Silva Neves Specialist Psychotherapy in Central London W1 & EC1



LGBTQ specific therapy . Gay Couple

Therapy dedicated to the LGBTQ community

Despite major step forwards in equality in recent years, people who identify as Lesbian, Gay, Bisexual and Transgender are still too often victims of homophobia or transphobia, and they are greatly misunderstood.
For this reason, I offer therapy dedicated to the LGBT community:
  • Couples Therapy: sexual and relationship problems. For more information, Click here
  • Treatment for Compulsive Sexual Behaviours. Problematic porn use. Compulsive use of hook-up apps. For more information, Click here
  • Treatment for sexual abuse and PTSD (Post-Traumatic Stress Disorder). For more information, Click here

    I also offer LGBTQ- specific therapy:
  • Coming out
  • Chemsex
  • Survivors of homophobic attacks
  • Receiving a HIV diagnosis, living with HIV and having a relationship with different HIV status
  • Excessive use of the gym and exercise. pre-occupation with gaining muscles. Muscle Dysmorphic Disorder (MDD)
  • Body image issues
  • Exploration of diverse sexuality and relationships, including non-binary sexualities: open relationships, polyamory, polysexual. The exploration of kink sexuality in a non-pathologising approach.


  • LGBTQ specific therapy . Balancing Life

    Coming Out

    Sometimes our sexuality and sexual desires can be complex, leaving us feeling confused about who we are. Accepting ourselves can be more difficult than it seems. Figuring out who we are and what to do can be a lonely process, especially when faced with pressure to conform to the ‘norms’ of society of what it ‘should’ be like to be a man or a woman, and what it ‘should’ be like to be sexual. There may be fear and anxiety thinking about the risk of humiliation or bullying by others, which can also be daunting and distressing when thinking about coming out.

    Coming out also applies when we start to think about our gender. The process of questioning our gender is often misunderstood, leaving people feeling isolated and open to humiliation and bullying by others.

    The process of coming out begins when we start to recognise our attitudes and feelings towards our own sexuality and gender. Comparing ourselves to the social and family ‘norms’ governing aspects of our lives, it may seem that our sexuality or gender is ‘abnormal’ or ‘deviant’, especially as our world is filled with heteronormative messages about what people believe to be ‘normal’ and ‘right’.

    Psychotherapy will help you challenge these social conditionings and enable you to decide for yourself what is right for you. I provide a humanistic, non-judgmental, safe space for you to explore your sexuality, sexual feelings and gender identity in depth in order for you to make sense of it all. This process will enable you to make choices for what is best for you, including steps and strategies for coming out, and the considerations to keep safe.




    LGBTQ specific therapy . Male violation

    Survivors of Homophobic Attacks

    Homosexuality has been decriminalised for 50 years now. Despite the advances of LGBTQ human rights like equal marriage, homophobia is still prevalent either in covert ways which can make people feel uncomfortable, or in overt ways: there has been 147% rise in homophobic attacks reported in the UK in 2016.

    According to Galop’s Hate Crime report 2016:
  • 4 in 5 LGBT people had experienced hate crime.
  • A quarter had experienced a violent hate crime.
  • A third experienced online hate crime.
  • A tenth experienced sexual violence as part of a hate crime.

    Surviving a homophobic attack can leave people feeling distressed and scared for a long time. For some people, it can develop into PTS symptoms (Post-Traumatic Stress) or PTSD symptoms (Post-Traumatic Stress Disorder).
    PTS and PTSD symptoms are:
  • Re-experiencing the traumatic event in a range of sensory forms. This phenomenon is called a flashback. 
  • Avoiding reminders of the trauma by avoiding or numbing emotions. In some cases, we call it dissociation. 
  • Chronic hyperarousal of the nervous system. This is called disregulated arousal. 

    It is important to note that these symptoms are normal to experience immediately after traumatic event. If some of these symptoms persist one month after the traumatic event, a diagnosis of PTS can be formulated. 

    When the symptoms of PTS are chronic, they can lead to psychological disturbances such as: 
  • Acute anxiety and panic attacks.
  • Sleep disturbances.
  • Loss of appetite.
  • Sexual dysfunctions.
  • Difficulties with concentration.
  • Difficulties with relationships.
  • Self-hatred towards sexuality, wishing to be heterosexual.

    PTSD is a specific psychological condition. It manifests with the same symptoms as PTS but it is more severe causing a high level of daily dysfunction. 

    Both PTS and PTSD can be treated with specific psychological trauma therapy. For more information on trauma therapy and EMDR Click here .


