Shirah Vollmer MD

The Musings of Dr. Vollmer

Archive for the ‘Money and Psychotherapy’ Category

Hit Them Where It Hurts: Financial Warfare

Posted by Dr. Vollmer on November 14, 2013


Juan Zarate spoke at UCLA today, telling us that the post 9/11 world involves financial warfare, meaning economic sanctions determines government power, and as such, the United States has the ability to hurt countries at the heart of their financial power base. Once again I am struck by the simple notion that if you know what matters to a person, a system, or a country, then you know how to control them. This is “theory of mind” at a global level. What I learned though, is that the United States has more power because they control major banking institutions and in our post 9/11 world, the banks are responsible for making sure that the money is not allocated to terrorist groups. This issue has always intrigued me, as banks are private institutions, in the business of exchanging money, and not, or so I thought, in the business of being the world’s moral compass. I am still a bit confused by that issue. Still, the basics of human behavior apply. If you strangle a country financially, you have their attention and changes can ensue. I wondered about alternative currencies, such as Bitcoins, as to whether this will be a game of cat and mouse, but unfortunately, I did not have a chance to ask my question. For every action, there is a reaction, and as such, I do not think it is as simple as strangling a country and then they comply with our demands. Yet, he did say that Iran is paying attention to our economic sanctions, and this, from his point of view, is very hopeful. I am no economist, nor am I political scientist, but as a psychiatrist, I find it interesting that worldwide warfare does not seem different than domestic, I mean marriage, warfare. In times of trouble, each side tries to get power, by hitting the other where it hurts the most. Duh. 

Posted in Money and Psychotherapy | 4 Comments »

Who Pays for Therapy?

Posted by Dr. Vollmer on November 6, 2010

    Does the value of psychotherapy change depends on who pays for it? Oscar, fifty-five has seen me on and off over twenty years. He had a good job and he paid me without much fuss. He moved around the country, going to therapists in different cities, all with variable quality and variable costs, according to Oscar. More recently, Oscar is unemployed, partly by choice and partly by circumstance. He could get a job as a teacher, as he has taught with excellent reviews for decades, but he decided that he wants to find a job as a school administrator and that he does not seem to be able to find. He is couch surfing, going into “his dark hole” and doing less and less each day to help himself. His devoted friends got together and they offered to pay for psychotherapy; they have seen therapy work for themselves and they have seen it help Oscar in the past. Oscar calls me “I guess I need to make an appointment,” he says grudgingly. I call him back, “OK, let’s make an appointment,” I say flatly, to which he responds “I guess you are making me come in.” Confused, I say “making you?” He does not answer, but I see him the next day.”I know I confused you but my friends are making me come in. I don’t really want to be here,” he says, as tears roll down his face. “Now, I feel beholden to my friends because they are paying for it. I don’t want that!” He says firmly and decidedly. “It sounds like you are backed into a corner,” I say, feeling bad for Oscar and feeling curious about how he is going to manage his conflict. A third party paying for therapy-parents, insurance companies, friends-complicates the treatment. The payor is always in the room. Oscar knows that; I know that. The short answer is yes.

Posted in Money and Psychotherapy | 6 Comments »

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