Don’t believe what you are about to read. Consider the source: a retired psychologist who is going to rationalize that counselors care about more than money.
THE CASE FOR THE AFFIRMATIVE: that good therapists are only or largely in their profession to make money.
- First, let’s look at the evidence against us. We do take your currency. Often, however, not exactly yours, but the dollars of third-parties like insurance companies or government payers. A therapist in independent practice receives this compensation directly. A clinic employee’s salary comes from the owner, who keeps a portion for himself.
- Second, we monitor the clock. A mental health professional is like a taxi cab driver, who starts the “empathy meter” when you enter the office and turns it off upon elapse of the predetermined time. There is a mercenary quality here, isn’t there? Indeed, “the oldest profession” operates on a similar model. To the good, the doctor does not walk the street in a revealing outfit.
- Third, we set limits on your access to us when “off the clock.” We don’t hang out with you, permit friendship, or consider a sexual relationship. Indeed, most of us won’t even stay connected once treatment ends.
Looks like a strong case to me. How about the case for the defense?
THE CASE FOR THE NEGATIVE: that good therapists are NOT only or largely in their profession to make money.
- Careful readers will notice I’ve qualified the terms of the debate. To be a good therapist (not in a moral sense, but as a matter of excellence) you cannot be predominantly concerned with the amount of cash you might squeeze out of your client, any more than you are preoccupied with her/his sexual attractiveness or ability to tell a joke. To do a superior job the psychologist must be experienced, study for his entire professional life, and bring a concentrated intensity to his work. Most important, he has to care. If he views the client as a cash cow, he will betray a lack of concern and lose focus in session. Inattention and indifference to your suffering shall be evident. Moreover, the therapist’s grudging presence can only cause ineffectiveness. Disinterested in his vocation, the counselor will himself suffer. Even assuming he continues to get referrals, poor performance is inevitable. Feedback attesting to one’s mediocrity is hard to bear. The hack might as well labor in an overheated factory at a job he hates. As someone who did this during a summer break from college, I know the difference between the dedication to healing I was privileged to do and the sweltering experience of a mindless job in a metal stamping factory.
- Many other professions offer more lucrative possibilities. Without a flourishing clientele of wealthy people happy to part with upwards of $150 per shortened-hour, therapy rates are set by insurance companies. Some of these may limit the fee to the neighborhood of $50 (before expenses), depending on your professional credentials. Were money the therapist’s only concern, he could do far better teaching in a business school, working on Wall Street, or making a living in advertising.
- Your therapist does numerous tasks without compensation. He responds to phone calls and email from prospective and current patients, manages his corporation, interacts with an office manager, goes to conferences, reads clinical books and journals, maintains notes and treatment plans, deals with emergencies, consults colleagues, markets his practice, and enrolls in professional education courses. A counselor contractually obligated to follow managed care guidelines must supply information to case managers about the client’s progress. Such “precertification of medical necessity” is demanded periodically over the course of the doctor/patient relationship.
- I’ve previously explained why therapists won’t hang out with you. It is not because they are not paid to do so. The first of two pertinent essays is called Being Excluded From Your Therapist’s Life/ The second is How would a Friendship with your Therapist Work?
- Much of the practitioner’s income covers his office expenses. These include rent, furniture, occasional remodeling, malpractice (liability) insurance, utilities (heat, air-conditioning, electricity, telephone), books and journals, continuing education, computer hardware and software, accounting services, and taxes. If you didn’t pay him he’d be operating a not-for-profit corporation with a large deficit. Obtaining another full-time job to support his family could not be escaped. Impoverished, fatigued martyrs are not ideal role models for their patients.
- The work of being a therapist can be stressful. You are responsible for the well-being of those good people who count on you during a difficult period of life. Depending on the size of your case load and the extent of emotional damage from which your patients seek to recover, shrinking heads demands the best of your intellect, stability, sensitivity, and frank energy. The danger of “burn out” always exists. A healthy counselor replenishes himself both through the fulfillment of the work and his life outside the profession. Most who wish only to make a fast dollar will discover their goal is inimical to their own well-being.
I hope I have convinced you. I doubt that I’ve persuaded all of you. I am not saying those who take on this vocation are indifferent to the value of a dollar, so contemptuous of money and worldly comfort we enjoy shelter in a cardboard box after a long day on the cross. The job is fulfilling, but the greatest part of the satisfaction is not from filling our pockets. Ministering to the suffering is wonderfully rewarding if you do it for the right reasons and have the temperament to match. Should the accumulation of wealth be the primary goal, the job becomes your enemy. If you want such a misguided person as a shrink, look for a “professional” who flagellates himself or sleeps away the day instead.
I hope I do not sound arrogant when I say I earned the comfortable living I made. And, by the way, I write these posts for free, a price everyone can afford.
The truth is, however, a few therapists ARE too concerned with making money. Some have even mastered the art of appearing touched by the lives of others. They can “fool all of the people some of the time and some of the people all of the time, but … cannot fool all of the people all of the time.”* The public in general knows little about the arcane science of psychotherapy. Many who never before consulted a therapist lack knowledge of what might be required to produce a good treatment outcome. I dare say most of us put too much faith in our psychotherapeutic, medical, and legal professionals, not to mention our plumber. The world has become a place of specialists and no consumer is a jack of all trades, ready to make a precise evaluation of the glut of service providers he employs in a lifetime.
My advice? Research the subject of therapy and get counseling referrals from those you trust before you visit Shrinkland, soon to be the newest attraction at Disney World. Know about your practitioner’s experience and training. Evaluate him as he evaluates you. But if you choose to put all of us in a barrel labeled Greedy Self-Interest, you will be dismissing most of us and surely the best of us: sort of like throwing out the champagne with the cork.
*This quotation is attributed to Abraham Lincoln, but can’t be verified. An interesting story about “Lincoln’s” words can be found here: Abe Lincoln.
The first photo is called Buzz Tweed, a fictitious Congressman, created by Buzz Tweed. The second image is A Lazy Person. It is the work of “A Dazed Memory.” Both are sourced from Wikimedia Commons.