Psychoanalytic-interactional method and the Göttingen model of group psychotherapy

1. Introduction

Version followed: individual technique follows Streeck & Leichsenring, Handbuch psychoanalytisch-interaktionelle Therapie (3rd revised ed., 2015; 1st ed. 2009). The basic attitudes follow Heigl-Evers & Ott (1994/2002; 1997 paper). The three-level group model follows Heigl-Evers & Heigl (1973, 1994). Interactional group technique follows Streeck's posthumous Die psychoanalytisch-interaktionelle Gruppenpsychotherapie (2024). Where these differ, the 2015 Handbuch governs individual work and Streeck 2024 governs group work.

Access caveat: This guide draws on the tables of contents, forewords, introductions and short reviews of the core books, plus one 1997 abstract. Their technique chapters are not drawn on. Wherever a step-level instruction below is not stated in the sources, it is tagged [synthesis] or [uncertain]. [source: Streeck & Leichsenring 2015 excerpt; Streeck 2024 excerpt]

The psychoanalytic-interactional method (PIM; in the trials, PIT/PIP) is a psychodynamically grounded, development-oriented therapy for structural disorders. These are developmentally rooted impairments of self- and relationship-regulation, such as severe or Cluster-B personality disorders, many addictions and trauma-related states. Heigl-Evers and Heigl first developed it in the 1970s as the interactional level of the Göttingen model of group psychotherapy, and later extended it to individual therapy. [source: Streeck & Leichsenring 2015 excerpt; Wikipedia DE "Göttinger Modell"]

Core idea of change: the method rests on a two- or more-person psychology. The patient's difficulties are not mainly hidden in an unconscious inner world waiting to be interpreted. They show up in the Zwischen, the here-and-now interaction with others and with the therapist, and they are carried by implicit, procedural (including bodily) relational knowledge. So the therapist does not interpret (Prinzip Deutung). The therapist answers (Prinzip Antwort): they respond selectively and authentically, as a real counterpart, so that the patient experiences how their behaviour affects another person and can try alternatives. Repeated answering, together with the therapist temporarily lending missing ego functions (Hilfs-Ich), builds the capacities for self- and relationship-regulation and for participating in social life. Therapy is "eine Koproduktion von Patient und Therapeut". [source: Streeck & Leichsenring 2015 excerpt; Streeck 2024 excerpt; Ärzteblatt review of Streeck 2024]

2. Framework

No formal phase model exists. The Handbuch is organised as a sequence (preparation and education, then frame agreements, then treatment in the answering mode, then ending). It does not set phase goals or session-based transition criteria. The phases below follow that sequence, and the criteria for moving on are my own synthesis. [source: Streeck & Leichsenring 2015 TOC; synthesis]

A. Choosing the level (Göttingen three-level model). Heigl-Evers & Heigl (1973) graded psychodynamic group therapy by how much regression it promotes, matched to how severe the disorder is. [source: Wikipedia DE "Göttinger Modell", summarising Heigl-Evers & Heigl 1973/1978/1994]

Psychoanalytic (analytic) group. For conflicts between ego, id and superego in patients with relatively mature defences. It promotes regression through abstinence. It brings revived unconscious fantasies and basic conflicts to awareness through transference and countertransference work and interpretation, following Greenson's sequence of confrontation, clarification, interpretation and working-through.
Analytically oriented (tiefenpsychologisch fundiert) group. For moderate impairment, where conflicts appear as drive-derivatives that are not mainly split off. It works with preconscious material and is only mildly regressive. It combines limited structure and confrontation with support, and the therapist shares observations and feelings without interpreting unconscious motives.
Psychoanalytic-interactional group. For severe ego weakness, splitting, borderline and psychotic-spectrum or other structural disorders. It is supportive, offers a positive relationship, uses little confrontation and no interpretation, and works on the manifest interaction. The therapist acts as an auxiliary ego.
In German statutory care, the interactional group of the Göttingen model is classed as tiefenpsychologisch fundiert group therapy. [source: DPG information page]
[uncertain] Secondary sources disagree on how Heigl-Evers' group-process levels map onto the three methods. These levels are normative behaviour regulation, psychosocial compromise formation and shared unconscious fantasy. Wikipedia DE attaches normative regulation to the interactional level. Check this against Heigl-Evers & Heigl 1978 before you teach it.

