Multifamily psychoanalysis

Domain I · Psychodynamic & depth psychology · Jorge E. Garcia Badaracco · 1960 · Buenos Aires

What it is

Badaracco began large groups with about 40 "chronic" inpatients at the Hospital Borda (Buenos Aires) in the early 1960s, and then brought families in. In 1968 he founded a private clinic (DITEM) that he ran for 25 years as a psychoanalytic therapeutic community. The multifamily group was the axis…

Format

• No formal phase model. None of the primary texts defines treatment phases, session counts or criteria for moving from one stage to the next. Mascaró (2005) describes only structural movement, from inpatient community to day hospital to outpatient care. The trajectory below is pieced together from…
• Psychoanalytic therapeutic community (DITEM model). The inpatient community and a mixed day hospital for patients leaving inpatient care. The multifamily group is the hub, combined with individual, family and group psychoanalysis. The team works as a "substitute family" that receives the patient's…

Questions to explore with your client

• What drew you to it, and what are you hoping it will change?
• Is there physical contact? Was it explained beforehand, and do you feel free to say no or stop at any point?
• Does it involve fasting, a special diet or 'detox'? Have you discussed this with your doctor?
• Is it a group, retreat or community? How do they respond if someone wants to leave or raises a concern?
• How do you and the practitioner understand what is happening, in spiritual or cultural terms? Is that a source of comfort, worry, or both?
• Who runs it, and what training or registration do they hold?
• What actually happens in a session or meeting, and how often?
• What does it cost, and is there pressure to commit to more?
• How do you feel afterwards, in the hours and days that follow?
• Does it fit with, or clash with, the work we do here?

What practitioners of it watch for

• Parents changing as well, which Mitre sees as a sign the work is taking hold.
• Working: members begin speaking from their own experience rather than from a "character".
• Talk that stays at the level of general opinion or metaphor. See 4.11 for moving it toward concrete events.
• The difference between pacing and avoidance. If a theme is put off week after week, name the pattern (5.1).
• Silence that is felt as abandonment or judgement. In very fragile patients, follow it with a brief verbal acknowledgement.

When to involve someone else

• New or worsening physical symptoms, or advice to stop or change prescribed medication: involve the client's doctor or prescriber.
• Signs of coercion, isolation from family and friends, escalating costs or secrecy: discuss openly and consider safeguarding.
• A crisis or thoughts of suicide: follow your crisis protocol. In the US, call or text 988; in the UK and Ireland, Samaritans on 116 123.

Drawn automatically from the guide's own sections. Stay curious: neither endorse nor dismiss what the client values, and check anything that matters against the full guide and its sources. Not medical advice.