Gallianno Cosme

I trained in psychology in South Africa and completed postgraduate clinical work in Portugal, after an earlier career in SEO and digital strategy. I moved into psychotherapy full time in 2015 and have worked with gay men exclusively since. I'm based between London and Lisbon, BACP registered (00993851), HPCSA registered (PRC 0034622), and hold BPS (509049) and NCPS (597) memberships. I also write Unfiltered Clarity, a weekly Substack on the psychological patterns gay men live but rarely name aloud.

I work integratively across psychodynamic, attachment-based, and relational frameworks, read through minority stress theory. In practice, that means we look at how growing up gay shaped your nervous system, your relationships, and your sense of what you're allowed to want, not just at the symptom you walked in with. My orientation is recognition over reassurance. I won't tell you you're doing great when the pattern in front of us says otherwise, and I won't pathologise things that are a reasonable response to an unreasonable environment. Direct, clinically grounded, no jargon for its own sake.

Therapeutic Services

Individual online therapy for gay men, weekly by default, delivered by secure video. First session is a paid 60-minute clinical assessment. €135 per 50-minute session thereafter, billed individually, no packages or minimum commitment.

Common presenting issues include:

• Internalised homophobia and gay shame
  
• Chemsex and compulsive sexual behaviour
  
• Relationship and attachment patterns, including open relationships
  
• Anxiety, loneliness, and social isolation specific to gay male experience
  
• Coming out at any life stage, including later in life
  
• Grindr and app-use compulsion
  
• Aging as a gay man
  
• Absent fathers and early attachment ruptures
  

The first session functions as a clinical assessment. You do not need to prepare anything specific. The session covers what brings you to therapy, relevant history, and what you are hoping to change or understand. The work begins there.