How I can help

Depression is not low mood and not weakness of character. It is a condition in which mood stays persistently low, interest in what used to bring joy fades, sleep and appetite change, and thinking becomes heavy. For mild and moderate depression, psychotherapy is comparable to medication in effectiveness, and the result lasts longer.

How I work: we start by understanding when the state began and what preceded it. Then comes work with the thoughts that sustain the decline, and a gradual return of the activities a person has given up. Where useful, I add hypnotherapy.

How long it takes: first shifts usually by the fifth or sixth session, a stable result in two to four months.

When a psychotherapist is not enough: severe depression with thoughts of death needs a psychiatrist. I will say so plainly and help you find one.

A panic attack is a sudden surge of intense fear with bodily symptoms: pounding heart, shortness of breath, trembling, a sense of losing control. It usually lasts five to twenty minutes. Psychotherapy is a first-line treatment for panic disorder, with proven effectiveness.

How I work: we take apart the mechanism of the attack — why the body reacts this way and why fear feeds itself. You learn not to fight the symptom but to change your response to it. Separately we work with avoidance: the places and situations you have started to keep away from.

How long it takes: attacks usually become rarer and weaker by the eighth to tenth session.

When a psychotherapist is not enough: if attacks come with chest pain or rhythm disturbance, rule out a cardiac cause first.

After severe events the mind can stay stuck in a moment that has already passed: images return, sleep breaks down, the body reacts to sounds and smells as if danger were near. This is not weakness and not imagination — it is how memory of trauma works.

How I work: first we restore a sense of ground and safety, and only then approach the event itself. Rushing here is harmful: going in too early makes things worse. I work at a pace the particular person can hold.

How long it takes: from several months, depending on how long ago it happened and how severe it was.

When a psychotherapist is not enough: severe PTSD that disrupts daily functioning may need joint care with a psychiatrist.

Insomnia rarely stands alone: more often it follows anxiety, depression or a habit that has set in. Cognitive behavioural therapy for insomnia is the first-choice treatment, recommended ahead of sleeping pills, because it addresses the cause rather than the symptom.

How I work: we look at your routine and at what happens in your head before sleep. We restore the link between bed and sleep and remove the behaviour that keeps insomnia going: daytime naps, long stretches lying awake, checking the clock.

How long it takes: usually four to eight sessions.

When a psychotherapist is not enough: snoring with pauses in breathing needs a sleep specialist — the cause there is not psychological.

Grief is not an illness and does not need treating. But sometimes it gets stuck: a year passes and more, life does not come back, guilt will not let go, thoughts of the person crowd out everything else. Then help is appropriate.

How I work: I do not hurry you and do not suggest letting go. I make room for what you feel and help find a form in which memory stays and life continues.

How long it takes: individual, more often several months.

When a psychotherapist is not enough: if grief has turned into severe depression with thoughts of death, a psychiatric assessment is needed.

Overeating under stress, refusing food altogether, a relationship with your body that gives no peace. Behind this there is almost always not food but a way of coping with feelings.

How I work: we look at what comes before the episodes and what task they solve. Then we look for other ways to hold tension — ones that do not damage the body.

How long it takes: from several months.

When a psychotherapist is not enough: with marked exhaustion, disrupted cycles or heart problems, care starts with a physician and an endocrinologist, and psychotherapy runs alongside.

Thoughts that come back against your will and frighten you by their very content. People are often ashamed to speak about them and conclude that something is wrong with them.

How I work: I explain the nature of such thoughts — they are not intentions. Then we learn not to argue with them and not to check yourself, because checking is what keeps them going.

A constant sense that you are not doing enough, and sharp swings of mood, wear you down no less than an obvious crisis.

How I work: we look at where the demands on yourself came from and whose they really are. Separately we work with your reaction to mistakes — that is usually what triggers the drop.

Tiredness that does not lift after rest, and work as the only way to feel needed. This is often burnout, not laziness or weakness.

How I work: we look at where your resources go and what stops you from pausing. We restore the boundary between work and the rest of life — without it recovery does not hold.

Difficulty getting close, fear of rejection, a sense that you will be chosen only on condition.

How I work: we look at repeating patterns — where exactly relationships stall and what you do at that moment. Then we try other ways of acting in the same situations.

Crisis in a couple, infidelity, divorce, the rebuilding of a relationship after a child arrives. These are the periods when the usual arrangements stop working.

