The Challenge of Alcoholism and Substance Abuse in Families Of

The Family Office Association Audio Series: Volume 17 with Arden O’Connor The Challenge of Alcoholism and Substance Abuse in Families of Wealth FOA Audio Series Volume 17 with Arden O’Connor The Challenge of Alcoholism and Substance Abuse in Families of Wealth

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Arden O’Connor

Arden O’Connor founded the O’Connor Professional Group to address the needs of families and individuals struggling with an array of behavioral health issues, including addiction, mental health disorders, eating disorders, learning, and other developmental challenges. With several relatives in recovery, Arden is passionate about helping families and individuals navigate the highly fragmented treatment system in a way that creates positive outcomes and allows families to heal.

Arden is a graduate of Harvard College and Harvard Contact Arden Business School. She remains heavily involved in community [email protected]. activities, as a board member of Winsor School Corporation, (617) 910.3940 ext 300 Massachusetts Association of Mental Health, and Justice (617) 290 9818 mobile Resource Institute (chair). Previously, she served as a board member for the Harvard Club of Boston, Victory Programs, and Harvard Business School Alumni Association of Boston. She maintains professional affiliations with the following organizations: Attorneys for Family Held Enterprises, Boston Estate Planning Council, Purposeful Planning Institute, Family Office Exchange, Collaboration for Family Flourishing, Family Office Association, USA 500, and Family Firm Institute.

Angelo J. Robles

Angelo J. Robles is Founder and CEO of the Greenwich, Connecticut- based Family Office Association (FOA), a global membership organization that delivers private educational and networking opportunities, proprietary research, and access to salient thought leadership to multiple generations of wealthy families and the professionals who run their single-family offices.

A member of the Princeton Council on Family Offices and the NYU Stern Family Office Council, Mr. Robles has a long record of leadership positions at top financial-service companies, including UBS. Before Contact Angelo launching FOA, he founded and ran several successful entrepreneurial [email protected] ventures: He served as President of the New England chapter of the (203) 570.2898 Hedge Fund Association, and pioneered online retirement planning for Fortune 1000 executives with two Internet startups - 401KRollover.com and IRARollovers.com.

Author of several books and articles, Mr. Robles has appeared on Bloomberg Television and Radio, and has been quoted in the Wall Street Journal, Thompson Reuters, Institutional Investor, Opalesque, Registered Rep, HFM Week, Investment News, EurekaHedge, The Luxury Institute, Private Asset Management, The Greenwich Times and many other media outlets.

Family Office Association is a global community of ultra-high net worth families and their single family offices. We are committed to creating value for each family that we serve; value that grows wealth, strengthens legacy, and unites multiple generations by speaking to shared interests and passions. FOA has the resources to solve your most difficult challenges and help you achieve your collective goals: to invest intelligently, give strategically, and learn exponentially.

FOA is the community leader in serving all the key imperatives for ultra-high net worth families, respecting your privacy but enabling an intimate community of global families like yours. Our organization delivers private education and networking opportunities, proprietary research, and access to salient thought leadership that will interest all generations of your family. Contact Family Office Association 500 West Putnam Ave, Suite 400 Greenwich, CT 06830 Email: [email protected] Website: www.familyofficeassociation.com Twitter: @familyoffice Phone: (203) 570.2898

