PSYCHO-ANALYTICAL RELAXATION GROUPS (SAPIR METHOD)
A TOOL FOR THE TRAINING OF CARERS
What follows concerns training groups for the carer-patient relation using relaxation.
We are indebted to Michel Sapir for the foundation of Psycho-analytical
Relaxation, also called Variable Induction Relaxation. If it has its
origins in Schultz's Autogenous Training, from the years 1955-60, it
was quickly distanced from that, by the first practitioners, Freudian
psycho-analysts, who were much inspired by the works of Férenczi,
Winnicott, Dolto and Balint.
The purpose is not to become relaxed; relaxation is offered as a way of
listening to the body and is in fact just a means, in the same sense as
the couch, to enable the lowering of defences and the psychological
circulation which permit analytical work.
The psycho-analyst relaxer, through his inductions, verbal, tactile or
otherwise, allows the subject to begin listening to the sensations
which then arise in himself, to put them into words and to relate to
This requires training groups comprising around ten carers from
different backgrounds, meeting regularly for thirty three sessions.
Ideally the group is conducted by a mixed couple with an observer,
either qualified or in training. All three are trained psychoanalysts.
The relaxation session progresses by two stages: first, a period of
relaxation introduced by verbal inductions, and followed by touching;
second, a period of speaking, when each person expresses in his own
rhythm, his own feelings in words. The touching and the verbal
induction are variable in the course of training sessions.
The work concerns the bodily sensations, through the impact of the
words and the touch of the conductors, attending to what the two
processes reveal : narcissistic regression of the group, and
narcissistic regression of the subject.
This is not therapy, but training, for carers who wish to question
their attitude to caring, through a corporal approach and in a group.
The association relaxation and group, makes possible a relation to
one's own body, within a secure setting, the group serving
simultaneously as vector, support, security and induction.
The appeal to the sensorial initiates a process of regression which involves all of the senses.
So we invite the relaxers to feel what is happening in their bodies;
(cénesthésique) sensations, but also, to awaken their senses: touch,
smell, taste, hearing, sight. In other words, to mobilize those sensory
organs that were so present in infancy, and even from the foetal stage.
"In infancy" J. MacDougall tells us,"the psyche is organized on a
pre-linguistic basis" although the first transactions from mother to
infant are made in "a linguistic community. . . . For human offspring,
in the beginning was, not the word, but the voice. . . a voice pregnant
with the corporality of the mother. . . To the mother's voice should be
added all the other perceptions of the senses: smell, touch, internal
and kinesthesic experiences . . . the skin-self, but also the
smelling-self, breathing-self, digesting-self."
Our hypothesis is that, ever since we have had a body and sensory
receptors, everything that we have experienced with this body, our
history, has encoded itself in the course of time in our sensory self,
by means of which we shall be able to recover the messages. In this way
the approach of psychoanalytical relaxation will favour their
expression through the discovery of their print. Our concern is that
the bodily sensations are made perceptible, then the perceptions put
into words, to be received, heard, by an other.
The sensation has a very particular meaning in the process we
establish. It arises in a quite precise situation, limited in time and
space, and it is, in some way, a response to an induction. It has a
location just like the talk which expresses it.
It is encoded in the transference which arises directly from the first sessions.
We have spoken of touch; indeed, with the model that we offer in RPS
touching is a central feature. After giving a spoken induction, we
touch the participants.
Touching is part of the model, established as such, expected by the
participants, reflected upon by the leaders, and has nothing to do,
with an acting out.
We are aware that this, involves undertaking a risky procedure, which
requires in the analyst a constant vigilance over what unfolds, what he
perceives in the relaxant, and what he perceives in his own spontaneous
What does this touching mean; how is it received; what is its effect?
"I felt I was trapped in an iron collar", reported Bernadette during
one of our relaxation groups; she said her skin had felt to her, like
"a thick crust" which could not feel anything. Then she recalled a
picture of herself as a young child, plastered from chest to legs for
The induction spoke of the skin thus: "the body present, enclosed in
the skin which protects it . . .", followed by the touching of her
legs, had brought back for her, that desperate lack of contact, between
her body and the body of an other.
The hand which touches comes to question the feeling.
It is clear in Bernadette's case how the sensation of someone else's
hand on her skin, re-awakened in her, the lack of that sensation at a
point in her life when she would have so much needed her relation to an
other to be from body to body. The verbal induction about skin had
provoked rejection in Bernadette :"skin, that means nothing to me, I
feel nothing", but in this context, the hand of the relaxer placed on
one of her legs, this live bodily element, provokes in her, a sensation
which, caught in the field of transference, gives rise to associations
whilst drawing out bodily traces of memory.
This touching happens at a moment when the subject is alone in his own
private space; it introduces the presence of an other into that space.
It invite each person to encounter bodily sensations experienced in the
past, and thus encoded somewhere inside themself.
This is why the participants are surprised to find themselves in the grip of ancient sensations:
Mireille:"I was like a baby swaddled in its bands";
Elise: "After the touching, I had the feeling of being released, like a baby who has been given the Moreau reflex".
