than expected is generally 
stronger to those you can predict.

In a sense, the stock market is like a vast gambling casino where the 
reward can be spectacular, but always unpredictable. For many, the lure 
of investing is the thrill of uncertain reward. Now that thrill is gone, 
replaced by anxiety and fear.

My patients lost more than money in the market. Beyond the rush and 
excitement, they lost their sense of competence and success. At least 
temporarily: I have no doubt that, like the economy, they will recover. 
But it’s a reminder of just how fragile our self-confidence can be.

Richard A. Friedman is a professor of psychiatry at Weill Cornell 
Medical College.


http://www.nytimes.com/2008/12/16/health/views/16mind.html?pagewanted=print