B. Assessment and preparation (individual: about 1–5 sessions; group: one or more pre-group interviews).

Goals: establish that the disorder is structural rather than mainly conflict-driven. The Handbuch takes severity from how much social life is impaired. OPD structure-axis ratings are commonly used in this tradition [uncertain whether the Handbuch requires OPD].
Explain the diagnosis and the treatment to the patient.
Agree the frame: focus, how suicidal or self-harming behaviour will be handled, medication, contact outside sessions, duration, missed sessions and fees. The Handbuch treats the struggle over the frame as itself therapeutic. [source: Streeck & Leichsenring 2015 TOC/intro]
Move on when (synthesis): the patient has heard and roughly accepts a working description of their problems as problems of relating and regulating; the safety and contact rules have been stated; and a first focus has been named.

C. Working phase (bulk of treatment).

The therapist works in the answering mode, lends ego functions, works with affects and nonverbal behaviour, anticipates habitual patterns, and gives primacy to self-regulation and to progression. [source: Streeck & Leichsenring 2015 TOC]
Format: individual sessions are face to face. Group sessions use a circle with an active, visibly responsive therapist. [source: Streeck 2024 excerpt; face-to-face individual setting is my inference, synthesis]
Typical dose [uncertain]: outpatient individual work is usually weekly 50-minute sessions over a year or more. Outpatient groups usually meet weekly for 90–100 minutes with roughly 6–9 members, slow-open. Inpatient work, for example at Tiefenbrunn where the RCTs ran, combines group and individual sessions over weeks to months. The Handbuch has a section on treatment duration that is not drawn on. It also has a separate short-term group format.
Move on toward ending when (synthesis): the patient can perceive and name their own affects and others' reactions with less help; repetitive interaction patterns get recognised sooner (often by the patient first); there are fewer frame crises and less self-harm or acting-out; and outside relationships and work or social participation are more stable.

D. Ending. The Handbuch has a section on ending ("Zur Beendigung der Behandlung"). Its content is not drawn on. Synthesis: plan the end well ahead, expect old patterns to return around separation and answer them as usual, and review together which capacities have been gained.

3. Guiding principles

[source for the four basic attitudes: Heigl-Evers & Ott 1997 abstract; others: Streeck & Leichsenring 2015 TOC/intro, Streeck 2024 excerpt and review; one-line practical meanings are synthesis]

Present, intensive, caring attention. Be visibly with the patient moment by moment. Do not hide behind a blank screen.
Unrestricted respect for the patient's history and development. Treat even disturbing behaviour as the best solution the patient's history made available. Do not moralise.
Emotional acceptance, at least as compassion. You do not have to like the behaviour, but stay compassionate. Acceptance "does not mean having only friendly feelings" (Streeck 2018 chapter title, paraphrased).
Selective authenticity (authentisch, aber selektiv). What you show must be genuine. Show only what helps development, and only within the patient's tolerance limits.
These are ideal norms. You will fall short. Lapses tend to show up in your verbal and nonverbal interventions and usually reflect countertransference, so use supervision or peer discussion as the "third party".
Prinzip Antwort over Prinzip Deutung. Respond as a real person to what is happening between you. Do not offer hypotheses about unconscious meaning.
Focus on the Zwischen and the here-and-now. The material is the current interaction (in the session, in the group) and the patient's present relationships. Childhood reconstruction is not the material.
Therapist as real and virtual interaction partner. You really take part, and you are also the figure the patient expects you to be. Notice both, and do not act out the expected role.
Two-person (or more-person) psychology; therapy as conversation and social action. Your own conduct co-produces what you see, so check your share first.
Development and progression orientation. Build capacities rather than uncover conflict. Look for and reinforce the next small adaptive step.
Primacy of self-regulation. Stabilising affect and arousal comes before exploring content.
Activity. Be active, structuring and conversational, close to everyday talk. Avoid long silences and abstinence that promote regression.
Auxiliary ego (Hilfs-Ich). Temporarily take over or support missing ego functions (perception of affect, reality testing, anticipation, judgement, impulse control). Hand them back as soon as possible. [source: Wikipedia DE "Göttinger Modell"]
Supportive elements are legitimate. Advice, recommendations and explanations belong to the method, unlike TFP or analysis.
Respect tolerance limits. Dose confrontation and the strength of your answers to what the patient can bear without destabilising.
Implicit and bodily relational knowledge. Posture, gaze, timing and handshake carry the disorder too (Zwischenleiblichkeit). Attend to them and respond to them.
Frame as therapy. Negotiating and protecting the frame is part of the treatment, not a precondition you enforce from outside.

