Multireferential psychotherapy

1. Introduction

Version followed: "psychothérapie relationnelle, intégrative et multiréférentielle" as taught by the CIFPR (Centre interdisciplinaire de formation à la psychothérapie relationnelle, Paris, founded 1985, directed by Philippe Grauer), in the 2019 school brochure and the 2025–26 programme listings (diploma "psychopraticien multiréférentiel®"). The theory side follows the publisher description and contents of Grauer & Lefebvre (2018), La psychothérapie relationnelle. [source: CIFPR Brochure 2019; je-change-de-metier CIFPR programme pages; CIFPR press release 2018]

What it is. Multireferential psychotherapy is not a single manualised therapy. It is a French integrative training tradition and practice framework, part of the wider "psychothérapie relationnelle" current. That current descends from American humanistic psychology and from innovative strands of psychoanalysis. [source: Mollat publisher page; CIFPR press release] A practitioner is trained in four separate methods and then works with all four as references:

1. Gestalt therapy, taken with an existential stance and Daseinsanalyse.
2. Bioenergetic analysis (Lowen), plus other psychocorporal work: breath dynamics and warm-water pool work.
3. The psychotherapy group: the groupe d'évolution, group dynamics and the integrative psychoanalytic group.
4. Psychoanalysis, including analytic psychodrama.

Psychopathology, philosophy and methodology are taught alongside. [source: CIFPR Brochure 2019]

How change happens. The relationship is the engine. The school contrasts going to see someone ("aller voir quelqu'un") with going to get treated ("aller se faire soigner"). [source: CIFPR Brochure 2019] The two founding principles of the book are Buber's "principe Relation" and Rogers's "principe Empathie". [source: CIFPR press release 2018, table of contents] The client works through speech, the body, the here-and-now encounter and the group. Using several methods means each one shows what the others miss, because they have "irreducible contradictions" and are not merged into one technique. The goal is the person's autonomy and responsibility; that phrasing comes from the FF2P framing of psychotherapy generally. [source: CIFPR Brochure 2019; Santé Mentale 2017]

Status and context. In France the title "psychothérapeute" has been legally regulated since 2010, so graduates practise as "psychopraticiens". This is a non-medical profession, regulated by professional bodies (SNPPsy, AFFOP) rather than the State. [source: CIFPR Brochure 2019; Mollat; Santé Mentale 2017] The CIFPR diploma is approved by the AFFOP. The method is sometimes called "FF2P-recognised", but FF2P recognition is [uncertain]

Limits of this guide. The sources used describe the school's principles and training modules, not a session-by-session protocol for clients. Procedures inside each component method are taken from the founders of that method (Perls/Hefferline/Goodman, Lowen, Moreno and the French analytic-psychodrama school, Freud), whose books are not drawn on here; those steps are tagged [uncertain]. How the four methods are sequenced and combined with one client is my own synthesis, tagged [synthesis].

2. Framework

No published client-phase model was found. CIFPR materials define stages for training (cycles C1–C5), not for treatment. [source: CIFPR Brochure 2019; programme pages] Below, the training structure is given as published, then a client-work framework built from it is offered as [synthesis].

2a. Training structure (published)

• C1, preparatory cycle (about 1 year):
  • Modules: continuous multireferential group, analytic psychodrama, practical multireferential-therapy seminar, psychopathology, philosophy, methodology, attachment theory, psychosocial transitions, and a warm-water clinical seminar.
  • Ends with an end-of-cycle review held in triads, with mutual evaluation before passing to the next cycle.
  • Hours: one listing gives 295 h over 45 days; another gives 124 h. [uncertain] [source: je-change-de-metier cycle 1 and full-programme pages]
• C2–C4, core training (3 years):
  • The four methods are taught in alternation each year: Gestalt, bioenergetic analysis, group dynamics and psychoanalysis.
  • Each year also includes analytic psychodrama, pool work, a 42-h summer seminar and an annual evaluation.
  • [source: programme page; Brochure 2019]
• C5 / C3 professionalisation (about 18 months):
  • Advanced Gestalt and bioenergetics, a 200-h placement as observer and then co-therapist, a clinical-case article and a training-path dossier, and a defence before a jury.
  • Group supervision is compulsory for the first two years of practice.
  • [source: Brochure 2019; programme page]
• Formats used by the school:
  • Monthly non-residential weekends (Friday evening to Sunday evening), two residential seminars a year, and multi-day pool seminars.
  • Trainees must be in personal psychotherapy or psychoanalysis and stay in it throughout training.
  • [source: Brochure 2019; CIFPR calendar CAL-P13C4]

