Psychologist, psychiatrist or psychoanalyst: who to see in France and England?

“I’m looking for a psy. But which kind?” Someone asked me this again recently at an event centred on meeting people and welcoming newcomers. The French shorthand “psy” can encompass a psychiatrist, psychologist, psychotherapist or psychoanalyst; alongside the counsellor familiar in Britain, these names point to different training routes, practices and professional frameworks, with further differences across the Channel (Bpifrance Création, HCPC, UKCP).

The comedian Gad Elmaleh played on two French expressions: “je vois quelqu’un”, which means “I’m seeing someone”, and “je me fais suivre”, which can mean receiving ongoing care or, literally, being followed, ending with: “I can tell you, the day I feel I’m being followed, I’ll go and see someone!” (L’Autre c’est moi, transcribed quotation). Somewhere between a romantic encounter and being tailed, language leaves plenty of room. The question remains: whom do we want to trust with what we have to say?

What does “psy” mean, and where do you begin?

“Psy” is an everyday French term that can refer to several kinds of practitioner; on its own, it tells us neither their qualifications nor their approach (Bpifrance Création). Looking for someone may begin with a simple question: who can I talk to about this anxiety, this bereavement, these difficulties in my relationships, or the sense of repeating something that hurts?

There may be hesitation, too: a fear of being judged, of not finding the words, of choosing the wrong person or committing to something without knowing where it leads. Those questions themselves can be part of an initial conversation. Asking about training, ways of working, fees, confidentiality and what happens in the first meetings can help give the process a clearer shape.

Psychiatrist, psychologist, psychotherapist: what differs between France and England?

• A psychiatrist is a specialist medical doctor. In both France and England, psychiatrists can make medical diagnoses, prescribe medication and offer or recommend other treatments, including psychotherapy (Bpifrance Création, NHS).

• A psychologist has university training in psychology and works within their area of specialisation. In France, the title is protected; the usual route includes a bachelor’s degree, a master’s degree in psychology and a professional placement (French Ministry of Higher Education). In England, “psychologist” on its own is not a protected title, whereas titles including “clinical psychologist” and “counselling psychologist” are protected and require HCPC registration (HCPC).

• A psychotherapist practises psychotherapy within one or more therapeutic approaches. In France, use of the title is regulated, with requirements for training, clinical placement and registration; in England, “psychotherapist” is not a legally protected title, and voluntary professional registers, such as the UKCP register, provide a way to check qualifications and ethical standards (ARS Île-de-France, UKCP).

• A counsellor, a familiar figure in the British context, helps people explore difficulties through talking. Counselling and psychotherapy overlap; “counsellor” is not a legally protected title in England, and membership of a register such as the BACP Register is something to check (BACP, introduction to counselling and psychotherapy, BACP Register, UKCP). This is distinct from “counselling psychologist”, a title regulated by the HCPC (HCPC).

• A psychoanalyst works with the unconscious, following a training process that brings together personal analysis, the study of texts and supervised practice (Paris Psychoanalytical Society). The title is not regulated in France; in England, professional recognition is provided, among other routes, by non-statutory professional bodies whose requirements and theoretical orientations vary (Bpifrance Création, British Psychoanalytic Council, NHS England).

These professions can overlap: a psychiatrist or psychologist may also practise psychotherapy (NHS Health Careers). One is not better than another simply by virtue of a title. What matters is finding an approach and a framework suited to the person, their circumstances and the care they may need. Through the meetings, a way of working can take shape, attentive to their sensibility and their pace.

Talking to AI when approaching a therapist feels difficult

If you began by talking to ChatGPT or another chatbot because writing felt easier than making an appointment, that hesitation deserves to be heard. “I need to talk, but I don’t know where to start” can itself be a way of introducing yourself to a practitioner.

Expressions such as “AI therapist” or “AI therapy” call for a distinction: a general-purpose chatbot, a clinically evaluated application and a consultation with a professional are different kinds of provision (Mental Health Foundation). A chatbot may help organise thoughts, but its responses can also be inaccurate or reinforce certain beliefs; the protection of what you disclose depends on the service, and it cannot replace a clinical assessment or appropriate help in a crisis (Mental Health Foundation).

What you have written to an AI can become a starting point for speaking about what you are looking for, what reassures you and what worries you. Reaching out to someone can begin with those uncertainties, without a perfectly ordered account of your life.

Becoming a psychoanalyst: experience and study that continue

In 1926, Freud wrote: “We also require anyone who wishes to practise analysis on others first to undergo an analysis themselves” (The Question of Lay Analysis, French quotation reproduced by Anne-Angélique Zémour; translated here). Personal analysis is indispensable here: having been an analysand, encountered one’s resistances, heard what escapes one’s intentions and experienced a shift in one’s certainties.

You have to have put your guts on the couch. The phrase conveys that intimate commitment, an experience that should leave a lasting humility in the presence of another person’s history. It accompanies intellectual and clinical work that is equally demanding.

Working through Freud, Lacan and Dolto takes years: reading alone, returning to texts in a group, discussing them in seminars, revisiting a passage that experience has illuminated differently. In this sense, psychoanalysis involves an endless process of study. The richness of its texts also lies in the other traditions of thought with which they engage.

Freud already included literature, mythology, the history of civilisations and the psychology of religion in his account of an analyst’s education (The Question of Lay Analysis, French edition, Gallimard, 1985, p. 133, cited by Anne Levallois). Philosophy, spiritual traditions and religions can broaden that horizon, opening up a wider range of possibilities while leaving each person room for their own words and beliefs. The task remains to hear the singular within the universal.