4. Intervention inventory

The names and existence of the interventions below come from the Handbuch 2015 table of contents and introduction, Streeck 2018 and 2024, Heigl-Evers & Ott 1997, and the Göttingen-model summaries. The manual's technique chapters are not drawn on, so the numbered steps are my operationalisation [synthesis] unless a source tag says otherwise. All example wording is my own (illustrative) unless it appears in quotation marks with a citation.

4.1 Preparation and education about diagnosis and treatment

Purpose / when: In the first sessions. Its purpose is to give the patient a shared, non-blaming language for their difficulties and to say how this therapy works, since it differs from what many patients expect. [source: Streeck & Leichsenring 2015 TOC "Vorbereitung und Aufklärung"]
Steps [synthesis]:
1. Collect concrete recent relationship episodes (what happened, who did what, what followed).
2. Reflect the recurring pattern back in everyday words, tied to how it impairs social life.
3. Name the diagnosis plainly (for example, a structural or personality disorder) as a problem of regulating feelings and relationships that developed for understandable reasons.
4. Explain the method: we will look at what happens between us and between you and others, and I will tell you at times how what you do affects me.
5. Ask for the patient's reaction to that explanation and respond to it.
Example language (illustrative): "From what you describe, the hard part is less any single event and more how quickly closeness turns into hurt, and then into a break. We'll work on that, partly by noticing it as it happens here between us. Sometimes I'll tell you honestly how something you do lands with me. What do you think of working that way?"
Watch for: the patient hearing the diagnosis as a verdict or insult, which you then answer as a here-and-now event. Working when: the patient can restate the focus in their own words.

4.2 Agreeing and negotiating the frame (Rahmenbedingungen)

Purpose / when: At the start, and again whenever the frame is tested. It sets the focus, the handling of suicidality and self-harm, medication, contact outside sessions, duration, missed sessions and fees. The Handbuch treats the struggle over these rules as therapy in its own right. [source: Streeck & Leichsenring 2015 TOC/intro]
Steps [synthesis]:
1. Agree the frame individually where possible rather than imposing a standard contract.
2. State each rule and its reason.
3. Ask how the patient expects to deal with it, and anticipate likely breaches (see 4.11).
4. When the frame is breached later, do not just enforce the rule. Treat the breach as an interaction: say what it does to you and to the work (4.3), explore what the patient was after (4.5), and renegotiate if necessary.
5. Keep the limits you need in order to keep working.
Example language (illustrative): "If you feel you might hurt yourself between sessions, here is what I'd like us to agree on… I'm saying this because I can't work well with you if I'm constantly afraid for you." Later: "This is the third time you've come twenty minutes late. I notice I'm starting to feel unimportant here, and also a bit annoyed. What was going on for you?"
Watch for: rigidity, where rules become punishments, and laxity, where you quietly absorb breaches and become resentful. Working when: breaches become talkable and less frequent.

4.3 Answering (Antworten, Prinzip Antwort): the core intervention

Purpose / when: Whenever the patient's current behaviour toward you (or toward group members) shows a dysfunctional relationship pattern. It shows the consequences of their social actions for the present relationship. It works on procedural relational knowledge that interpretation does not reach. Streeck: "Antworten sind eine umschriebene und selektive Äußerung". Answers can be verbal, nonverbal or bodily. [source: Ärzteblatt review of Streeck 2024; Streeck 2024 intro; Heigl-Evers & Heigl 1983 via Wikipedia; Bilitza ref list "das interaktionelle Prinzip 'Antwort'"]
Steps [synthesis built on the sources' definition]:
1. Notice your own reaction (feeling, bodily impulse, wish to withdraw or rescue) as it arises in response to a specific, observable behaviour of the patient.
2. Check it. Is this mine (my own history or mood) or a response to what the patient is doing now? Is it the kind of reaction others in the patient's life probably have?
3. Select. Choose the part of your reaction that could help the patient see the effect of their behaviour. Leave out what would only shame, burden or overwhelm them (tolerance limits, 4.9).
4. Phrase it as a first-person, bounded statement linked to the concrete behaviour: "When you …, I notice I …". Make it neither a judgement of the person nor a hypothesis about their unconscious.
5. Where useful, add the consequence for the relationship and an open question about the patient's intention, or an alternative (4.4, 4.5).
6. Follow the patient's response and answer it in turn.
Example language (illustrative): "While you were telling me that, you kept your eyes on the floor and talked very fast, and I noticed I couldn't get a word in. I started to feel shut out." Or: "When you say I'm the only one who understands you, part of me feels flattered, and part of me gets uneasy, as if there's no room for me to make mistakes."
Watch for: answers turning into self-disclosure about your private life, hidden reproaches, or covert interpretations ("you are making me feel…"). Working when: the patient can take in the information without collapsing or counter-attacking, gets curious about their effect, and later anticipates it ("I know, I'm doing that rushing thing again").

