How do people pay for psychoanalysis?

Right now I pay out of pocket for once/week psychodynamic therapy. I’m trying to find a way for twice weekly sessions but have had difficulty with scheduling. I’m just wondering how people in the U.S. pay for this. I’m not sure if the cost is the same in Europe, but it’s really expensive here. I pay $160 per session, so you can do the math, but at twice per week that would be 8-10 sessions per month. I called my insurance and they have no reimbursement for out of network psychotherapists which mine is. I’m just trying to plan for twice/week, but I know that some see their therapists 3 or 4 times/week. The cost seems like quite an obstacle, so I’m wondering how people do this?

I've been lucky that everyone I have worked with has either taken my insurance, or when I paid out of pocket, they had a sliding scale. With my former T, when I needed a second session in the week, she discounted the second session by 1/2 but it wasn't a regularly occurring thing. Kit

I could not afford to see someone who was not covered by my insurance - it just wouldn't be an option.

Savings that were earmarked for a flat. But I figured, without hyperbole, the way I was going I would be dead so what earthly use was a flat. I don't regret it so far but it has been a sacrifice.

That was basically my logic too. Whatever it took to keep my butt alive. I should try to remember that now, cuz i guess i thought it was gonna pay off when i would have still had had a chance to enjoy it. Well dont count me out yet.

I rely on insurance. My T did say she'd work with me if insurance ever stated that they would not pay for the multiple sessions a week. I am currently at 3x a week.

I have no idea. My t was out of network too so I paid out of pocket. The last 5 months that I still saw her we'd gone back to 1 x week after being at every 2 weeks for a long time and she gave me a reduced rate for that which helped a little. I could not have afforded 2x a week.although if I could have, I would have done it.

European here, just to give you some perspective.
My sessions are about 180 bucks I think. My T calculates it by the minute and I never see that calculation, so I'm not 100 percent sure but something around that number.

My insurance (as well as all other insurances in my country) doesn't pay at all for the first 300 dollars I spend on any medical expenses (i.e. therapist, regular doctor, whatever else I need...). Then they pay everything but 10% for the next 700 dollars and after that everything is paid by the insurance.

Right now I'm going twice a week, which is around 1800 a month. That means the first month of the year I spend 450 dollars. After that around 180 for a few months, and then nothing at all. If I went more, I'd have to pay even more in the first few months, but after that I'd not pay anything regardless, so unless somebody's living paycheck by paycheck, they can fully well do this. However, as far as I know insurances are not too happy about people going more than two or three times a week, and they have to give some kind of approval to cover (which normally is no problem to get, but they might say something if somebody went that much). I've never seen such a quantity of sessions offered by anyone though.

Never would have happened without medical insurance.

I wonder how analysts pay for their own analysis? Seems like many of them go 4x/week for 5 or so years which by my math would come out to over 30k per year.

Not psychoanalysis, but I see mine twice a week, and my insurance does have out-of-network benefits. So I pay a net of $70 a session (he charges $175, insurance reimburses 60%--we have the most expensive of H's insurance plan options from his work because it works out better for various reasons).

Some T's also offer a sliding scale, so could that be an option? When I was worried recently about H losing his job (and thus our insurance--I also work, but freelance, and he makes more than me) recently, I asked my T about this, and he said he's worked with clients on costs, like based on percentage of income they'd lost. As in, if they were making 60% less, then he might reduce his rate by 60% (I would also drop back to once a week if that happened.)

Insurance covers most. I pay a $20 copay/session. But, I purposely found a T that was in network with my insurance. If my insurance changed and she didn't take it...I'd probably find a new T who did.

As far as I know, every big city has psychoanalytic institutes, sometimes more than one. They might have their own counseling centers where you can get psychoanalysis at a low cost or even free of charge if you commit to a certain time frame and a certain frequency of sessions. In this case, you'd be seeing a psychoanalyst in training, but they are a licensed professional, because in the US you can't start the psychoanalytic training if you are not licensed yet. Psychoanalytic training goes on top of the standard academic program (for those who want to pursue it) and it's always post-licensure.

In my city, all psychoanalytic institutes have clinical research as part of their training program. Each analyst in training is supposed to have several clinical cases to conduct a research. If you agree to be a research subject, which would entail seeing an analyst 3-5 times a week for one year minimum, you could get your analysis for free.

