Monaco is two square kilometres with roughly forty thousand residents, and that single fact governs everything about seeking help there.
There is no anonymity. Not as a complaint, simply as a description. The person in the waiting room may know your family. The clinician may treat someone at your table next week. For a resident whose name is known, or whose family’s name is known, the ordinary act of walking into a consulting room carries a cost that people elsewhere never have to calculate.
This is the most common reason people in Monaco make contact. Not the absence of practitioners on the Côte d’Azur, but the absence of any that can be used without the fact travelling.
Image, and what sits underneath it
Monaco concentrates a particular pressure. Bodies are visible, scrutinised, discussed and photographed, and a great deal of social life happens where they are on display. An eating disorder in that setting can be almost entirely invisible, because the behaviour reads as discipline and the results read as success.
Many people arrive having been complimented for years on the thing that is destroying them. That is one reason these disorders go so long untreated here: the environment provides continuous positive feedback for the symptom.
In French or English
I am French, and I practise in both. For eating disorder work that is not a convenience. Shame and the vocabulary of the body are held in the language they were learned in, and it is frequently not the language somebody conducts their social life in.
Practical
Sessions by secure video, Monaco being one hour ahead of London. In person in central London if you are travelling. No local record of any kind, and nothing disclosed to any family member or third party without your written consent.
Usually once to three times a week at the beginning, reducing as things steady. How the frequency works, and why.
UKCP-registered psychotherapist and Jungian analyst with a professional doctorate on eating disorders and twenty-five years of practice. Both registers are public.
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.
Common questions
Is it truly confidential given how small Monaco is?
Yes, because nothing happens in Monaco. No premises, no records held locally, no receptionist, and no possibility of encountering someone who knows you or your family.
Can we work in French?
Yes. I am French and practise in both languages. For this material it often matters more than people expect, because shame and the vocabulary of the body tend to be held in the language they were learned in.
Can I be seen in person?
In central London, when you are travelling. The rest online by secure video.