Host Dr. Flowers, co-host Robin French, and VIP Guest Dr. Paul Hokemeyer discuss Dr. Paul’s groundbreaking book, Fragile Power: Why Having It All is Never Enough, as well as how Dr. Paul came to develop his expertise in such a distinct and controversial niche. Dr. Flowers, Dr. Paul, and Robin discuss setting forth a new standard of culturally competent and clinically effective care for high net worth individuals and families who struggle with mental health, personality, relational and addictive disorders.
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Fragile Power: Why Having It All Is Never Enough With Paul Hokemeyer Ph.D
Introduction And Guest Introduction
Welcome to Understanding the Human Condition with your host, Dr. James Flowers. We have a special guest for everyone listening, Dr. Paul Hokemeyer. I’m going to do a brief bio, and then we’ll get on to some fun here. Dr. Paul L. Hokemeyer is one of the world’s foremost experts on resolving the complex, sensitive, and highly nuanced issues that arise among the world’s most prominent families. He is a founding principal of the London-based Drayson Mews International, a mental health and addiction treatment collective, and is listed as one of the world’s top problem solvers in Tatler’s High Net Worth Address Book. In his groundbreaking book, Fragile Power: Why Having It All Is Never Enough, Dr. Paul sets forth a new standard of culturally competent and clinically effective care for UHNW individuals, ultra-high net worth, and families struggling with mental health, personality, relational, and addictive disorders. Welcome.
Thank you.
Is there anything that I didn’t hit in your bio that you think our audience would enjoy hearing?
I think that’s enough. It’s rather long as it is. Let’s move on.
Thanks for agreeing to Zoom with us.
He’s got an amazing history, an amazing career, and most people listening will know who he is.
I’m sure they will, but there might be a mom or two out there who’s like, “Oh.” You were saying you wrote in your book, which, by the way, I love, and everyone in our office reads it. Anytime we have a new staff member, we have them read it as well. It’s an excellent book. You wrote in there, my work seeks to pierce labels of other that society places on human beings. Tell me what you mean by that.
My work is an extension of cultural competency. I started my career working with people who live in the world in positions of powerlessness, and there were certain labels attached to that. As I got deeper into my career, I saw that people who live in the world in positions of power, as a minority, were not allowed culturally competent, clinically relevant care. So I set out to develop a new paradigm for treatment.
The labels that we attach to those people are celebrity, executive, rich person, beautiful person. These are objective labels that we attach to a person. In doing that, we deny them their humanity. My work as a clinician seeks to pierce those labels and attach to the human being that exists underneath the label to establish a reparative psychotherapeutic relationship. That way, we can meet them where they are in their humanness and then move them into a healing paradigm.
We deny people their humanity when we attach labels like ‘rich’ or ‘celebrity.’ My work seeks to pierce those labels and meet them in their humanity.
It’s true. People don’t allow them to be human. They’re not supposed to struggle. What made you get into this, though? What sparked this interest?
It started probably when I came out of the womb. I somehow had the sense of being othered and was obsessed, really curious about it. I grew up as a middle-class, white American male in America. The message that I received was very aspirational, that if you had all the accoutrements of wealth, then you had the keys to the kingdom, and all your problems would be solved. I quickly found out that that wasn’t quite the case. I was always curious about wealth and money and the power inherent in money. I majored in economics in college, went into banking, and then decided to become a lawyer. I studied bankruptcy law because, again, I was fascinated by the destructive power in money and how people were making decisions that were really against their best financial interests.
I was able to leave the practice of law at a significant age because of a confluence of events. I went into civil rights work and started doing fundraising and philanthropy work for some of the world’s leading human rights and environmental organizations. I saw that the way people of wealth were being talked about was very objectifying and manipulative. These people should be doing X, Y, and Z. I found that rather disturbing because here was an organization that was doing amazing work on behalf of the planet or humanity. Yet there was this group of people who were funding the work, and they were being objectified and manipulated. I found that disturbing.