Angelo Robles: Hello everyone. It’s Angelo about 7 years in recover and the other brother Robles of Family Office Association. In our is about 2 years at this point. So we grew up in audio podcast today we’re very fortunate to the Boston area. We had a brief period of time have Arden O’Connor, founder and CEO of when we moved out to Arizona, and then my O’Connor Professional Group. Arden, how are parents moved back to the Boston area. But I you? have grown up around wealth. I’ve grown up in the private school system, and I’ve grow up Arden O’Connor: I’m well, thank you. How with not only my immediate family members, are you? but some of my extended family members, as well as colleagues and friends who have Angelo: Wonderful. I’ve had a chance to know struggled with behavioral health issues; so Arden over the last several years. We’ve done substance abuse, mental health, and eating some programs together and did a webcast disorder experiences. about a year ago, certainly one of the true thought leaders in the space that we’ll be Angelo: Yes. And certainly we’ll have a discussing today, and a subject matter that chance in today’s audio podcast to effectively for some is very sensitive. That I believe for touch, at least somewhat, on all of that. I’ll every family, and may be amplified more of the start with a specific question, perhaps a little issues of the issues with families of wealth, bit ignorant from my perspective, but based are going to be the issues of substance abuse on your response, to tell us a little bit about and mental health issues. Arden, why don’t we you and what you’re doing. You mentioned start with a little bit of background? Tell us a Irish Catholic, and some people will assume little bit about yourself please. some other ethnicities as well that may be a little bit more susceptible to certain challenges, Arden: Sure. I come from a family of five, specifically in substance abuse. I would think two brothers and myself, I’m the oldest of from the outside looking in, and maybe it’s three, and my parents were from the Boston me being a little naïve, but I thought that was area. We grew up right outside of the city in simply a myth. Is there a specific biological Chestnut Hill, Massachusetts. I come from a issue that is real? family, I’m Irish Catholic by decent, so there is a fair amount of alcoholism and substance Arden: There are certainly ethnicities that are abuse throughout my family. My father is 30- more prone to prevalence in the substance some years in recovery and one brother is abuse arena. I would also say, particularly

related to alcoholism, that the genetic mine, which is excellent. The reality is that predisposition is a huge issue, so sons of an alcoholic may or may not be someone alcoholic fathers are at four times greater who has the profile that you’re describing. It risk than males with non-alcoholic fathers to can certainly be someone who is homeless, become alcoholics. So if you think about a on the streets, where they have suffered dire gene pool, if it exists at the grandparent level consequences due to their drinking. But it and then is passed through the parent level, also affects every other demographic that you in my family, which is not so unique for Irish can think of. It’s somebody who’s physically Catholic families, there’s a lot of extended addicted to the substance of alcohol, so family members, because that gene existed they’re physiologically craving it every day. you see several of the offspring who are Psychologically, they have trouble with the struggling with alcoholism. idea that they cannot access the substance, and there’s oftentimes the occurrence of Angelo: And if you don’t mind me asking obsessive thoughts; waiting for 5:00 to come another likely naïve question, but again, I think every day so they can pour their first drink. a fair number of our listeners are perhaps And then, there’s a series of tests, I’m not a going to feel this way as well. What would clinician, I’m an MBA who owns the business be the definition, maybe your definition of alcoholism? An alcoholic may or may not be someone who fits the There’s a perception that typical profile...it affects every demographic you can someone like me is going think of. It’s somebody who’s physically addicted to the to have that it’s something substance of alcohol, so they’re physiologically craving it that is an out and out, quote every day. unquote drunk, and it has severe effect on their personal relationships and on business. I’m assuming, so I don’t like to diagnose people, but there’s yeah, sometimes it could be that outward, but a fairly simple set of questions that somebody I’m assuming many cases it’s to some degree can ask themselves to understand whether more subtle. or not they have a problem and if they would be defined by the clinical criteria as Arden: Sure. It’s a great question, and there’s somebody who, at least, should be going to a actually a book written specifically about the professional to get a diagnostic assessment high functioning alcoholic by a colleague of to determine whether they are, in fact, and

