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 the residential clinics near Geneva
The clinics within reach of Geneva are among 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.
Elsewhere in Switzerland: addiction treatment for Zurich, Zug and Basel.
Referring a client? Addiction referrals for Switzerland, for physicians, advisers and family offices.
Dr Philippe Jacquet is a UKCP registered psychotherapist, a Jungian analyst and an HCPC registered art psychotherapist, with twenty-five years of clinical practice. His Doctorate of Professional Practice at the University of Essex examined male eating disorders from the perspective of analytical psychology. Registration can be checked on either public register.
How the work is delivered from here
All international sessions are by secure video, in English or French. Online therapy is not a reduced version of consulting room work: it is the format that lets weekly work survive living abroad, travelling, or relocating. Sessions run in United Kingdom hours, which suits most regions, and if your time zone makes none of it workable, say so when you enquire rather than assuming it rules you out.
For clinicians and treatment services
Dr Jacquet supervises clinical teams in private residential addiction treatment and in a private psychiatric hospital. For treatment centres, psychiatric units and group practices looking for external clinical supervision, including in places where no supervisor of this seniority is available locally, team supervision is also delivered by video. For individual practitioners, see clinical supervision.
Common questions
Can we work in French?
Yes. I am French and practise in both languages.
Would a Swiss clinic be better?
Sometimes, and I will say so honestly. I have no involvement with any Swiss facility, so the answer carries no commercial interest. My residential experience is English: nine years inside private residential treatment in the UK and five supervising clinical teams there.
Can I do this while continuing to work?
That is most of this practice. Sessions are arranged around a demanding diary, and nothing is disclosed to any employer or institution without your consent, save for the narrow legal and safeguarding limits every registered practitioner is bound by, which are explained at the outset.