I was living in Amsterdam, actually working for Greenpeace International, when September 11th happened. As a white, privileged male growing up in America, the security in my world had always been guaranteed, until on that day, it wasn’t. I was really rattled to my core, like many of us in the field. I came back to America and started working as a concierge lawyer. Part of that work, working with ultra-high-net-worth families, I saw that there were addictive and mental health disorders that were not being addressed at all. In fact, the families were throwing money at the problem, thinking the money was going to fix it. In reality, the money was compounding a lot of systemic issues that were in the family.
I did a master’s degree first in clinical psychology with a focus on family systems, and then I did a Ph.D. because I really wanted to explore what that lived experience was like. What does it mean to be a person of wealth intrapersonally? What’s my self-concept interpersonally, and then socioculturally? We can talk about, certainly, what that means in the zeitgeist and the sociocultural zeitgeist that we’re living in. We’re living in a world where the divide between the haves and the have-nots has never been greater. I think, looking at the work, what we’ve been doing clearly is not working. If we can understand the pathology and the issues that people of wealth and power struggle with, and we can connect with them and begin to heal them, then maybe we can create some compassion and empathy. We can begin to create the goal. It’s an ambitious goal, isn’t it?
It’s a great goal.
It’s certainly worth working for, isn’t it?
Wealth And Mental Health Struggles
Absolutely. What did you find in that study about wealthy individuals and high-net-worth individuals and their interpersonal relations with themselves? What sets them apart?
I found that there was a very similar coming-out process that LGBTQ people go through. Having this identity, most of my participants felt unsafe. They did not immediately want to disclose to the general public or other people that they were a person of extraordinary wealth. There was a fair amount of shame around it. There was a fair amount of guilt around it. There was a sense of feeling unsafe and insecure in the world, which we wouldn’t think about because we think, you eat the healthiest food, you drive the safest car, you have access to wherever, you live in the best zip codes, and all of that. And yet there’s this profound sense of feeling unsafe, of feeling like they’re going to be objectified and manipulated.
Having it all doesn’t guarantee security. Many wealthy individuals still feel unsafe, isolated, and objectified by society.
Over the last 15 or 20 years of working with high-net-worth individuals and in our concierge practice, it’s amazing working with a twenty-something-year-old who is the son or daughter of a billionaire and the amount of guilt that they often carry with them. Quite frankly, shame. How do you work with that in your practice?
The first thing is what you do, which is recognize that there are two different personality constructs. So, as you know, working in this field, locus of control is critically important. Locus of control is how we determine our sense of identity in the world. Typically, generation one, the wealth earner, has a very robust internal locus of control. They feel pretty confident in their abilities. In fact, probably sometimes almost overconfident in their abilities. If they lost their money, they’d be a little grumpy, but they feel pretty confident they could make it again. Generation two, the people who inherited the wealth or actually spouses who marry into wealthy families, have an external locus of control.
Who would they be if they didn’t have their money? Would people like them? Could they survive in the world and actually build wealth? Two completely different personality constructs. The first level of analysis is: let’s not pretend that we’re dealing with an apple and an apple, we’re dealing with an apple and an orange, aren’t we? Let’s start out the analysis by recognizing that this is a different personality construct and then realizing the commonality in every single human being who walks this planet. Regardless of your gender, socioeconomic class, or religion, every person wants to be seen and heard. That’s a fundamental truth of the human experience.
Feel a connection.
Feel the connection and feel validated. Saying that, like, let’s cut this kind of BS, if you will, in terms of saying that the probability of you being as successful as your parents is a black swan event. Let’s not pretend that you need to have that ambition in terms of attaining a financial goal, but let’s find something that you genuinely feel interested in and have a collaboration so that Dad realizes this. A lot of families that you work with, a lot of families that I work with, have private family foundations, and they wonder why their kids aren’t interested in these family foundations. Because A) it’s not their money, they didn’t make the money. B) They don’t really have a sense of agency in the world. Giving away money, while we all think, “How wonderful it would be,” is not that wonderful. There’s a lot of negativity.
The Process Of Writing Fragile Power
There’s a lot of negativity there, a lot of baggage that needs to be unpacked before you can get to a place of acceptance. That’s right. I think it’s amazing, Dr. Paul, that you wrote this book, Fragile Power: Why Having Everything Is Never Enough. Every single psychologist, counselor, and social worker that works with me in my practice, I give them a copy, and then we sit and talk about it before they start seeing patients in my practice. I think it’s amazing. Tell me about your process of writing the book. What’s the idea behind it? Obviously, I know the idea that sparked it, but congratulations on having a bestselling book. It’s an amazing book, and I’ve read it many times.