4.4 Showing interpersonal consequences and alternative ways of acting

Purpose / when: Usually right after an answer. Streeck names showing participants the consequences of their behaviour for others, and possible alternative actions, as the main lever on "disorders of the social". [source: Streeck 2024 intro]
Steps [synthesis]:
1. Link the behaviour to its likely effect on others, generalising cautiously from your own reaction.
2. Ask whether that effect is what the patient wants.
3. Explore other ways of doing the same thing that might work better, ideally generated by the patient.
4. Where possible, try the alternative right now in the session.
Example language (illustrative): "If people react to this the way I just did, they might pull back without telling you why. Is that something you know from outside?… How else could you have let me know you were upset? Want to try saying it to me now?"
Watch for: this sliding into coaching or lecturing. Working when: the patient tries out new behaviour in session or reports doing so outside.

4.5 Asking about intentions and thinking ("Was haben Sie sich dabei gedacht?")

Purpose / when: After puzzling or provocative behaviour. It helps you understand the patient's motives, and it invites them to reflect on their own action. It is meant as understanding, not control. [source: Dally & Falck foreword in Streeck 2024]
Steps [synthesis]:
1. Ask in a genuinely curious tone, after the affect has calmed if necessary.
2. Take the answer seriously, even when it seems implausible.
3. Answer the answer (4.3).
Example language: the cited question, "Was haben Sie sich dabei gedacht?", and (illustrative) "What did you hope would happen when you left in the middle of the session?"
Watch for: a tone that sounds like a reprimand. Working when: the patient starts to state intentions spontaneously.

4.6 Auxiliary-ego function (Hilfs-Ich)

Purpose / when: When an ego function is temporarily or chronically unavailable. Examples are affect perception, reality testing, judgement, anticipating consequences, impulse control and self-protection. The therapist lends the function so the patient can experience being held and protected and can develop it further. [source: Wikipedia DE "Göttinger Modell" (goals of the interactional level); detailed operationalisation not drawn on, uncertain]
Steps [synthesis]:
1. Identify which function is failing right now (for example, "cannot foresee what happens if I send that message").
2. Perform it out loud, briefly and concretely, marked as your own view.
3. Invite the patient to check it against their own view.
4. Next time, prompt the patient to perform the function before you do.
5. Gradually withdraw.
Example language (illustrative): "Let me think it through with you for a second. If you send him that message tonight, my guess is he'll be angry tomorrow and you'll feel abandoned again. Does that seem realistic to you?" Later: "What do you think happens next if you do that?"
Watch for: fostering dependency, or permanent take-over. Working when: the patient increasingly does the anticipating or judging first.

4.7 Working with affects: perceiving, differentiating, naming, regulating

Purpose / when: When affects are undifferentiated ("bad", "stressed"), acted out, expressed only bodily, or overwhelming. This follows the primacy of self-regulation. [source: Streeck & Leichsenring 2015 TOC "Umgang mit Affekten", "Primat der Selbstregulierung"; steps synthesis]
Steps [synthesis]:
1. Slow down.
2. Name what you can observe (voice, posture, tempo).
3. Offer tentative affect words, including mixed ones, and let the patient choose or correct.
4. Link the affect to the interaction that triggered it.
5. If arousal is too high, prioritise regulation (pace, grounding, structure) over exploring content.
6. Name your own affective response where it helps differentiation (4.3).
Example language (illustrative): "Your voice got sharp just now. Is that anger, or something more like being hurt, or both?… It seemed to start when I mentioned the holiday break."
Watch for: imposing labels, or flooding the patient. Working when: the patient uses more differentiated affect words and recognises triggers.

4.8 Attending to nonverbal and bodily behaviour (Zwischenleiblichkeit)

Purpose / when: Throughout. Implicit relational knowledge is enacted in posture, gaze, timing, greeting and leaving, for example a patient pulling back their hand at a handshake, or staying seated after the therapist has stood up. These moments are co-produced. [source: Streeck 2024 (Bergmann foreword); Streeck & Leichsenring 2015 TOC "nichtsprachliches Verhalten"]
Steps [synthesis]:
1. Register bodily micro-events, including your own part in them.
2. Choose whether to answer bodily (adjusting distance or tempo) or verbally.
3. If verbally, describe the event neutrally and your part in it, then explore.
Example language (illustrative): "Just now when I stood up you stayed sitting, and I hesitated too, as if neither of us quite wanted to end. Did you notice that?"
Watch for: making the patient self-conscious or feel scrutinised. Working when: patients begin to notice their own bodily signals in relationships.

