Money, Psychoanalysis, and Social Democracy

Saturday, July 15, 2017
Glendale, California


Money, Psychoanalysis, and Social Democracy

Psychoanalysts should be Marxist, says French intellectual Jacques Lacan.


Because in capitalist systems, patients must pay for psychoanalytic psychotherapy. And, the fee, not to mention the fee-setting process, corrupts psychoanalysis.

Cultural theorist Slavoj Zizek writes,

Money – paying the analyst – is necessary in order to keep him out of the patient’s pathology.

Zizek proceeds to describe the depth psychotherapist as:

A kind of ‘prostitute of the mind,’ having recourse to money for the same reason some prostitutes like to be paid so that they can have sex without personal involvement, maintaining their distance—here, we encounter the function of money at its purest.

In other words, the fee must be set, fairly to both parties, to enable psychoanalytic work to proceed. Psychoanalysts resenting their lower-fee patients pervert the process; in like manner, patients’ resentment of their psychoanalysts’ fees disrupts the work.

As psychoanalysts understand, setting fees with patients becomes part of the transformational process. Like many of my colleagues, I happily reduce my fee as long as my patients and I are treated fairly.

Some patients volunteer to pay my full fee, and only to later confess the set amount exceeds their capacity to pay — often revealing a masochist streak. Others, clearly able to afford the fee, insist on negotiating a rate reduction — often revealing a narcissistic features.

Sadly, poor people rarely have the financial resources to consult psychoanalytic psychotherapists. Rose City Center in Pasadena, or the Wright Institute in Los Angeles, represent a few exceptions. At those institutions, economically disadvantaged persons can receive psychoanalytic services at low cost.

However, these persons are usually preoccupied with obtaining basic necessities of living — housing, food, education, work. Obtaining help for their emotional troubles is the least of their worries.

In purely capitalistic systems, patients’ capacities to pay depend on their socioeconomic success.

Freshly returned from an in-depth exposure to Cuban communism, I disagree with Lacan’s idea that psychoanalysis is best practiced by Marxists.

Communism was a wonderful idea, introduced by Karl Marx in the mid-19th century. It suffers from but one serious problem:

It does not work.

As Zizek himself points out, no one has yet solved the problem of having communism without an immense state to run it.

And that state inevitably becomes corrupt.

Soviet Russia functioned quite well the first few years after the 1917 revolution. Then, with Marx cringing from the crypt, the same class inequality haunting capitalism dominated. Powerful leaders running the state enriched themselves; the lower classes returned to their deplorable status.

During the decades Joseph Stalin led the Soviet Union, some 30 million Russian people were executed for various alleged crimes against the state.


I have visited Russia once, and China twice. They sport overly communist governments. However, both these countries, ironically, now feature hyper-capitalism. The distribution of wealth is more pronounced than in the US. They have one-party, communist systems — on paper. In reality, though, the extremely rich run both systems.

The poor, as usual, get the short end of the deal.

How does this relate to the psychoanalytic project?

Because psychoanalysis ultimately concerns itself with human freedom. By exploring what troubles them, patients uncover unconscious processes. They see how they repeat destructive patterns. They learn to differentiate between elements of their lives they can control from those they cannot.

Ideally, then, patients achieve greater autonomy and agency from psychoanalysis. They feel a greater sense of independence. They become more capable of directing their own lives. They make more informed choices about how they work, love, and play.

But these goals cannot be achieved by persons struggling with basic necessities of living. In Cuba, for example, even physicians — among the most highly paid of the generally poorly paid workers in the country — often work as regular staff members in hotels. They earn tips and otherwise supplement their income by carrying luggage to hotel rooms or handing out towels to guests by the pool.

I propose social democracy — currently achieved by perhaps ten percent of the world’s nations — as the best government systems to promote self-actualization. Among the best examples are the governments of Denmark, Finland, the Netherlands, Canada, Sweden, Norway, Ireland, New Zealand and Belgium.

I will visit Sweden and Norway later this summer, partially to assess how their systems support the type of unique personal growth offered by psychoanalytic psychotherapies. I anticipate individuals there, whether troubled by severe psychological problems or seeking to address more subtle difficulties in their personal lives, have a better chance of striving for self-actualization. Apparently, they have freer access to psychoanalytic psychotherapy.

Meanwhile, they have little if any homelessness or poverty and offer free healthcare, education, and other basic services. They subsidize housing for their poor.

Many have wondered about my personal interest in politics. It seems self-evident.

Having devoted my professional life to providing psychoanalytic services to individuals, couples, and families, I have grown convinced that, without a combination of socialism, capitalism, and democracy, citizens struggle to live. They lack the luxury of enhancing their personal freedom through services like psychoanalytic psychotherapy.

With no possibility in sight as long as Trump remains president, our country, with its amazing natural and human resources, could easily transition to a social democracy. Such a system would facilitate all citizens — not just those consulting psychoanalysts — to live fuller and more meaningful lives.




Lacan, J. (2002). Ecrits. Trans. B. Fink. New York: Norton.

Zizek, S. (2008). In defense of lost causes. New York: Verso.




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