Thank you. It was a long and circuitous process. It took probably a decade. I always wanted to write a book. I remember when I was practicing law at a big, fancy law firm, and I was a little grumpy about the whole thing because I wasn’t where I needed to be. The partner said to me, “Paul, what do you want to do?” I blurted out, “I want to write a self-help book.” Fast forward twenty years later. I call her my daughter, I call her Franny. I’m very protective of her. I love hearing that she’s in good company.
She’s well taken care of. We love following you on social media, and I love seeing the book on Facebook and Instagram everywhere around the world and people holding it up. It’s really amazing to watch your journey with this book.
It was a journey in terms of having to protect and having to push back against exploitation in the book. When I wrote it, I had an agent, and they shopped it around to the major publishing houses, and they wanted The Devil Wears Prada. They wanted more salacious. I’m like, “You don’t get the work,” and so I tucked her away. Then Hazleton reached out to me, and Vanessa Tirado, who was the acquisition editor, understood the need for the sensitivity of the book, that my daughter needed to be protected, that she wasn’t going to be exploited, and that she needed to have class and dignity. She also pushed me, Vanessa, to expose my own vulnerability and my own process in this work, which, as a clinician, is rough. As a white male, that’s rough to begin with. It was a good issue. I really owe an enormous debt of gratitude to Hazleton. It was the right publishing house for me.
A while ago, you mentioned the apple and the orange, and the difference between them. What differences do you see in your practice among the folks who marry into money and experience, really, quite frankly, stress and trauma over marrying into a family with that money?
It’s a process, isn’t it? I do a lot of pre-nups. I help couples with pre-nups and post-nups and then revisiting pre-nups later on. It’s a very valuable process. There’s an integration that has to happen. There has to be an identity integration in terms of if you marry into a family of wealth, there’s all sorts of assumptions that the world makes around you. You’re a gold digger. You’re just there for the money. Very dehumanizing, very demeaning judgments are put against us. We need to talk about those. We need to talk about that because we tend to think of the quantitative aspects, that you came from a middle-class background and you’re flying off to Aspen in a private jet. You have such an amazing life. It’s lovely and wonderful, and there are certain challenges to that.
What I try to do is avoid this better-than/less-than analysis because my work gets criticized all the time, “You just think that we should be nice to rich people.” A) Yeah. B) What’s the problem with that? C) We should be nice to poor people, we should be nice to middle-class people, and we should really be nice to everybody. Let’s avoid this better-than or more-deserving/less-than paradigm. We have to recognize the duality. Part of our work as mental health professionals is resolving conflict and integrating the lightness and the dark with health and pathology. We know that one of the standards of mental health is the capacity to hold two divergent truths.
I love flying private, and there are assumptions made about me that diminish who I am. Quite frankly, I suffer from what’s called imposter syndrome. I don’t know whether people like me for me or whether they like me for my surname or my money. It’s complicated. It’s not black and white, and so that’s the work that we do, isn’t it?
It is.
In chapter seven of your book, titled Opulent, you address a sorely needed subject in the rapidly changing field of residential and outpatient addiction treatment, specifically, how some centers out there are taking advantage of wealthy families and high-profile people by being rich in amenities but lacking in clinical substance. I thought you and Dr. Flowers could touch on that because it really needs to be addressed.
Dr. Paul?
It’s all building on something, isn’t it? I think that this niche had to start somewhere, and where this niche started from is living in a capitalistic society. Treatment centers saw, “This is great. We can have a high profit margin. These are all private-pay patients because we don’t want to deal with insurance.” They recognized, from a marketing standpoint, that they needed to create what’s called an egosyntonic environment. What do we mean by an egosyntonic environment? Egosyntonic is an environment that’s consistent with the person’s sense of place in the world. If I’m a CEO of a company and I don’t really do anything domestic, putting me in a treatment center where I have to clean my room, make my bed, and scrub the floors, I’m probably not going to last very long.