In a group, the touching is thus the point at which the leaders
approach an individual, attend to him, and then leave him to go to an
other. Being chosen, being left, being selected or not. Anne, while
waiting for the leaders to make a move, thought that they would forget
The touching identifies the individual within the group; effectively,
if our words are addressed to everyone (though each person receives
them personally), our touching is addressed to each person individually.
"When you were leaning over me," Madeleine verbalized, "I smelt your
perfume; it is not the same perfume as my mother's, but I fond myself
back, very small in my bed, when my mother came to hug me in the
morning before leaving for work; I kept the smell of her
perfume until the alarm clock sounded." Enfolded in this perfume
comfort blanket, Madeleine had to wait for the alarm, get up alone and
go to have her breakfast at the neighbour's.
It is through the channel of transference that the affective situation
is able to show and express itself. It was not the smell of her
mother's perfume which carried Madeleine back to her little child's bed
wrapped in her mother's perfume; that perfume was suggested by a smell
which, borne by the transference, produced that effect.
We are truly at the level of the symbolic and the touching is simply a question of interrogating the body.
If this procedure appeals readily to the sensations, these will not
mean so much without words. Words are what enable connections to be
made, what give meaning to the senses. This is the point at which we
leaders are closest to the classic position of the psycho-analyst,
listening to the words of each person and assisting by our
interventions in the search for the meaning of what has been
We ask the participants to stay as close as possible to what they have
just experienced in their bodies. It is a creative time, during which
what has been felt as "a sensation of coldness" or "a meaningless
gargoyle" is to become a door opening onto a forgotten world.
There is what has been felt and the representation which the relaxant
has been able to construct out of what has happened for him in his
body. This representation, say Monique Meyer and François Reverchon*
has its origin, associatively in the body feelings, in the flooding of
the sensory stimuli (interior and exterior) whether or not recognized
at the conscious level.
What to talk about, what not to talk about? To whom is this talking addressed?
The making of this choice has a meaning.
"I had some vague images, I don't know what I'm going to say
about them to make sense of them. I've had some images that I don't
want to talk about, here" – it's too private? "Yes, that's it, and then
it's like nothing, it can't be shared, not comprehensible", says Lise.
We are not here dealing with the classical psychoanalytic treatment
which the fundamental rule of saying everything that comes to
consciousness. During the times of silence, each person is by himself,
amongst the others, listening to his own sensations, from which he
knows that he will have to recover something. So he will take the time
to formulate, to try to find words for what has surfaced inside
himself, in his body, he will judge what he can communicate, what will
be understandable by the analysts, but also by the group.
If the persons addressed by the words, are most often the three
psychoanalysts: the two leaders, who can react to these words, and the
observer, who writes down everything that is said, to keep it in
memory, the group will also allow lateral transferences between the
participants, which we shall also note.
In the course of the sessions, we see quickly emerging sensations and
their colours, symbols of pleasure, displeasure, affects, differing
between one participant and another and from moment to moment.
Manifestations of father and mother figures, make their appearance. We
are the place of projections and projective identifications.
In the Group
The group will play a role, sometimes as brake, sometimes as
facilitator. We discover in this time of verbal exchange the known
group phenomena (Kaes) which play their habitual role:
The containing role for example for Sylvain:"This group gives me
confidence, I feel safer here with the others around me . . . I think
that without the group, being touched by your hands, would have been
It is a group matter how the space is shared out, the positioning of
the mattresses either in dormitory-style rows, or in a star, randomly
etc. . . next to the door, beside so and so . . .
Where will each one settle, beside whom, away from who else? And what will he be able to do about it?
Claire to her neighbour: "I heard loud breathing beside me, I felt as
though you were choking and I was not able to relax." Or again Claude:
"Lying down with the others beside me, I found myself back, in boarding
school; there were even prefects!"
We note also the games of projection/identification which can be
primary, encouraged by the passivity of relaxation, or secondary,
supported by the signifiers which come from an other.
This oscillation between the singular which goes through the body and
the plural which embodies the group characterises our work and confirms
our commitment to balance, in the sense of working at the peak, at the
margin, at the limit, a path which enables the emergence of unconscious
What is essential, is that out of a regression in ones own body, a
fantasy arises, which can join in, or be supported by particular group
movements, or be registered in a significant personal chain.
In this quite specific model, the group joins in the quest of each
person on his individual journey, through what his body is saying.
But is this not a game of chance? This is stressed by J.P. Lehmann, in
his article from a book on relaxation groups, published by Dunod in
1985: "Paradoxes of Psychoanalytical Relaxation in Groups". On page 23
he quotes René Kaes in his work of 1976 on the psychic group device:
"For the group to become a body, makes each individual body a partial
object, it denies ones own contingent and limited body . . ." and
further, "The group becomes a body through the denial of this singular
J.P. Lehmann goes further in saying: "Thus there arises a major
(aporia) which we cannot ignore. It can be expressed in this way: as
for the regressive process proper to relaxation, is it not in danger of
being lost in the narcissistic regression of the group?"
