English-Speaking Therapist in Madrid.

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. No Spanish license. No public-system involvement. No diagnosis on any record. You pay directly, in any currency. Madrid evening sessions are easy to schedule across time zones. If what you need is meds, testing, or covered care, the Spanish system handles that, and I will say so directly.

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 Madrid brings to therapy

Madrid is the business, money, and embassy capital. It is the serious Spanish work city, not the tourist or nomad one. Global head offices, the banks, the consulting firms, the embassies. Here is the thing internationals run into. The famously warm, late-night culture is hard to enter from outside without native Spanish. The rhythm that looks freeing in the guidebook can feel draining when you are doing it alone. What I see most is high-functioning depression behind a full social life. You are out. You are included. You are fine on paper. And none of it reaches you. Warmth all around, and a person standing slightly outside it.

From the médico de cabecera to an actual appointment

The public route in Madrid starts with your médico de cabecera, who refers into the community mental health centers. What happens next is mostly waiting: recent studies of Spanish public mental health units put the median gap between referral and a first psychology appointment at around fifty days, and half of everyone waits longer than the median. The Spanish anxiety and stress society put the national average at about six months in May 2026. The two figures measure different things, a median in the units studied and a national average, and both are real. Psychiatry, being medication-centered, moves faster than psychotherapy, and when talk therapy does arrive it comes in limited blocks of sessions rather than open-ended work. Couples therapy is not a routine public service at all. The wider Spanish picture is on my Spain page.

None of this is a scandal; it is arithmetic. Spain staffs its public system with a small number of clinical psychologists relative to demand, so the system triages, treats what is acute, and moves on. Sustained depth work was never what it promised.

For internationals in Madrid the practical choice is usually private from the start, and the choice within that is whether your therapist sits inside the Spanish system or outside it. I am outside: no Spanish record, no referral, no session cap except the ones we choose. What is covered, what you pay, and how long you wait: my Spain guide to insurance, cost and waiting lists.

The Spanish system, and the English pool

Spain's public mental-health care has waits and limited sessions, so sustained work generally moves to private practice. In Madrid the English-speaking depth-therapy pool is real but smaller than the international population, and notably smaller than the heavily anglophone scene in Barcelona, which also means less competition for an appointment that fits. The wider picture is on my Spain page.

Work with me is private and online, with no Spanish record and no wait.

Late nights in Madrid

It is easy to fall into Madrid's late nights. Your weekday alarm does not move with them. Sleep researchers call the gap between your weekday and weekend sleep times social jet lag. A 2025 review of the studies on it found a link with depressive symptoms, but a very weak one. Across 18 studies, social jet lag explained less than one percent of the differences in people's symptoms. So late nights can wear you out without being the whole reason you feel flat. Being tired also makes the flatness easy to explain away. A flatness that outlasts a rested week needs more than sleep.

Questions people ask from Madrid