Frequently Asked Questions (FAQ)

Evidence-based answers on online therapy, neurodivergence, eating disorders, anxiety, and expatriate adjustment in Spain.

Therapy and psychological support

How do I know if I should start therapy?

If emotional distress, anxiety, low mood, relationship difficulties, exhaustion, emotional dysregulation, or problems related to food, attention, or self-esteem are affecting your daily life, therapy can help you. Many people start therapy not because they are 'broken,' but because they want to understand themselves better, improve their emotional well-being, and develop healthier strategies.

What happens during the first therapy session?

The first sessions usually focus on understanding current difficulties, emotional experience, personal history, and therapeutic goals. The process is collaborative and adapts to each person's pace. The assessment may include aspects related to emotional regulation, cognitive patterns, neurodevelopmental traits, stress, relationships, and daily functioning.

Is therapy confidential?

Yes. Therapy is completely confidential and is conducted following professional ethical standards and data protection regulations. Creating a safe and trusting environment is a fundamental part of psychological treatment.

How long does therapy usually last?

Duration depends on present difficulties, therapeutic goals, emotional history, and individual needs. Some people benefit from brief and structured work, while others prefer a deeper and more prolonged process.

What type of therapy do you use?

Treatment integrates evidence-based models such as Cognitive-Behavioral Therapy (CBT), Acceptance and Commitment Therapy (ACT), and Dialectical Behavior Therapy (DBT), always adapted to each patient's cognitive, emotional, and neuropsychological profile.

Do you offer online therapy?

Yes. Online therapy allows safe, flexible, and accessible treatment from anywhere. Sessions are conducted through encrypted and confidential platforms designed to protect patient privacy and facilitate a comfortable therapeutic experience.

Can therapy help even if I don't know exactly what's wrong with me?

Yes. Many people begin therapy feeling overwhelmed, disconnected, anxious, or blocked without fully understanding why. Therapy helps identify the emotional, cognitive, and neuropsychological factors that are maintaining the distress.

Autism / ASD in adults

What are the most common signs of autism in adults?

Autistic people may experience sensory sensitivity, social exhaustion, masking or social camouflage, cognitive rigidity, emotional saturation, burnout, or difficulties understanding implicit social norms. These traits are often confused with anxiety, perfectionism, or introversion.

Can autism be diagnosed in adulthood?

Yes. Many people reach adulthood without having received an adequate evaluation, especially those who have developed compensatory strategies or social masking. The evaluation explores developmental history, communication patterns, emotional regulation, sensory processing, and daily functioning.

What is masking in autism?

Masking consists of hiding or compensating for autistic traits to adapt socially. It can include forcing eye contact, rehearsing conversations, or imitating social behaviors. Maintaining this effort for years can generate exhaustion, anxiety, identity confusion, and burnout.

Can autism look like anxiety or depression?

Yes. Chronic stress related to sensory overload, masking, or social difficulties can generate anxiety, depression, emotional exhaustion, and low self-esteem. In many cases, autism goes unnoticed because only the emotional consequences are observed.

Can autistic people have emotional regulation difficulties?

Yes. Many autistic people experience intense emotions, difficulties identifying emotions, emotional blocks, saturation, or problems recovering after stress.

What therapy works best for autistic adults?

Therapy should be structured, collaborative, and adapted to the person's neuropsychological profile. Models like CBT, ACT, and DBT can be very effective when properly adjusted to neurodevelopmental needs.

Can there be a relationship between autism and eating disorders?

Yes. There is a high relationship between autism and eating problems, especially restrictive patterns. Sensory sensitivities, cognitive rigidity, and emotional regulation difficulties can influence the relationship with food.

ADHD in adults

How does ADHD manifest in adults?

ADHD in adults usually includes executive difficulties, procrastination, impulsivity, emotional dysregulation, mental saturation, attention problems, forgetfulness, and organizational difficulties.

Can ADHD affect emotional regulation?

Yes. Emotional dysregulation is very common in ADHD. Many people experience intense emotions, low frustration tolerance, emotional impulsivity, or difficulty recovering from stress.

Why do people with ADHD procrastinate even when something matters to them?

Procrastination in ADHD is usually related to executive difficulties, emotional saturation, perfectionism, or problems initiating tasks, and not simply lack of interest.

Can ADHD cause anxiety or depression?

Yes. Chronic stress, academic or work difficulties, emotional dysregulation, and repeated experiences of failure can increase the risk of anxiety, exhaustion, and depression.

Can ADHD and autism coexist?

Yes. Both conditions appear together frequently and may share difficulties related to emotional regulation, sensory sensitivity, executive functioning, or social exhaustion.

Can ADHD affect relationships?

Yes. Impulsivity, organizational difficulties, forgetfulness, or emotional intensity can affect romantic relationships, friendships, and family dynamics.

Eating Disorders and relationship with food

What are the signs of an eating disorder?

EDs can include food restriction, binging, compensatory behaviors, obsessive thoughts about food or body, guilt after eating, intense fear of weight gain, or rigid rules related to eating.

Can there be an eating disorder without being underweight?

