Addiction Counselling for Geneva

People rarely contact me from Geneva because something has collapsed. They contact me because their quality of life has quietly become poor, in a life that from outside appears to be going extremely well.

The institutions, the banks and the missions concentrate a particular population: senior, capable, well paid, and often a long way from wherever they are from. The work is demanding and meaningful, the surroundings are orderly, and there is very little visible reason to be struggling. Which makes it considerably harder to say that you are.

There is also a practical reason people write to me rather than to somebody nearer. I am French, and I trained and practise in Britain. That combination is uncommon: French as a first language, with British clinical registration, doctoral training and twenty-five years in London. For someone who wants to do this work in French, but wants a clinician outside the French and Swiss professional worlds entirely, there are not many places to go.

The confidentiality problem is structural

Geneva is a small city whose international population all knows one another, and whose clinical community is smaller still. Seeking help locally can mean being treated by somebody who supervises a colleague, sits on a board with your director, or will be at the same dinner in a fortnight.

For a senior person in an institution where reputation is currency, that risk is usually judged not worth taking, and the drinking continues.

Working with a clinician in London removes the calculation entirely. Different country, different professional world, no possibility of overlap.

On Swiss clinics

Switzerland has some of the best residential facilities anywhere and I am not going to disparage them.

I should be clear that I have no involvement with any Swiss clinic and cannot comment on individual ones. My residential experience is English: nine years working inside private residential treatment in the UK, and five years supervising clinical teams there.

What that lets me offer is a general judgement rather than a local recommendation. Residential care is right where there is physical dependency needing supervised detox, where risk is high, or where somebody genuinely needs to step away. It is wrong where a person cannot disappear for six weeks, where the exposure is unacceptable, or where the real task is learning to live differently inside their own life. It is easy to stay sober in a clinic where there is nothing to drink. The test is the client dinner in March.

In French or English

I am French and practise in both. For this work the choice matters: shame tends to be held in the language it was learned in, and it is often not the language somebody conducts their professional life in.

Practical

Geneva is one hour ahead of London. Once, twice or three times a week as needed, reducing as things steady. Hazelden-trained, UKCP-registered, twenty-five years of practice, both registers public.

More on the choice between residential care and intensive one-to-one work.

On the choice between residential treatment and intensive one-to-one work: addiction counselling and therapy in London.

Treatment built rather than allocated

Standard treatment assumes a standard life: a fixed hour each week, a local service, a group whose circumstances resemble your own. For someone in three countries a month, whose name is known, and for whom a six-week absence would be noticed, none of those assumptions holds.

There is also a subtler problem. When most people around you are employed by you, advised by you or dependent on the relationship, there may be very few whose opinion is genuinely disinterested. The ordinary correctives that slow a problem down are not reliably available, so it accelerates unobserved.

That is why the work has to be built around the life rather than the other way round, and why the clinician needs to be independent enough to say the unwelcome thing. More on how that is arranged.

Containment, and challenge

If you have spent decades being the most capable person in most rooms, the people around you have adjusted. Staff do not push back, boards do it within a managed frame, and family have usually concluded it is not worth the cost. The result is not arrogance but isolation of a particular kind: your own judgement becomes the only judgement operating on you, and judgement never met by another judgement drifts.

What helps is not sympathy or admiration. It is a clinician who can contain what you are carrying without buckling, and who has nothing whatsoever to lose by disagreeing with you. More on what that means in practice.