Read this article published on the Cercle Psy website.

Gone are the days of quasi-religious devotion to a single theoretical chapel: « new generation » shrinks tend to multiply the strings to their therapeutic bow. Even if it means doing everything and its opposite?

If we were to be remotely emphatic, we’d say that there are as many psychotherapies as there are patients. Or almost. There are currently between 500 and 700 different methods in the West alone, according to psychiatrist and psychoanalyst Richard Meyer, founder of the European School of Social and Somato-Analytical Psychotherapy (EEPSSA), and author of the Manifesto of Integrative Psychotherapy (1). All are, moreover, enriched by personal variables specific to the psychotherapists themselves, multiplying them ad infinitum. They are generally grouped into five main families: psychoanalytic, behavioral and cognitive, family systemic, body-psychological and humanistic.  » This proliferation is not recent. It has accompanied the emergence of the main psychotherapeutic schools, dating back to the 1930s-1950s in Western countries. Moreover, with the human potential development movement * As a result, many authors have invented their own theories and methods, » saysFrançoise Zannier, a doctorate in psychology, psychotherapist and integrative supervisor, and author of Éclectisme et intégration en psychothérapie : intérêts et enjeux d’une profession (2).

Novelties and « pata-theories

This proliferation of methods is first and foremost the result of a broadening of the human dimensions that can be exploited in therapy. Today, the body(through relaxation), altered states of consciousness(through meditation), affection for animals(through therapy with animals), creativity(through art therapy), but also the family, the couple and sexuality can be called upon. And that’s not all:  » These include EMDR* for post-traumatic stress disorder, systematic desensitization for anxiety, and systemic therapy for family disorders. And let’s not forget that psychopathology is evolving, and that the very definition of mental disorders is becoming increasingly complex. « says Richard Meyer.

Every poison has its antidote; every psychological difficulty its psychotherapy? Let’s not be fooled by appearances. These methods are not so different from one another.  » Many authors have taken concepts and notions and integrated them into new constructions. To the uninitiated, these may seem like original methods, but in reality, some of this knowledge, which I call pata-theories, endlessly plagiarizes the main models. « says Françoise Zannier. If these psychotherapies seem so distinct from one another, it’s because they are officially maintained as such by their precursors, founders and followers.

Unofficially, the limits are specious.  » To find essential differences between two psychotherapeutic systems (…) is like the story of five blind men who touch different parts of an elephant, believing that the elephant can be summed up as a hollow pipe (the trunk), or four trunks with scales at the base (the 4 legs), or two flat leaves (the two ears touched by one of the blind men), and so on. The same applies to the various therapeutic chapels. Their apparent differences supported the illusion of their own originality, like real beings with an autonomous existence. The world of psychiatry and psychotherapy, » observe psychiatrists and psychotherapists Olivier Chambon and Michel Marie-Cardine in their book The basics of psychotherapy. Integrative and eclectic approach (3).

Blending for fresh consumption?

The proximity of these various approaches can only pave the way for eclecticism and integrative psychotherapy. Why limit ourselves to a single method when there are so many others within our reach? « There is such a synergy between these methods that, put to work together, successively or simultaneously, the therapeutic power of each increases, » says Françoise Zannier. « Bringing together hundreds of methods gives us an overall view of human functioning, and a global understanding of it. A single method does not make it possible to understand everything, » adds Richard Meyer.

Each method implies a specific attitude on the part of the psychotherapist. Integrating several methods enriches the therapist’s toolbox: it’s no longer up to the patient to « acclimatize » to the therapist, but up to the therapist to adapt to the patient’s uniqueness.  » Applying just one method to all patients reminds me of the myth of Procrusteus, who stretched a person’s limbs with ropes, or cut off their feet to fit the bed, » quips Olivier Chambon. Of course, integrating different therapeutic methods has its advantages. But is it enough to mix your three favorite methods and serve them fresh to your seasoned patient? No. This work is a pioneering and creative adventure, requiring a real personal investment on the part of the psychotherapist, coupled with unrivalled ethics. Because, given the power of such tools, abuse can be rampant. Integration is more complex than simply opting for cognitive-behavioural therapy for someone who wants to get back up and running as quickly as possible, or for an analytical approach for someone who is inclined to introspection and wants to address their difficulties in a broader context.The aim is to deconstruct methods and pathologies, and identify common factors, » explains Richard Meyer. For example, in the relationship with the patient, we find the therapeutic alliance, attachment and transference. Among the 400 pathologies listed by the DSM-5 (4)There are three basic processes: stress, shock and block – repeating the same thing over and over again. If the psychotherapist sees a patient suffering from stress, he will couple stress with an appropriate method, from among the 4 or 5 stress-treatment methods in his toolbox « . A highly specialized technique requiring in-depth knowledge of methods and mental disorders.

Beware: a war of chapels!

Diversity, unity and creativity in psychotherapy… On paper, integrative psychotherapy sounds very appealing. However, in the world of psychotherapy, diversity does not rhyme with unity. Each tends to advocate his or her own psychotherapeutic approach, snuggled up in their own theoretical chapel.

As Olivier Chambon and Michel Marie-Cardine point out, belonging to a chapel cultivates the shrink’s sense of security and provides him with a form of identity.  » It’s important to go out and meet the patient, and to distance ourselves from the reassuring shelter of the theoretical model. At some point, you have to leave your family if you want to grow up. « says Olivier Chambon.  » Most psychotherapists have mastered one, two or three methods through lengthy training courses. Once they’ve invested so much time and effort, they don’t have the time or inclination to do any more, which limits their learning curve. As a result, once in practice, they try to apply them to all their patients and extrapolate them as best they can. Unfortunately, this reduces the effectiveness of such methods « explains Richard Meyer.

Nor do universities promote great diversity. Many psychology courses remain predominantly psychoanalytic, presenting behavioral therapies as different, even alternative, currents.

The ultimate brake on this eclecticism is the loss of momentum of less scientific approaches: « The generalization of quantitative methods, and their assimilation as the only possible scientific approach, prevents the full recognition of qualitative methods. The latter are then relegated to the background, if not declared unscientific and excluded from research laboratories. « laments Françoise Zannier.

Nevertheless, certain methods from traditional, non-Western cultures could come to play an increasingly important role in the range of psychotherapies over the next few years: « The holistic or spiritual will be the next step in this integrative approach. Soon we’ll be integrating the soul and altered states of consciousness, » stresses Olivier Chambon. It’s important to remember that the term ‘psychotherapy’ includes the Greek word psychewhich means soul. Over time, we have forgotten this dimension of the individual.  »

(1) Richard Meyer, Manifeste de la psychothérapie intégrative, Dangles, 2010. See also Full presence. A meditation based on the 12 main psychotherapies Guy Trédaniel, 2013.
(2) Françoise Zannier, Éclectisme et intégration en psychothérapie : intérêts et enjeux d’une profession, L’Harmattan, 2010.
(3) Olivier Chambon and Michel Marie-Cardine, The basics of psychotherapy. Integrative and eclectic approach Dunod, 3rd edition, 2010.
(4) To find out more about the DSM-5, see the dossier « Maladies mentales: quoi de neuf, Docteur? », Le Cercle Psy n° 9, June-July-August 2013.