alcoholic or an addict. It involves things like do pool of people for whom the struggle and their you have blackouts? Has somebody in your families may report it, but they themselves are family system or your friend circle talked to you struggling with the idea of that. They wouldn’t about the use of your alcohol? Does it have define themselves that way. an impact on your functioning in the world; your school, your work, your family relationships? [Alcoholism] is about ten percent of the population, and most people assume that that number is underreported And even with high functioning because these are people who are coming forward and alcoholics, it’s oftentimes with seeking treatment. those folks, they may be able to carry on in the work place, they may be able to carry on in the family system, meaning that they’re not sort of what you described; somebody who’s just Angelo: There’s probably also a belief, and out on the streets and really struggling. But again, my question coming to a degree from oftentimes if you dig a bit deeper, these are not ignorance, that usually these issues, whether people who developed in their careers, and drug or other substance abuse, is going to they’re people who often have very strained begin to happen, I’m going to say, 13 to 15 and familial relationships because of the disease. then starts to progress. Does that tend to be a pattern that is true or does it often start even Angelo: If there had to be an approximate later in life? percentage, believed to be where something like alcohol, and I’ll throw in drug abuse, had Arden: It’s an interesting question. I think we to be affecting quote unquote people, is it five do see, certainly my family story; my brother’s to ten percent of the population? Is it less? Is it use started when he was 12-years-old with more? the typical experimenting, drugs, alcohol, and marijuana, and progressed pretty significantly Arden: Sure. It’s about ten percent of the throughout his high school years and college population, and most people assume that years to include crack cocaine and heroin that number is underreported because these eventually. That is a typical story that we see are people who are coming forward and in our practice. But I have to say with the seeking treatment for substance abuse or onslaught of the opiate epidemic, which we’re another addictive disorder. There’s a whole seeing increasing rates of amongst even

older individuals, we think about going to a describe it as, was going to be one of my doctor to get medication because you have questions for a little bit later, which I’ll still delve a back ache, or going to a dentist and you into. But that was certainly a good introduction have a procedure, because the opiate based from that perspective, as well. Given that our prescriptions are so readily available, many focus at Family Office Association is going people later in life are going in and starting to be with families of wealth and resources, with what seems like an innocuous drug to often with quote unquote a business or help with the pain of something, and then multiple businesses, what are some things become physiologically addicted to that. So all that they could be aware of? I’m assuming the sudden it’s opened up a pool of older folks that having wealth and resources potentially, who are developing addictions, even way into although it may help in some of the treatment older life. If you look at people who are defined aspects, prior to that it could also fuel the fire, as 50 years old and older, an estimated 2.8 depending on their access to capital. How million older adults in the U.S. met the criteria does that play into it? for an alcohol abuse disorder, and then it’s expected to reach to 5.7 million in 2020. And Arden: I think it can be a huge help, just as they’re seeing an increase of almost double you’ve outlined, if somebody is identified percentages between 50 and 64 who are as having an issue and then needs to seek using illicit drug use, so from about 2.7 percent in 2002 up to about 6 If you look at people who are defined as 50 years old and percent in 2013. So it’s older, an estimated 2.8 million older adults in the U.S. an interesting question, met the criteria for an alcohol abuse disorder, and then because I think you do tend to see a lot of folks it’s expected to reach to 5.7 million in 2020. develop those patterns of use, particularly if there’s a genetic predisposition and some treatment, because often the cost of whether environmental factors that weigh in, but we’re it’s outpatient or inpatient treatment is very also seeing a much larger percentage of older expensive. And it’ll be interesting to see adults develop these issues later in life. how the new parenting laws change this dynamic, but most of the behavioral health Angelo: Yes. And pain killers, what I’ll loosely that I have seen has been paid for privately,

