The world’s therapy capital isn’t Los Angeles, where celebrities like Kieran Culkin and Merritt Wever shout out their therapists during awards shows, or New York. Instead that honor belongs to Buenos Aires, where Argentina’s 222 psychologists per 100,000 people (compared to just 30 per 100,000 in the United States, according to the World Health Organization) have created a culture in which therapy isn’t just normalized — it’s practically required.
Beneath its ubiquity lies a tension that troubles even the most analyzed city on Earth: the intersection of money and therapy. Psychotherapists in Buenos Aires do not simply have a fixed rate for their time and services. Instead, therapist and patient often negotiate rates case-by-case and then theoretically revisit their negotiations in the midst of treatment, often using the price-setting conversation itself as a therapeutic tool.
If that sounds unusual to you, you might be American. For UT Austin economic sociologist Daniel Fridman, who grew up in Argentina and bases a large body of his work there, this is commonplace. Now the negotiation between psychotherapists and patients in Argentina has become the latest site for Fridman’s sociological investigations into everyday economic transactions.
“We treat money as if it were completely fungible, without meaning, or that people only use it rationally. But when you look at real economic exchanges, you see money in the context of relationships,” says Fridman. “It’s rooted in relations and rooted in meaning.”
To illustrate the way money and relationships blend, Fridman points to the way we might fight over a restaurant bill, struggle to decide how to pay for a wedding or funeral, or look down on “dirty” money. Money, he says, shapes how we define value in our lives.
In the price-setting dynamics of Argentine psychotherapists, Fridman has found a productive place to examine a certain set of economic behaviors and the cultural setting that surrounds them. “This behavior and its context are so intertwined,” he explains. “How people interact, consciously make things work for and against their economic needs, their economic interest — all this mixes within the context of a relationship.” It is a relationship, he says, affected both by the economic transaction of a cost for a service and the therapeutic bond.
It’s worth noting that the overwhelming share of therapy in Argentina is psychoanalytic psychotherapy, as conceived by Freud and Lacan. Unlike other therapies more familiar to American audiences, such as cognitive behavioral therapy (CBT) or behavioral therapy, psychoanalysis is rooted in understanding the unconscious. In Argentina, therapy is the sacred and often mysterious work of mining the psyche, and payment is seen as another point of interpretation and uncertainty.
In practice, this takes many forms. The first, as Fridman describes it, exists in the negotiation between psychotherapist and patient in the absence of fixed prices. This might look like the initial session with a new patient wrapping up with the question, “Are you comfortable with this rate today?” If the patient is not comfortable, the therapist and patient discuss the patient’s financial situation, the therapeutic work, and where they might meet. Fridman describes this as an “inverted bazaar,” a version of anthropologist Clifford Geertz’s work on the organization of Indonesian bazaars where buyer and seller explore pricing through conversation.
“But unlike the bazaar, they can’t just try to walk away with an amazing deal (or maybe having paid a lot more than they should have if they lost the negotiation),” Fridman says. “They are trying to build a solid therapeutic bond that cannot be framed as a competitive, self-interested, commercial transaction,” even while it is, in fact, a commercial transaction. But the logic of the transaction, according to Fridman, is closer to gift-giving, where both parties try to give instead of take, than to the haggling you’d get at the bazaar. While patients want to pay enough to maintain balance and avoid feeling indebted, analysts can also charge little or nothing as long as they maintain the relational work needed to preserve the therapeutic bond.
Beyond the negotiated fees lies an equally intricate dance around time itself — how long each session runs, how long the overall treatment lasts, and what to do about no-shows. In every case, therapists find themselves having to balance their therapeutic ideals with the realities of making a living. They also hope to respect “the time of the unconscious,” the idea that breakthrough moments can’t be scheduled and healing doesn’t follow a clock. So, they can (theoretically) abruptly end a session after 20 minutes if they sense that the patient would benefit from stopping then, and they could also expect that very same patient to remain in treatment for years without any clear endpoint. When patients miss appointments, deciding whether to charge them anyway becomes a therapeutic tool rather than just a business policy.
What makes these practices even more complex is that Argentine psychoanalysts operate within a professional culture that explicitly positions itself as anti-capitalist. They see themselves and their flexible approach to time as resistance to market logic, viewing shorter, goal-oriented therapies as symptoms of American-style commodification. Fridman documents how deeply this thinking runs through analysts’ own language when writing about one analyst who dismissively labeled cognitive behavioral approaches as resultadistas, a soccer term used to describe coaches who care only about winning rather than beautiful play. Just as a results-obsessed coach misses the art of the game, these analysts argue, outcome-focused therapists miss the deeper ambiguity of real therapeutic work.
It’s a complicated balance of interests, beliefs, and philosophy, says Fridman. Therapists need to sustain themselves financially while preserving the therapeutic relationships that define their practice and resisting some of the structures of the free market.
For patients, this economic dimension remains in the background as they focus on the work of personal growth. Their drive for self-improvement isn’t unique to therapy, however. Fridman has observed similar patterns in his earlier exploration of financial self-help culture in his 2016 book Freedom from Work: Embracing Financial Self-Help in the United States and Argentina (Stanford University Press), in which he studied people who relied on American businessman and best-selling author of Rich Dad Poor Dad Robert Kiyosaki’s teachings as they worked toward financial independence.
What distinguishes Kiyosaki’s approach from standard financial advice, Fridman found, is its scope. Followers aren’t just learning investment strategies or financial terminology. The program presents financial success as fundamentally tied to personal transformation, suggesting that achieving economic goals requires rethinking one’s entire relationship to money, work, and self-worth. It is financial education that doubles as identity work, embedding what Fridman sees as neoliberal economic principles within a framework of personal development.
In other words, whether in therapy or financial self-help, people are seeking both validation of their worth and guidance in reshaping it by turning to experts who can identify areas for growth and provide roadmaps for change.
The patterns become clearer when viewed against economic conditions. Fridman’s current research shows how payment flexibility in Argentine psychoanalysis evolved alongside broader economic pressures, while his financial self-help work reveals similar dynamics in the face of employment uncertainty, shrinking retirement security, and eroding social protections.. “I think it’s a combination of practices that were present since the beginning,” he says about Argentina’s therapeutic payment arrangements, “but also extended as therapy became more popular in Argentina and as financial crises and inflation pushed them to extend this flexibility even more.”
Economic uncertainty, Fridman’s work suggests, creates conditions where industries focused on personal transformation tend to flourish. These sectors are adaptive responses to changing circumstances that leave people seeking to improve their situations. What emerges is economies embedded with meaning, where financial transactions carry symbolic weight and social relationships shape market behaviors in ways that purely rational economic models can’t capture.
But perhaps the most compelling question Fridman’s research raises isn’t about Argentina at all but about what we might be missing in our own approach to care and money. The Argentine approach may seem financially chaotic or therapeutically indulgent to American sensibilities, but it also suggests possibilities for organizing care around human connection. As Fridman’s work demonstrates, the way we handle money reveals the way we understand value itself. The question becomes: what values are embedded in our own system, and what might we gain — or lose — by examining them through the lens of Buenos Aires’ therapeutic culture?