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The [[role ]] of [[money ]] in the [[analytic ]] setting is an essential aspect of the arrangements that institute [[treatment ]] and underpin it as it proceeds. [[Freud ]] realized early on that [[subjective ]] attitudes toward money are sure to create difficulties, for they inevitably are affected by [[outside ]] [[reality]], that is to say [[social ]] and [[economic ]] factors, and [[affect ]] [[psychic ]] reality, especially in its [[sexual ]] [[dimension]]. Payment, as customarily required in the contract between [[analyst ]] and [[patient]], is a necessary if not always sufficient condition—the needed [[symbolic ]] mediation—that frees the [[analysand ]] from the [[danger ]] of the analyst's [[repeating ]] the kind of abuse to which the analysand has already been subjected in [[life]]. It is a [[mechanism]], in [[other ]] [[words]], that saves the patient, in the [[transference]], from [[acting out ]] and paying in pounds of flesh and with the coin of [[suffering]]. It is also a means of protecting the analytic [[process ]] from an [[excess ]] of unanalyzable [[resistances]]. The analyst is thus helped in [[interpreting ]] the transference. And, last but not least, the analyst's [[material ]] [[needs ]] are taken into account.

In two technical papers, "Recommendations to Physicians Practicing [[Psycho]]-[[Analysis]]" (1912e) and "On Beginning the Treatment" (1913c), Freud addressed the function of payment in the dynamics of [[therapy ]] and its implications for the transference and [[counter-transference]].

In "On Transformations of [[Instinct ]] as Exemplified in [[Anal ]] Erotism" (1916-1917e), Freud discussed the metapsychological ramifications of money in the analytic [[situation ]] and the equivalence, for the [[unconscious]], of the [[concept ]] of excrement (and its derivative notions of money and gifts) with the [[concepts ]] of the [[infant ]] and the [[penis]]. Finally, in 1918, with the publication of From the [[History ]] of an [[Infantile ]] [[Neurosis ]] (1918b [1914]), the "[[Wolf Man]]" provided the opportunity for considering a variation in the framework of analysis that took the [[form ]] of money collected to support the patient. In the same year, at the International [[Psychoanalytic ]] Congress in Budapest, Freud drew attention to the [[neurotic ]] suffering of segments of the population who for economic reasons were unable to benefit from [[psychoanalysis]], and for the first [[time ]] he broached the [[idea ]] of an institute where analysis would be free.

Under the direction of Karl [[Abraham]], the Berlin Psychoanalytic Polyclinic began its activities in 1920. Ernst Simmel, in his report to the Berlin Psychoanalytic Institute in 1930, emphasized the role of the new social institution of "health insurance" in assuming financial [[responsibility ]] for treatment. From the 1980s this question became the [[subject ]] of intense debate, though one rarely discussed in the [[literature]], to judge by the scarcity of [[work ]] on it (Dupeu; Frécourt; Levy; Viderman). Meanwhile, a growing [[number ]] of analytic practices make use of [[third]]-party payment systems (such as health insurance) within a private or institutional context. Thus, there is considerable risk that such systems will strengthen the medical approach to psychoanalysis already strongly developed in many countries.

# [[Freud, Sigmund]]. (1912e). Recommendations to physicians practicing psycho-analysis. SE, 12: 109-120.