2b. Client-work framework [synthesis]

The phases below are built from the school's principles; they are not a CIFPR protocol.

Throughout every phase: own personal therapy and supervision, and checking oneself against the other references. [synthesis, grounded in Brochure 2019 principles]

3. Guiding principles

[source for all unless tagged: CIFPR Brochure 2019; je-change-de-metier programme pages; CIFPR press release 2018]

• Multiréférentialité. Apply each method in its own right, and accept the "contradictions irréductibles" between them. Practice: when you run a Gestalt experiment, run it as Gestalt; when you interpret transference, do it analytically. Do not blend them into one technique.
• Intégrativité, partial and only where possible. Combine methods only where they fit together. Practice: move from body work to verbal elaboration within a session, but name the shift and do not force a synthesis.
• Each method is critiqued by the others. Practice: when you are stuck in one frame, ask what the others would see. For example, is this "resistance" (analytic) actually an interrupted contact (Gestalt) or chronic muscular holding (bioenergetic)?
• The relationship is the engine. "Aller voir quelqu'un" rather than being treated. Practice: treat the encounter itself as the main tool; technique serves the relationship.
• Principe Relation (Buber). Practice: meet the client as a subject, not a case; stay present and real. [source: press release, contents; Buber's text]
• Principe Empathie (Rogers). Practice: follow the client's frame of reference and check your understanding back with them. [source: press release, contents]
• Transference and countertransference are central. Both appear as chapters in the founding book. Practice: track what the client relives with you and what you feel; use both, and take them to supervision. [source: press release, contents]
• A method is not a technique. Short techniques belong to the helping relationship (relation d'aide), not to psychotherapy. Practice: do not run exercises without a frame; every technique sits inside an ongoing relationship and is worked through afterwards.
• Inséparabilité. Your own personal work cannot be separated from your practice. Practice: stay in personal therapy and supervision, and recognise your own material before acting on it.
• Experiential learning ("expérientiel didactique"). Practice: offer clients only methods you have experienced yourself, as a client, in training.
• Existential stance. Gestalt is taught with an existential and Daseinsanalytic posture. Practice: take questions of meaning, freedom, finitude and choice seriously as material. [uncertain: how this stance is operationalised was not found]
• The intrapsychic and the social are linked. Attachment theory and psychosocial transitions (Parkes) are taught explicitly. Practice: read symptoms against life transitions such as birth, loss, migration and job change, and against attachment history. [source: cycle 1 page]
• Know psychopathology. Training covers the neurosis/psychosis distinction, schizophrenia and the other psychoses. Practice: assess before you choose regressive or body-intensive methods; refer when needed. [source: cycle 1 page]
• Ethical rules of group clinical practice. The brochure sets eleven rules, including no acting out ("s'interdire tout passage à l'acte"), sexual or otherwise; anonymity and confidentiality understood as discretion; and no attending under alcohol or drugs. Practice: state these rules aloud in any group or body-mediation setting. [source: Brochure 2019]
• Professional ethics codes. Follow the SNPPsy and AFFOP deontology codes. Practice: know the code you are registered under and its complaint route. [source: Brochure 2019]
• Autonomy and responsibility as aims. Practice: avoid creating dependency; the FF2P explicitly warns against cultic misuse of psychotherapeutic techniques. [source: Santé Mentale 2017]

4. Intervention inventory

How this inventory is built. CIFPR sources name the methods and settings below; they are the school's "four cardinal points" plus its specific mediations. [source: Brochure 2019; programme pages] The CIFPR sources used give no step-by-step client procedures. The steps for each component method summarise the standard practice of that method's own founders (books listed in Sources, not drawn on here), tagged [uncertain]. The guidance on when to switch methods is [synthesis]. All example language is illustrative and my own.

