Why does my psychiatrist ask me to pay more?

Why does my psychiatrist ask me to pay more?

I have just started a psychoanalysis. The psychiatrist that I consult asked me to give him, in addition to the 35 euros reimbursed by the social security and my mutual, a sum of 10 euros, alleging that the patient must personally participate in the cost of his psychoanalysis to show his good will. What do you think of such an approach? (Yann, 20 years old)

Dr. Florent Farges


The question of money in an analysis remains controversial. Traditionally - and this under the influence of the founding father of psychoanalysis, Sigmund Freud - the therapy must cost the patient. It legitimizes this financial cost according to theoretical grounds that it would be too long to develop here.

Thus, the great majority of psychoanalysts, and the schools to which they are attached, require a fee-for-service payment, in cash (the symbolic value of the notes), and by paying the missed sessions. These analyzes, whether performed by psychotherapists (who are never reimbursed) or psychiatrists, are therefore entirely the responsibility of the patient.

Other clinicians (minority, it is true) oppose the financial sacrifice of the patient by comparing physical and mental suffering and arguing that there is no need to discriminate between these pathologies. Thus it is possible to make a "free" psychoanalysis in certain public structures or when the psychoanalyst is also a psychiatrist and makes sheets of care. It seems that the therapeutic results are not affected.

Thus, Yann, your analyst has adopted an intermediate position : you are repaid in large part, but he still wishes that your cure costs you in a reasonable proportion. It is an attitude that is completely honest and justifiable. Finally, a last word to remember that the title of psychoanalyst is not protected and that anyone can overnight self-proclaiming analyst and screw his plate. You do not choose a therapist in the yellow pages of the directory, do you recommend it by a doctor or a person of your acquaintance the practitioner.


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