Let’s just back up. What is treatment? Treatment is basically a frame. You have a patient who’s destructing in some part of the world. We need to take them out of that system and put them in a new, contained, safe system. Ideally, that system is egosyntonic for them. A blue-collar worker is not going to do well in an executive treatment center. Simultaneously, an executive is probably not going to do well in a blue-collar-oriented treatment center. There are all sorts of case-by-case exceptions, but treatment centers realized that we need to do something different. We need to provide a different level of care. Their motivation was all marketing. They didn’t really focus on, “We have these people.” We’re looking at them as a minority, the top 10% or 1%. That’s a minority population.
We know empirically that minority populations have distinct cultural markers. Until my work, nobody took the time to tease out what those markers are. You ask, “What are those markers?” There are three, isolation, suspiciousness of outsiders, and hyper-agency, which is this capacity to control your world to avoid any discomfort. What do we do when we ask a patient to go to treatment?
What do we do?
It cuts against every single one of those cultural markers. Come out of your world because you live in a very rarefied, isolated world. Trust a team of professionals who are going to come from outside of your social class. Tolerate emotional discomfort as we talk about the trauma that you experienced in your youth, as we talk about your need to have control, as we probe and poke around. The success rate, as we’ve seen in terms of celebrities and people of power, is dismal. It’s really been dismal. Clinicians like you who recognize that, in addition to having an egosyntonic frame or environment, we need to be providing culturally relevant care. Just like we provide culturally relevant care to a Muslim, to a Jew, to a transgender person, or to a woman, we have to be providing culturally competent care. It’s not better-than or less-than. Let’s just stop with that already. It’s in addition to.
The success rates for wealthy individuals in treatment are often dismal because we fail to provide culturally relevant care.
That’s great.
Common Family Dynamics In High Net-Worth Families
This question is for both of you again. What common family dynamic do you see in high-net-worth families? Is there some common denominator with them or no?
I would say dysfunction many times.
That’s fair.
I’m going to go on the other side of that. I’m going to say the need to be seen and heard. I’m going to say that, really, this desperate hunger to be seen and heard as a human being who is highly functioning but just hasn’t really been provided the nurturing environment that they need to grow. We’re all on the same page. We’ve worked together. We believe in the human capacity to heal, that humans are self-healing. They just need to be provided the right environment, the right soil. To provide the right soil, to figure out what that is, the person needs to be seen and heard.
Feel that sense of trust. We often talk, when we’re talking to families and we’re talking to folks, physicians, and psychiatrists. I always say the cornerstone of our treatment, and the cornerstone of my treatment, is building an authentic relationship with the client so that they can feel heard, they can feel understood, they can feel that you’re present, and they can feel that you’re okay to talk to. They have that sense of trust.
Dr. Paul’s Personal And Professional Changes During COVID
They end up feeling like we’re their family, and it makes it hard for them to leave us, which is pretty cool. Let’s talk about this year specifically. Have you had to pivot in any way, personally or professionally?
With COVID, you mean?
Yeah, with COVID. Sorry.
Pivot the way you’re doing your life and work.
First of all, there’s this. I think that there’s the embracing of this, which I resisted. I’m a middle-aged man. There’s a saying in French: I like to smell the patient. There was that element. Personally, it was really rough. For me, the apocalypse hit around the middle of March. I was out of the country and had to come back quickly because they were closing the borders. I really had a hard time finding my footing and taking on new patients. We hold an enormous amount of psychological pain. I need to have a safe, contained environment to do that. I didn’t have that.
I was pretty terrified that the world was falling. The stock market crashed. We didn’t know anything about this other than it was killing people. I lost a dear colleague of mine, Neil Walsh, may he rest in peace, who passed away in New York. People were dying. It was really unsettling. I actually had to back away from the work.
The day Neil died, we knew COVID was here. We knew things were happening, and then Neil died. It hit me like a ton of bricks. I was like, this is big, this is here. What an amazing human we lost in Neil.
Such a gorgeous, beautiful light.
We both probably lost several friends this year, colleagues.
