Contemplating Raising Fees: An Exercise in Therapist Disquiet

Abstract

This paper discusses the experience of psychodynamically oriented therapists in private practice as they contemplate raising their fees. Raising fees stirs up competing self-interest, transference-countertransference reverberations, financial fantasies and realities, ethical concerns, and uncomfortable as well as satisfied self-reflection. These dynamics are discussed under the following categories: exercise of power; incurring guilt; inappropriate entitlement; fear of loss; modeling of self-care; rapaciousness; unconscious factors; and self-esteem. A cautionary case example is provided. Six suggestions are offered to make therapists' contemplation of raising fees less stressful. The author hopes that this article will foster more open discussions among therapists about the tensions involved in raising fees and, in the process, lead to an enhanced understanding, acceptance, and detoxification of the feelings involved.