Why I use the term 'patient' rather than 'client' in psychoanalytic psychotherapy

When I first began my training as a psychologist, I became aware of a subtle yet powerful choice in language—one that quietly shapes how we understand those who come to us for care. Across clinicians, theoretical orientations, and treatment settings, different terms are used to name the therapeutic relationship. Many therapists use the word client. I, along with many others in the analytic tradition, choose the word patient. This choice is neither

incidental nor purely stylistic. While client is often favoured because it is perceived as less pathologizing, my own values and worldview around mental health lead me elsewhere. I understand psychological struggle as universal and deeply human, rather than something that automatically signifies pathology.

In more formal psychoanalytic settings, the clinician is referred to as the analyst and the person in treatment as the analysand. These terms are not relics or affectations; they reflect an ethical and relational stance. They speak to a commitment to depth, to asymmetry, and to the seriousness of the work undertaken together. Language, in this sense, is not neutral—it carries assumptions about suffering, responsibility, care, and healing.

For me, the word patient holds a gravity that extends beyond commercial, contractual, or coaching relationships. It acknowledges the reality of psychic suffering and honours the therapeutic process as something reparative, transformative, and worthy of reverence. In choosing patient over client, I am naming therapy as a healing endeavour rather than a service transaction. In what follows, I hope to explore more fully why this distinction matters to me, and how it shapes the way I practice psychoanalytic psychotherapy.

The meaning of 'patient' and its universality

The term patient comes from the Latin patiens, meaning "one who suffers." This root meaning is crucial because it reminds us that therapy is not a transactional service or a casual consultation. Instead, it is a space where suffering is recognized, witnessed, and treated with care.

Nancy McWilliams, a respected psychoanalyst and author, emphasizes that psychotherapy involves working with people who are vulnerable and in pain. Using patient acknowledges this vulnerability and the seriousness of the therapeutic endeavor. It places the person seeking help in a position of dignity and respect, rather than reducing them to a consumer of services.

This universality of patient as "one who suffers" connects all who come to therapy, regardless of diagnosis or background. It equalizes the experience of suffering and healing, reminding us that therapy is a shared human journey.

Why 'client' feels less equalizing and more transactional to me

The word client has become popular in many therapeutic and coaching circles. It suggests a business relationship, where services are bought and sold. While this language may feel modern and professional to some, I find it less fitting for psychoanalytic psychotherapy.

Client implies a certain distance and a commercial exchange. It can unintentionally suggest that therapy is a product or a service to be consumed, rather than a sacred process of healing. This framing risks minimizing the emotional depth and complexity of the work.

In contrast, patient signals a relationship grounded in care, trust, and responsibility. It acknowledges that the therapist is not just a service provider but a partner in a healing process that requires commitment and respect.

How this choice reflects my approach to therapy

My use of patient is deeply connected to how I understand therapy. I see psychoanalytic psychotherapy as a unique relationship that goes beyond coaching or counselling. It is a space where unconscious processes are explored, where suffering is met with empathy, and where transformation happens over time.

Using patient reminds me to approach each person with humility and reverence. It keeps me aware that I am working with someone who is vulnerable and seeking relief from suffering. This awareness shapes how I listen, respond, and hold the therapeutic space.

I also want to be clear that this is a personal and professional choice. Not every clinician will feel the same way, and that is okay. The important thing is to be intentional about the language we use and what it communicates about our work.

The sacred nature of the therapeutic relationship

Therapy is not just a meeting or a transaction. It is a sacred encounter where trust is built, wounds are revealed, and healing begins. Using patient honours this sacredness.

This term reminds both therapist and patient that the work is serious and meaningful. It is not about quick fixes or coaching tips. It is about engaging with the whole person, including their pain, history, and unconscious mind.

This sacred view also means that therapy is not a customer service interaction. It is a commitment to hold space for suffering and to walk alongside someone as they work through their challenges.

Examples of how language shapes therapy

In my practice, I have seen how the language we use affects the therapeutic relationship. When I refer to someone as a patient, it sets a tone of respect and care from the start. It signals that this is a place where their suffering is taken seriously.

For example, when discussing treatment plans or progress, the word patient keeps the focus on healing rather than on service delivery. It reminds me to stay grounded in the therapeutic alliance rather than slipping into a transactional mindset.

Some therapists prefer client because it feels more neutral or less medical. That can work well in other approaches, especially coaching or counseling models focused on goals and skills. But for psychoanalytic psychotherapy, where the unconscious and emotional depth are central, patient feels more fitting.

Why this matters for potential patients and therapists

If you are considering therapy, you might notice how therapists describe their work and the people they work with. The choice between patient and client can give you clues about their approach.

A therapist who uses patient may be signaling a commitment to deep, long-term work that honours your suffering and the complexity of your experience. This can help you feel seen and respected as a whole person.

For therapists, being intentional about language helps clarify your professional identity and the kind of relationship you want to build. It encourages reflection on how you view the people who come to you for help.

Final thoughts on language and therapy

Choosing to use patient rather than client is more than semantics. It reflects a worldview about suffering, healing, and the therapeutic relationship. It honours the sacred nature of psychoanalytic psychotherapy and the deep work involved.

This choice is personal and professional. It may not be right for every clinician, but it is right for me because it aligns with my values and approach.

If you are seeking therapy or are a therapist yourself, consider how language shapes your experience. Words matter. They frame how we see ourselves and each other in the healing journey.

Therapy is a place where suffering is met with care, not a service to be bought. Using patient keeps that truth alive for me.