Model foundations
Foundations of the
psychotherapeutic Relational Intelligence model®
I - Origin
The Relational Intelligence® (RI) model was born of the clinical and personal experience of its founder, François le Doze. Trained as a neurologist, he began practicing psychotherapy as part of his work as a hospital neurologist.
In this position, he had the opportunity to apply the Internal Family Systems (IFS) psychotherapy method (Schwartz 2019) (Schwartz, n. d.) to patients with medical disorders (migraines, multiple sclerosis, functional neurological disorders...). IFS has shown itself to be particularly well-suited to the application of psychotherapy to people with medical disorders. He has progressively deepened his mastery of the IFS model by becoming an IFS trainer, and has also acquired indispensable knowledge in the field of psychopathology and the neurobiology of psychological trauma.
The IFS model is based on two foundations and a therapeutic lever: the Self and psychic multiplicity on the one hand, and self-regulation on the other.
After some ten years, he identified difficulties in understanding certain problems, such as attachment disorders, using this method. These disorders develop at a time in life when the brain is not yet mature enough to produce an episodic memory, i.e. one that refers to a spatio-temporal context that can later be apprehended through the paradigm of parts. At this stage in an individual's development, only implicit memory can be mobilized. This is independent of the spatio-temporal context, and therefore cannot be evoked through the parts paradigm.
His encounter with Deborah Dana and Deirdre Fay gave him the theoretical elements to overcome this limitation. These two people have in fact developed methodologies to better understand the issue of co-regulation. Co-regulation, in the context of the therapeutic relationship, deals with the mechanisms involved in inter-human relationships and communication. IFS insists on the primacy of the intrapersonal relationship (between the individual's Self and its own parts) as a therapeutic lever over the intersubjective relationship. However, neuroscience data show that brain organization responds to a hierarchy based on the autonomic nervous system, which is shaped from the earliest childhood experiences in the relationship with others (the so-called attachment figure).
II - Theoretical underpinnings
The Internal Family Systems (IFS) model offers an operational model of consciousness called Self. It is the involvement of consciousness (especially body consciousness) and not language that constitutes the therapeutic lever in this method.
The systems thinking to which the IFS refers applies the principles of systems theory developed in the fields of physiology and biology to the psychological life of individuals. It enables us to understand psychological functioning as the attempt by sub-systems (called parts) to return to the internal equilibrium disturbed by a potentially traumatic external situation. This systemic conception is also a way of situating the individual as a system within other, broader systems (couple, family, country, society, etc.) that are interdependent and interact with each other.
Attachment theory is not detailed here. It is mentioned because it provides a frame of reference for the IR model, insofar as the IR therapist acts explicitly as a secure attachment figure. From this reference posture, it is possible to identify and treat the attachment disorders on which relational security and the progression of therapy are based.
The study of not only neuropsychological, but above all neurobiological processes underlying human memory, has shown that the traumatic memory thought to be indelible is not, in fact, indelible. The brain, through its capacity for neuroplasticity, has the means to reconfigure itself in a perennial way, abandoning emotions and beliefs that are no longer useful to it, and replacing them with information that enables it to update itself.
The Polyvagal Theory (TPV) proposed in 1994 is the fruit of the work of Stephen Porges (Porges 2011), who conducted neurophysiological research into the responses of the autonomic nervous system (ANS) in dangerous situations. He has described responses common to animals and humans, inscribed in the phylogeny of their ANS construction. These discoveries are already having a considerable impact on our understanding of the fine mechanisms and management of psychological trauma in general, and attachment disorders in particular. TPV offers a highly efficient conceptual and operational framework, as it enables us to decode the bodily imprints of these traumas and, by bringing neuroplasticity into play, to promote a stable reconfiguration of the ANS to ensure relational security.
The IR model recognizes the theoretical neurobiological references on which the work of Bessel van der Kolk – synthesized in his book The Body Keeps the Score (2014) –is based. From a therapeutic point of view, these include the importance – known in the past and taken up by van der Kolk – of considering that the organization of the NS corresponds to a hierarchy. Numerous other authors have referred to this hierarchy, including MacLean (1972), and Panksepp and Perry (Perry, n.d.). This hierarchy has its origin in the phylogenesis of the NS, which leads us to consider that the NS of human primates is made up of successive strata. The Polyvagal Theory accounts for this, considering that the ANS was constituted successively, during evolution, of the dorsal parasympathetic component (reptilian period), the sympathetic component (fish) and finally the ventral parasympathetic component (mammals).