A. Preliminary interviews and setting the frame (cadre)

• Purpose / when: At intake, and whenever the frame is tested. Its job is to establish the relationship as the engine and to decide which references and settings fit the person. [synthesis; frame and contract are core to the analytic and relational traditions the school draws on]
• Steps:
  1. Let the person tell their request in their own way; listen before asking questions.
  2. Explore: the history of the problem, any recent life transition, relational and attachment history, previous treatment, medication and current psychiatric follow-up.
  3. Screen for psychotic organisation, suicidality, substance use and medical conditions relevant to body work (cardiac or respiratory problems, epilepsy, pregnancy, recent surgery).
  4. Explain how you work: talking, attention to the body, and possibly group or psychodrama.
  5. Agree the frame: frequency, duration, fee, missed-session policy, confidentiality and its limits, how ending happens, and your professional title (psychopraticien, not psychothérapeute, unless you hold that title).
  6. Agree a first setting and review it after a few sessions.
• Example language (illustrative): "Let's take a couple of meetings to see whether working together makes sense for you. Then we'll agree how often we meet and what happens if you miss a session."
• Watch for: Pressure to start body work or intensive groups before there is a stable relationship. A request that is really medical or psychiatric. Signs it is working: the person can say what they want to change, and the frame holds without constant renegotiation.

B. Relational presence and empathic understanding

• Purpose / when: In every session. This is the "principe Empathie" and "principe Relation" of the founding text. [source: CIFPR press release, contents; Rogers and Buber — uncertain]
• Steps:
  1. Attend to the client's felt meaning rather than the facts.
  2. Reflect back your understanding tentatively, and let the client correct you.
  3. Disclose your own here-and-now response sparingly, when it serves the client.
  4. Name what happens between you (for example a sudden distance) rather than only what the client reports from outside.
• Example language (illustrative): "If I follow you, it isn't the criticism itself that hurts, it's feeling unseen. Is that right?" / "Something changed between us just now. You seemed to step back."
• Watch for: Empathy sliding into reassurance or fusion. Disclosure that is about your needs. Signs it is working: the client corrects and deepens your reflections, and says more than they planned to.

C. Working with transference and countertransference

• Purpose / when: Throughout. Transference and countertransference are chapters of the founding text and part of the psychoanalysis pole. [source: press release, contents; Brochure 2019] Use it when the client repeats an old relational pattern with you, or when you notice strong or unusual reactions in yourself.
• Steps [uncertain: the general analytic tradition, not a CIFPR text]:
  1. Notice repeated feelings, expectations or roles in the relationship with you: idealisation, fear of being dropped, defiance.
  2. Note your own reactions as data, privately first.
  3. Wait until the pattern is clear and the alliance can bear it.
  4. Link here-and-now with you to there-and-then and to current relationships.
  5. Take strong countertransference to supervision before acting on it.
• Example language (illustrative): "You've apologised three times for taking up my time. I wonder if you expect me to tire of you, the way you described your father."
• Watch for: Premature or intellectual interpretations. Defensive agreement. Signs it is working: new memories, an emotional shift, and the pattern loosening in outside relationships.

