Therapy after a late ADHD or autism diagnosis

Services

For adults who have found out, or begun to suspect, partway through a demanding career that their brain has been working differently all along. Many of the people I see work in finance; you don't have to.

A diagnosis in your thirties, forties or fifties answers one question and opens several more. Why did the things everyone else found easy cost me so much? What was all that effort for? Which parts of me are me, and which parts were the performance? And now that I know, what do I change, and what do I tell work?

Therapy with me is a place to work through those questions properly, with a psychologist who worked in finance for over 25 years and who is openly ADHD.

I'm a psychologist, not an ADHD coach

ADHD coaching can be genuinely useful. It is usually about strategies: planners, routines, systems for email and deadlines. If you have already had coaching, it isn't wasted, and you may well keep using what you learned.

Therapy works on a different layer. Most people who are diagnosed late do not arrive short of a planner. They arrive with decades of being told, and then telling themselves, that they were lazy, careless, too much or not enough. Those messages harden into beliefs about who you are, and no system fixes a belief. That is clinical work, and it is what I am trained to do.

I am an HCPC-registered counselling psychologist with a doctorate in counselling psychology. "Practitioner psychologist" is a protected title in the UK; ADHD coaching is not a regulated profession. That matters if there is also depression, anxiety, burnout, trauma or drinking in the picture, because I can work with those too rather than referring you on.

What the work involves It depends on you, but most of it falls into four areas.

Shame. The inner critic that still talks in the voice of old school reports and performance reviews, and treats every slip as proof.
Identity. Grief for the version of your life that might have gone differently, relief, anger, and the slow work of deciding what the diagnosis means to you.
The cost of masking. Years of performing the expected version of yourself at work often surfaces as exhaustion, burnout, or strain in relationships. We look at where that effort goes and what you can afford to put down.
Practical decisions. Whether and how to disclose at work, what reasonable adjustments to ask for, and whether the job still fits the person you now understand yourself to be.

Why schema therapy and EMDR

Schema therapy is built for long-standing patterns laid down early: the unrelenting standards, the sense of being defective, the fear of being found out. For many late-diagnosed adults those patterns are not distortions to be argued away; they are reasonable conclusions drawn from real experiences, made without the information you have now. Schema therapy works with where they came from as well as how they run today.

EMDR is for specific memories that still feel live: a humiliation in a meeting, a teacher's comment, a review that landed badly. When those memories lose their charge, the beliefs that grew out of them usually loosen too.

I also use CBT where it fits, adapted for how your mind actually works, and I'm happy to explain why I'm suggesting one approach over another. There is more on the difference in

schema therapy or CBT: which is right for me?

Alongside medication

I don't prescribe. ADHD has well-evidenced medication options that often reduce the day-to-day friction a great deal, and therapy sits comfortably alongside them; I'm happy to work with your GP or psychiatrist. Medication can change how much you get done; it doesn't change what you believe about yourself, which is where therapy comes in. Autism has no equivalent medication, but the clarity of a diagnosis is often a turning point in itself, and therapy can help you make use of it.

If you haven't been assessed yet

I offer ADHD and autism assessments for adults, either standalone or folded into therapy. For ADHD, I have a relationship with an affordable and reputable private psychiatrist who can help with medication if needed. Standalone assessment fees are £1,350 for ADHD, £1,500 for autism and £2,500 combined. You don't need a diagnosis to start therapy with me; plenty of people come while they are still working out whether one fits.

You can read about how I run assessments in

adult autism assessment in London: what to expect

Practicalities

Fee

£150 per 50-minute session.

Insurance

I'm registered with Aviva, BUPA, Bupa Global, Vitality and WPA, and some smaller insurers, so do ask. Some policies exclude neurodevelopmental conditions, so check with your insurer what yours covers before you start. I can also invoice you to claim back yourself.

Where

Online on Microsoft Teams, or in person in Bayswater and at Chancery Lane (Gray's Inn), London.

How long

It varies. Some people come for a handful of sessions to make sense of a new diagnosis. Work on long-standing patterns with schema therapy usually takes longer, often several months. We review how it's going regularly, and you can change the pace at any point.

I'm currently waitlisted, with very limited space for new clients. If this sounds like what you're looking for, join the waiting list and I'll be in touch when a place opens.