How I work: I see both individuals and couples. The task is not to judge who is right but to find a way of talking to each other about what has not worked so far.

The main specialist for stuttering is a speech therapist. The psychotherapist works alongside: with anxiety before speaking, fear of answering in class, and the parents' reaction.

How I work: I ease the tension around speech for the child and help the family stop correcting and hurrying — that is often what makes stuttering worse.

The gut and the brain are directly connected: stress changes motility and sensitivity. That is why with irritable bowel syndrome tests often find nothing while the symptoms remain.

How I work: I use gut-directed hypnotherapy — a method with an evidence base, included in clinical guidance as an option when first-line treatment has not worked. We work both with the symptom itself and with the anxiety around it: fear of an episode on the road or among people often gets in the way more than the episode does.

How long it takes: a course of six to twelve sessions.

When a psychotherapist is not enough: the diagnosis is made by a gastroenterologist. Inflammatory bowel disease and other organic causes must be ruled out before psychotherapy.

When pain lasts for months, a second layer appears: tension, fear of movement, poor sleep, irritability. That layer amplifies the pain itself — and a loop forms.

How I work: cognitive behavioural therapy and acceptance-based therapy for chronic pain both have an evidence base. The aim is not to convince you the pain is not there, but to give you back a life alongside it: movement, sleep, work, relationships.

How long it takes: eight to sixteen sessions.

When a psychotherapist is not enough: the cause of pain is established by the relevant specialist. Psychotherapy runs with treatment, not instead of it.

If the difficulty appears in some situations and not in others, the cause is more often psychological: anticipatory anxiety, tension in the relationship, fear of failure that confirms itself.

How I work: we take off the self-monitoring mode you fall into and look at the relationship and the expectations around it. Where useful, I invite your partner to a session — together it resolves faster.

How long it takes: usually six to twelve sessions.

When a psychotherapist is not enough: see a urologist first — vascular and hormonal causes need to be ruled out.

Stress does not cause ulcers, but it affects their course: flare-ups happen more often in periods of strain.

How I work: alongside treatment by a gastroenterologist, we work with what keeps you permanently mobilised. The ulcer is treated by the gastroenterologist; psychotherapy reduces the factor that stands in the way of remission.

A pressing pain that lasts for hours is often linked to muscle tension and anxiety.

How I work: we learn to notice tension before it turns into pain, and to release it. Before that you need a neurologist to rule out other causes.

Depression after a stroke is neither rare nor a sign of weakness: it affects roughly a third of those who have had one and directly influences recovery. What is hard is not only the consequences but the fact that life has changed.

How I work: I help you accept the new situation and find footing in what remains and what is coming back. Separately I work with the fear of another stroke — it often constrains more than the limitations themselves.

How long it takes: from several months, alongside rehabilitation.

When a psychotherapist is not enough: recovery is handled by a neurologist and a rehabilitation specialist. I work with the state, not with the consequences of the stroke.

Fertility treatment means months of waiting, hope and disappointment, often with guilt and strain within the couple. Psychological support along that path is an established practice.

How I work: I help you hold the cycle of waiting and setbacks, ease the tension between partners and untangle the guilt. I often work with the couple rather than one person.

How long it takes: usually throughout the treatment period.

When a psychotherapist is not enough: the cause of infertility is established and treated by a fertility specialist. Psychotherapy here is support, not treatment.

The main treatment for enuresis is a urologist and behavioural methods. A psychotherapist is needed where shame and punishment have appeared around the subject.

How I work: I take the blame off the child and help the parents change their response. Without that, treatment often stalls.

Psychotherapy in addiction is part of treatment, not a replacement for an addiction specialist. It works where the question arises of what to do with a life the substance has left: how to fill the time, how to hold tension, what to do with guilt towards the people close to you.

How I work: we look at what task the addiction was solving and what can replace it. I work both with the person and with the family — codependent relationships hold someone in the loop no less than craving does.

How long it takes: a long process, counted in months.

When a psychotherapist is not enough: withdrawal management, medication and treatment of related conditions belong to an addiction specialist. That is where to start.

Games and betting take hold through the same mechanism as substances: relief first, then the need to raise the dose.

How I work: we look at what gambling rescues you from, and what to do about debts and secrecy. I often involve the family — without them relapses repeat.

Compulsive behaviour that goes out of control and damages relationships and work.

How I work: this is almost never about desire but about a way of quieting anxiety and emptiness. That is what we work with — alongside rebuilding trust in the couple.