or at least there’s some need for a more they’re safe from those kind of more painful expensive copay than would be typical for experiences that might motivate them to a medical procedure. So it does help if you change what they’re doing. We’re also seeing have treatment issue. But getting to the point a lot of families, in families of wealth, if you that a person is going to admit that there is an look at a family business angle, and I know issue or that their family members admit that you mentioned that, there’s a trust advisor there is an issue is a whole other question. I out of Texas who estimates that 50 percent of think to your point, you’re exactly right, folks the client businesses that he’s worked with, who have access to resources, for a variety which he’s surveyed about 100, see addiction, of reasons are often at higher risk and there’s either currently or will in the future, as part of a higher level of acuity, at least when we see the issue that they’re dealing with. I’d say if folks walking through our door. Really, I think you think about someone working in a family it’s for a couple of reasons. People of wealth business, they’re often reporting to a family are often very concerned about privacy and member. There’s often not necessarily a discretion; very nervous about naming an hugely formal HR structure, particularly for the issue, even if it’s not done in a public arena. more executive team members. There’s not But if someone is to go into a therapist’s necessarily performance reviews in the same office, you have to actually acknowledge way that you’d find at a company if you weren’t that there is an issue to get them to the door. related to the folks who own the business. So Oftentimes the resources, financial or the you often see something that’s been latent status resources that a family may have, have for a long time. The person’s still receiving a allowed somebody to avoid the consequences salary and they haven’t really performed up to of their own behavior. We’ve seen many what would be considered regular expectation, clients who’ve been through our practice who but they can still, to the outside world, look like have been arrested multiple times but never they are sort of high function and not struggling served a night in jail because they’re able to with anything. I think those are some of the create some kind of arrangement where the reasons, and there’s a host of others in terms person gets out of whatever the charge is. So of what impacts it. But I do think you’re right to you’re not seeing people experience some of say that folks with resources have a battle to the same consequences that they would if they fight if their loved one has an addiction or any were in a different demographic. And in those other kind of behavioral health issue. cases, the person oftentimes doesn’t get the impetus to really change the behavior because Angelo: Yes. An overused term, but certainly

money and the perspective of family members implies to a lot of individuals is that if it’s a looking to potentially sweep it under the rug disease it can’t be controlled and the person could absolutely lead to enabling. But you bears no responsibility for their actions. And brought up an issue per prior conversations I don’t, in fact, think that’s the correct way that we’ve had, and again, I’m staying focused to think about it. I do think family members, effective on our core audience, and many of and whether that’s in the context of the family them are going to be families that have quote business or outside of that context, it could unquote business or business interests, and also be in the context of another shared how you described it, with if there’s one or asset like a family office, if the person is multiple family members involved, and simply unwilling to get help themselves, because given the ration of the general public and it is a disease and because you’re dealing money only potentially acting as an amplifier with someone who’s not thinking clearly, then of challenges that could occur. Maybe I’m not the responsibility shifts more acutely to the going to phrase it as best as it could be, but surrounding family members, who must rally family members that are giving everything [Alcoholism] is a disease. I think family members struggle with and their all to the that because what that implies to a lot of individuals is that family business and if it’s a disease it can’t be controlled and the person bears no receiving the benefits responsibility for their actions. I don’t think that’s the correct of it, where others way to think about it. may be a drain or not living up to their perspective in the business, not necessarily behind that person to get them the support because of a lack of talent or motivation, they need and use whatever leverage they but simply because of something that is an have in order to get that person to comply alcohol or substance abuse, another sensitive with what would be considered professional question. Is it a disease or is it simply a lack of recommendations of care. So there are willpower. certainly people we have worked with and certainly people I know in the community Arden: Well, it’s been defined by the American who, they have a consequence, they show up Society of Addictive Medicine as a disease, late to a meeting, they miss a deadline, their so it is, in fact, a disease. And I think family spouse talks to them and they decide to go members struggle with that because what that into AA or they decide to go meet a therapist