D. Free association and interpretation (analytic listening)

• Purpose / when: To work with unconscious material in verbal sessions. This is the psychoanalysis pole. [source: Brochure 2019; Freud — uncertain]
• Steps [uncertain]:
  1. Invite the client to say whatever comes to mind without selecting.
  2. Listen with evenly suspended attention, noting slips, repetitions, dreams and omissions.
  3. Offer interpretations as hypotheses linked to what the client has actually said.
  4. Leave the client space to take them up or not.
• Example language (illustrative): "Just say what comes, even if it seems off-topic." / "You moved from your sister straight to the exam failure. Is there a link?"
• Watch for: Fragile or psychotic organisation, where unstructured association can disorganise the person. Prefer supportive, structured relational work then. [synthesis]

E. Gestalt here-and-now awareness work

• Purpose / when: When the client talks about experience rather than from it, or intellectualises. This is the Gestalt pole. [source: Brochure 2019; Perls, Hefferline & Goodman 1951 — uncertain]
• Steps [uncertain]:
  1. Bring attention to the present: what the client is aware of now in body, feeling and thought.
  2. Ask "how" and "what" rather than "why".
  3. Point out how contact is interrupted: averting the gaze, holding the breath, changing the subject, saying "one" instead of "I".
  4. Invite first-person, present-tense language.
  5. Stay with the emerging figure until it completes or something new appears.
• Example language (illustrative): "As you say that, what do you notice in your chest?" / "Try saying 'I' instead of 'you'. What changes?"
• Watch for: Overwhelm when attention to feeling intensifies; slow down or ground the client (see H). Signs it is working: livelier speech, emotion that fits the content, and the client noticing their own interruptions.

F. Gestalt experiments: enactment, amplification, chair work

• Purpose / when: To turn an inner conflict, an unfinished situation or a stuck gesture into an experience in session. This is part of the Gestalt pole. [uncertain: specific techniques from Gestalt literature, not CIFPR text]
• Steps [uncertain]:
  1. Propose an experiment and get consent: "would you be willing to try…".
  2. For an unfinished relationship: the client speaks to the absent person imagined in an empty chair, then may switch chairs and answer as them.
  3. For an inner split: dialogue between the two sides on two chairs.
  4. For amplification: exaggerate a small gesture or phrase and say what it expresses.
  5. Debrief: what did you discover?
• Example language (illustrative): "Would you be willing to imagine her here, in this chair, and tell her what you never said?"
• Watch for: Experiments imposed rather than co-created. Retraumatisation when the absent person was abusive: lower the intensity, keep distance, and allow the client to stop at any point. Signs it is working: spontaneity, a felt shift, and a new sentence or stance the client can take outside.

G. Dream work (Gestalt and psychodrama routes)

• Purpose / when: When the client brings a dream. CIFPR psychodrama is staged from "rêves et fantasmes". [source: cycle 1 page] The Gestalt variant (identifying with each element of the dream) is [uncertain].
• Steps:
  1. Have the client tell the dream in the present tense.
  2. Gestalt: invite them to speak as different elements ("I am the locked door…") and notice which one carries energy. [uncertain]
  3. Analytic: gather the client's associations to each element before offering any meaning. [uncertain]
  4. In a group: stage the dream as psychodrama (see O).
• Example language (illustrative): "Tell it as if it's happening now." / "Be the door for a moment. What do you say?"
• Watch for: Nightmares linked to trauma; give priority to stabilisation over enactment. [synthesis]

H. Bioenergetic grounding

• Purpose / when: To anchor a client who is anxious, dissociating or "in their head", and as the base for any body work. This belongs to the bioenergetic-analysis pole, "basée sur les travaux d'Alexander Lowen". [source: programme page; Lowen 1975 — steps uncertain]
• Steps [uncertain]:
  1. Explain the purpose of the exercise and ask for consent.
  2. Client stands, feet hip-width apart and parallel, knees slightly bent and not locked.
  3. Weight goes to the front of the feet; the client feels contact with the floor.
  4. Breathing stays easy, belly soft.
  5. Optionally the client bends forward with knees soft and hands touching the floor, letting the legs tremble if vibration comes.
  6. Come up slowly and talk about what was felt.
• Example language (illustrative): "Let your knees soften and feel your weight go down into the floor. What do you notice?"
• Watch for: Dizziness, back or joint pain, and panic when trembling starts. Stop and sit down if needed. Check medical conditions first. Signs it is working: the client feels steadier, breathes more fully and can speak about feelings without leaving the body.

