English-Speaking Therapist in Milan.

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 Italian license. No public-system involvement. No diagnosis on any record. You pay directly, in any currency. Milan evening sessions are easy to schedule across time zones. When what you need is prescribing, assessment, or covered care, the Italian system handles that. 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 I see from Milan

Milan runs on work, money, and appearance. No other Italian city is built that way. Each of the three exacts something. The finance world around Piazza Affari. The private banks. The fashion and design houses with their studios and their seasonal churn. The multinational headquarters. Over all of it sits la bella figura. The duty to keep up the surface. The quiet exhaustion that comes with it. The expat who arrived dreaming of the warm Italy. Milan turned out cooler, faster, and harder to enter. The perfectionism that dresses itself as elegance. The high achiever whose composure is total and whose private life has gone hollow. It photographs beautifully and costs more than it shows.

The ticket, the bonus, and the private reality

The public route in Milan runs through your medico di base into the Centro di Salute Mentale, where visits are free or carry a ticket of roughly 36 to 46 euro and waits run from weeks to months. It is psychiatry-first and session-limited. Italy's more interesting invention is the Bonus Psicologo: an INPS-administered contribution of up to 1,500 euro toward private psychotherapy, income-tested against your ISEE, paid at up to 50 euro a session. The catch is arithmetic again: demand has exceeded funding so badly that in 2023 only around three percent of applications were funded. The rest of the Italian picture is on my Italy page.

Private sessions in Italy commonly run 50 to 100 euro, and Milan sits at the top of that range. If you go local, the title distinction matters: a psicoterapeuta has completed a four-year specialization beyond the psychology degree, and psychotherapy with registered Italian providers is deductible at 19 percent as a medical expense.

My arrangement stands outside all of that: American training, private online practice, direct payment, no Italian registration and no Italian record.

The Italian system, and why people go private

Italy's public mental-health provision is underfunded, the waits are long, and the contact tends to be brief, so anything sustained generally moves to private practice. Within that, the pool of therapists doing depth work in English is small and concentrated in Milan. The mechanics are on my Italy page.

Work with me is private, outside the Italian system, with no record and no wait.

Questions people ask from Milan