or they decide to go into a residential program, probably fail, or do you help them realize the but they take it upon themselves to seek the path that they’re heading and help them be help they need. That’s certainly the minority motivated to really want to be truly active in of who we see in our practice. More often changing the habit or whatever that is causing than not, it is the cousin, the brother, the son them both personal and often business of somebody who’s family has created quite problems? And I know that sounds like the a thriving business and usually by the time obvious answer, which I’m sure it is, but it’s they’ve gotten to us, they’ve been kicked out probably easier said than done. once, if not multiple times, from the family business because of a behavioral health issue. Arden: That’s exactly right. And it’s a nuance And really, in those cases, the family needs, question because there is some controversy whether it’s the employees of the organization depending on who you listen to. A lot of or whether it’s other family members, but there families that we’ve spoken with have gone needs to be somebody who is figuring out what to Al-Anon, for instance, which is a great is the leverage in this situation? What is going resource for families; it’s the version of AA to get this person motivated externally until for family members, not the individual who they get clear headed enough to develop their struggling with the substance abuse issue, own sense of internal motivation to address but their family members. And some of the this issue productively. So it is a disease, but I messaging that our families have heard at Al- don’t think of it in the same way that you think Anon, whether it’s actually stated or whether about a medical diagnosis, where the family it’s their interpretation, is you have to let the really has no control over what the impact person hit rock bottom. I think that phrase is of that disease is on somebody. You can commonly used in society now, and that would make choices that get the person potentially imply, again, hands off. Either no contact or slightly more motivated to actually engage in you don’t do anything to help the person. The something productive. truth is I think that messaging has to come into play in certain family situations. If you have Angelo: Oh, and you partially answered the young children in the house and the person question that effective is my next question. is using in the house and they’re putting other One where there really is no easy answer to. members of the family at risk, there may And that is do you force a family member to be a question of if, and you don’t have the quote unquote seek treatment? My instincts resources to do anything else, do you need would be that potentially you could and it will to just lock the person out of the house? My

experience is that that messaging does not chemistry starts to change, where they get, as necessarily resonate with folks who come the phrase in AA says, sick and tired of being from means, who have the capacity to actually sick and tired, and they start to really embrace afford to do something different. And certainly some of the healthy lifestyle activities that it did not resonate with my family because they’re being offered. But the short answer to we all knew instinctively that my brother’s your question is yes, I think families do need to bottom was death. He’s two and a half year take a proactive approach when dealing with sober largely due to the efforts, particularly my this. It just may not be that the one approach, parents did to make sure that he had care at the family members need to be more flexible various moments. So yes, I think people every at times around what types of interventions day force people into treatment. That’s why they use. An example of that might be we’re the term intervention came up, that’s there’s doing an intervention now on a woman who’s now the whole TV show dedicated to. And the percentage of actually getting We believe that you need to meet clients where people to either go into a treatment they’re at. I think families do need to take a or accept some kind of help, even proactive approach when dealing with this. Family if they’re not willing, are actually members need to be more flexible at times around quite high if they’re done through a what types of interventions they use. traditional intervention process. We also believe, at least at our firm, that you need to meet clients where they’re at. So in her 40s. There is a trust that’s at play. There often times in situations where there’s less is some leverage over that trust, although not leverage. If you have a 22-year-old young complete control over that trust, and she is person and their parents are supporting their an independent woman who’s married. So it’s entire lifestyle, it’s much easier to use some a little bit of a different type of intervention in leverage to get that person to do something terms of the types of boundaries you can set they’re not necessarily internally motivated. than someone who is much younger, where Now, does it mean they’ll fully engage? No, you have much more control over what their but some of this, not to call it a game and lifestyle looks like. But I am a big believer, make it a sort of flip answer, but some of this as I said earlier, in creating consequences, work is trying to get people from the time that creating boundaries, making life just that they were impulsive around their use to an much more uncomfortable for the addict or older age, closer to their 30s, where their brain alcoholic so that they’re incented to change

