I’ll just raise the topic in this piece. Because for me, and I know many other therapists and clients, this topic is packed with thoughts, feelings, and entanglements. So there will be more to say. Here is a collection of things I’ve heard, thought, felt, wondered about when it comes to money and therapy: Client perspective:

I can’t afford to continue psychotherapy.

It feels terrible to ‘pay’ for ‘love’.

What I pay my therapist doesn’t nearly compensate her for everything she has done and does.

I am glad my therapist charges a healthy fee. I can sense that she cares for herself and knows what she is worth.

I am also glad she will work with her clients on a sliding scale as necessary. I can see that she is pulled by the ethical questions of the work, as I am.

Therapist perspective:

I hate charging cancellation fees.

You don’t pay me the value of the work that I do, you pay me so I can do the work.

Even therapists with decades of experience struggle with payments and cancellation fees.

Do we struggle because of issues around our own value? Do we struggle because we don’t want our work reduced to a business transaction?

I wish clients who cancelled with short notice would say that they know they owe me the fee so I don’t have to tell them.

The financial insecurity of private practice is hard to bear.


What is exchanged when money is exchanged?

The financial nature of the transaction is an important part of the boundaries that allow the work to occur.

A monthly flat fee such as that commonly found in coaching engagements would separate the fee from day to day scheduling and the emotional vagaries that these contain.

Why should psychotherapy services be different from any other type of service for which fees are provided?

Psychotherapy should be available to all, regardless of income or wealth.

Nothing is resolved here, of course. And there’s much left unsaid.

Every statement we make about money ricochets with our history and our being. It is important that we treat our thoughts and feelings about money the same way we treat our thoughts and feelings about anything else. As things to be learned from and reflected upon.

With money we have to do two things: deal with its reality and hold it as an energetic and subjective experience just like any other.

I have found this piece the most difficult to write of pretty much anything I've written.  And while I have gone over it many times it still reads in a disjointed way, and I still feel unsettled as I read.  Exposed and perhaps unsafe.  This is a well that needs more digging before the water is found.


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