Is the clinical fee a difficult issue for therapists and if so, what are the conscious and unconscious dynamics that make it difficult?

A lot has been written about money but little about the clinical fee and even less about the analyst’s relationship with this important aspect of the therapeutic dyad. This project researched psychoanalytic psychotherapists' and psychoanalysts' thoughts and feelings about the clinical fee. By beginning with Freud, this thesis explores how, historically, aspects of money have been discussed, and illustrates from both historical and current perspectives that little attention has been paid to it. Looking at how money is contextualized within psychoanalytic discourse may shed some light on why the clinical fee can be an arena that is fraught with anxieties, avoided by analysts and analytic institutions. This thesis explores the reasons why this area has been little researched, which may be because the clinical fee is associated with primitive thoughts and feelings regarding money and consequently avoided, leading to an absence of open and transparent discussions on this significant aspect of the therapeutic frame. This thesis discusses how these primitive roots of our relationship with money may lead to avoidance of discussion concerning the clinical fee, and explores some conflicts that underpin this avoidance. This thesis looks at the analytical fee from the point of view of the analyst and analytic training organizations. More often than not, when any attention has been paid to the clinical fee, fee-related issues have been left with the patient. This thesis raises two questions and two hypotheses which are addressed: 1. Is the clinical fee a difficult issue for therapists? 2. If so, what are the conscious and unconscious psychodynamics that make it difficult? Twelve therapists who are psychoanalytically trained and/or psychoanalysts, kindly agreed to take part in this project, and were interviewed for this investigation.