Money on the Couch: Treating Acute Financial Stress (Part 3)

The Immediate Impact of Talking About Our Stress

Juan seemed … better.

I should probably use clinical terms for this. I spent a lot of money learning to use psych jargon.

His affect was brighter. His mood euthymic. The content of his speech was more positive. His gait was lighter and more energized. He seemed to leave behind the sour, burdened, punched-in-the-gut young man I’d spoken with over the past month and a half. He was smiling, asking friendly questions about my weekend. He was, well … better.

Juan was in the final week of a research trial where we tested the effectiveness of treatment approaches to Acute Financial Stress (AFS) — A newly identified, but long-suffered, condition afflicting 23% of Americans that is essentially PTSD caused by financial concerns and stress. So the next logical step was finding ways to treat it.

A Story of Acute Financial Stress

We recruited people like Juan, normal folks living normal lives but experiencing abnormal amounts of stress, and had them take an online test to see if they met the criteria for AFS. We then invited them into our office to hear their stories and teach them a few stress-management techniques.

“This isn’t how it’s supposed to work,” he said, “Working really hard and doing the right thing is supposed to get you somewhere.”

From the first interview, I knew I really liked Juan.

He had a humble smile, a dry sense of humor, and a genuine curiosity about what he was experiencing. “This isn’t how it’s supposed to work,” he said, “Working really hard and doing the right thing is supposed to get you somewhere.” I could tell that this was the first time he had told anyone about his financial stress, feeling too much shame about his situation.

At 28 years old, Juan had a fairly standard story.

A good student and hard worker, who took out loans to earn a degree. After graduation, he lived off his credit cards as he looked for a job. When he found a decent entry-level job, his loan and credit card bills took 75% of his monthly income. He told us he decided to take turns defaulting on his bills, pay student loans one month, utilities the next and credit cards the third. After four years of this, his debt was out of hand, phone calls and emails from collectors were frequent, and he was stressed.

Juan felt like he couldn’t talk with his family about his problems because they worked hard to get him into college.

He couldn’t sleep. His thoughts raced constantly. He jumped every time the phone rang. Worst of all, according to Juan, his relationships were falling apart. So he tried to escape through drinking, smoking pot and online gambling.

Juan felt like he couldn’t talk with his family about his problems because they worked hard to get him into college. They regarded him as “the golden boy” for earning a degree and a solid job. He thought telling them about his crippling distress would crush them.

He also spent less time with his friends both because hanging out cost money and he felt ashamed around them — they seemed to have better jobs and never talked about financial problems. So Juan suffered in silence — working hard, feeling alone, going deeper into debt. He was losing hope that his circumstances would ever improve.

Using Cognitive Behavioral Therapy to Fight AFS

So week-by-week, we taught Juan and the others some very simple stress-management techniques to help them gain more control over their stress. We didn’t reinvent the wheel. Stress is stress. We simply took tried-and-true techniques borrowed from Cognitive Behavioral Therapy (CBT) and taught Juan that he could learn and apply them himself on a daily basis, including:

Progressive Relaxation — Start with deep, slow breathing. While still breathing, flex the muscles in your feet for a few seconds, then fully relax them. Gradually move up your body through your calves, thighs, glutes, core, shoulders, arms, hands, neck and face. Do this a couple times a day.

Name It to Tame It — When do you feel stress the most intensely? Early morning? Midday? In the middle of the night? For a few days monitor your thoughts, feelings and behaviors and look for patterns in your stress.

Negative Thought Replacement — What are you telling yourself about your finances? They suck, and now you suck, and it’s never getting better? That’s not going to help you stay motivated. How about “I’m working on it,” “I’ve conquered other challenges in the past,” or “There are more places I can look for help”?

Your Money Story — This was our departure from normal CBT into a psychodynamic/narrative therapy approach. Think about your own history. How were finances handled in your childhood home? Who taught you about money and what was their message? When did money become a stressor? What does money mean to you? How does your financial worth relate to your value as a person?

Mindfulness — It’s all the rage these days for a good reason. Unplug from the rat race of “out there” and “what if” and focus instead on your body, thoughts and emotions right here and now. A great, cheap and quick way to gain control and calm all at once.

It Works

So far in our research, this appears to work, with subjects reporting a reduction of 57% in their AFS scores.

The variety seems important as well, as not everyone benefits from the same interventions. For example, people who experienced more stress in their bodies (muscle tension, upset stomach, tension headaches, etc), reported feeling more relief from the relaxation and mindfulness exercises. People complaining of intrusive, worrisome thoughts reported more benefits from replacing negative thoughts and becoming more aware of patterns of their stress. Still, others found the money story exercise gave them insight and changed their whole outlook on money.

Let’s Talk About AFS, Baby

Which brings me to my final meeting with Juan. As a worrier, he seemed to benefit quite a bit from identifying his stress patterns. He realized he was most worried first thing in the morning and right before bed, which were also times he checked his bank balances. Instead, he decided to start reading when he went to bed and woke up, and check his bank account before lunch and only on Tuesday and Friday. This little change was making a significant difference.

But his mood was much better than I would expect from that minor shift. He was downright giddy. Was it because of our interventions? Because he finally hit a jackpot with online poker? What was going on and can we bottle it?

I told Juan that he appeared happier than before and asked why he thought that was. “I talked with my friends last night, and it was an amazing experience. I feel tons better.” It turns out Juan was watching a movie at a friend’s house and in passing he mentioned the research study. His friends asked more about his participation, and he took the risk and told them more about his financial circumstances and stress symptoms. He said it felt great to be so open with all of them.

Once Juan opened up, they all dog-piled in with their own financial stress stories.

But then the real treat came. One by one, his friends started talking about their own financial circumstances and the stress they were feeling. These friends with the new clothes and great vacation photos on Facebook had different stories but nearly the same results as Juan. Large levels of debt. Huge medical bills. Off-the-rails family inheritance battles. Unending legal battles that cost a fortune.

It turns out, every one of his friends had significant stress related to their finances and future, but no one had ever talked about it. Once Juan opened up, they all dog-piled in with their own financial stress stories. That lead to supporting one another with encouragement and tips.

At the end of the night, some commented on how odd it was that they knew each other for years but never talked about the most significant strain in their life. They promised to keep the communication going and support one another however they could. They looked at Juan as the brave one both for opening up to the research study and taking the risk to talk with them about his own stress.

So why did Juan seem so much better today? His debt was still there, none of the numbers had changed. He felt better because he was no longer trapped in shame. He took the risk to talk about the most shameful part of his life, and found support. Rather than the rejection he feared, his friends deeply understood because they were experiencing the same thing. He no longer had to hide his struggles. His debt didn’t mean he lacked character or value. They were all struggling together and that felt okay.

Juan planned to talk with his family later that day. I wish we had another meeting so I could have heard how that went.

It turns out one of the most important treatments for AFS is older than money itself — talking. Talk about your stress, and you may find you’re not alone. Connection has a great way of giving hope to even the most challenging issues. Juan was proof of that.