Définition de la maïeusthésie en anglais

Definition ­‐ Origins ‐ Areas of implementation - Documentation


The word "maïeusthésie" defines; on the one hand, a certain approach to communication, and on the other hand, an innovative way of considering and implementing psychological accompaniment.


Thierry Tournebise (1951) is the founder. He was a psychosomatician in 1977, psychotherapist since 1979 and trainer with caregivers since 1988. Author of three books and of a website of more than 1150 freely accessible pages, it makes an abundance of documentation available to readers. The word "maïeusthésie" is composed of the Greek maieutkê, "(art) of giving birth to someone" (the Historical Robert Dictionary of the French Language) and aisthanesthai (Indo-European origin) “feel, perceive “, like the word " anesthesia "without  “an". "Maïeusthésie" means "the art of being sensitive to the process of childbirth, the birth of the Self ". It is an approach where the human and the lived experience, are free from all schools of thought.  However, maïeusthésie is theorized precisely and can clearly be found within the existing theories in psychology.



The notion of communication has been so overused for several decades that it is sometimes difficult to pinpoint what it is. Here, maïeusthésie is clarified by differentiating two ways of exchanging between two beings: On the one hand, it favours information and, on the other it favours the individual. In addition, the notion of validations makes it possible to define more precisely the differences between "relationship" and "communication".

1-­ Difference "relationship / communication"

Note that the idea of "relation" implies that of "being connected", and therefore a "link".
Concerning the two interlocutors, one thus depends on the other; one is relative to the other. The concept of "communication" implies the idea of "openness": being communicative signifying "being open". In the latter case, the two interlocutors are "open" one to the other, and no longer "attached" one the other.

What is troubling is that these words are usually used in another sense: That which seems warm is often mistakenly named "relationship" and that which is cold and informative is called "communication". Those who make this awkward inversion confuse human warmth and affectivity, it confuses sensitivity (which enables us to perceive and be lucid) and emotivism (which wakes us from our insensitivity but does not allow us to perceive with precision), it confuses being touched (sensitive to being) and that of being affected (upset by ones problem). The concept of "psychic tact" holds a great place in maïesthésie, as we see below.

2-­ Favouring the information (relational)

We find here all the approaches that put the information before the interlocutors.
Attitudes such as "manipulation", "conflict" or "#light" are included this category and are abusively referred to as "communication". Even the school of Palo Alto (nevertheless referenced in this field) maintains, "one cannot communicate ". But here it confuses "information" and "communication".  Two people who insult each other do not communicate, even if they exchange information: they are in a conflicting relationship. We will therefore take care to differentiate relational situations where there are issues of interest and the communicational situations defined below.

2­‐ Favouring the individual (the communicative)

When that which motivates the interlocutors is the individual and not   the information, we will not speak any more about "interest" (because one is interested in a thing) but about "Attention" (because we give attention to someone) : An interested being thinks of his profit, whereas a caring being thinks of others with delicacy.

We arrive at an attitude that can be called "assertiveness" (assertiveness in the respect of others). For a situation to be "communicational", it is the interlocutors (communicators) who count more than the information. 

This is why the information is much better transmitted. We could summarize the situation by stating :

For the communicator to understand, he must first exist, and in order to exist he must first receive consideration. This can only happen if the being (the person) is thought better of than the information (the thing). To prioritise being in relation to information, such is the paradoxical stake   for this to circulate better.

3-­ Validations

Concerning the way in which an exchange takes place, technically, in maïeusthésie one relies on 6 validation points, in return for what has been expressed to us : 
1/ Acknowledgement of receipt… access to the information and
validation of the receipt,
2/ Message of understanding ... access to meaning and validation of understanding,
3/ Welcome Message…. Recognition of the other's point of view and
validation of the subject,
4/ Message of thanks ... gratitude in the face of an answer to our question and validation of the privilege (we note that a reply is never due to us),
5/ Coherence message ...Recognition of the logic of the other, cognitive validation,
6/ Message of consideration ... recognition of being and its feeling,
existential validation (Validation of being).

All these points are expressed simultaneously (verbal and non-­verbal, or only in non-­verbal form). If there are only the first two points (access to information and feeling) we are only in a relational situation.

The communicative supposes that the six points are present, that is what creates the quality of the exchange.

To conclude

It is important to remember that the relational does not exceed the second validation point (message of comprehension) whereas the communication contains the six points of validation (including existential validation). To learn more about this subject, read the Assertiveness document.


Humanistic – Integrative

For the practitioner of maieusthesie, the psychological aid is approached in a humanistic and integrative way and takes into account many approaches:

Psychoanalysis (Karl Jung, Donald Wood Winnicott), existential and humanistic psychology (Karl Jaspers, Carl Rogers, Abraham Maslow, Rollo May), Focusing (Eugène Gendlin), cognitivism (Jerome Bruner), psychocorporel (Gerda Boyesen), as well as CBT Behavioral and cognitive), that is psychodrama (Jacob Levy Moreno), that Gestalt therapy (Fritz Perls, Laura Perls and Paul Goodman),  haptonomy (Franz Veldman) ...

