The work
The work I do is relational and focused on pattern. I don't run intake checklists. I don't assign homework. I pay attention to what happens in the session. The moments when something shifts or goes flat. The pattern that keeps showing up underneath the problem. Most people already know their own story. They still keep landing in the same place. What's missing is someone watching in real time, someone who can name what you cannot see from inside it. More on how I work, and how I work with couples.
The arrangement
I am a US-trained psychodynamic therapist working online and privately. Off-island, and outside every local system. No insurance billing. No diagnosis. No clinical record. No tie to anyone in your industry or community. You pay directly. Cayman afternoon and evening sessions are easy to schedule across time zones. We start with a free 15-minute call.
What people bring to online therapy
The people I work with in English come for a wide range of reasons: anxiety, depression, stress and burnout, anger management, grief and loss, relationship difficulties, loneliness, self-esteem issues, procrastination, sleep problems, attachment patterns, self-sabotage, perfectionism, identity questions, and existential concerns. Online counseling makes this work possible from wherever you are, whether you need an English-speaking therapist, a virtual counselor, or simply someone who can work in your language at a depth that matters.
How it works
Sessions are online via secure video call. I work with individuals and couples (60 minutes). Before your first session, we have a free 15-minute call to see if this feels like the right fit for you.
What I see from the island
It is paradise that is also a small, enclosed world. That tension is usually the material. The hedge-fund and fund-services professional. The captive-insurance and reinsurance crowd. The lawyers and accountants servicing offshore structures. The finance family that moved here. The Caribbean isolation that looks like a permanent holiday. After a while it feels like confinement. The drinking culture. The trailing spouse on a rock with no career and a shrinking world. And the high-functioning strain that has nowhere to go in a place where your therapist might be your neighbor.
The Cayman system, briefly
Public mental health care on Grand Cayman runs through the Health Services Authority. The Behavioural Health unit at the Cayman Islands Hospital covers psychiatry, an eleven-bed inpatient facility, and outpatient services, reached by referral and subject to waits. Alongside it, the government's Department of Counselling Services offers free help through the Counselling Centre and its sister facilities, and for short-term support it is a genuine resource.
Insurance is the other structural fact of Cayman life. Every worker must hold a Standard Health Insurance Contract from day one of employment, with the employer paying at least half, and mental health treatment is one of the areas those contracts commonly restrict or exclude. So even people with good coverage often discover that sustained therapy is a self-pay proposition anyway.
What no local arrangement can offer is distance. The public services, the private practices, and the insurance administrators all sit inside the same small professional community you work in. My practice sits outside it: paid directly, off-island, with no Cayman record of any kind.
Why off-island matters here
Cayman packs an enormous financial industry, hedge funds, fund services, captive insurance and reinsurance, the law and accounting firms around them, onto a small island where everyone in the sector knows everyone else. Local depth-therapy provision is a handful of private practices and government services, and none of it is anonymous in a community this size. The privacy cost of being seen is high enough that many people simply absorb the strain instead.
Working with me removes that problem entirely. I am off-island, with no link to the local industry or social web, and there is no record of any kind.
Questions people ask from the Cayman Islands
Selected research on this approach
My work is psychodynamic and depth-oriented. These are some of the studies on the effectiveness of that kind of therapy. They describe research on the method in general, and are not claims about any individual outcome.
- Shedler, J. (2010). The efficacy of psychodynamic psychotherapy. American Psychologist, 65(2), 98-109. doi:10.1037/a0018378
- Steinert, C., Munder, T., Rabung, S., Hoyer, J., & Leichsenring, F. (2017). Psychodynamic therapy: as efficacious as other empirically supported treatments? A meta-analysis testing equivalence of outcomes. American Journal of Psychiatry, 174(10), 943-953. PMID 28541091
The full reading list is on the approach page.