their behaviors. And frankly, I keep mentioning looking in, and I think drugs, or if I could addicts and alcoholics, but that type of mindset loosely define that word, or illegal drugs take also applies to people with eating disorders you to a whole different place. and mental health cases. The treatment interventions and the type of offerings may be Arden: It’s an interesting question. I think slightly nuanced in those other diagnoses, but your comment is correct about, especially for oftentimes what you’re really trying to do is get younger folks, folks under 18, somewhat for someone who is not thinking clearly and who older folks too, but particularly the younger is sick, physically and emotionally, to start to folks who are quite venerable, that if they’re feel like they have no other option other than getting drugs off of the street, presuming to accept help. that they’re not just stealing them from their parents’ medicine cabinet or basically trying Angelo: And, although we could go on to get a doctor to prescribe something that’s probably for hours with the issues with alcohol, inappropriate for them. There’s all sorts of from it’s being legal to the controversy with different ways to access drugs these days. My that an marijuana, how come on is, one isn’t, brother, in his glory days, got a fair amount of switching over a little bit to substance abuse, narcotics off of Silk Road, and it was in short, you touched on it a little bit with the pain called fit claims and all sorts of stuff. So there’s killers, that although different, some of that all sorts of creative ways to do it, but I would may be a legal prescription from a doctor. say that fundamentally you are usually being And again, that’s probably another subject of exposed to folks where there’s no regulation some level of a little back and forth on. When over the substances. You’re usually getting I look at it from an outsider looking in, alcohol them in bad neighborhoods, although that’s not is legal, drugs per the perspective of illegal always true. And oftentimes, you’re exposed drugs, being illegal drugs are not, and I think to substances that are much stronger. We one of the challenges that I would look at is it hear all this talk, and you mentioned it earlier, takes you to an underground, a world that is about the marijuana, even in states where it’s seedier, and there’s a lot of things that could decriminalized, the content of that marijuana is really, really go wrong. And I’m not looking so much stronger than we had years ago that to downplay the challenges with alcohol; you question if somebody gets physiologically it probably is initially more of a gateway if addicted to that, sort of what else does it lead nothing else, as well as its other challenges. to down the road? That said, a lot of folks But I have to admit, looking from the outside these days are getting opiates, as I mentioned

earlier. They’re starting down the road of but there’s certainly this idea that alcohol opiate use from something as simple as going is somehow a relaxing thing; it’s something in for a medical or a dental procedure and to celebrate with. So there are times that getting pills. And they’re starting to be some I wonder about the messaging that young additional regulation in that market. But until people, particularly, are absorbing from our doctors are really held, and dentists, who are culture around the appropriate use of alcohol. some of the primary offenders of this, really You know binge drinking is rampant on college held accountable and educated from the time campuses. And many family members, if it’s they’re in med school about the prevalence of alcohol or marijuana, we hear a much higher addiction, how to spot it in their office, I think level of denial. Well, it’s just pot. Well, it’s just we’re going to continue to see people who booze. They’ll grow out of it. Versus it’s much are obtaining, at least the start of the drug harder for families, I think, to turn a blind eye using behaviors, in a very legal fashion. That’s why we’re Until doctors and dentists are really held seeing 45-year-old accountable about the prevalence of addition, housewives, who how to spot it in their office, I think we’re going to are not necessarily continue to see [addiction]. going to inner city environments to get pills, but they’re getting them from a doctor, to using cocaine, to some degree, certainly they’re taking them from a family friend. So I heroin or methamphetamines. There’s not do think it’s an interesting question. I would usually that same level of, what’s the word I’m also say, that for some folks, alcohol can be, looking for? Sort of complicit; oh, it’s okay, and as you put it, the gateway drug, but it’s also, sort of minimizing what someone’s doing. So I because it’s legal it’s so readily available, think it’s a bit of a double edged sword that it’s and I think there tends to be a little bit more legal and that it’s such an accepted part of our societal acceptance of outrageous behavior culture. due to alcohol. I watch the show Blue Bloods every Friday night and I love it, and there’s Angelo: Well, that does beg the next question not an episode that goes by that Tom Selleck and a conversation that we’ve had before. isn’t having a scotch with his father in the Why should marijuana be legal? show. They don’t show people drunk in that

