"Ex-client of counselling centre paid €235,000” says the Irish Times headline in front of me. The furore about counsellor Clare Hoban, who was a tutor at the Roebuck Counselling Centre, which has now changed its name (and not a moment too soon) to Roebuck Consulting Ltd, has hit the headlines and Liveline. At the time of writing, the websites for both entities have been suspended by their hosting provider. Hoban reportedly asked a man who had come to them looking for help, Des Martin, “What are your dreams worth to you?”

Well, if you put it like that...
What price happiness? The relationship between therapy and money is a vexed one (and for therapy, read psychoanalysis, psychotherapy and counselling, basically different manifestations of the “talking cure”). At the “high church” end of the spectrum, a course of psychoanalysis can last years, sometimes decades, and often, if it is twice or three times a week, costs tens of thousands of euro over many years. At the opposite end of the scale, counselling can be a six-or twelve-week service that is subsidised by a government agency or charity to deal with a specific issue. Even in those circumstances, it is common practice for the client to be expected to pay a token amount to their counsellor, on the principle that if people don’t pay for something, they don’t value it. This argument has a lot of merit – if people don’t show up to sessions, or are late, there is often an unconscious process at work in which they are revealing their own tendency to neglect their emotional and mental well-being. If they are required to pay for their sessions, including when they cancel, there is some expectation, which I believe is healthy, that some good should come out of the work. They make an effort because it is costing them something. Naturally it also is important for the counsellor to be paid, who after all has spent years in training and deserves it, like any other professional.
But the trouble is that it’s not like any other profession. Unlike a plumber, a teacher, or a masseur, customers can evaluate the value of a transaction afterwards and arrive at some conclusion as to whether it was worth the money, because as disempowering as it may be to be without central heating or a particular skill or have a back in spasm, we, as lay people, are fully empowered to judge. Some professions, however, like lawyers, wield enormous power, and it is very difficult to know whether or not they are doing a good job for us, because we have to take it on trust that they know what they are doing, and, often, shoddy work takes years to become apparent. If it does, we are left with very limited options as consumers, because in order to challenge whether or not they provided a good service, we have to have some legal knowledge ourselves, or pay more lawyers to challenge our old lawyers. But at least, in the end, a judge gets to decide; as imperfect as judges may be, being human, at least the system is in place, with enough checks and balances to gradually improve and evolve into something approaching a transparent system of justice.
It may feel the same in therapy, but to a large degree this is because vulnerable people project their power on to therapists. A lawyer (supposedly) knows all about the body of knowledge and rules called law, as it is has been written down over centuries, and how to argue it and apply it. A therapist does not “know” anything, to the same concrete degree, about how the human mind works, and in particular how the mind works of the client or patient sitting in front of them; there are many different theories of human nature, and none is the “truth”. There are no definitive manuals on consciousness, no tried and tested prescribed routes to recover from pain. Freud wrote in 1910 that if psychoanalysis was simply about the imparting of knowledge, “then all you would need for a cure would be for the sufferer to listen to lectures or read books. However, that would have about as much impact on neurotic symptoms as distributing menus would have on hunger during a famine.”
Someone who goes to a therapist has lost touch with their own capacity to self-nurture, to self-care, to look after themselves or to deal with their feelings, and one of the skills that often disappears under such stressful experiences is the capacity to get perspective, to self-monitor. If someone goes to a therapist, they’re trusting that the therapist will do the monitoring for them, and do what is best for them; at the very least, to do no harm. Good therapists work to making themselves redundant as soon as possible, and encourage people to decide for themselves how they’re doing, what support they need, and decide for themselves what “success” looks like. A lawyer doesn’t seek to teach their clients law, but therapists are often educating (in the original sense of “bringing out”) their capacity to look after themselves, to become emotionally literate, to become their own therapist, to become independent. But unfortunately bad therapists can (consciously or unconsciously) exploit a client’s lack of ability to get perspective.
People seeking therapy are, by definition, emotionally vulnerable, and often desperate; in the bewildering grip of confusing feelings, nothing makes sense, and if a counsellor sounds plausible, often people will do as they are told. Towards the “high church” end of therapy, psychotherapists and psychoanalysts will encourage a client to keep on coming even if they are hating the process, because, based on time-honoured theory, it is healing for a client to express negative feelings towards their therapist as well as positive ones, and often that only happens after a period of years. I have heard many people wonder dubiously about their friends in long term analysis/therapy, saying that they are concerned that a dependency is being encouraged, which seems on the face of it to be contrary to what is best for them. But it can work spectacularly well if someone works the dependency through, and all the mucky feelings that go with that, and comes out the other side, stronger and wiser and more able to tolerate relationships, with themselves and others.
The level of trust required in such work is immense, and why it is essential that the profession is regulated by legislation, to ensure that only those with integrity who are well trained, compassionate and properly supervised get to make those delicate judgment calls on behalf of their vulnerable clients.
But to ask such people for thousands of euro as proof that they want their dreams to come true? That’s charlatanism, pure and simple.

See http://www.inter-actions.biz/blog/2007/10/a_little_knowledge_is_a_danger.html