The “Big Shot” Raises His Fee: Social Class in the Psychoanalytic Encounter

The role of social class in the analytic encounter has been given little attention in our psychoanalytic literature and training institutes. This dimension of the treatment relationship tends to remain invisible most of the time. However, when the analyst raises the fee, it can become a catalyst for bringing social class concerns of both patient and analyst into the treatment room. The fee increase discussed in this presentation evokes shame, envy, and guilt for both participants, each raised in a working-class home. The author considers unconscious dynamics informing psychoanalytic work between patients and analysts who outwardly appear to have no conflict about their social class origins but privately harbor much shame and anger about where they come from.