Arden: Oh, this is a tricky one. My youngest in our country talk about it, the marijuana brother, who inspired me to start the company, market is positioning itself the same way the and I had a huge debate about this recently. tobacco industry did 30 years. And if you think I am actually not in support of it being legal. I about how long it’s taken us to have all the was much more neutral on the issue until I saw information out there in the community about some of the leading experts from our federal the impact of smoking, I think we’re going to government present on this. And if you look at be, if it does in fact, become legalized, we’re sort of what the experiment in Colorado has going to be in the same position where we’re produced, we’re seeing 32 percent increase now trying to educate our grandchildren and in pot-related traffic deaths. We’re seeing a our great grandchildren around the negative much higher percentage, 40 percent higher on impacts of trying to undo the very thing we’re average, of younger folks under 18 smoking starting right now. pot and becoming addicted than what we’re seeing across the country. We’re seeing Angelo: Indeed. And your comments about things like pot gummy bears coming out that not that Washington and Colorado it has are really targeting younger folks under 18. been legal, although, not for a long amount And if you look at the long term statistics, of time, but maybe enough to have a little there’s absolutely evidence that permanent bit of research to be done on that. And it cognitive impairment can be caused by folks sometimes doesn’t look so great, why don’t using marijuana if they’re under 18. And we’re I leave it at that? Mental health, including anecdotally seeing more and more people issues like eating disorders, substance abuse in our practice where there’s likely been a that we covered earlier, and again, never predisposition to a mental health issue but enough time, we could go on for hours, is they wind up having a psychotic break in their an area of challenge to families and broadly late teenage or early 20 years, and oftentimes in society. But I think families of wealth and they have had a long term history of very success, I think actually mental health, eating heavy marijuana use. So I am not in favor of it, disorders, a variety of different areas, are even personally. There’s all sorts of arguments on a more sensitive topic. It shouldn’t be, but the other side, and this could be a podcast in the perspective of shame, did I do something and of itself. But certainly an interesting market wrong as a parent? What’s wrong in my and I’m going to be curious to see how it gene set that it worked for me and not for my plays out over time. But I think, in many ways, heir? There’s a variety of different factors. if you listen to many of the leading experts Maybe describe to our audience some of the

challenges with mental health issues, that well taken. I think in many cases, depending again, you mentioned ballpark about then on what the actually diagnosis is, tend to be percent of families are affected by alcohol. also be viewed as a chronic, long term issue What’s the percent of families affected to some that needs to be managed over time. And degree by issues pertaining to mental health I think in some ways, the substance abuse and what kind of toll does this take on the issue, a lot of families will say they just need family? to stop. There’s sort of a lack of understanding about the disease model, where I think there’s Arden: Sure. About 24 million people of a higher acceptance around someone’s brain all ages struggle with an eating disorder; chemistry being off if they’re struggling with a mental health issue, which makes it all that About one in four [adult] individuals is affected much more shameful for family members or for with a mental health issues that can range from that individual. The other challenges, I’ll speak anxiety and depression up to more serious issues to them separately. On the eating disorder like schizophrenia, bipolar disorder. side, I think there’s a lot of factors in families of wealth from everything, from social events and parties to celebrity goals or expectations anorexia, bulimia, and now they’ve just added if you’re a celebrity and you’re in the media; binge eating disorder to the clinical guideline. all those types of factors weigh into somebody That wasn’t an official diagnosis until this past who develops an eating disorder. Also, year. That’s a significant enough percentage oftentimes 90 percent of the people who have of the population. And then about one in four an eating disorder are women. We’re seeing individuals is affected with a mental health an increased number of males, but they often issue, and I’m talking about adults at this are folks who have very high achieving lives. point. And that can range from anxiety and Eating disorders are often something within depression up to more serious issues like family systems, as well, but I would say there’s schizophrenia, bipolar disorder. We work a lot of pressure on high net worth individuals with a lot of folks in our business who have that coincide easily with folks who develop an borderline personality disorder. And I think eating disorder. On the mental health side, I you’re absolutely right, there’s in fact, more think what makes it complicated for families shame and stigma around these issues. is just some of the things you’ve mentioned. There’s still a genetic component, although, I don’t necessarily want to admit that this I think your comment about the gene pool is is in my gene pool. Sometimes one of the

