James Earl Reg COSRT

MSW CQSW (Sussex) PCert PgDip (Relate) BA Hons (Mddx)

Psychosexual & Relationship Therapy

Your first session is free

to check it feels right

I can see you quickly

usually in a day or two

Book directly in my diary

no need to speak to me first

See me online, or in person

in Hampton, Richmond, SW London

For couples and individuals: a calm, confidential space to speak openly, make sense of what's happening, and explore what could change, in your relationship, your sex life, or elsewhere.

I can help with:

Loss of desire and mismatched libido

When desire quietly goes missing from a relationship you care about, or one of you wants sex far more than the other …

Affairs and

betrayal of trust

Discovering an affair or betrayal can feel like the ground has gone from under your feet, leaving you unsure what's real anymore …

Erection, orgasm and sexual difficulties

Erections that won't last, orgasms that come too soon or not at all, sex that hurts — mostly treatable, and rarely just physical ...

Compulsive sex

and porn use

Often called sex or porn addiction: when it no longer feels like a choice, and you keep going back despite wanting to stop …

About me

I am an experienced and professionally qualified psychosexual and relationship therapist. I hold a Professional Certificate in Psychosexual Therapy and a Postgraduate Diploma in Relationship Therapy from Relate, as well as a Master’s degree in Social Work from the University of Sussex.

I am a registered member of COSRT, the professional body for sex and relationship therapists.

I have been in private practice for 15 years in Hampton, in the London Borough of Richmond, SW London, near Barnes, Teddington, Twickenham, and Kingston. I see clients from London, the UK & world-wide.

Alongside my clinical work, I contribute regularly to the media, including interviews for The Guardian and Newsweek, workshops for HSBC, and writing and podcasts for Liz Earle Wellbeing. I am currently writing a book on the nature of love and desire.

Before training as a therapist, I was a professional jazz pianist and a university lecturer in philosophy — experiences that continue to shape how I work with people.

I also work at Innisfree Therapy, the world-renowned sexual compulsivity & trauma clinic in London's Harley Street.

MORE ABOUT ME

How sessions work

You book for one hour, 90 minutes, or two hours. (I also offer half-day or whole-day sessions.) I can see you in person, or online. You can see me regularly, or book ad-hoc, depending on what feels right.

Cancellations

You may always cancel with no charge: I appreciate life gets in the way sometimes.

My rates

Your first session is free. If you decide to continue, the cost is £110 per hour for couples and £80 per hour for individuals. I offer reduced prices for the unemployed or those on a low wage (please let me know). You pay after you book, or after the session if you prefer.

Booking

You can book a session without speaking to me first: my diary is online, so just choose a date and time that suits you.

Diversity

I work with people of all cultural backgrounds, sexualities, genders, and relationship structures.

Confidentiality

I observe complete confidentiality at all times as a matter of professional ethics, except where I believe there to be an immediate risk to yourself or others, or as a legal duty.

FAQs

Why my approach is different

Many therapists treat sexual and relational difficulties as problems to be identified and removed. I see them differently — as intelligent responses to something else, even when they cause real distress.

Take loss of desire in long-term relationships, for example. It isn't usually a problem with the relationship, or with either partner — it often reflects something more structural. Desire struggles to want what it already has. My work is to help couples understand this dynamic, rather than search for someone or something to blame. Once it's understood, new ways of relating to each other — and to desire — can emerge.

Affairs fit the same pattern, though the cost is different. I don't see an affair as simply a betrayal to be judged — I see it as a destructive yet ultimately dissatisfying

solution to a real problem, usually a loss of connection, curiosity, or desire that had nowhere else to go. My work is to help both partners understand what the affair was actually reaching for, rather than only relitigating what happened. Once that's understood, it becomes possible to rebuild — not by excusing the affair, but by addressing what it revealed was missing.

Erectile dysfunction is another example. I don't treat it as a problem in itself — I see it as the body's own solution to something else, often anxiety. My work is to help bring what's underneath into consciousness, so that new, alternative strategies can emerge. Once they do, the symptom often becomes redundant, and lasting change becomes possible.

The same is true of what's often labelled 'porn addiction' or compulsive sexual behaviour. Rather than treating it as an

addiction to be broken, I see it as behaviour that's usually doing something for the person — soothing anxiety through arousal, exploring a kink that doesn't seem to have a place in their relationship, or managing the frustration of low desire with a partner. My work is to help understand what the behaviour is actually solving, rather than simply trying to stop it. Once that's clear, the compulsion often loosens on its own, and more rewarding ways of meeting the same need become possible.

None of this, to me, is a behavioural problem to be corrected. It's a meaning to be understood — and that understanding is what makes the change last.

I can also help with anxiety, depression, anger, OCD, ADHD, and the many other issues that can affect you, your partner, and the relationship. Contact me to discuss anything that concerns you..

Client feedback

"I feel really comfortable with James— he always manages to put me at ease and feel comfortable to open up to him. I never feel judged and through his vast experience and identification always come away with food for thought and some clarity."

………

"I feel really heard, which is a huge relief."

"James really helped at a time where I needed his support. He helped me put things in to context, and I've had a better couple of weeks as a result. It's also helped my partner, as a secondary benefit."

………

"We feel that you're on our wavelength and I don't think there are many people of whom that would be true."

MORE FEEDBACK

Acknowledgement from Liz Earle

Liz Earle (no relation) kindly acknowledged me in her 2024 book "A Better Second Half"