Money's Funny
Money’s so funny. One of several truisms sloppily attributed to Freud goes something along the lines of Money is like poop: it’s a big part of everyone’s daily life, but no one wants to talk about it. And it’s true that communicating about money can get awkward fast. When the site of communication is “paying for psychotherapy”, the discussions can be hooked into our deepest terrors or our most basic notions of how relationships work, or both, and can import invisible and sensitive landmines into moments that are obvious and simple transactions in pretty much every other profession.
In every single person’s landscape of formation, money was weighted with meaning. General cultural messages around things like greed being bad or sharing being good are transmitted in highly specific and complex ways within families and communities, where we internalize understandings of money as reward, as coercion, as a threat, as affection, as atonement, as validation. A climate of competition, of merit, of abundance, or of scarcity can serve as water many fish never realize they’re swimming in. Psychotherapists can support people to become aware of the role of money in their lives, and challenge approaches that compromise their liberation, peace, and enjoyment of life.
This support, well, it’ll run ya… ah, [tap tap tap click] a hunnerd n fiddy bones an hour. Cheeks sometimes flush and stomachs flip on both sides of this exchange, which many would prefer not to have at all.
It can feel awkward for new therapists to charge for service, and being charged can create various types of distress in clients. I used to teach post-secondary students learning in contexts of mental health struggles, addiction recoveries, and often poverty; my program was tuition free. I was occasionally accused of “getting paid to care about” them. I assured them I could do my job just fine without caring about them. Caring was a choice, as it is in the vast majority of jobs, even in the helping professions. “Caring about” my particular child wouldn’t factor into my search for the best pediatric neurosurgeon available. Of course, what made me excellent as a professor had a lot to do with how and how much I did care, while what made me a groceries-buyer had everything to do with how the college paid me to show up. But with psychotherapy, isn’t caring… the job?
The thought that sessions are “just a job” for therapists can cause such anguish for people who feel unlovable, who bring chaotic histories with attachment, and wounds left by brutal transactions they believed to be relations.
Fee for service, however, has a more important function in this profession than perhaps any other. This remains true for clinics and agencies where the service is free-at-the-point-of-delivery, like my college program; it doesn’t matter if it’s governmental or charitable, as long as the therapist gets paid.
Because if someone is providing psychotherapy for free, one can imagine that they have some bizarre beliefs about themselves (messiah complex?) or at least some… boundary issues. Consider: if a lawyer advises their friends pro bono, they may feel not-great after a while, maybe taken advantage of or stretched too thin, but it’s their choice. If a shelter worker gives donated food to their friends, not a huge deal. But in the case of a therapist, it’s a hard NO – it would feel creepy and likely mess up the friendship, because healthy friendship is a two-way thing. In the horizontal power dynamic of a friendship, reciprocity demands that each person seeks to have their own needs met inside that bond, as well as to meet the other’s. Seeking the same from a client as a therapist is gravely dangerous and unethical.
Money is thus essential to the energy exchange, so that the dynamic is preserved as entirely “about” the client. With money directed towards the therapist, they are free to direct literally everything else towards the client. As a practitioner enthusiastic about both transparency and psychoeducation, I spell these ideas out in session if that’s indicated in the relationship. After all, “awkward” is basically a linguistic marker pointing to some sort of shame, and shame gets its batteries charged in silence.
Understanding all this, someone may of course still balk at the price itself: $175 an hour? That’s like 3 bucks a minute! That would indeed be quite steep if an hour were what you paid for; an hour, however, is not what you get.
You get a person who genuinely cares for you holding awareness of you like a co-presence throughout their entire week, a tab left open even as they are focused on others. Bits of neuroscience research relevant to your current struggles are tracked, flashes of insight into something you said are pocketed, and a question that a song in the grocery store inspires them to ask you next time is jotted down. If you’re in crisis, you get a week of low-level worrying in the heart of someone able to fully experience both concern and respect for you at the same time. Importantly, that someone has spent a startling amount of money and life-changing years studying the what and how and why of supporting you.
Acknowledging the financial doesn’t have to feel funny. Therapists owe it to clients to bring money into the conversation, into the framework, as part of the priceless encounter that is good therapy.
This content is for general educational purposes and is written for therapists early in their careers. It is not therapy, clinical guidance, or professional supervision, and it does not establish a therapeutic, supervisory, or consultative relationship. If you’re experiencing distress, please reach out to a qualified mental‑health professional. If you are in immediate distress or at risk of harm, in Canada you can call or text 9‑8‑8 or call 9‑1‑1; internationally, visit FindAHelpline.com for free, confidential support in your region.