Writing Advice For Aspiring Authors
Any advice while writing a book to anyone writing a book, any mistakes along the way?
Yeah, keep at it. You have to be passionate about it. You have to be passionate about the subject matter. One of the questions I asked Vanessa early on was, why should I even write a book? Why don’t I just do blogs? Why am I going to spend all this time and energy doing it? She said, “Because you really want to do it, Paul.” She was right. Stick with it. Another good friend and colleague of mine, David Ebershoff, who wrote The Danish Girl and has written another book, said, “Paul, just focus on writing the best manuscript that you can.” Those are the two best pieces of advice.
Don’t be attached to the outcome because it’s publishing, as you know. You don’t do it for the cash prize, that’s for sure. You do it for the passion, and this is just the beginning. I really hope that what I’ve done in this book has put a flag in this piece of territory, and that we, as colleagues, can continue to expand this work. Because this is just the beginning. We have a lot of work to continue to do in this space.
We do. With that said, do you have any plans to do the next book? Anything following up? I’m going to put you on the spot.
I really don’t. I just feel that Franny is, I’ve got to get her sorted out in the world. Franny, my book Freshwater, she had a good coming out, and then it all shut down. She’s my love child, and I feel like I want to get her sorted. I think I want to get her properly set up with colleagues and mates and get her off to the proper schools.
What are your plans this year with Franny? I know it’s still difficult to travel, obviously, and being out in person, but what are you planning next?
I’m not traveling. I went back to school. I got accepted to a graduate program at Yale School of Management, and I’m studying digital technology. Because, as a middle-aged man, I was like, wow. I want to explore how I can get Frannie launched more digitally. I tried to find people who could help do it, but nobody takes care of your child like you take care of yourself. I’m not going to send her out to her nanny. I need to make sure that her integrity continues. I think I’m just going to do that. My practice has opened back up again, and I have really fascinating cases all around the world. A lot of empowerment, like empowering women, empowering minorities to transcend cultural restrictions and embrace other identities. I think I’m in a pretty deep parenting stage of my life. That’s a gift that we can do, right?
It sure is.
That’s what you guys do.
Absolutely. When the world is safe enough to travel and we’re able to get out and about, I’d love to come up and visit. I’d love to have you here in Houston. Love to show you Houston. I’m sure you’ve been here. Show you the practice and take you out to dinner.
Sounds great. I look forward to it.
I have a couple of fun little questions here. What’s on your bucket list that you’ve never done that you’d still like to do?
Good question.
It’s good to know the Dr. Paul on the personal level.
It’s weird. I don’t really have a lot of aspirations. I wanted to write a book. I did that. I wanted to get a PhD. I did that. I’ve traveled all around the world. I live a rather transient life, and so I do have something, and it’s to build a nest. I think one of the things we’ve all been learning is the importance of a nest. My husband and I are building a house outside of Palm Springs in Rancho Mirage.
I did not know that. That’s so cool.
I think getting that done is on my bucket list.
That’s fantastic. I love Rancho Mirage and spending time out there.
Is that your happy place? Because we all have a happy place, right?
It is. It seems to be. I feel there’s a wonderful sense of community. I love being in the valley. I started playing tennis, a lot of tennis. It’s a good place to play tennis. It is my happy place. I love the desert. There’s a subtle beauty to it.
I agree.
What else do you like to do for fun? You travel, but you can’t really travel.
I get grumpy sometimes when I travel. I basically like to read. Writing is my passion. I love to write. It is my creative expression. I feel so blessed to be able to do it.
You’re good at it. We have to wrap things up here, but thank you so much for being with us.
Thank you so much. It’s so good to see you.
If someone wants to reach you, how do they reach you?
Just Google me. It’ll come up. Just Google Dr. Paul Hokemeyer and then pick whichever way you want to do it. I’m not great with phones, so I don’t really answer my phones because there’s always people trying to sell me things that I don’t really need. Email is best, [email protected].
There you go.
Dr. Flowers, how can they reach you or the J. Flowers Health Institute?
JFlowersHealth.com. Paul, thank you so much.
Thank you.
It’s so good to see you.
Stay safe.
Great to meet you.
Take care.
Have a good afternoon. Bye. Bye.
