Eating Disorder Treatment 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.

And Switzerland has clinics

Switzerland has some of the finest residential eating disorder 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 experience of residential treatment is English: nine years working inside private residential care in the UK, and five years supervising clinical teams there.

What that experience does let me say is something general rather than local. Residential care is right for some people and wrong for others, and the distinction is usually predictable.

It is right where there is medical risk, where weight or physical health requires supervision, or where somebody genuinely needs to step out of their life for a period. It is wrong where the person cannot afford to disappear for six weeks, where the exposure is unacceptable, or where the real work is learning to eat inside their own life rather than inside a facility. Recovery has to hold in the world it will be lived in, and a clinic suspends that world by design.

If you are weighing a Swiss clinic against outpatient work, I am happy to tell you honestly which I think fits, including when the answer is the clinic.

In French or English

I am French, and I work in both languages. For eating disorder work this is not a convenience. Shame is held in the language it was learned in, and so is the vocabulary of the body. Most people find one language easier for the difficult material and it is not always the one they conduct their professional life in.

The clinical position

UKCP-registered psychotherapist and Jungian analyst, HCPC-registered art psychotherapist, professional doctorate from the University of Essex on male eating disorders, twenty-five years of practice. Both registers are public and can be checked independently.

Geneva is one hour ahead of London, which makes scheduling straightforward. Frequency is usually once to three times a week, higher at the beginning. What that involves, and why, is here.

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.