    If you have survived a homophobic attack and feeling distressed by it, do not suffer in silence. There is specialist treatment that can help you heal.



  • LGBTQ specific therapy . Love capsule

    Chemsex

    What is Chemsex?

    It is the behaviour of intentional sex under the influence of psychoactive drugs, mostly among men who have sex with men (MSM).
    The drugs used are predominantly mephedrone (GHB) or butyrolactone (GBL) and crystalised methamphetamine. These drugs are often used to facilitate sexual activities lasting several hours and, sometimes, days with multiple sexual partners.


    What are the drugs used?
    Mephedrone and crystal meth are physiological stimulants increasing the heart rate and blood pressure, triggering euphoria and sexual arousal. GHB and GBL are powerful psychological disinhibitor and also a mild anaesthetic.
    These drugs thus increase sexual pleasure with less inhibitions. They sustain arousal and chemically induce a feeling of instant rapport with sexual partners.


    Chemsex: an epidemic
    Chemsex behaviours is prevalent in London amongst the gay scene. Researchers also observe the same behaviour in other big cities around the world.
    The regulation and monitoring of sex establishments such as saunas make Chemsex behaviours more difficult to engage in. Therefore, most Chemsex behaviours happen in private sex parties, in someone’s home, behind closed doors. These sex parties are also called ‘chill out’ parties. The great escalator to Chemsex behaviours is hook-up apps, such as Grindr, where it is easy to find the nearest ‘chill out’. In a big city, one can be walking into someone’s flat for a ‘chill out’ in only a few minutes.

    It is so prevalent amongst gay men and MSM that health professionals are starting to call it the new epidemic affecting the gay scene. It is a hidden epidemic, that causes significant harm to the individuals engaging in Chemsex and the wider gay community. A majority of people engaging in Chemsex do not have sex without drugs (or sober sex) for a long period of time. The more people engage in Chemsex, the harder it is to have sober sex.


    Engaging in sex can be tricky: the anxiety of being rejected because of a belief that our body is 'not good enough', which in turns may create erectile problems. The drugs used increase sexual arousal and decrease inhibition. In an instant, the drugs give the illusion that all of these terrible pressure and anxiety disappear. As soon as one is in the chemical haze of feeling instantly connected sexually with multiple partners, it is the equivalent to finally finding the key to intimacy, connection, acceptance.

    It makes sense, therefore, that Chemsex is prevalent in the gay scene. It seems like it is the ‘cure’ to what the gay community has been suffering from: low self-worth.
    Chemsex is the illusion of the antidote to homophobia: an instant, deep connection with multiple people, in a safe bubble.

    Chemsex, internalised homophobia and shame.
    There is another side to the trauma of homophobia. It is insidious, toxic and contagious, just like a virus. When one is feeling rejected because of who they naturally are, a deep psychological phenomenon happens: shame.

    Most gay men have a sense of being different from other boys, usually as far back as they can remember, in early childhood. Of course, then, the young boy cannot put words like ‘gay’ or ‘sexuality’ or ‘homophobia’ into those uncomfortable feelings. So, instead, he has to make sense of those feelings the best he can. Often, the young boy translates those feelings into simple phrases such as: ‘There is something wrong with me’. Or ‘I am bad’. Or ‘I am wrong’. Or ‘I am not good enough’. These simple phrases feel so true at the time that they become embedded in the psyche, they become core beliefs, and the young boy grows up until adulthood retaining those core beliefs. By adulthood, those core beliefs are so deep-seated that they are even unconscious. However, being unconscious does not mean dormant. In fact, it is the opposite. Those unconscious core beliefs are dynamic, and they often pull the strings and run the show. It means that an intelligent fully grown man can make decisions based on core beliefs rather than on the reality is that in front of him.

    Those core beliefs become triggered especially in situations when we feel vulnerable. We mostly feel vulnerable when we go on a first date. When we have sex. When we try to connect to others. When we want to be liked. When we want to feel accepted. Those core beliefs are the great motor of one of the most distressing human feelings: shame.


