14/11/2025
In psychodynamic work, we often say that the unconscious speaks through action more than intention. The way a patient pays for therapy is not about financial etiquette — it is a live expression of their inner world unfolding in the therapeutic relationship.
Money carries emotional weight. It represents dependence, separation, care, autonomy, guilt, longing, anger, and attachment. When a patient reaches for cash, forgets to bring it, overpays, apologises, hesitates, or becomes irritated, they are not simply performing a transaction. They are expressing something about:
how they experience being held or not held
how safe they feel in needing someone
how they manage closeness and distance
what they learned about giving and receiving in childhood
how they negotiate boundaries and expectations
what they fear, long for, or defend against in intimacy
In this way, payment becomes a microcosm of the patient’s relational patterns. It is never about judgment. There is no “right” or “wrong” way of paying. Instead, each pattern becomes material — a moment rich with information about how the patient relates to others, to themselves, and to the therapeutic space.
When a therapist explores these subtle behaviours with the patient, something important can happen:
awareness deepens, repeated relational cycles become visible, and the possibility for new experience emerges.
Even the smallest rituals — handing over money, asking for change, forgetting the wallet, or hesitating at the door — can reveal profound emotional truths.
Nothing in therapy is just a coincidence.
Everything that happens in the room becomes part of the meaningful dialogue — even the moment of payment.
— your therapist, Sylwia