Method
Therapy faces in two directions
Towards the history a difficulty emerged from, and towards everything it has since put out of reach.
One face — the past
Where it came from
What people describe almost always points back to a particular moment: the one where the symptom appeared, apparently from nothing. Retracing the history places it — it does not excavate for the sake of excavating.
In practice that means a clinical history and a family history: previous care, any medication, the context you grew up in and the relationships that shaped it.
The past is not a sentence, and it is not a destiny.
The other — what is ahead
Towards what
The second face looks at the possibilities a difficulty has narrowed. Part of the work is an inventory of what is still there: strengths, capacities, room that has gone unused.
Where memory or concentration feel unreliable, that can be checked properly — with validated neuropsychological instruments rather than by impression.
Towards the end we set out horizons: projects over the medium term that the difficulty had been deciding against.
In between
The path
Phase one
The first session
What is happening, since when, in which situations, what you have already tried. Clinical history and family context. I ask the questions, so you do not need a prepared account.
At the end I tell you what I have understood and what I would propose.
Phase two
The mechanism
A reading of how it formed and what keeps it running now. Something usually shifts here already — not because the symptom has gone, but because it has stopped being unreadable.
From there we work on who you want to be without that weight.
Phase three
Trying things out
Understanding is not enough. What changes a pattern is doing something different and seeing what actually follows — not what you predicted would.
Between sessions there is concrete material we bring to the next one.
The diary
Anxiety remembers itself badly. Days later the general impression survives and the details are gone — and the details are exactly what the work needs. It is not homework to hand in; it is material.
"16:00. A colleague asks whether I can take on a file. I am already behind on my own deadlines. But I am afraid that if I refuse he will take it badly, so I accept. Then the anxiety, because I already know I will be late home again."
Small experiments
Agreed steps, deliberately small. What actually happens when you decline something you did not want — and then we write down what happened, rather than what you feared would.
The rhythm. The first two or three sessions are close together, because the picture is still being built and long gaps disperse the detail. Then the interval widens, and when to widen it is decided together rather than announced in advance.
The relationship
Not affection, and not judgement. A particular distance — close enough to be useful, far enough to see.
A clinical relationship is not the one you have with a friend or a relative. That conversation has real value and its own rules; this one has a method behind it, and a distance that is deliberately maintained.
Research on outcomes is fairly consistent on the point: what predicts change is less the school a therapist belongs to than the working alliance the two people manage to build. Which is another way of saying that the relationship is not the setting for the work. It is part of the work.
And it is why doing this alone is harder than it looks. Examining your own errors from the inside is structurally difficult — Galen was already recommending that we let someone else help with the task, and the problem has not improved since. Becoming a psychotherapist in Italy takes about ten years of theoretical and practical training, with continuing education that does not end. That is what the distance is built on.
The approach
Would you buy shoes from someone who stocks a single size?
A method that forces every difficulty into the same frame speaks one language — its own — and leaves you to translate yourself into it. If you hold a hammer, everything starts to look like a nail.
I would rather begin from the person and choose the tool afterwards. I have never met two people with the same anxiety.
What I ask of you
Think of a gym. A trainer can build the programme and correct your form, but nobody can lift on your behalf — the exertion does not transfer.
The same holds here. I will not stand in for you in your own process. What I will do is make sure the work has a direction, and that you can tell whether it is moving.
If the fit is wrong
Sometimes what someone is looking for is not what I offer — a specific technique I do not practise, or a kind of support that belongs somewhere else entirely.
The first session is partly for establishing that, and when it is the case I say so and point you towards where to look. It costs one session and saves a great deal else.
How it ends
Deliberately, not by drifting. In the closing phase we set out what comes next: projects over the medium term that the difficulty had been quietly deciding against.
Then follow-up sessions, spaced out over the months that follow, to see how things are holding. Everything learned along the way stays with you — that is rather the point. The direction of the work is towards not needing it.
Online and in person
Same length, same fee, same way of working. Two studios in Milan, one in Monza, one in Cernusco sul Naviglio — or a private platform, from wherever you are. Sessions are held in English or in Italian, whichever you think in.
Alongside your doctor
I am not a physician and I do not prescribe. Where medication is already in place I work with whoever prescribed it; where it is worth assessing, I say so and point you there.
What stays in the room
Everything, including the fact that you are here at all. In Italy professional secrecy is a legal obligation rather than a courtesy.
Recognising the individuality of the person in front of me is perhaps the highest form of respect I can offer them.
Dr. Giuseppe Iannone — Psychotherapist
FIRST STEP