I. Body reading and breathing work (bioenergetic)

• Purpose / when: To link chronic bodily holding (the "character" written in the body) to emotional history. Use it once the alliance is solid. [uncertain: Lowen's character typology and stress positions]
• Steps [uncertain]:
  1. Observe posture, breath, tension and energy, with consent, while the client stands.
  2. Share observations as invitations, not diagnoses.
  3. Invite the client to deepen breathing and notice where the breath stops.
  4. Explore the feeling and memory that come up.
  5. Elaborate in words afterwards; this is the link back to the verbal methods. [synthesis]
• Example language (illustrative): "I notice your shoulders lift when you talk about her. Would you like to stay with that and see what comes?"
• Watch for: Shame about the body. Hyperventilation, so keep breathing natural and not forced. Strong emotion surfacing faster than it can be integrated.

J. Expressive body work (bioenergetic)

• Purpose / when: To release blocked anger, protest or grief in a contained way. Use it only in the working phase, with ego strength present. [uncertain: specific exercises such as hitting a cushion, kicking, or using the voice come from the bioenergetic literature, not the CIFPR pages]
• Steps [uncertain]:
  1. Agree the exercise and a stop signal in advance.
  2. Use safe equipment: a mattress or cushion, and space around the client.
  3. Have the client ground first (H).
  4. Do the movement with voice ("no!") for a short, bounded time.
  5. Slow down, ground again and talk it through.
• Example language (illustrative): "Say 'no' as you push. Louder if it feels right. Stop whenever you want."
• Watch for: Contraindications [synthesis]: psychosis or a history of psychosis, unstable PTSD or dissociation, recent violence, cardiovascular or musculoskeletal conditions, and pregnancy. Catharsis without integration is not the goal. Signs it is working: relief followed by reflection, and the feeling links to its context.

K. Dynamique du souffle (breath dynamics)

• Purpose / when: The 2019 brochure lists this as a psychocorporal module. Its content, author and protocol were not found, and current listings do not mention it. [uncertain] [source: Brochure 2019]
• Safe practice if you use breath work [synthesis]:
  1. Use only methods you have trained in and experienced yourself.
  2. Avoid prolonged deep or rapid breathing.
  3. Screen for epilepsy, cardiac, respiratory and psychiatric contraindications, and pregnancy.
  4. Sit or lie the client down, and keep the eyes-open option.
  5. Stop at tingling, cramping, panic or dissociation.
  6. Leave time for verbal integration.

L. Warm-water pool clinical work (travail en piscine d'eau chaude)

• Purpose / when: A body-mediated group setting the school runs as multi-day clinical seminars. Practitioners experiment with the method on themselves and learn the dynamics of "un groupe à médiation". [source: cycle 1 page; calendar CAL-P13C4; Brochure 2019] The CIFPR sources used give no detailed protocol. [uncertain]
• Steps [synthesis: inferred safe practice, not a CIFPR protocol]:
  1. Hold the pool sessions only in a group setting led by trained therapists.
  2. Make sure there is a lifeguard or first-aid cover and water of suitable temperature and depth.
  3. Screen beforehand: fear of water, medical conditions, skin or infection issues, trauma involving water or touch.
  4. Agree touch rules explicitly before entering the water (who may hold or support whom, and how to refuse).
  5. Start with individual floating and contact with the water before any supported holding.
  6. Alternate time in the water with a verbal group sharing out of the water.
  7. Bring material that emerges into the client's ongoing individual work.
• Example language (illustrative): "Before we go in: no one will be touched without asking first, and 'no' or 'stop' is always respected at once."
• Watch for: Regression, early-attachment material and sexualised feelings. This is exactly where the no-acting-out rule ("s'interdire tout passage à l'acte") applies. [source: Brochure 2019] Signs it is working: participants can name what holding and floating brought up, and link it to relational history.

