Persuasion therapy

Domain II · Behavioural & cognitive · Paul Dubois, Jules Déjerine · 1900 · Bern

What it is

Persuasion therapy (also "moral treatment of the psychoneuroses", "rational psychotherapy", Persuasionsmethode) was a physician-delivered talking treatment for what were then called neurasthenia, psychasthenia, hysteria, hypochondria and functional (psychosomatic) complaints. It was developed by…

Format

• Format in the original. Individual physician–patient talks. Dubois worked mainly as an office and home-visit physician in Bern and admitted selected patients to a clinic stay, for which they agreed in advance to roughly a month without visitors, a darkened room and a strict diet; he wrote long…
• Modern outpatient format: weekly (or, early on, twice-weekly) 50-minute individual sessions, roughly 8–20 sessions, with brief written summaries or letters between sessions in place of Dubois's correspondence. No isolation, enforced rest or dietary regime (see 4.17).

Who practises it, and how they are trained or regulated

• Goal: establish that the complaints are functional, gain the authority to say so honestly, and map the patient's "mentality" (fears, habits of attention, moral judgements).
• What it is. Persuasion therapy (also "moral treatment of the psychoneuroses", "rational psychotherapy", Persuasionsmethode) was a physician-delivered talking treatment for what were then called neurasthenia, psychasthenia, hysteria, hypochondria and functional (psychosomatic) complaints. It was developed by the Bern neuropathologist Paul Dubois (1848–1918) around 1900 and, in a modified, emotion-centred form, by…

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 any substance, plant preparation, remedy or supplement? Has your doctor or prescriber been told, especially about any medication you take?
• 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?
• 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

• dependence or boundary drift. Working: the patient rereads and quotes the letter.
• family conflict or blame of the patient. Working: fewer symptom conversations at home.
• the therapist's tone becoming judgemental. Working: setbacks shorten and are discussed openly.
• reassurance-seeking loops (see 5). Working: visible relief and a shift to discussing what to do.
• formulations the patient experiences as blame. Working: the patient adds links to the chain unprompted.

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.