Why Do Some Therapists Accept Cash or Cheque Only?
It’s not about being old-fashioned
Most of modern life is built for efficiency. You can tap a card, swipe a screen, and forget the entire exchange before you’ve left the shop. Psychoanalytic therapy moves in the opposite direction. It insists on a real, human-to-human encounter. Something tangible, even awkward – because that is where human experience is most alive.
In that spirit, payment is never just an administrative detail in psychoanalytic therapy. It is part of the treatment itself. People “pay” with their determination to show up, with the time they reserve during a busy week, with the energy it takes to speak openly. Money is only one vehicle for effort, not its essence.
Why cash or cheque, then?
A cheque carries a person’s name and their signature – the one mark nobody else can reproduce. Writing it out is a small act of authorship: I stand behind this session. Cash too has a visceral weight. Notes must be extracted from the bank, counted, folded, and handed over; the slight friction involved can stir thoughts and feelings that a friction-free tap never will.
In a world where capital markets prize seamless efficiency, psychoanalytic work moves in the opposite direction. By keeping payment concrete—cash in hand or a signed cheque—we pause long enough to feel what the exchange actually means.
If that sounds inconvenient, good: therapy itself is inconvenient to the part of us that craves quick fixes.
Some people assume these methods are tax-dodges or nostalgic quirks, but the reality is simpler yet more radical.
By staying physical payment stays human. The cost and effort of the session is brought to bear. Very little escapes attention in psychoanalytic work – no stone left unturned. Including the little stones of everyday transactions.
More on Appointments
Recommended Reading:
-
Jacques Lacan – The Direction of the Treatment and the Principles of Its Power.
- Fink, B. A Clinical Introduction to Lacanian Psychoanalysis – Chapter 3
“There is no analytic act without payment. And it is up to the analyst to know how to receive it.”
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