M. Continuous multireferential group (groupe continu multiréférentiel)

• Purpose / when:
  • A standing therapy group that also serves as a training ground.
  • The school describes it as initiation to group psychotherapy and as deciphering group dynamics "en situation".
  • It uses an integrative grid: Lewin, Rogers, Schutz, Perls, and Bion/Anzieu.
  • Use it for relational difficulties, isolation and repeated interpersonal patterns.
  • [source: cycle 1 page; Brochure 2019]
• Steps [synthesis built from the listed references]:
  1. Set the frame: the same members, the same time, confidentiality as discretion, no acting out, and no attending under substances. [source: Brochure 2019]
  2. Open with a round on what each person brings, or leave it unstructured.
  3. Follow the here-and-now between members.
  4. Draw on each reference as material calls for it:
     • Rogers: empathic facilitation.
     • Perls: a Gestalt experiment with one member while others witness.
     • Bion/Anzieu: interpret group-level phenomena such as dependency, fight-flight or shared fantasies.
     • Lewin and Schutz: name inclusion, control and affection issues.
  5. Close with a round.
• Example language (illustrative): "Several of you have gone quiet since Paul arrived late. What's happening in the group right now?"
• Watch for: Scapegoating, subgroups, and the therapist being idealised. Members being pushed to disclose. Signs it is working: members give each other direct feedback and try new behaviour in the group.

N. Reading group process ("diagnostic groupal évolutif")

• Purpose / when: The leader's ongoing task: reading the forms of interaction across a group's life. [source: cycle 1 page]
• Steps [synthesis]:
  1. After each session, note: who speaks to whom, absences, themes, the group mood, and the leader's own countertransference.
  2. Name the current phase (forming, conflict over control, intimacy, separation).
  3. Decide whether to interpret at group level or work with one person.
  4. Review in supervision or co-therapy.
• Watch for: Over-interpretation; keep hypotheses provisional.

O. Analytic psychodrama (psychodrame psychanalytique)

• Purpose / when: To enact dreams, fantasies and scenes from the client's own material. It is taught as Moreno's encounter with psychoanalysis, with Aristotle's catharsis as a reference. [source: cycle 1 page] Use it in groups, or with a small team in individual psychodrama. [uncertain: setting details from the French analytic-psychodrama tradition]
• Steps [uncertain]:
  1. The protagonist brings a scene, dream or fantasy.
  2. The protagonist briefly sets the scene and chooses who plays whom (group members or co-therapists).
  3. The scene is played for a short time.
  4. The director stops or turns the scene: role reversal, a double, replay.
  5. Afterwards the protagonist and players associate verbally.
  6. The director offers interpretation, linked to transference within the group.
• Example language (illustrative): "Who in the group could play your mother? … Begin where she comes into the kitchen." / "Stop there. What came to you as she said that?"
• Watch for: Flooding, physical acting out, and players playing out their own material. Keep scenes short and debrief everyone, de-roling the players. Signs it is working: new associations, and the protagonist responding differently in the replay.

P. Attachment and life-transition formulation

• Purpose / when: At assessment and reformulation. The school teaches attachment theory and "transitions psychosociales" (Parkes, with Bowlby's group), with parenthood and perinatal psychopathology at the meeting point of the intrapsychic and the social. [source: cycle 1 page]
• Steps [synthesis]:
  1. Map the client's attachment history and current attachment figures.
  2. Identify recent or pending major transitions: birth, loss, migration, retirement, illness.
  3. Formulate the symptom as both a response to the transition and an echo of the attachment pattern.
  4. Share the formulation with the client in plain words.
• Example language (illustrative): "Since the baby arrived, old feelings of being on your own seem to have woken up. Shall we look at both?"
• Watch for: Perinatal depression or psychosis, which need medical referral.

