Make sense of A visit to the 'psy'

"Fed up to the back teeth, eh? Now there's a feeling I can have empathy with"

There are many reasons people consider visiting a ‘psy’, from a general sense of dissatisfaction, to serious mental illnesses 

IF YOU are looking to talk over problems in France, you have probably come across the term ‘psy’, but in fact this vague term covers a range of different professionals.

You will find, of course, psychiatres – doctors specialising in mental health and psychologues, who have undergraduate and masters degrees in psychology.

However the word is especially associated with people trained in psychotherapy – un psychothérapeute – who may or may not also be a psychiatrist or psychologist.

One traditional form of this is psychanalyse such as Freudian analysis, where you might traditionally lie on a couch and spend years delving into childhood memories. In fact, however there are many kinds of psychotherapy based on different philosophies and techniques – though all use a talking-based approach.

In 2010 the government brought in a new definition of a psychothérapeute, to avoid people with very fringe ideas using it. Unfortunately many professionals say criteria were poorly  chosen, leading the largest professional body, Fédération Française de Psychothérapie et Psychanalyse (FF2P) to come up with a new word – psychopraticien.

A bilingual psychotherapist and FF2P member from the Dordogne, Lynne Rigaud, explained: “The government said ‘psychotherapy’ is only practised by psychologists and doctors, which put to the side everyone who had training in psychotherapy by not those particular degrees.

“Rather than them not being able to practice, FF2P, and another body AFFOP, gave this new title to them as long as they have specific training in face-to-face interviews with a therapeutic plan in mind.”

In fact, she said, some people with medical or psychology degrees may have little or no practical psychotherapy experience.

“The government now says certain types of doctor who are not psychiatrists, and certain types of psychologist, do have to do some hours of psychotherapy study, but not necessarily face to face. It could be university study of what pyschotherapy is rather than real training for practitioners.”

FF2P members must all meet its psychopraticien criteria, she said. It is also the only French body that may accredit people with the European Certificate of Psycho­therapy (CEP), which she said has similar requirements to the French one, though an additional application is required to obtain it.

 She said: “If you want to join FF2P you have to bring a file with all your training and experience and it is looked at case by case, unless you went to a school which is accredited, which is the direct route.

“You need theoretical and practical training in a recognised method and in mental illnesses and you have to have done an in-depth psychotherapy yourself so you are not projecting your problems on your client or imposing your own values.

“Every psychopraticien must also have a superviser, who is an experienced practitioner with a certificate in supervision. They help you manage your caseload in a safe and ethical way.”

Ms Rigaud said cognitive-behavioural therapies are popular, as well as humanistic ones and psychoanalysis. “However all of them are evolving as research comes out about good practice and what works.

“Cognitive behavioural therapy is based on how distorted thoughts around a situation affect how we behave. The practitioner helps the client notice the distorted thinking and looks to see if there may be other ways of thinking about it.

“Humanistic practitioners, like myself, believe the client is on an equal level with us – we don’t set ourselves above them as ‘experts’. We just try to help them realise their potential, without imposing anything on them. I use an integrated method, so I might consider thinking patterns, but also work with emotions, and with sensations which are more bodily-orientated.”

Ms Rigaud said psychotherapy overlaps with what is called ‘counselling’ in the UK, but a psychotherapist must have substantial training in serious mental illnesses.

In her own practice she said she typically works very practically on what is happening now in the client’s life, rather than dwelling on past experiences. “The client usually comes in because the here-and-now is not feeling right for them.

“I notice what they bring into the session with them, in terms of the ways in which they relate to others and the world, and we work through whether these are still useful or have become sterile. We experiment with slightly new ways of doing things and we notice together whether that’s opening more opportunities.”

Typical situations revolve around relationships, she said. “It can be difficulties in the couple, or feelings around bringing up children, or feeling shy and not going out, which is linked to a feeling of being judged. I take people from 15, as I don’t have training on working with children.

“For therapists who do work with them it might be issues like them being shy, or feeling bullied, or having had other difficult experiences that are affecting them.”

The number of sessions (typically 10 or more) depends on how deeply-rooted problems are. If you have a very specific problem you wish to address – such as a phobia - a very ‘solution-focussed’ therapy may be quick.  Once a week, or sometimes every fortnight, is the typical rhythm.

Costs are from around €35-80/hour with rates tending to be higher in cities than the countryside. www.ff2p.fr has an annuaire (directory) of therapists, and it is possible to narrow your search by criteria including languages spoken. People looking for therapy in English may also like to check
counsellinginfrance.com which includes details of professionals’ individual qualifications and approaches.

Most people pay privately for psychotherapy, with visits to a psychiatrist being the most common exception where there is full state reimbursement. You may also be able to obtain reimbursements for help from a psychologist at a centre médico-psychologique (CMP) or if you have psychological help in hospital.

Typically people visit psychiatrists with serious concerns for their mental health, possibly requiring medication, beyond ‘existential’ worries and difficulties in life. They, or specialists called addictologues, are also consulted by people with addictions, who may need specific medical support.

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