How is debt talked about in therapy?

My interest in debt arises from my work prior to being a therapist. I worked in debt advice at the Citizens Advice Bureau and also was a volunteer advocate helping clients with their finances. I also worked as a constituency caseworker for a local Member of Parliament. I witnessed how money interweaves through our lives, the ways it impacts on our wellbeing, our decision making, our security, our identity.

Money is a sensitive subject for many people. Debt even more so, like a crocodile hiding just under the surface of the water, waiting.

Therapists and counsellors might eventually have conversations around debt with their clients, and hopefully these conversations arise before extreme crisis point. Our financial security, or lack of it, sits towards the bottom of Maslow’s hierarchy of needs. Our finances dictate how safe we feel, and in terms of our psychological needs, money can enable us to have sufficient food and shelter.

'It’s the economy, stupid!' (President Bill Clinton). Personal finance is currently a hot topic nationally and globally, the cost of living is going up, and we have the prospect of ongoing global economic downturn (COVID-19, war in Ukraine, climate crisis). For some of us it’s a constant worry. Debt starts small, grows and builds on itself, often over years, and in my experience is always accompanied by shame.

A therapist may look wealthy and assured and so a client may feel diminished and hide their money troubles. A client with debt problems (whether acknowledged or concealed) has to feel very secure and welcome in the therapeutic relationship. They need to feel that their therapist is genuinely interested in them and also be able to support and hold out hope that there is a way through.

Bringing the client to the point of acknowledging the debt may take some time. The greater the shame, the greater the need to conceal it from others and from self. People can have an overwhelming fear that everything in their lives will collapse once the debt comes out into the open. Relationships will suffer and nothing will ever be the same. This fear is probably realistic, as, yes, things will change, but calm, sensitive, permissive therapy can help.

Overspending, gambling, keeping up appearances by conspicuous spending can be a cover for deep unresolved feelings in just the same way as alcohol, substance abuse or disordered eating. A fertile breeding ground for debt. There may be feelings which the client can’t face alone or might not even realise they have. So, there are two problems: the debt itself and then the client’s lifestyle – coping mechanisms and choices that existed, often out of awareness, prior to the debt build-up.

The priority for therapists might be to work practically with the client on signposting to a specific debt support agency such as StepChange or the Citizens Advice Bureau. Therapists can then also support the client as they come to terms with their relationship with money, how this originated and what function it has served over time. Money is often wrapped up into our identity and so we as therapists need not to be coy about it.