Janet's bodily automatisms

Domain IV · Body-oriented psychotherapy · Pierre Janet · 1886 · France

What it is

This is not a manualised therapy. It is a theory with a set of clinical procedures. Janet (1859–1947) was a French philosopher-physician who worked at Le Havre and at the Salpêtrière in Paris. He described psychological automatisms: acts, postures, sensations and memories that run in a fixed,…

Format

• Order, format and length
• Format. Individual work, in hospital (Salpêtrière) or as an outpatient. Families and acquaintances were interviewed.

Who practises it, and how they are trained or regulated

• Goals: prevent relapse, and remedy residual deficits. These include poor attention, suggestibility, inability to begin or finish acts, constricted affect, hypochondria, functional somatic complaints, motor contractures, doubts and rumination.
• Modern adaptation: weekly individual sessions of 50–60 minutes. Stage 1 runs until the client has stable sleep and eating, no recent crises, a working alliance, and can regulate arousal inside the session. Memory work runs only while the client stays within a tolerable arousal range. Stage 3 is woven through from the start.

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 intense or unusual breathing? Have you been told about the medical conditions for which that is not advised?
• Does it involve fasting, a special diet or 'detox'? Have you discussed this with your doctor?
• 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

• Rule out laryngeal disease first. Expect emotion when the voice returns.
• Effortful straining that worsens the symptom. Pain or swelling means stop and refer.
• Sudden emotional release or re-enactment when the part softens. Pause and ground (4.9).
• Too little rapport leads to drop-out. Too much produces dependence and relapse at every break.
• Rising distress when attention turns to the body. If that happens, keep attention on the outside room only.

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.