When life feels tough
You may be here because something in your life feels unclear or difficult. You might be facing a specific challenge, or a period of change or loss. Or you may just feel stuck, with the same old behaviours repeating themselves.
I am Avis Underwood, a psychodynamic psychotherapist in London. I offer a confidential and thoughtful space where we can work together to make sense of what you are going through.
Sometimes we know something isn't working, but we don’t know why.
If this feels familiar, you are welcome to get in touch to arrange an initial consultation.
Why therapy?
People seek therapy at many points in their lives. Sometimes there is a particular challenge that prompts them to seek help. At other times it’s just a sense that something needs to change.
You may recognise one or more of the following feelings:
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anxiety or persistent overthinking
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low mood or a sense of emptiness
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relationship difficulties
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repeating the same patterns in relationships
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self-criticism or low self-esteem
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feeling stuck or dissatisfied
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loss, change, or uncertainty
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burnout, work-related stress, or questions about direction
Making sense of a diagnosis
Sometimes people come to therapy following a diagnosis, such as ADHD or autism, particularly later in life. A diagnosis can bring relief, clarity, confusion, or grief, or a combination of these things. Therapy can be a place to think about what this means to you. It can help you understand how it fits with your experience of yourself, and whether it changes the way you think about your past, your relationships, or your future.
Learning from repeated behaviours
People often come to therapy because they notice they are repeating the same old behaviours, despite wanting things to be different. You may recognise patterns in your relationships, and find yourself reacting in ways that feel automatic. Or you may be frustrated that the same problems continue to arise, despite your efforts to change. These patterns are rarely deliberate. They often develop over time as ways of coping with relationships, managing difficult feelings, or navigating the world. While they may have made sense in the past, they can often leave us feeling stuck and unable to move on in life. Therapy offers an opportunity to pause and look at these patterns more closely, rather than simply living with their consequences. Many people find this helps them to break out of familiar cycles, enabling them to tolerate difficult feelings, and to be clearer about what they need from themselves and others.
A psychodynamic approach
I work psychodynamically. This means I pay attention to the connections between past and present experiences, relationships, and emotions. The relationship that develops in therapy is important. Over time, aspects of how we relate to others can begin to emerge within the therapy itself. Paying attention to these experiences can lead to a deeper understanding of difficulties that are often hard to see on our own. There is no set agenda for what emerges in therapy. Through regular conversations, we gradually build a deeper understanding of your experiences and the patterns that shape them. The aim is not to become someone different, but to understand yourself more fully and feel less constrained by behaviours that no longer serve you.
Starting therapy
Starting therapy can feel daunting. Asking for help is not always easy, particularly if you have been coping by yourself for some time. You might not be sure what to say. Perhaps you should have a clearer understanding of what is troubling you before getting in touch.
You don't need to arrive with all the answers. We can start from wherever you find yourself.
I offer two ways to begin: a brief initial conversation or a full consultation. Both are confidential, and there is no expectation to continue any further if you don’t want to.
First steps
The first session is an opportunity to talk about what has brought you to therapy.
You are welcome to arrange a free 15-minute video or telephone call, or you may prefer to book a full initial consultation of 50 minutes.
The brief call offers a chance to ask initial questions and get a sense of whether it feels right to meet again. The full consultation allows us to explore in more detail what has been happening and what you may be looking for from therapy.
Ongoing therapy
If we decide to continue, we will meet once a week at the same time each week. In some situations, it may be more beneficial to meet twice weekly, if this is practical and feels helpful for the work.
Sessions last 50 minutes, either in person near London Bridge or online.
The regularity of sessions provides a consistent space for therapy to develop over time.
Practical information
I charge for missed sessions, although where possible, I will offer an alternative appointment if one is available, or an online session.
My fee is £85-120 per session.
Contact me
Reaching out for therapy can feel like a big step, especially if you’re not sure exactly what to say. You’re welcome to contact me in whatever way feels easiest.
You don’t need to have everything worked out—just a sense that something isn’t quite right, or that you’d like to understand yourself more.
1B - Building 7
Maidstone Buildings Mews
72-76 Borough High Street
London SE1 1GD
My practice is located just off Borough High Street, near London Bridge. It offers discreet access whether you are a professional working in the area, or a resident of nearby areas.