4.9 Dosing to tolerance limits

Purpose / when: With every answer or confrontation. It keeps interventions within what the patient can bear, which is part of selective authenticity. [source: Heigl-Evers & Ott 1997 abstract; Streeck & Leichsenring 2015 TOC "antwortende Interventionen und Toleranzgrenzen"]
Steps [synthesis]:
1. Before intervening, estimate the patient's current state (arousal, shame-proneness, alliance).
2. Choose a smaller and softer version if in doubt.
3. Watch the immediate response.
4. If the patient destabilises, acknowledge it, reduce intensity, and repair (see 5).
Example language (illustrative): "I said that more bluntly than I meant to. How did it land?"
Watch for: avoiding every answer out of fear of hurting the patient, which is a failure of authenticity.

4.10 Handling idealisation (and its flip into devaluation)

Purpose / when: When the patient idealises the therapist, typically early. The aim is neither to collude nor to interpret it away. [source: Streeck & Leichsenring 2015 TOC "Idealisierungen"; steps synthesis]
Steps [synthesis]:
1. Receive it without rejecting it.
2. Answer realistically about your limits.
3. Anticipate the disappointment that will come.
4. When devaluation comes, answer it with the same stance (4.3).
Example language (illustrative): "I'm glad this feels helpful. I also know I'll get things wrong at some point. I'd like us to be able to talk about it when that happens, rather than it ending things between us."
Watch for: your own gratification, or defensive self-deprecation.

4.11 Anticipating habitual behaviour

Purpose / when: Once a recurrent pattern is known, and especially before predictable triggers (breaks, endings, conflict, success). The aim is to name the likely pattern ahead of time so it can be noticed rather than enacted. [source: Streeck & Leichsenring 2015 TOC "Antizipation habituellen Verhaltens"; steps synthesis]
Steps [synthesis]:
1. Recall the pattern with the patient.
2. Name the upcoming situation.
3. Predict together what is likely to happen in and outside the room.
4. Plan a small alternative.
5. Review afterwards.
Example language (illustrative): "We have a two-week break coming. Last time, you stopped answering texts from friends and then didn't come to the first session back. If something like that starts happening, what could you do instead?"
Watch for: sounding fatalistic. Working when: the patient starts the anticipation themselves.

4.12 Progression orientation: acknowledging progress and competence

Purpose / when: Constantly. Give priority to building capacities and to adaptive, forward steps over regression and uncovering. Recognise small gains and the survival value of the patient's ways of coping. [source: Streeck & Leichsenring 2015 TOC "Primat der Progressionsorientierung"; Heigl-Evers & Ott 1997 (respect for history); steps synthesis]
Steps [synthesis]:
1. Look for an actual, specific new behaviour.
2. Name it concretely and link it to its effect.
3. Do not overpraise.
4. Respectfully acknowledge what an old pattern protected the patient from.
Example language (illustrative): "You told me directly that you were annoyed with me, instead of just going quiet. That made it much easier for me to understand you."
Watch for: generic praise, which patients with structural problems often distrust.

4.13 Supportive interventions: recommendations, advice, explanation

Purpose / when: When the patient lacks information or a skill, or is in a crisis where reflection is not possible. Unlike TFP, the method explicitly allows supportive elements. [source: Streeck & Leichsenring 2015 intro]
Steps [synthesis]:
1. Check whether the patient wants advice.
2. Give it briefly and practically.
3. Mark it as your view.
4. Later, explore what happened when the patient used or ignored it.
Example language (illustrative): "Can I make a practical suggestion? Before you answer your boss's email, wait until tomorrow morning and show me the draft first."
Watch for: advice that replaces the patient's own judgement in the long run (see 4.6, withdraw gradually).

4.14 Working with reports about outside relationships

Purpose / when: When the patient talks about others ("Der Patient spricht über Beziehungen"). The aim is to make these reports concrete interactions you can respond to, not narratives to interpret. [source: Streeck 2018 TOC 5.5; steps synthesis]
Steps [synthesis]:
1. Ask for a concrete scene: who said what, in what order, how it ended.
2. Ask what the patient did and what they think the other person experienced.
3. Answer from your own vantage as listener ("as I hear it, I imagine I'd have felt…").
4. Look for the same pattern in the room.
Example language (illustrative): "Walk me through it. What did she say exactly, and what did you say back?… Hearing it, I can imagine she felt cornered. Is that possible?"
Watch for: siding with the patient against absent others, or with others against the patient.