Maieusthesie can not be likened to any of these approaches, and none of these approaches can be assimilated to maieusthesie. But we will find areas of proximity because many practitioners have pointed out major elements and it is natural to find bridges between their remarks.
In its integrative dimension, maieususthesis is in no way "above” these approaches but recognizes the wealth of the contributions from all of these practitioners and theories, as no doubt others will probably do in connection with maieusthesie.


1-­ Look at the symptoms

The practitioner in maïeusthésie considers a being in psychological suffering as seeking to integrate a part of self that has remained suspended. One of the few to have come very close to this notion is Abraham Maslow, for whom the human being sought to become   more human and suffered only from deficiencies at this level. We also have Karl Jung for whom the individual leaned towards the realization of the Self (being), which he carefully differentiates from moi freudien (appearance). Although not considering psychopathology as such, maieusthesie can precisely state the notions of semiology (symptoms), Etiology (causes) and pathogenesis (mechanisms by which causes cause symptoms). Read the document "Psychopathology"

Very often, symptoms would disappear following the implementation of maieusthesie. Also one would be tempted to speak of "psychotherapy". However, with maïeusthésie, one never considers the disappearance of the symptom as a cure, but only as the fulfilment of what was in the making. The symptom, in maieusthésie does not disappear because one   is "cured", but because it has "ceased to be necessary". In the same way that a woman who has given birth is not "cured of her pregnancy" (but with certainty she is no longer pregnant), a subject who no longer has his symptom is simply in "gestation of himself" concerning this part of Self which has manifested a need to "come into the  world".

Although the psychological aid delivered in maieusthesis is more than significant and that the symptoms disappear (without being simply moved, but really disappear), it does not really correspond to the idea of psychotherapy. Indeed, it means more to "give birth" and "to heal". It is undoubtedly a point that distinguishes it particularly from the many other   approaches.

2-­ Constitution of the psyche

For the practitioner in maieusthesie the psyche is considered to consist of a set of three elements. These elements are: the one we are currently,
that we have been since we have existed (from our conception to this day), all of which we have become since we have existed (from conception to this day, or until the end of life if one is deceased). This includes the present, the past (recent and distant, including prenatal) and trans generational, the "coming into the world" mentioned above, always referring to the parts of Self.

3‐ Concepts of drives/impulse

The practitioner in maïeusthésie points to two impulses: the drive of Life (to differentiate carefully that of Freud *) and the survival drive. The drive of Life tends to "gather" the different parts of Self in order to constitute our unity. The drive of Survival tends to "disperse" and sets aside "the parts of Self that one can not yet know how to integrate without putting ourselves in danger, until our maturity no longer allows it.

To be more precise, each of these impulses has two  roles.


­‐ To integrate 
The drive of Life makes it possible to ensure the cohesion of the different parts of Self in proportion to existence ... but it will also seek to integrate the parts of Self left previously pending, producing the "psy symptoms" allowing access to it again.

- Conservation
The drive of Life makes it possible to keep (the "nursery") the parts of Self that the survival drive rejects, in order to be able to find them later. For this purpose it places them in the unconscious, which becomes for them a delicate "nanny".


­‐ To separate
The survival drive makes it possible to set aside the parts of Self that have suffered too much to be spontaneously integrated.

- To Compensate
The survival drive makes it possible to mask the voids left, where there is "the place" where the parts of Self have been" distant. "

* The notion of the life instinct in maïeusthésie must be carefully differentiated from the life instinct in the Freudian psycho-­‐dynamics, in which it denotes, in fact, a libidinal impulse (energy) rather in the domain of the survival drive in Its compensating version. The Freudian death instinct can also be assimilated to   the survival drive, aimed at "extinguishing" parts of the Self that are too bulky. For more details on these items read both of the following documents : "that, superego, me and Self" , "Libido, Love and other flows".

The Freudian psycho-­‐dynamics to a libidinal tends to the restoration of the ego (energy) while maieusthesis tends to an existential rehabilitation of the Self (life).

4-­ Life Difference / energy

The practitioner in maïeusthésie distinguishes precisely on the one hand the  Life (vita = set of an existence) and on the other hand the energy (ergos = energy, labour). Life corresponds to "being", energy corresponds to "doing". These are not the same issues and it is important to understand that to express the urge of survival consumes energy while the impulse of Life does not need it. This means that in case of exhaustion, the impulse of Life always resumes it’s rights ... and that which has been set aside spontaneously resurfaces.


The accompaniment takes place in two distinct stages. On the one hand "localization" (or rather the identification) on the part of the psyche "asking" for rehabilitation, on the other hand, rehabilitation itself. The whole is carried by  the idea of existential validation.