complications that comes up is that substance But why don’t we give it a shot with the issue abuse and mental health symptoms mimic of the person who has the challenges. Let’s one another, and it can be difficult to tease forget about the toll on the family. What kind out which of those issues you should treat of treatment and help do they need and how first. So I think that’s a number of reasons could a family help them realize that? families really struggle with what to do. There are oftentimes, especially with a mental health Arden: It really varies according to what the issue that’s a serious one, the medication diagnosis is and what behaviors are being that’s prescribed may have side effects that exhibited. And then really it comes a lot of the person doesn’t necessarily want to have. times back to what is the family willing to They’ll be episodic, at best, in taking the do if the person is not willing to get help. So medication. And the family that are struggling, some folks raise their hand and say I know do they try and over manage the loved one’s I’m struggling with this, or they take a little bit life by themselves? And how do you address of encouragement; a loved one, of a spouse, it in a way that doesn’t feel penalizing, a sister says I see that you’re not functioning particularly if the person is on the older end of the way you typically do. Are you open to the spectrum? getting help? And the person says yes. And the help really ranges. Some folks benefit from Angelo: Indeed. To a degree, I’m actually a stay in an inpatient rehabilitation center that going to, I don’t know if I’d quite use the word just addresses psychiatric issues. There are apologize for my question, but it was a little whole psychiatric hospitals in my backyard emphasis on quote unquote the toll on the here in Boston; there’s McClain and there’s family. And there’s nothing wrong with that, but ones across the country. And then there’s the problem with how I phrased that question some small residential programs typically is how about the toll on the actual person? It’s hosted in the community. They’re dedicated to almost, and maybe this is I’m almost blaming, just psychiatric issues or just eating disorder it sounds like, that person, which is, trust me issues. It really depends on how acute the everyone, unintentional, but that probably symptoms are and is medication part of the is, unfortunately, what pops to mind of many picture? Have they been on medication? people. Let’s talk a little bit, and if we don’t Has it not been working? Or do they need continue with a great connection, I’ll let you to be tied into this with medication, in which know and what we’ll do is we’ll do a part two, case and see potentially see a therapist totally dedicated only to mental health issues. and psychiatrist, or a psychiatrist who does

some talk therapy. So it’s a huge range, from the reception the last then minutes, it certainly minimally only a couple of hours a week of wasn’t perfect, and I think the issues pertaining outpatient services up to and including we’ve to mental health are important. I would like to had folks who’ve actually had family members schedule a separate 30 minute, which we’ll do go forward with guardianship petitions if offline, that will dedicate itself exclusively to the person is really suffering from a mental that issue. But I’m sure this audio podcast with health issue. They’re spending quantities of somewhat of a focus, with a clearer connect, money, they’re not taking their medications on substance abuse was very insightful. as they are prescribed, and they really are in For our audience, if you don’t mind Arden, acute phases or a danger to themselves or because it is an audio podcast, if you could somebody else in the community. So we see read off how people could contact you that a big variety in terms of the types of needs would be appreciated. in there. Fundamentally, you need someone to come in and get an accurate diagnosis Arden: Sure. My contact information, my cell and come up with actions for that individual phone number is 617-290-9818. We also can that’s communicated with the people who are be reached at 617-910-3940, extension 300. family or are surrounding that person and My email address is aoconnor@oconnorpg. their emotional support community, so that com. everybody’s sort of on the same page of what a person’s going to benefit from. I think it’s Angelo: Wonderful. Everyone, this is Angelo a big one, because again, this is similar to Robles at Family Office Association. We are substance abuse issues and many people with very fortunate to have featured today Arden mental health issues who deny the diagnosis O’Connor, founder and CEO of O’Connor or they’ll accept the diagnosis but they’ll deny Professional Group. We will do a part two the therapy; they don’t take their medications soon. The part two will be within the next on a regular basis, they’re not open to therapy. several weeks and be exclusively focused on And often, depending on the seriousness of mental health issues. Arden, thank you very the issues, someone sort of lying in bed and much for your time; we appreciate it. not being productive, which is sort of a very sad existence for family members to watch.

Angelo: Indeed. I think what we’re going to do, Arden, although it wasn’t overly bad with