4.15 Fostering motivation

Purpose / when: When motivation is ambivalent or externally imposed (common in addiction, forensic and inpatient settings). [source: Streeck & Leichsenring 2015 TOC "Motivation"; steps synthesis]
Steps [synthesis]:
1. Accept the ambivalence openly.
2. Tie the work to goals the patient owns, such as relationships, work or fewer crises.
3. Answer disengagement honestly as it happens (4.3).
Example language (illustrative): "You're here because the clinic sent you. That's fine. Is there anything about how things go with people that you'd actually like to be different?"

4.16 Using countertransference as the basis for answers, with a third party

Purpose / when: Continuously. The therapist's experience is the raw material for answers. When the basic attitudes slip, this usually reflects countertransference, which often needs supervision or peer discussion to be understood. [source: Heigl-Evers & Ott 1997 abstract; Streeck 2018 TOC 6.2 "Gegenübertragung und abgestimmte Antworten"]
Steps [synthesis]:
1. After sessions, note your strongest reaction and the behaviour it was tied to.
2. Sort it into what came from the patient's pattern and what came from your own.
3. Bring persistent or intense reactions to supervision.
4. Decide in advance which part could become a useful answer.
Watch for: acting out countertransference (coldness, rescuing, retaliation) as "authenticity".

4.17 Ending treatment

Purpose / when: Final phase. Separation is the last and often most intense test of the patient's relationship-regulation. [source: Streeck & Leichsenring 2015 TOC "Zur Beendigung der Behandlung"; content not drawn on, steps synthesis]
Steps [synthesis]:
1. Set the end date well in advance.
2. Anticipate how the patient habitually handles endings (4.11).
3. Answer devaluation, withdrawal or crisis as usual.
4. Review together the capacities gained and the warning signs to watch for.
5. Agree what follow-up is possible.
Example language (illustrative): "Since we set the end date, you've been late twice and seem more distant. I miss the way we were working. I wonder if pulling away first is easier than being left."

Group-specific interventions (psychoanalytic-interactional group) [source for topics: Streeck & Leichsenring 2015 TOC ch. on group therapy; Streeck 2024 TOC and intro; steps synthesis unless stated]

4.18 Pre-group interview and preparing the patient for the group

Purpose / when: Before a patient joins. The aim is to clarify expectations, explain what happens in this kind of group, and anticipate how the patient's typical pattern may show up there. [source: Streeck 2024 TOC "Vorbereitung der Patienten"; Handbuch "Vorgespräch"]
Steps [synthesis]:
1. Explore the patient's past group experiences (school, family, work).
2. Explain that the group talks about what happens between members here and now, and that the therapist will sometimes say how things affect them.
3. Explain confidentiality and attendance rules.
4. Predict together what might be hard, for example: "you may want to stay silent and then feel ignored".
Example language (illustrative): "In the group it's less about telling your story and more about noticing what happens between you and the others. Given what you've told me, what do you think could be hardest for you there?"
Watch for: unrealistic hopes (instant belonging) or dread. Address both before the first session.

4.19 Defining the situation and the basic rule (Grundregel)

Purpose / when: At the start of a new group, when new members join, and when it becomes unclear what the group is for ("What are we actually doing here?"). Explicit and implicit definitions of the situation regulate what members feel they may do. [source: Handbuch TOC "Definition der Situation", "Grundregel"; Streeck 2024 TOC "Grundregel", "Was machen wir hier eigentlich?"]
Steps [synthesis]:
1. State the basic rule simply.
2. Invite members to speak openly about what they experience with one another in the group.
3. When implicit rules contradict the explicit one (for example, "we only talk about problems outside"), name the discrepancy.
4. Re-state the rule when confusion arises. [uncertain] The exact wording of the PIM group basic rule is not given in the sources.
Example language (illustrative): "Here we try to say what's going on between us, including what irritates or pleases you about each other, as far as you can."
Watch for: the rule being used as a weapon ("you have to be open!").