1­‐ The "localisation" (identification)

This localisation (identification) is done by statement, listening and the precision of feelings, whether these are bodily, somatic emotional or psychic. Starting with these feelings of precision, access to the part of Self on hold is often revealed fairly quickly during a first session, by ‘simply’ following a (“Simply" is in quotation marks because of its great subtlety).*

* The word "localisation" is used here to state the phenomenon according to a language we are accustomed to. We are used to thinking in terms of space. But the word "localisation" is accompanied by the nuance "Identification" because, in maieuthesis, the psychic structure is not considered in terms of space or in terms of time. It is then a question of "identifying" a part of the psyche rather than "locating" it. In maïeusthésie, the psyche is considered to be neither "topical" (topos = place) nor "chronic" or "chronological" (khronos = time). Everything is there, at the same time, at every moment and one cannot reason in terms of "temporal distances" or "spatial distances". 

It is not the intention here to detail these nuances but they must be mentioned because they have a great deal of importance. (The thread of Ariadne evoked above does not therefore consist of a thread unrolled in a space). An upcoming book Thierry Tournebise will be entirely devoted to it.

2-­ Rehabilitation

This consists in the restoration of the "communicating" state between Self and this part of the psyche. It is thus a contact that opens between "Self" and "self" to find an integrity that was hitherto only waiting.
This is produced "concretely" by directing one’s attention to that part of Self that has been identified and by recognising, with sensitivity and delicacy, the feeling caused. Be careful, it is to recognise this feeling and not to remove it. There is thus an opening of the canal that was closed in the psyche, and the result is a feeling of relief, reality and inner closeness.

The imaginary action implemented here in the psyche cannot be reduced to the idea of visualisation or mental psychodrama because it is mainly a new existential "positioning" (of being) ..., to put it more precisely "a new Inner attitude" between Self and self. 

There is no attitude of power, but only an attitude of recognition. When this opening occurs, usually the symptom disappears. Again, it is important to understand that it does not disappear because it is cured, but because it has ceased to be necessary. Its role was to permit "localisation" (identification) on the part of the Self to rehabilitate. Therefore, any attempt to eradicate a symptom without realising the rehabilitation can be unfortunate.

3­‐  Existential validation

This point is undoubtedly one of the most important in maieusthesis. It marks  an important specificity during an interview. It is not enough for the practitioner to have the competence to produce the accompaniment allowing to "locate" (identify) the part of the corresponding psyche, nor is it sufficient that he accompany the rehabilitation by the quality of his attention, it is not enough for him to have all the delicacy and humanity of the world: it is especially necessary that during the emergence of the "localised" (Identified) he bears witness to a certain "rejoicing". This notion of "rejoicing" corresponds to the fact of being touched by an emergence of life. Indeed, the practitioner does not have his attention on the circumstantial (which produces the affect), but on the existential (being, which he is "touching"). This is not, of course, an action but a feeling, of an attitude, of a state.

We note that the word "empathy" imperfectly translates the original German word "Einfühlung". We owe this original word and concept to Theodor Lipps and Sandor Ferenczi. "Ein" means "in" and "Fühlen" means "psychic tact" (which is found in the English "feeling" and especially in the "Hapsy" of the haptonomy). Empathy would therefore consist above all of a kind of "psychic tact" allowing “to touch "what is inside the other (and not putting oneself in his place).

In maïeusthésie, we will push the idea a little further by signifying that it is not so much to "touch the being" as to "be touched by it". Yet people like Lacan with the mirror (or at least some of its concepts), or Winnicott with regard to the mother, had already warned us. It is a question of extending the notion. This is major because it can be said that the effectiveness of the Psychological accompaniment depends on it. The practitioner has felt being touched by this emergence in the person he is accompanying, a bit like in maternity one can be touched by the birth of the child carried by the parturient.
This, of course, calls into question the notion of "therapeutic distance". If it is to "distance oneself from the circumstantial", it is also appropriate "to have proximity with the existential (being) ". Rather than "putting oneself in the poor understanding of empathy and seeking a "good" professional distance, it would be necessary to be distinct (never in the place) without being distant (being close, in contact). This amounts to knowing "being touched without being affected".

Here in particular the maieusthethie practitioner marks his ability to clearly differentiate on the one hand, the dramatic circumstance of the former time,   and on the other hand, the being he found there. It is this emergence of the one who has lived the circumstance, and who has this day had to remain in the shadow, which justifies the rejoicing of the practitioner. This notion of "Rejoicing" is neither a simple way of speaking nor an accessory of  Maïeusthésie. This is a major foundation that must be understood in all of its nuance.

You will find more information in the publication "Existential Validation"

We would like to simply point out that when faced with someone who is obviously happy to see us, they are willing, and that when faced with someone who seems afraid of us they shy away spontaneously. There is no doubt that in psychotherapy, we find this one of the causes of the "resistances" we often experience in patients when they seek to correct or eliminate something bad, rather than rehabilitate what is precious in them.

Roland COYAC

28 septembre 2020

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