Shouldn’t The Best Therapy Be Free?

[Written around 2004.]

Charging fees is a backbone of what keeps the therapy process professional. Not only does it allows the therapist to survive in the world, but it affirms his self-respect. He gives the best of himself to his patients, and they return the gift with something of value. Patients who pay a fee make a sacrifice – and thus buy a service. This is invaluable for them, because when the going gets ugly in therapy, as it invariably does if the process goes well, they must feel comfortable expressing their negative feelings – which are often toward the therapist – as freely as they need to. This step is made all the more difficult if patients are not clear that they – and no one else – have bought the therapist’s service.

In the same way honest people would have a difficult time giving orders to a waiter if they knew he was working for free, it is difficult for patients to really express their full selves – and thus heal – in a non-professional environment. If this weren’t the case people would never go to therapy and would instead just work out their deeper problems and conflicts with their friends or significant others, assuming these intimates were enlightened enough to be of true service. But even the most enlightened of friendships and personal partnerships cannot sustain that level of intensity. They were not intended to.

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