4.20 Working with group norms, sanctions and interaction patterns

Purpose / when: When the group develops norms that block development, such as only being nice, avoiding conflict, or scapegoating, or when members sanction each other informally. These social regulations are the main material of the interactional group. [source: Handbuch TOC "Sanktionen", "soziale Normen", "Interaktionsmuster"; Wikipedia DE "Göttinger Modell" (normative regulation)]
Steps [synthesis]:
1. Notice the repetitive pattern (who speaks, who is ignored, what reaction follows certain topics).
2. Describe it in plain, non-blaming language, including your own share.
3. Answer it (how it affects you).
4. Ask members how they experience it and what it protects.
5. Invite an experiment with a different norm.
Example language (illustrative): "I notice that whenever someone gets angry here, the group quickly changes the subject, and I go along with it too. I'm left with a sense that anger isn't allowed here. How is that for you?"
Watch for: members feeling exposed. Address the group pattern before individuals if tolerance is low.

4.21 Answering in the group and mobilising members' answers ("Mit Blick auf den anderen")

Purpose / when: Throughout. In the group, the therapist's answers and members' answers to each other show how each person's current social actions affect present relationships. [source: Ärzteblatt review of Streeck 2024; Streeck 2024 TOC "Mit Blick auf den anderen", "Warum überhaupt Antworten?"]
Steps [synthesis]:
1. Give your own answer, selective and bounded (4.3).
2. Ask a member how they experienced another member's behaviour just now, so that peers supply answers.
3. Help members phrase answers as first-person statements about effects rather than verdicts.
4. Return to the recipient: how is it to hear that?
Example language (illustrative): "Anna, when Tom interrupted you just now, how was that for you?… Tom, how is it to hear that?"
Watch for: pile-ons and scapegoating, which call for protective auxiliary-ego intervention (4.6, 4.9). Working when: members spontaneously give and receive feedback without collapse or retaliation.

4.22 Working with explicit and implicit themes

Purpose / when: When the overt topic (for example, work stress) carries an implicit relational theme in the room (for example, who gets attention). [source: Handbuch and Streeck 2024 TOC "Explizite und implizite Themen"; steps synthesis]
Steps [synthesis]:
1. Let the explicit theme run for a while.
2. Note how members are relating while discussing it.
3. Bring the implicit relational aspect into the here-and-now without interpreting unconscious meaning.
Example language (illustrative): "We've been talking about bosses who don't listen, and I notice it's been hard for several of you to get a word in today."

4.23 Protecting the group frame: confidentiality, attendance, changing membership, avoidance

Purpose / when: When the frame is threatened (absences, lateness, subgroups outside, breaches of confidentiality), when members change, or when a patient avoids taking part. [source: Handbuch TOC "Rahmengefährdungen", "Verschwiegenheit", "wechselnde Teilnehmer", "Schüchternheit"; Streeck 2024 TOC "Gefährdungen des Rahmens", "Vermeiden"]
Steps [synthesis]:
1. Raise frame events in the group, not just privately.
2. Answer how they affect you and the group.
3. Explore with members how they experience the breach.
4. Re-negotiate or restate the rule.
5. Prepare the group for arrivals and departures and give them time.
Example language (illustrative): "Three people are missing tonight without letting us know. I notice I feel a bit deflated sitting here. What is it like for those of you who came?"

4.24 Short-term group psychotherapy

Purpose / when: In time-limited settings, for example inpatient stays. [source: Handbuch TOC "Kurzgruppenpsychotherapie"; content not drawn on, uncertain]
Steps [synthesis]:
1. Narrow the focus to one or two interactional themes per patient.
2. Be more structured and active.
3. Address the ending from the start.

Other Göttingen levels (for orientation only; not PIM technique)

4.25 Analytically oriented (tiefenpsychologisch fundiert) group interventions

Purpose / when: For less impaired patients whose conflicts appear as preconscious drive-derivatives that are not mainly split off. The aim is to loosen excessive dependencies and parental images and to improve adaptation and judgement. [source: Wikipedia DE "Göttinger Modell"]
Steps (as summarised):
1. The therapist shares observations about self and others, and feelings, together with their understanding of them.
2. Use moderate structure and confrontation, with a supportive stance, and avoid excessive frustration.
3. Do not interpret unconscious motives.
Example language (illustrative): "It looks to me as though, whenever the group disagrees, you check what I think first."

4.26 Psychoanalytic (analytic) group interventions

Purpose / when: For patients with relatively mature defences and intrapsychic conflict. [source: Wikipedia DE "Göttinger Modell"]
Steps (as summarised):
1. Use abstinence to promote regression.
2. Work with transference and countertransference.
3. Interpret revived shared unconscious fantasies and basic conflicts through confrontation, clarification, interpretation and working-through (Greenson).
Watch for: using this level with structurally impaired patients. In the model's logic, that is exactly the mismatch the interactional level was created to avoid.

