Very often, I am asked: Why do therapists charge so much? Many other unsolicited comments follow this inquiry: “But you are only paid to listen to someone.” “A friend can do that.” “It’s too much money spent for simply talking.” “It looks like an easy job.” “I can give therapy to others as well,” and so on.

Simply put, and a very difficult concept to explain: we charge for the space we give to our clients in our psyche. The client might as well pay me rent for a space in my psyche at the beginning of each year rather than paying for each session. Unlike doctors who see us for a short time and do not engage beyond physiology, we emotionally invest in people every week in a process that will last from weeks to months to years. During an hour-long session, we are not simply listening but using our cognitive, emotional, and intuitive awareness to hold space and understand the unique and complex human being sitting before us. We sit with them as they open their wounds, becoming the reparative parents, friends, and spouses in their psyche as we guide them towards a free and functioning life. Is the therapist’s hour alone? No, it isn’t. Beyond all the training, years of experience, supervision, emotional energy, and thinking, the professional fees, we also spend time outside the hour, carrying our clients with us. When a client expresses suicidal tendencies, we think and worry about them beyond that hour and at the expense of our time.

I think this question arises from the limited understanding of what a therapist does. A therapist is NOT paid to just listen. There is additional work between sessions and time and cost outside the session. That one-hour session is just one part of the therapist’s job description. Every therapist continues to invest time and energy in their personal therapy, supervision, and continuing professional development to understand the complex human psyche and support the mental health of clients. Time is spent making notes, record-keeping, and taking complex cases to supervision. Education doesn’t end for a therapist once they get a license; every professional therapist continues to train themselves in different modalities, keep up with new developments, or specialize because the psyche is so complex and one lens is not enough to understand it. A therapist has to be exceptionally mindful of their self-care to be able to work in this field, which also means that at most, a therapist can work for six to seven hours a day. The fees, which are regulated at market price, mean the monthly income will not grow beyond a point, unlike in other fields. There are no annual bonuses or promotions, etc. So, if the charges are high, it is also because a therapist cannot work beyond a few hours a day to provide a high standard of mental health support.

One cannot begin to explain the emotional labor in this job, where on a regular day, a therapist moves from one emotionally powerful experience to another and by the end of the day, may have very little bandwidth left for their personal life.

Another important factor to reflect on is how we are unwilling to pay for our mental well-being but willing to spend twice the cost on coping skills. A drug addict is willing to waste thousands on drugs to cope with trauma but not on therapy that can help with the addiction. There is a higher cost being emotionally and monetarily paid with unhealthy coping mechanisms, but there is resistance to paying for professional help that has been tried and tested.

I think the real question is not why therapists charge so much, but why are you unwilling to invest in the mind that defines every important aspect of your life? How well do you understand and value yourself?

Zara Maqbool
The writer is a BACP (British Association for Counselling and Psycho-therapy) accredited individual and couple psycho-therapist based in Islamabad. She can be reached at zaramaqbool@yahoo.com.