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It is possible to foresee that at some time or other the conscience of society will awake and remind it that the poor man should have just as much right to assistance for his mind as he now has to the life-saving help offered by surgery. When this happens, institutions or out-patient clinics will be started, to which analytically-trained physicians will be appointed. Such treatments will be free We shall then be faced by the task of adapting our technique to the new condition (my emphasis).
This is a very difficult subject and I realize that much I shall say is controversial
This paper addresses the framework of once- or twice-a-week psycho-analytically-informed psychotherapy offered under the Canadian medicare system to patients who do not fit a neurotic profile. A basic premise motivating the experiment to be described in the following pages is that the absence of a payment gesture in this specific framework limits the examination of certain issues by the therapeutic couple. To avoid misunderstanding, let it be clarified that the gross efficacy of treatment in this setting is not questioned. Rather, the point will be made that at a subtler level, it is easily possible for various payment-related matters to go without mental representation and