Yes. Eating disorders can affect people of any body weight. Many people suffer from binging, restriction, or obsessive thoughts without being underweight.

Why do I constantly think about food?

Constant thoughts about food may relate to restriction, anxiety, emotional regulation, guilt, or biological responses to hunger and deprivation.

Are eating disorders related to emotional regulation?

Yes. Many eating behaviors function as attempts to regulate anxiety, shame, emotional saturation, or feelings of loss of control.

Why do I feel guilty after eating?

Guilt usually relates to rigid rules about eating, perfectionism, fear of weight gain, or emotional difficulties related to self-image.

What therapy works best for eating disorders?

Evidence-based treatments usually integrate CBT, ACT, and DBT. Therapeutic work can focus on emotional regulation, perfectionism, cognitive rigidity, self-esteem, impulsivity, and rebuilding a healthier relationship with food.

Can perfectionism contribute to eating disorders?

Yes. Perfectionism and high self-demand are frequently associated with restriction, compulsions, and difficulties tolerating uncertainty or error.

Can trauma or chronic stress affect eating?

Yes. Trauma, emotional invalidation, bullying, or prolonged stress can increase vulnerability to developing eating problems.

Do autism or ADHD increase the risk of eating disorders?

Yes. Sensory sensitivities, impulsivity, cognitive rigidity, or emotional regulation difficulties can increase vulnerability to eating disorders.

Anxiety, burnout and emotional regulation

Why do I feel emotionally disconnected or empty?

Emotional disconnection can appear in anxiety, depression, burnout, trauma, or chronic stress. In many cases, it functions as a protective response from the nervous system.

Why do I overthink everything constantly?

Rumination and over-analysis usually relate to anxiety, perfectionism, intolerance of uncertainty, or emotional hyperactivation.

Can therapy help with panic attacks?

Yes. Therapy helps understand the mechanisms involved in panic, reduce associated fear, and develop effective emotional and physiological regulation strategies.

What is emotional dysregulation?

Emotional dysregulation involves difficulties managing intense emotions, recovering from stress, or tolerating emotional distress flexibly.

Why do I feel exhausted after social interaction?

Social exhaustion may relate to anxiety, masking, sensory overload, emotional hypervigilance, or neurodevelopmental conditions like ASD or ADHD.

Can burnout affect mental health?

Yes. Burnout can contribute to anxiety, depression, irritability, cognitive fatigue, insomnia, and feelings of emotional disconnection.

Expats and international patients

Do you offer therapy in English?

Yes. Sessions are available in both English and Spanish for adults, expats, international students, and people who prefer to do therapy in English.

Can therapy help with adjusting to living in another country?

Yes. Moving abroad can generate loneliness, adaptation difficulties, cultural stress, or feelings of disconnection. Therapy can help process these changes.

Is online therapy effective for expats?

Yes. Online therapy allows maintaining therapeutic continuity and access to psychological support regardless of the country where the person is located.

Neuropsychological perspective

What does it mean to have a neuropsychological perspective in therapy?

It means understanding how processes like emotional regulation, executive functioning, sensory sensitivity, or cognitive rigidity influence mental health and daily functioning.

Why is emotional regulation so important?

Because it directly influences anxiety, impulsivity, relationships, self-esteem, eating, and the ability to handle stressful situations.

Can cognitive rigidity affect mental health?

Yes. Cognitive rigidity can contribute to perfectionism, anxiety, extreme thoughts, difficulties with change, and emotional regulation problems.

Does therapy consist only of talking?

No. Therapy also involves developing practical tools, emotional regulation, cognitive flexibility, self-knowledge, and new ways of relating to thoughts and emotions.

Fees, insurance reimbursement & invoices

Can I get reimbursed through my private health insurance (Sanitas, Cigna, DKV, Bupa, etc.)?

Yes, in many cases. If your private health insurance policy includes out-of-network reimbursement (póliza de reembolso de gastos médicos), your insurer will typically reimburse between 80% and 90% of your psychological consultation costs. As a licensed General Health Psychologist (Psicólogo General Sanitario, Collegiate Registration No. 31628 - COPC), I provide official healthcare invoices containing all required tax details, clinical concepts, and collegiate accreditation codes. You can simply upload your invoice to your insurer's customer app to request your refund.

Are psychological therapy sessions subject to VAT (IVA) in Spain?

No. Under Spanish tax law (Article 20.One.3 of the Value Added Tax Law — Ley del IVA), healthcare and psychological services delivered by licensed General Health Psychologists are legally exempt from VAT. You pay the exact stated rate (€65 per individual session or €220 for the 4-session pack) with no hidden fees or additional taxes.

How does payment work?

Individual sessions are €65 (50 minutes), and a 4-session bundle is available for €220. Sessions can be paid securely via SEPA bank transfer or Bizum prior to the appointment. An official clinical invoice is issued immediately upon receipt.

What is the cancellation and rescheduling policy?

Appointments can be rescheduled or cancelled without charge with at least 24 hours' advance notice. Cancellations made with less than 24 hours' notice may be billed in full to respect the reserved clinical time slot.

Have specific questions regarding your situation?

We can discuss your goals and therapeutic options during an introductory consultation.

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