Clinical Meeting: Therapeutic values

We returned from the Christmas holidays to consider something which is on many clients’ and therapists’ minds every January: money. As a follow-on from the clinical meeting last May (Penny for your thoughts), this session involved a psychoanalytic exploration of ideas around the notion of monetary “value” in therapy. Led by Dave Rogers – art therapist, coach, mentor and trainer – the clinical meeting explored some of the following themes:

1. What does money represent in the therapeutic encounter? In what ways can the client’s feelings and attitudes around paying for therapy be discussed and used therapeutically in the sessions?
2. How can we quantify the real value and cost of therapy?
3. Do we, as therapists, reflect our own personal issues or approaches to money when charging our clients? (An interesting literary example can be found in Yalom’s novel Lying on the Couch.)
4. How are the different methods of transaction relevant to us, or to our clients? It so, what do they mean?
5. What is the most ethical way to manage an art therapy intervention with a client who can no longer afford personal therapy?

 

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Dave introduced the notion of value, which can be viewed as financial, symbolic and powerful, as well as related to personal identity. Starting off through a role-play “interview” with Centre director Hephzibah Kaplan, we were able to think and discuss the tricky dynamics that can arise when charging in an interpersonal context. Dave asked us to consider the theory and meaning behind these questions by introducing ideas from Marx, Freud, Ferenczi and Jung. We referred to Dr. Raj Persaud who has written about the motivations of those who prioritise money in their professional lives, including the need to control others. The discussion resonated with the group and the therapy team were able to share their own journeys and ways of grappling with this complex issue.

 

Art therapy has traditionally only been available in the NHS with fewer art therapists offering private practice consultations, however this has and is changing. Private practice allows clients to self-refer and clients are not compelled to be service users in order to engage with art therapy. Thus art therapy has become more accessible and at the same time, clients are now paying for their own therapy. This can be highly empowering for clients; it shows they value, and are willing to invest in themselves and their own growth.

As usual we had an art-making component to the meeting, where we explored Jungian ideas around the shadow and the trickster archetypes. We also read extracts from Freud’s writing on the power and shame inherent in our thinking about money – themes that can affect us as a group practice. The London Art Therapy Centre offers art therapy to both the private and public sectors and perhaps its inclusiveness is a way of managing this issue.

At the end of the meeting I was left with the following quote, which Dave read to illustrate the inherent paradox around the way we put a monetary value on therapeutic value:

A patient concluded his request for help by telling the analyst,
‘Doctor, if you help me, I’ll give you every penny I possess!’
The doctor replied, ‘I shall be satisfied with thirty kronen an hour’.
‘But isn’t that rather excessive?’ the patient remarked. (Ferenczi, 1914)

Further reading: The Cash Nexus: Or How the Therapeutic Fee is a form of Communication by Marguerite Valentine
The Analyst in the Counting House: Money as Symbol and Reality in Analysis by Jane Haynes and Jan Wiener
In Pursuit of Money by Dr. Raj Persaud

Copies of all three articles can be found at the London Art Therapy Centre’s office.
The following books may also be of interest:

How Money Talks (United Kingdom Council for Psychotherapy) by Lesley Murdin
Lying on the Couch by Irvin D. Yalom

Dave Rogers’s website: http://www.daverogers.org/  

Posted by Nili Sigal, art therapist & clinical meetings coordinator

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