To give these remarks their due, we must indeed make it clear, that the
particular spatial arrangement of these groups, will reinstate an
aspect of the individual: at the first meeting, we ask the participants
to introduce themselves, then, each one lies down on a mattress which
he arranges as he likes in the room and the trio of leaders is seated
on chairs. No instruction is given about this.
Next, the leaders take over, accompanying each person in his relaxing,
and if the spoken induction is addressed to everyone, it is received
individually. But it is above all the individual who is totally
attended to in the touching, this body to body with one of the leaders,
which engenders then, in the talking time moments, which are clearly
transferential: "I don't know who touched me, the man or the woman". "I
thought you had forgotten me". "Why did you touch me so quickly?" "Do
you touch everyone in that way?". . .
In the course of these groups, we remain virtually, a clinic of
sensoriality and its expression in words. The contributions of the
leaders, during the time of verbal exchange, even if they issue from
elements of the group dynamic, remain within the field of relaxation
and the individual thought processes of the participants.
The model proposed, its framework and regularity, enables this personal
experience in the group, to become a fundamental experience in the
training course offered.
Psychoanalytical Relaxation, a resource for training
Relaxation, with its questioning of the body, in its relation to the
word, and in body-to-body has rapidly seemed to us, a suitable tool for
the training of carers in the carer/patient relation and has been the
basis of our groups for over 50 years. Its transmission as a method of
psychotherapeutic care, also proceeds via an initial period in groups
to personal considerations.
In the chapter on training, which I wrote from 1975 in our first book,
called "Relaxation: its psychoanalytic approach", I began with this
observation: "When one says of a girl that she is formed, that means
that from now, she can give birth".
Is it up to us now, to give birth to beings who can take over from us?
I would suggest the two points that I have already mentioned above.
training by relaxation, which addresses all carers, and aims to modify
the relational approach to their patients, by means of a personal
change of their relation to their own body.
training in relaxation, which, more than the transmission of knowledge,
is imparting an experience of acquiring a specific approach to a
patient in psychotherapy through bodily mediation.
This brings us to asking the difficult question: These so-called
training groups, are they therapeutic groups? This arises with every
kind of training group. But, it is clear that these personal groups,
conducted in the same fashion, as groups of patients, can only become
formative, in as far as they touch in the carer, very deep places in
their personality; at the same time, these are relatively short-term
groups, and are responding, to an initial request, from the carer for
training. Of course, there can be no precise answer, and each one will
use this group in his own way, as in all the other psychoanalytic
training by group mediation.
However, the specifics of bodily mediation, will introduce here, a particular dimension of great value.
Thus, I remember a nurse, lying down in a group, who, towards the end
of the induction, said she was very afraid of the leader coming to
touch her. And she associated this, with the fact that she had never
imagined the fear that a patient might feel in bed, waiting for a carer
from whom he didn't know what to expect. She said that infact, she
feared he would crush her hand, expressing a possible aggression. From
this, there followed the recall of many childhood memories.
Over the years, our requirements for training, have constructed the
form of a course, which has now taken on a very clear plan. The
candidate will find himself offered, at a first stage, after an
introductory interview with one of the members of the association, who
will become his supervisor and will not have him in his group,
participation in a personal group, which will act as a common basis for
the two aspects of the training by and for . . .
Monthly groups of eight to ten persons in 35 sessions, which proceed as
we have described, led by a pair of psychoanalyst relaxers and an
At the end of the group, the candidate will have an interview with his
supervisor and will be able eventually to continue the course, if he
has an analytical qualification (not required to participate in the
first stages of the training).
Final stage of this first module, common basis, a day workshop three months after end of group, called "day of perspectives".
The second module is that of training as psychotherapist by psychoanalytical relaxation, Sapir model.
This is only offered to carers already engaged in a psychoanalytical process and having completed the first module.
Then the third module is that of training of trainers, offered to those
who have completed the first two modules and who wish to become members
of our team of leaders of training groups.
So much for the practical aspect of things.
Finally a word about the use of relaxation, in the form of sensitivity
training seminars, on the care/patient relation, in Balint method. In
this case there is a very brief use of two sessions of one hour, with
groups of a dozen carers, where the sessions proceed, in the way that
we have described fully. Although in all the rest of the seminar, the
case presented about a patient, allows a certain distance, even if it
is handled by working much on counter-transference, in the relaxation
groups, by contrast the carer is directly involved with his own body.
We have discovered frequently that, even this minimal approach, changed
the way of speaking of the carer, in further presentation of cases.
As to conclude
We wish to insist on the originality of this approach which, although
groupal, favours the individual, by a work on sensoriality,
through a regression induced both by the group and by the relaxation
We consider that its importance for the training of carers, in their
relationship with patients, is based on the fact that it allows them to
put words on counter-transferential body reactions, until then remained
unknown to them but perfectly felt by the patient.