Q. Psychopathology-based indication and referral

• Purpose / when: Before choosing regressive, body or group methods, and whenever the clinical picture changes. Training covers the neurosis/psychosis distinction, schizophrenia and the other psychoses, and Gestalt, bioenergetic and analytic psychopathology. [source: cycle 1 page; Brochure 2019]
• Steps [synthesis]:
  1. Assess reality testing, identity integration and defences.
  2. With fragile or psychotic organisation, favour supportive individual relational work and avoid intensive cathartic, breath or deep-regression methods.
  3. Coordinate with the psychiatrist or GP when medication or risk is involved.
  4. Refer when the problem lies outside your competence.
• Example language (illustrative): "I'd like us to work alongside your doctor as well, so both sides of what you're going through are covered."

R. Clinical vignette, supervision and the comparative method (practitioner procedure)

• Purpose / when: The school requires written accounts, the clinical vignette method, a case article, and group supervision for the first two years of practice. Each method is to be examined critically by the others. [source: cycle 1 page; Brochure 2019; programme page]
• Steps [synthesis]:
  1. After key sessions, write a short vignette: the facts, what was said and done, your felt response.
  2. Read the case through each of the four references in turn.
  3. Note where they converge and where they truly contradict.
  4. Bring the vignette to supervision.
• Watch for: Using one method's language to dodge what another would reveal.

S. Intensive and residential seminars

• Purpose / when: The school uses weekend intensives, two residential seminars a year, and a 42-h summer seminar for concentrated individual and group self-work "sans didactique". [source: Brochure 2019; cycle 1 and programme pages] For clients these are an optional add-on to ongoing therapy, never a substitute for it. [synthesis]
• Steps [synthesis]:
  1. Screen participants.
  2. Set a clear frame and rules.
  3. Mix individual work witnessed by the group with group process.
  4. Leave time for closure.
  5. Arrange follow-up with each participant's regular therapist.
• Watch for: Post-intensive decompensation and the high of group euphoria. Make sure there is a follow-up contact.

T. Child and adolescent psychotherapy

• Purpose / when: Listed as a training module. [source: Brochure 2019; calendar] Its content was not found. [uncertain] Apply the general frame (A) with parental involvement and play- or mediation-based work only within your own training. [synthesis]

5. Handling problems

The CIFPR sources used give ethical rules (no acting out, confidentiality, no substances, the SNPPsy/AFFOP codes, compulsory supervision) but no problem-specific guidance. Everything below is [synthesis] unless tagged otherwise.