5. Handling problems

The Handbuch has a "special problems" section covering silence, affective and impulsive behaviour, negative transference, suicidality, dreams and ending, plus group complications. I saw only its headings. The responses below apply the method's principles and are my own synthesis unless a source tag says otherwise. [source: Streeck & Leichsenring 2015 TOC; Streeck 2024 TOC]

Silence (Handbuch topic) [synthesis]. Do not wait it out analytically, because long silence is regression-promoting and can be experienced as abandonment. Answer it: "The silence feels heavy to me. I'm unsure whether you want me to wait or to help you start." Offer structure (a concrete question, a recent scene). In a group, ask how members experience the silence.
Affective and impulsive escalation, overwhelm (Handbuch topic) [synthesis]. Follow the primacy of self-regulation: lower the pace, shorten your sentences, name what you observe, and take over auxiliary-ego functions such as anticipation and limits. Set a clear limit on behaviour that threatens safety or the frame: "I want to keep talking with you, and I can't while you're shouting at me." Leave exploration until arousal is lower. Afterwards, review what happened between you.
Negative transference, devaluation, hostility (Handbuch topic) [synthesis]. Do not interpret it as displaced ("you're angry at your father"), and do not retreat into neutrality. Answer it selectively: acknowledge any real trigger in your own conduct, say how the attack affects you within tolerable limits, and ask what the patient hoped for. Hold the frame. Use supervision for your countertransference (Heigl-Evers & Ott 1997).
Suicidality and self-harm (Handbuch topic). Agree the handling in the frame before it is needed (4.2) [source: Handbuch TOC]. When it arises, conduct a standard structured suicide risk assessment and follow local protocol and crisis pathways, including inpatient referral where indicated. That takes precedence over method. Once safety is established, also treat the communicative and interactional side of self-harm (what it does to relationships, including the therapeutic one) [synthesis].
Dreams (Handbuch topic) [uncertain]. Consistent with the method, treat a dream report as a communication in the present relationship. Ask what the patient wants you to do with it and how it relates to current relationships. Avoid deep symbolic interpretation [synthesis].
Patient wants interpretations or "depth" [synthesis]. Explain the rationale openly (4.1). Answer the wish itself: "You'd like me to tell you why you're like this. I can see the relief that would bring. My worry is that my theories would mean less to you than noticing together what happens between us."
Answer experienced as rejection, criticism or attack (rupture) [synthesis]. Acknowledge it at once, check what was heard, own the part of your phrasing that was too much (4.9), and keep the core content if it was important. A repaired rupture is itself a new relational experience. Signs of a missed rupture are abrupt compliance, lateness or drop-out after an answer.
Stuck therapy / no change [synthesis]. Check whether you have slipped into interpreting or chatting rather than answering. Check whether answers are too vague or too cautious (lack of authenticity), or too strong (beyond tolerance). Check whether the focus is still owned by the patient (4.15). Review your countertransference with a third party. Re-negotiate the focus.
Non-attendance, lateness, frame breaches (Handbuch topics: missed sessions, fees, contact outside) [synthesis]. Treat them as interactions (4.2, 4.23). Answer their effect on you and the work, explore intentions, restate or renegotiate the rule, and keep only the limits you can actually hold.
Excessive dependency and idealisation [synthesis]. Keep reducing the auxiliary-ego functions you perform (4.6). Answer the idealisation realistically (4.10). Anticipate disappointment around breaks and the ending (4.11).
Therapist overwhelmed, angry or bored [synthesis]. Since the basic attitudes are "ideal norms" that will be missed, notice the lapse in your own interventions, take it to supervision, and be careful with "authenticity" that is actually retaliation or withdrawal [source for ideal-norms point: Heigl-Evers & Ott 1997]. Selective authenticity means you do not hide your reactions and you do not unload them either.
Group complications: frame threats, changing membership, shyness and avoidance, dysfunctional relationship patterns (Handbuch and Streeck 2024 topics). Raise them in the group. Protect quiet members by inviting rather than demanding participation. Interrupt scapegoating actively in the auxiliary-ego role. Address the group-level norm first when individual tolerance is low (4.20). [synthesis for responses]
Substance use or intoxication in session (common in this method's addiction-treatment field) [synthesis]. Do not conduct the session on content while the patient is intoxicated. Answer what you observe and its effect, reschedule, and address it in the frame.
Patient with very low structure (for example, psychotic-spectrum) or acute crisis [synthesis]. Increase structure, reality-oriented auxiliary-ego work and supportive elements, and coordinate with psychiatric care. Medication is a frame topic in the Handbuch; no dosing guidance is given here.

Sources

Sources: