On what principles the price is formed for consultation with a psychologist or psychotherapist, why and how much do they need to pay?
What money does in psychotherapy, whether discounts are possible, what is the difference between free and paid psychological help-Daniil Nesterovich Khlomov, director of the Moscow Gestalt Institute, answers these and other questions about money.
Psychologies: What do money in psychotherapy mean?
Daniil Khlomov: Money here means relationships. I will explain. For each type of human activity, for each specialty, the money is filled with some kind of meaning. And this meaning is different for the financier and for the builder, for example. For a practicing psychologist, money is a relationship. And, accordingly, these relations can be, for example, for one person, say, too large, for another – too alienated and so on. But without this financial border between me as a psychologist and the person with whom I work, there will be no relations of psychotherapy.
Can’t the psychologist give the interlocutor any recommendations
in a normal conversation?
D. X.: Maybe, but it will not be psychotherapy. If I do not understand why, in an ordinary conversation, for no reason I begin to psychologize, then something is wrong with me, maybe I lack a sense of self-importance or something else-in this case it is time for me to do some kind of solutiontheir own problems.
That the money is changing?
D. X.: The money that the client pays for the work of the psychotherapist is some primary frame, confirmation that for the agreed time I am not in this person in order to satisfy my needs, but in order to help him.
That is, while people communicate without payment, each of them satisfies their own needs, and when one pays, the other satisfies not his own, but his needs?
D. X.: Exactly. In any case, this should be in honest communication. Sometimes this balance is disturbed, but how and why, it needs to be sorted out in each individual case. Psychotherapy is also engaged in this – cases of violated balance in communication.
How the relations of the client and therapist differ from the usual relationship besides payment?
D. X.: Therapeutic relations are much simpler than other personal relationships between people. Typically, relations between people are very complex, they constantly change, even if it is a stable relationship and their participants have known each other for a long time. But one needs to talk, and the other is busy at this time. Or one found out something about another and has not yet decided, either to tell him, or to keep silent, and this knowledge becomes an underwater stone in their relationship. In personal relationships, not everything is said aloud, you have to guess a lot. When something happens in these relations, it is often not clear what it is connected with: whether one participant, with both or some other circumstances.
And how relations are built in therapy?
D. X.: The relationship between the client and the therapist is much easier. Their participants conclude a contract, they agree on all conditions, discuss them aloud. We meet at a certain time, and it is clear to both of us that, after the time ends, we are not going to be friends, but just diverging. I remain on my territory, even if the client wants to talk, even if feelings arose and he is ready to pay extra. But we have an agreement, and we act in accordance with it. And this is good, because in this case everything that happens between us does not refer to our relationship, but either to one person or another. We remove all unclear factors from our relationship. We express feelings in words, not in some other ways, as is the case in other respects. For example, people build houses nearby, but behind this is their personal sympathy for each other, which is this expressed – through joint activities. Or vice versa, someone does not like someone, and people refuse to cooperate and profitable offers, thus expressing their antipathy.
How the price of a psychotherapist is set?
D. X.: There is an average price, the same as in the rest of the world, it is known.
What to do for whom this price is too high?
D. X.: It is good that work with a psychologist is not mandatory for life. This is a service that you can buy for yourself, like other services. If it is not available to you, and there is a need for psychological knowledge, you can find information in psychological books, films – among them there are very good ones – and work yourself.
But there is a difference between an attempt to independently solve your problems and work with a psychotherapist?
D. X.: There is a difference. But this does not mean that only one thing is possible. Satisfy the same need in different ways. I will explain with the help of an example – you can buy a piece of bread, cheese and beer in the nearest store, go to the square and there on a bench drink and eat all this. Can you go to a restaurant. You will be saturated and enjoy both the first and in the second case. The question is that you are pleased at the moment. In addition, one does not cancel the other.
When a person has the feeling that he lacks money?
D. X.: It depends not so much on objective reality as on the ratio of income and expenses. Some people with high income sometimes have too much expense, and they don’t have enough money, despite the fact that they seem to get them enough. In general, if you have little money, it means that some of your needs remain unsatisfied, and then you need to deal with this and put yourself in order.
Are there any special nuances in working with those whose income is high?
D. X.: It is difficult to work with those whose income and expenses greatly exceed the average level. Firstly, for his own money, such a person can buy any headache for himself. Secondly, if such a client pays the money that is noticeable to him, then it can be too much money for a specialist. And then the specialist will not be able to work, because his own balance will be violated. But there are ways to solve these issues.
D. X.: For example, I had a client who, because of his position, was used to swimming from everything, replacing real relations with money. For him it was a familiar way of action. And it was important not to give him such an opportunity to ensure a more realistic background of relations. Therefore, we agreed that payment for psychological work will be postponed until certain results are achieved. So that he feels like a debtor for some time, so that he was worried about this as some duty, attachment, which he avoided in his life. And it worked. Money is a psychotherapy tool. Many practicing psychologists use to increase and decrease payment as a tool for helping the client in solving his problems.
And yet, are discounts for low income customers possible?
D. X.: They must be very justified from a psychological point of view. If we consider the exchange of money as a relationship, then a decrease in payment means a deterioration in relations. And the experience shows that after a decrease in relations really worsen, people become less attentive to each other, so the discount is not always definitely good. I’ll give an analogy again. Some people prefer to buy things in a more luxurious, expensive store, although the quality of the goods there is not much higher than in the clothing market. But they are ready to pay for convenience, for the opportunity to calmly, without crowds and noise, choose what is suitable for them – that is, they pay for the attitude. And during discounts and a normal store it turns into a cheap sale. Therefore, it is important to pay – both for psychotherapy and for other services – no less than your capabilities. If I pay and buy cheaper than I could afford, then this is at the same time the attitude towards me as a less significant thing than I actually.
What is the difference between the work of psychologists in free crisis centers from the work of a private psychotherapist?
D. X.: Free psychotherapy means that there the specialist will be interested in taking your symptom. If you have, say, insomnia, then his task is to make you just fall asleep. And perhaps it is best to use a tablet. He should not, by duty, with you to recognize the circumstances of your life in which you want to figure it out. And in the event that you hire a private psychologist, you deal with him in the various circumstances of your life. And there is another factor. Cooperation with a private psychologist – long -term project. It is difficult to learn many important details about a person for fifteen minutes and even an hour. This knowledge arises gradually, due to the effect of accumulation. Money metaphorically give the same effect, it accumulates. So, deposits are growing on both sides, our relations become more expensive with each meeting, and this means that we can talk about more and more complex things.
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