Who doesn't have a fraught relationship to money? What makes money problems a "disorder"? Debtors Anonymous's poignantly titled Friday-night "Prosperity Meeting" puts the question to rest. It is filled with people who are drawn to "getting to zero," literally as well as figuratively ("When I see a couple of hundred dollars in the bank, I have to spend it"). They grope for metaphors of breath to explain how vital their money problems feel: They are drowning or crushed or pressed or flattened by mountains of debt. They do things like freeze their credit cards into blocks of ice and then go ahead and call Lands' End and use the number anyway. "It's as if I keep my dollar bills on top of my head and whenever I step out, they just blow away," a man complains. An Upper East Sider reflects how she married three times for money -- three! -- in order to underwrite compulsive spending before she got help.
Although money has always been an important motif in psychotherapy, thinking about how to treat money problems has begun to change in recent years. Such problems had always been considered secondary symptoms of neurotic conflicts or underlying mental illnesses, such as bipolar disease. However, clinicians have observed that money pathology, like alcoholism, has a tendency to take on a life of its own, and become a dominant defining condition. The DSM (the Diagnostic and Statistical Manual of Mental Disorders) may include "compulsive shopping" in its next edition, in a section on impulse-control disorders, such as compulsive gambling and kleptomania. Such an inclusion would make it an official, insurance-covered psychiatric disorder.
Carl Jung defined addiction as a low-level spiritual quest -- a phrase that seems to capture the truth that the longings that drive addiction also drive the basic human quests for love, meaning, and peace. The snake in the garden of addiction is the transience of its fruits. The addict's pathology is underscored by her keen awareness that her satisfactions are increasingly brief and her letdowns increasingly cruel -- and by her decision to keep at it anyway.
Overspending generally divides along gender lines: 70 to 75 percent of compulsive gamblers are male, whereas 80 to 90 percent of compulsive shoppers are female. According to Harvey Greenberg, professor of psychiatry at Albert Einstein College of Medicine, existent studies suggest compulsive shopping affects between 1 and 5 percent of the population (in comparison, anorexia and bulimia affect almost 3 percent.) Compulsive shoppers average $20,000 to $27,000 in credit-card debt. They gravitate toward crowded stores, buzzing with action and lit timelessly, like casinos, where they experience rising tension and excitement. But they also describe a sense of agony, of wrestling to control their impulses even while succumbing to them. At the moment of purchase, they feel a sense of relief, satisfying as an orgasm, followed by depressive deflation, despair, and guilt. Interestingly, studies show the same letdown among rich and poor women alike, suggesting that the depressive effect is not a result of regret over having spent money they can't afford but an organic part of the cycle.
"There's a rush of anxiety at a sale -- it's a kind of high," A.J. says. "It's a very primal thing, the hunt of it -- riffling through clothes, competing, scoring: spearing something with your credit card."
Yet the shopper typically has little interest in the things themselves. One sign separating a compulsive spender from an ordinary shop-till-you-drop type is the tags still hanging on her walls of clothes. Sarah Jessica Parker may have hundreds of pairs of shoes, but she actually likes shoes, whereas one of Ron's clients, who has 300 pairs, wears the same shabby loafers day after day.
Although society tends to diagnose such people as suffering from terminal shallowness, compulsive shopping behaves similarly to -- and is often accompanied by -- other disorders, such as anxiety or depression. Treatment may include Prozac and mood stabilizers such as lithium. Although it typically begins in adolescence and blooms in the late twenties and early thirties, its causes remain obscure. In psychoanalysis, it is viewed as a complex symbolic restitution redressing low self-esteem, fear of death, depressive emptiness, and the filling of a void.
Since -- unlike the Debtors Anonymous crowd -- none of Ron's clients is actually poor, it's easy to see that the source of their problems is in their heads, not their wallets. (His fee selects an affluent population: $150 for a 45-minute session, with a typical spending plan requiring at least eight sessions for setup and many more for maintenance.) But in contrast to traditional therapy, Ron's counseling does not focus on plumbing the patient's emotions. "The hope that insight-oriented therapy will translate into behavioral changes doesn't work with money addictions any more than it did with alcoholism," he says. "First, you have to stop the behavior."
Ron's authority, like that of most addiction counselors, is based as much as anything on personal experience. At 49, he has a prosperous, well-fed look, with silver hair, baby-blue eyes, and little round reading glasses he puts on when looking at figures. His rapid-fire questioning style betrays the manic businessman he once was.
"I have dollar signs in the synapses of my brain," he is fond of saying. His lineage includes a Cain-and-Abel fable: His uncle, Herb Gallen (the founder of the clothing line Ellen Tracy), was rich; his father, who worked for him yet didn't speak to him, "was not." Ron inherited his father's money lust. He recalls walking down Fifth Avenue one day while calculating the cost of the clothing he was wearing, which included a Bijan suit, "to see if I was okay -- if the figure was high enough," he says. The sum was a satisfying $10,000. Should he add his Rolex watch, he wondered?
Drinking, scoring cocaine, and trying to retain the attention of a high-maintenance model, he woke up in the summer of 1987 seven figures in debt, with calls from 48 creditors. He went into recovery and eventually became an alcohol-and-drug counselor. But he came to feel that the missing piece of his clients' treatment was money.