The important thing to remember is that patients often get the treatment they want. If you're a self-absorbed neurotic, and you want to spend an hour a week for years talking about yourself, you can find someone who will take your money. [...] Most patients don't want to get better [...] they want to talk about themselves.

Perhaps unwittingly, this comment suggests wherein the value of such psychotherapy lies. There's a social taboo against talking about oneself in this fashion, and a place that is "safe" from this (and other) conversational taboos may well be worth paying for.