• Stuck client (same themes repeating, no movement).
  • Use the comparative method: describe the impasse in each reference's language.
    • Analytic: is it a repetition being lived out in the transference?
    • Gestalt: what contact is being avoided right now?
    • Bioenergetic: where is the body holding?
    • Group: what does the stuckness protect?
  • Then offer one change of mediation, explained and agreed, for example a short grounding exercise or chair dialogue in an otherwise verbal therapy.
  • Take the case to supervision.
  • Example (illustrative): "We seem to keep circling. Would you be willing to try something different for ten minutes and see what it shows us?"
• Resistance.
  • Treat it as meaningful, not as opposition. Analytically it can be interpreted; in Gestalt it is a form of contact to explore. Rather than pushing through, invite the client to amplify the "no".
  • Never override refusal of body work or touch.
  • Example (illustrative): "Part of you clearly doesn't want to go there. Can we hear from that part?"
• Overwhelm, flooding or dissociation during body, breath, pool or psychodrama work.
  1. Stop the exercise.
  2. Orient the client to the room: eyes open, feet on the floor, naming objects.
  3. Slow and normalise the breathing.
  4. Sit the client down.
  5. Shift to verbal processing at low intensity.
  • Afterwards: lower the intensity of future work, give priority to stabilisation, and review whether the setting is indicated (see Q).
  • In a group: one leader stays with the person while the other holds the group.
• Non-adherence to the frame (missed sessions, late payment, absences from group).
  • First hold the frame as agreed: fee policy, notice.
  • Then explore the meaning in the relationship, as possible transference or ambivalence.
  • In groups, absences affect everyone, so let the group name this.
• Ruptures (client angry, withdrawing, threatening to stop).
  • Acknowledge your part without defending yourself.
  • Explore the client's experience of the rupture.
  • Look for links to earlier relationships only after repair has started.
  • Rupture and repair are part of the relational work itself.
  • Example (illustrative): "I think I pushed too fast last week, and you felt cornered. I'd like to understand how it was for you."
• Confusion caused by too many methods (client feels "experimented on").
  • This is a risk specific to multireferential work.
  • Slow down. Keep one main setting and treat other mediations as occasional, agreed additions.
  • Explain why you propose each one.
  • Respect the school's own distinction: techniques without the frame of a relationship are helping work (relation d'aide), not psychotherapy. [source: Brochure 2019]
• Erotic transference, touch and boundary risk.
  • Body and water work raise this risk.
  • Name the rules before any touch. Ask consent each time. Prefer client-led touch, or none at all.
  • Document what happened, and take any sexualised dynamic to supervision promptly.
  • Sexual acting out is explicitly forbidden. [source: Brochure 2019]
  • Remember that the FF2P warns against misuse of techniques to create dependency. [source: Santé Mentale 2017]
• Group-specific problems (scapegoating, a dominating member, subgroups, breaches of confidentiality).
  • Interpret at group level first: "what does the group need Marie to carry?"
  • Protect the targeted person.
  • Restate the rules.
  • Meet individually with a member who keeps breaching the frame.
• Post-intensive decompensation (after a residential seminar, pool seminar or psychodrama).
  • Arrange a follow-up contact within days.
  • Liaise with the person's regular therapist.
  • Refer to medical care if psychotic or suicidal symptoms appear.
• Suicidality and risk.
  • Follow standard risk assessment: ideation, intent, plan, history, protective factors.
  • Make a safety plan and agree lethal-means restriction (secure storage, or removal of means).
  • Link with the GP or psychiatrist and, when needed, emergency services.
  • Suspend cathartic or regressive methods while risk is raised.
• Working outside your competence or title.
  • As a psychopraticien, do not present yourself as a psychothérapeute unless you hold that title. [source: Brochure 2019; Santé Mentale 2017]
  • Coordinate with medical professionals for diagnosis and medication.

Sources

Sources

• CIFPR – Brochure 2019 (school brochure, PDF)
• CIFPR – Communiqué de presse, La psychothérapie relationnelle (2018, PDF)
• CIFPR – Calendrier P13/C4 2020 (PDF)
• Psychothérapie relationnelle multiréférentielle (cycles 1, 2 et 3) – CIFPR programme listing
• Psychothérapie multiréférentielle – cycle 1 – CIFPR programme listing
• À propos du centre CIFPR
• Mollat – Grauer & Lefebvre, La psychothérapie relationnelle (publisher description)
• Santé Mentale – Reconnaître le métier de psychopraticien en France (2017)
• Le Quotidien du Médecin – L'extension du domaine de la psychothérapie (2017; introduction only)
• Kananas – FF2P association record (no information on recognised methods)

Further reading (not drawn on directly; used for component-method steps marked [uncertain])

• Grauer, P. & Lefebvre, Y. (2018). La psychothérapie relationnelle : de la naissance d'une profession à l'émergence d'un champ disciplinaire. Enrick B. éditions.
• Durand-Dassier, J. (1969). The book the CIFPR credits with founding the concept of relational psychotherapy. The title was not verified. [uncertain]
• Perls, F., Hefferline, R. & Goodman, P. (1951). Gestalt Therapy: Excitement and Growth in the Human Personality.
• Lowen, A. (1975). Bioenergetics.
• Buber, M. (1923). Ich und Du.
• Rogers, C. (1961). On Becoming a Person.
• Anzieu, D. (1975). Le groupe et l'inconscient.
• Parkes, C. M. (1971). Psycho-social transitions: a field for study. Social Science & Medicine, 5.