    Chemsex is prevalent amongst the gay scene because it provides an instant psychological relief to the most painful feelings that many gay men have in common. So why is it bad?
    The survey conducted by David Stuart and Johannes Weymann reveals that:
    Chemsex episodes of between 12 to 48 hours are the norm:
  • 12% reported one partner per episode
  • 32% reported 2 or 3 partners per episode
  • 45% reported between 4 and 10 partners per episode
  • 11% reported 10 or more partner per episode

    HIV+ve patients not on medications:
  • 64% reported zero condom use for intercourse
  • 10% reported using condoms for intercourse less than 50% of the time

    HIV+ve patients on medications:
  • 25% reported zero condom use for intercourse
  • 51% reported using condoms for intercourse less than 50% of the time

    HIV –ve patients:
  • 10% reported zero condom use for intercourse
  • 40% reported using condoms for intercourse less than 50% of the time

    These statistics show that the likelihood of contracting HIV when engaging in Chemsex is very high. When one feels the illusion of being free of shame, and having an instant deep connection to multiple sexual partners, it is much harder to engage the rational brain about the reality and the consequence of sexual behaviours. In fact, thinking about reality is not desirable because it would spoil the euphoria state that feels so good at the time.

    The Chemsex Study published in March 2014 by Adam Bourne, David Reid, Ford Hickson, Sergio Torres Rueda and Peter Weatherburn looked at the relationship between Chemsex and sex, relationships and intimacy. It supports the psychological evidence that I observed in my psychotherapy consulting room: Chemsex is not only a drug problem.
  • It is a sexual problem, sometimes covering other sexual problems such as erectile dysfunctions.
  • It is a relational problem.
  • It is an intimacy problem.
  • It is a self-esteem and self-worth problem, including body image.
  • It is an internalised homophobia problem.
  • It is governed by deep-seated shame and deep-seated core beliefs about the self.

    We form habits, addictions and compulsive behaviours by frequently going down the same pattern of behaviours. In the brain, it creates what we call a neuro-pathway. The more we engage in the behaviour, the stronger the neuro-pathway gets. And the stronger the neuro-pathway gets, the weaker other, healthier neuro-pathways get.
    It means that pretty soon, it becomes impossible to feel sexual without drugs.
    Sex and drugs become fused, it hijacks the natural arousal template of the individuals. Cues become distorted: for example, the sight of the iphone can be arousing if the individual has the habit of starting the Chemsex behaviour with Grindr, because on iphone there is Grindr, and on Grindr there is Chemsex. The thought of drugs can be the arousing element, rather than the sex itself, etc.

    Other than high HIV transmission rate, and the hijacking of sexual arousal, Chemsex has many more negative consequences.
    After Chemsex behaviours, when the drugs wear off, there is a crash into reality. When it happens, the negative core beliefs come back with a vengeance, usually much more acute than before starting Chemsex. People often feel intensely ashamed, angry with themselves, disgusting, depressed, anxious, ill, etc.
    What seemed to be the ‘magic pill’ to the underlying shame actually makes it worse. And when we feel worse, we need to self-medicate more. A lot of gay men are trapped in that dark cycle of feeling bad and self-medicate, and they can’t see a way out. Indeed, when in that cycle, it is very hard to see a way out, unless you access professional and specialist help.

    Other negative consequences include:
  • More sexual problems: The Chemsex Study (2014) reports: ‘Many participants described how drugs could significantly increase sexual desire or libido, but at the same time diminish sexual performance. Erectile dysfunction under the influence of crystal meth and mephedrone was very widely reported, as was retarded ejaculation.’
  • Difficulties maintaining a job, sometimes leading to losing a job.
  • Difficulties maintaining relationships and friendships.
  • Feeling more and more alienated from the rest of society, including the gay community, unless it is within the Chemsex users.
  • Feeling depressed and living in despair.
  • And, of course, the ultimate negative consequence is death. Chemsex does a lot of harm to the body as well as psychologically. Taking an overdose and passing out is common. Many young gay men in their early 30’s with no medical problems died as a direct result of Chemsex. In fact, often, patients come to me for help when they know a friend who died of Chemsex. It is the wake up call that gives them the courage to face their problem and seek professional help.


  • What does therapy addressing Chemsex look like?
  • First, we have to address what is urgent: addressing the present behaviours to start to be safe and stopping the self-harming behaviours.
  • Addressing behaviours to seek a more balance in life: how to self-care and nurture ourselves. How to recognise when we are not feeling good about ourselves.
  • Addressing intimacy issues. Recognising intimacy. Learning to feel vulnerable and intimate without resorting to drugs.
  • Addressing relationship issues. Finding the map to navigate relationships and connections.
  • Addressing sexual issues. Re-connecting with the natural arousal template and getting to know ourselves sexually.
  • Addressing self-esteem and self-worth. Learning to heal the shame and internalised homophobia. Identifying the negative core beliefs and change them to more reality-based, positive core beliefs.
  • Re-connecting with your daily needs and making the healthy choices to meet those needs.

    The therapeutic process is challenging but it is the best gift of love to give to yourself. It is a place where you can start to make long-lasting changes and reconnect to your true self. The investment in therapy is so much less costly than drugs and its negative consequences.

    If you feel trapped in the negative cycle of Chemsex, do not hesitate to seek help. I am a specialist in sex and relationship therapy with years of experience working with gay men. Call me on 07958320565. Or send me an e-mail on: [email protected]

    If you are not sure about therapy, or if you can't afford the private fees, please do not stay without support! Access 56 Dean Street Clinic in Soho. It is a free NHS service and it is the world’s leading clinic in Chemsex support. For more information about 56 Dean Street, Click here






  • LGBTQ specific therapy . Lesbian couple old

    Homophobia & homo-negativity

    The equal rights of LGBT people have improved significantly over the last few years. However, the LGBT community has a long history of trauma.

    Today, unfortunately, homophobia still exists. And it is still violent.

    The history: the trauma of homophobia
    Gay people were jailed and homosexuality was pathologised as a mental health disorder until 1967. Harassment continued a long time after 1967, with many gay men and women fighting for equal rights, marching in the streets whilst stones were thrown at them throughout the 70’s and 80’s. The AIDS crisis in the 80s added another layer of large scale trauma in the gay community. Today, although the UK is one of the wonderful leading countries in LGBT equal rights, where gay men and women can get married, we still hear stories from too many countries where gay men still get jailed and killed. When gay people hear those stories, they can relate to it straight away.
    Homophobia is still very much alive.

    Internalised homo-negativity
    There is another side to the trauma of homophobia. It is insidious, toxic and contagious, just like a virus. When one is feeling rejected because of who they naturally are, a deep psychological phenomenon happens: shame.

    Most gay men have a sense of being different from other boys, usually as far back as they can remember, in early childhood. Of course, then, the young boy cannot put words like ‘gay’ or ‘sexuality’ or ‘homophobia’ into those uncomfortable feelings. So, instead, he has to make sense of those feelings the best he can. Often, the young boy translates those feelings into simple phrases such as: ‘There is something wrong with me’. Or ‘I am bad’. Or ‘I am wrong’. Or ‘I am not good enough’. These simple phrases feel so true at the time that they become embedded in the psyche, they become core beliefs, and the young boy grows up until adulthood retaining those core beliefs. By adulthood, those core beliefs are so deep-seated that they are even unconscious. However, being unconscious does not mean dormant. In fact, it is the opposite. Those unconscious core beliefs are dynamic, and they often pull the strings and run the show. It means that an intelligent fully grown man can make decisions based on core beliefs rather than on the reality is that in front of him.

    Those core beliefs become triggered especially in situations when we feel vulnerable. We mostly feel vulnerable when we go on a first date. When we have sex. When we try to connect to others. When we want to be liked. When we want to feel accepted. Those core beliefs are the great motor of one of the most distressing human feelings: shame.

    The LGBT population share a traumatic history, and still have to face both external and internal homophobia today, causing a range of difficulties:

  • Low self-esteem and self-worth
  • Body image problems
  • Difficulties starting or maintaining relationships
  • Sexual difficulties
  • Engaging in high risk sexual activities
  • Engaging in Chemsex
  • Sex addiction
  • Other addictions: drugs, alcohol, gambling
  • Eating disorders
  • Compulsive exercise
  • Acute anxiety
  • Depression
  • Feeling suicidal

    Processing and resolving traumas can help with:

  • Coming out
  • Acceptance of sexuality
  • Healing from homophobic attacks
  • Having satisfying relationships
  • Having a satisfying sex life
  • Finding balance in life
  • Managing a HIV diagnosis
  • Healing sexual shame

    I employ a sexuality diversity affirmative approach.



  • LGBTQ specific therapy . Gaysex

    Receiving a HIV diagnosis, living with HIV and having a relationship with different HIV status

    Receiving HIV diagnosis and living with HIV.
    Despite so much medical progress in treating HIV, the virus cannot yet be eradicated and the condition cannot yet be cured. However, receiving a HIV diagnosis is not a life sentence any longer. If diagnosed early and treated early, HIV is now a chronic condition that can be well-managed with medications to be taken for life.
    Receiving the diagnosis of HIV Positive can be shocking and it is an abrupt life changing moment. Suddenly, the future that you had imagined for yourself may crumble leaving a void before you. It can be difficult to figure out your thoughts and feelings and what it all means for you. Sexual psychotherapy can help you explore all of those thoughts and feelings in a humanistic, non-judgmental and safe space in order for you to make sense of it all and enable you to make the necessary steps forward for the lifestyle changes needed, to keep you safe and to re-construct the vision of a new future for yourself.

    Having a partner of different HIV status.
    You may have heard the rather horrid term: serodiscordant couples to describe a couple with different HIV status.
    Thanks to the medical progress in HIV research, couples with different HIV status can now enjoy a sexual life that has few barriers. If the HIV Positive partner is on medication is his condition is well managed to the point of having an undetectable viral load, the virus is unlikely to be transmitted to the HIV Negative partner. However, there is still a lot of stigma around the HIV status.
    Sexual Psychotherapy can help with:
    Disclosing your HIV status to your new partner.
    As a couple, you can explore together your sexuality, sexual desires and sexual practices so that you can make your own choices for a fulfilling sex life.
    As a couple or an individual, you can explore your anxiety, doubts, blocks, thoughts and feelings regarding HIV in a safe and non-judgmental space.
    As a couple, you can explore the relationship issues that you may have and find some ways to move forward into the relationship that you both want.



    LGBTQ specific therapy . mangym

    Excessive use of the gym and exercise. Pre-occupation with gaining muscles. Muscle Dysmorphic Disorder (MDD). Body Image.

    Excessive use of the gym and exercise. Pre-occupation with gaining muscles. Muscle Dysmorphic Disorder (MDD).
    Being pre-occupied with gaining muscles and going to the gym and exercise excessively is very common amongst gay men. Sometimes it develops into MDD (Muscle Dysmorphic Disorder).
    Muscle Dysmorphic Disorder, sometimes called bigorexia, is a psychological condition that makes people obsessively believe they are too small and not muscular enough. If left untreated, this condition can have serious damaging consequences such as social isolation, risk of suicide, high likelihood of substance misuse and steroid abuse. The quality of life of people suffering from MDD is severely impacted by the obsessional need to train, and the inability to prioritise other important needs for wellbeing.
    If you think you have an issue with this, do not wait until you suffer the damaging consequences. Psychotherapy can help with exploring all the thoughts and feelings you have about your body image and your exercise behaviours in a safe and non-judgmental space, so that you can make the choices that you want in order to lead a functional and fulfilling life that feels right for you.

    Body Image
    Gay men are bombarded with what the ideal body ‘should’ look like. Having a body that is ‘perfect’ has become the unattainable goal for many gay men in order to feel desirable and wanted.
    This unattainable goal of body perfection deepens the pain of the already embedded homophobic message of ‘I’m not good enough’ which many gay men have internalised unconsciously by the very fact that they grew up in a heteronormative world.
    Other factors can also affect how we see our body and escalate the struggle to accept ourselves as we are: disrupted childhood, violence in childhood, experiencing hate crime, bullying, being humiliated by others.
    As a result, it is common for gay men to suffer from strong body image issues: focusing on the parts of their body that they do not like and being hyper-critical of those parts. Gay men can struggle to accept themselves as they are.
    Sometimes, the body image problems lead to other psychological disturbances such as MDD (Muscle Dysmorphic Disorder), BDD (Body Dysmorphic Disorder) and eating disorders.
    If you struggle with accepting your body, are pre-occupied by how you look, and notice that you start to be concerned with the amount of exercise you do or what you eat, do not wait until your life becomes unmanageable. Seek professional help now. Psychotherapy will help with exploring your thoughts and feelings you have about your body image, your exercise behaviours and your eating behaviours in a safe and non-judgmental space, so that you can make the choices that you want in order to lead a functional and fulfilling life that feels right for you.



    LGBTQ specific therapy . Sexuality Diversity

    Diverse Sexuality and Relationships

    It can be difficult to find a meaning to our sexuality, sexual desires and how we want to form relationships.
    There are many social and family ‘norms’ that preach how sexuality, sexual desires and sexual practice ‘should’ be like and what is ‘right’ or ‘normal’. If you feel you don’t fit in this narrow ‘norm’ which is often heteronormative, it can be a lonely and distressing place to be.
    Sex and Relationship Therapy will help you challenge these social conditionings and enable you to decide for yourself what is right for you. I provide a humanistic, non-judgmental, safe space for you to explore your sexuality, sexual feelings, sexual desires, sexual practice preferences in depth in order for you to make sense of it all. This process will enable you to make choices for what is best for you. I am experienced in exploring all types of sexual desires and practice including Kink and BDSM. I am also experienced in working with all kinds of relationships including monogamy, open relationships, polyamory, etc.



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