When Lacan defines the professor as “one who teaches about teachings”, he raises questions about transmission and the desire to teach (Anxiety, seminar of 13 March 1963; translated here from the French transcript). For the person listening, a question remains: how much room does their knowledge leave for something they had not expected to hear?

Freud, Lacan, Dolto, Klein and Winnicott: thinking in dialogue

My university training in the British tradition introduced me to other ways of thinking and working. The writings of Melanie Klein and Donald Winnicott are part of this dialogue, with their points of convergence and their differences.

Klein writes: “In their play children represent symbolically phantasies, wishes and experiences”, while Winnicott emphasises that “it is only in being creative that the individual discovers the self” (Klein, quoted in Winnicott, Playing and Reality, chapter 3, p. 41; Winnicott, chapter 4, p. 54, in this edition). In Klein’s work, play opens onto phantasy and anxiety; for Winnicott, the very possibility of playing has a central place in the therapeutic experience (Melanie Klein Trust, Winnicott’s theory of playing: a reconsideration).

These differences keep thought alive and invite further reading, in dialogue with clinical experience. They offer ways of questioning what happens in a meeting, rather than a single account that would settle it in advance.

The time of the unconscious and the moment of encounter

Something said long ago returns with a new resonance; a digression opens a path; a metaphor appears where explanation seemed exhausted. The time of the unconscious can be approached through these returns, these shifts, these moments when something becomes possible to hear.

Jankélévitch writes: “Anything can become an occasion for a restless consciousness capable of making chance fruitful” (Quelque part dans l’inachevé, conversations with Béatrice Berlowitz, Gallimard, 1978, pp. 39–40, passage reproduced in Poezibao; translated here). This thought about the opportune moment finds an echo in the analytic encounter: an openness to what emerges, whose significance belongs to a particular history.

A scansion, a punctuation of speech, a question or a silence involves the responsibility of the person who intervenes. Its appropriateness is worked out within this clinical situation, this transference, at this precise moment. Attending to the moment also includes restraint, the capacity to wait and to sustain the continuity of someone’s speech.

Vulnerability, supervision and clinical responsibility

Freud, Lacan and Dolto all had medical training: Freud was a neurologist, Lacan a psychiatrist, and Dolto a paediatrician with experience in psychiatry and child neuropsychiatry (Freud Museum, Stanford Encyclopedia of Philosophy, Dolto Archives). Their paths recall the importance of encounters with illness and suffering in clinical training (Freud Museum, Dolto Archives).

Psychologists’ experience of hospital work also deserves recognition as a setting in which to learn about vulnerability and working alongside other professionals. What it should teach is a sense of proportion: recognising what supports a person, assessing risks and knowing when to seek other expertise. Safety, the limits of competence and collaboration are among the British Psychoanalytic Council’s requirements for its registrants (BPC, standards 1, 6 and 9).

The analytic notion of the “hystericisation of discourse” concerns the subject’s questioning of their relationship to knowledge; it grants no general licence to rush an interpretation or unsettle what sustains someone (Jacques Adam, “Questions préliminaires à toute direction possible de la cure analytique”, Hétérité, no. 5, pp. 54–57). Where there is a risk of destabilisation or harm, protecting the person and ensuring the care they need remain priorities (BPC, standards 1, 3 and 6).

Supervision keeps this questioning alive. When Georges Juttner asked Dolto about the supervision of his practice, she replied, according to his account: “You are the one who will tell me… you are the one asking for help here” (Témoignage du travail avec Françoise Dolto, p. 226; translated here). Asking for help, returning to a difficulty and recognising where the practitioner is personally implicated are part of that responsibility.

At times, a practitioner may find it necessary to return for a further period of personal analysis. Freud was already considering such periodic returns in 1937, while also recognising that an analysis can reach an ending (Analysis Terminable and Interminable, extracts from the French edition, p. 87). Continuing study and the ending of an analysis each have their place.

A psychiatrist, psychologist, psychotherapist or counsellor may embark on analytic training within the requirements of their chosen institute (BPC, psychoanalytic training). Training as a psychoanalyst, in turn, gives no automatic access to the qualifications of a psychologist or psychiatrist, which require the corresponding studies and professional credentials (French Ministry of Higher Education, HCPC, NHS).

Looking for a French-speaking psychoanalyst in London: a first contact

If your search begins with “psy in London” or “French-speaking psychoanalyst in London”, these distinctions may help clarify what you hope to find in a meeting. A word starts the search; the practitioner’s training, their way of working and the first conversations help give it direction.

In my psychoanalytic practice in South Kensington, I see adults in person, in French and English (my approach to psychoanalysis). You can write a few lines to arrange an initial meeting, mentioning what brings you here today and any questions you would like to ask. What follows can be considered from there, with your history, the things that sustain you and your own time.

Need urgent help?

In England, the NHS advises calling 111 and selecting the mental health option for urgent help, and calling 999 or going to A&E if there is immediate danger or you cannot keep yourself or someone else safe (NHS, urgent mental health support). In France, 3114, the national suicide prevention helpline, is free and available 24 hours a day for people in distress and those close to them; in an immediate emergency, call 15 or 112 (3114, ARS Île-de-France).

A note on quotations

Quotations drawn from French texts have been translated for this article, rather than taken from published English translations. The Klein and Winnicott quotations retain the English wording in the edition of Playing and Reality linked above.