Other than that the only reasonable way to afford psychoanalysis is to find an analyst who happens to be a provider from your insurance, in which case you'd only pay a co-pay. But they are rarely on insurance panels. Their classic way to build up practices is to form and maintain consistent sources of out-of-pocket referrals. They maintain strong connections with psychiatrists and other MDs, family lawyers and other professionals who could refer clients who are able to afford their fees. Many analysts are also pdocs and are well connected to other medical professionals. That's how they get a well paying clientele.

All in all, psychoanalysis these days is a model that is largely for those who are well off, not a middle income and certainly not a low income folks.

I have pretty good insurance. After we hit our whole family deductible of 3k, my sessions are covered at 70%, until we hit 8k as a family out of pocket, then my sessions are covered at 100%. If my therapist was in-network, it would be less. We always go through our deductible and always hit our family max out of pocket. Kids are expensive. I’m expensive. It’s worth it to us because therapy is really helping me become a better parent to our kids.

I couldn't do it without good insurance.

I see my T once a week. He charges half the recommended rate and my insurance covers $500 a year, so five sessions. I pay everything else out of pocket. I can afford it, but when I saw him years and years ago I had no money and he saw me for free. Where I am Ts are encouraged to provide some of their practice pro bono. One of my goals when I am a T is to “pay it forward” and provide services to people who would otherwise not be able to access them.

I do psychoanalysis (4 times per week) but I'm in Europe.

In my country there is a public healthcare system which generally does not cover psychotherapy. In case of mental health problems it would probably cover psychiatric services and perhaps some very limited amount of psychotherapy but there really needs to be a clinical indication. Thus, most of the psychotherapy is paid out of pocket and so do I for my sessions.

My T offers a sliding scale. He has a fixed fee on his web page for the initial consultation but for long term therapy he negotiates the session fee with every person separately. For those who go less frequently the session fee is higher. So I guess that someone who goes 2 times per week actually pays the same amount per month as I do going 4 times per week.

As for about how I can afford it then yes, I am generally quite well off at least for now compared to the average pay in my country. Monthly I pay about 1/3rd of my income for therapy and I can afford it, especially because my spouse is also earning quite well right now. We don't have huge savings and thus we are not bolstered against anything but I don't expect to be in therapy forever and at some point (I suppose in 4-5 years time) I will not have this cost anymore.

R lets me pay less and I've been on his lower scale since we started. He's raised his later evening price to £75 per hour and £60 for a normal session, but I'm not working and pay the same amount which I've always done- which works out to be £20 cheaper for a normal session.

But the UK psychoanalysis org does offer some low cost spaces.

In the UK is about £70 a session.
I get reduced rates.

your better off finding a gym and getting a good self help book or audiobook. use the money to build better aesthetics. build a sanctuary to escape to. a place to think, a place to rest.

counseling is a sinkhole of money in medicine and private counseling is over priced and varies psychologist to psychologist

While it’s true that exercise has been dubbed a poor mans antidepressant and there is significant evidence supporting its use in combatting depression, many of us, myself included, would not be alive without having had the experience of a skilled and caring therapist.

I have it all and want for nothing. But that is not enough to combat the demons in my head. Therapy keeps me alive. I’m sorry it was a sinkhole for you but for me it’s been an investment in my health.

That is often like the people telling my husband, who suffers from a degenerative neurological pain disorder, "you're better off meditating, breathing deeply, and praying the pain away. Stay away from neurologists, pain specialists, orthopedists." (Yes, clueless people actually say things like that.) It is insulting to minimize the level of psychological suffering and true disability that is the result of abuse, neglect, depression, addiction, etc. The assistance and support of therapists and psychiatrists is often the line of defense between life and death for people. Perhaps YOUR emotions can be handled that simply; do not assume everyone is the same as you.

I don't think therapy is the only way to approach anything. It seems to work for some. For me, any number of other things are more useful than therapy ever was. I never figured out what was actually supposed to be happening in a therapy appointment. From my vantage point, nothing ever did. The therapist was useful as a place to vent about grief and my person's illness and death, but it was not, for me, the only way even for that - it was simply a use I finally had for the appointment.
I paid for appointments in cash. I have low expenses and no children.

Overall the 7+ years I saw prev t was an investment in my health too and worth every cent that I paid her.