It is therefore accepted that within the ANS and within the NS more generally (MacLean’s triurne brain) (MacLean 1972), the influence of brain structures on each other is conditioned by their date of appearance during evolution. The older they are (archaic brain, ANS), the more automatically they function (vegetative life, relational security). The more recent they are (cerebral hemispheres), the more consciously they function (language, abstraction, creativity, learning, etc.). It is accepted that the phylogenetically oldest structures (anatomically located in the lower parts of the NS) constitute a kind of foundation on which the most recent structures are based. The conditioning of the lower part of the NS is stronger than the learning of the more recently developed upper part of the NS. The flow of information in this network of interconnected structures has two directions: top-down and bottom-up.
- This is mainly based on the top-down regulation pathway.
In the early stages of life, the mature structures are the lowest the bottom-up way is the most solicited. In the course of life, as the higher structures mature, they will become more and more important in the NS and the This is mainly based on the top-down regulation pathway. route will develop. In adulthood these structures are interconnected, but their reciprocal influence is not symmetrical, because the Bottom Up path dominates over the other, since it is on it that the survival processes (physical and psychic) are based.
Psychic trauma is known to affect the entire NS. Concretely this implies taking into account in the field of psychotherapy that the neurobiological stigmas of the trauma on the lower structures are more decisive on the course of therapy, than those left on the upper part. Neurobiological psychotherapy (Cf. infra) will take this into account and seek to prioritize the ANS deregulations.
The SN is innately endowed with a program for reacting to danger by attacking or fleeing (like all vertebrate animal species). The SN's vocation is to return to regulated social functioning once the danger has passed. Unlike other animal species (whose SNs can return to a regulated state on their own), human beings, especially children, need external regulation to bring about this return to the basic state.
This regulation, which involves interaction with another human whose NS is regulated, is called co-regulation. It is therefore through co-regulation that the dysregulated NS of an individual exposed to danger returns to regulation. If the danger persists or if the individual does not find co-regulation, dysregulation sets in over time, at the cost of adaptations that involve brain regions devoted to emotions and social interactions: the development of automatic patterns that condition behavior, based on belief systems and repressed (non-metabolized) emotions. This is fundamentally an adaptive mechanism based on dissociation.
This corresponds to a fundamental neurobiological adaptation mechanism that explains the development of personality sub-compartments that are independent (to varying degrees) of one another. These sub-compartments organize themselves to maintain an internal equilibrium and thus attempt to replace the lost equilibrium (that which existed before the danger occurred) and which could not be restored. These new internal balances (which remain fundamentally imbalances) most often manifest themselves in the form of psychic states experienced as polarizations or antagonisms.
There is only one alternative to dissociation, and that is association. This can be seen as one of the main functions of the NS: to integrate in a coherent and meaningful way the different components of an individual's experiences. This work involves the NS as a whole.
Co-regulation is a key factor in mobilizing the SN's ability to carry out this association process, since it primarily involves the oldest structures in the SN, which are dedicated to survival mechanisms.
From the perspective of the IR model, it is the peri-traumatic dissociation mechanism that accounts for the development of the parts as described in IFS, and their organization in rigid interaction patterns. When the dissociation is deep and present from the period of attachment, it leads to dissociative personalities or structural dissociation as theorized by Ono Van der Hart(Nijenhuis and van der Hart, 2011). From this point of view, the vision of the IR model differs from that of the IFS model in that the fundamental psychopathological mechanism is peri-traumatic dissociation and not, as represented by the IFS vision, the diversion of the normal functioning of parts that the individual is claimed to be endowed with at birth. The IR model, like the IFS model, nevertheless recognizes the modular functioning or multiplicity of the psyche.
Dissociation appears to be more fundamental than traumatic memory (which also proceeds from dissociation through the fragmentation of memory elements). This element is essential in the treatment of attachment disorders which do not give rise to episodic memories, but are immediately inscribed in the brain in the form of dissociative memory.
III - The fundamental characteristics of the RI model :
The criteria for defining neurobiological psychotherapy (NBP) are :
– the methods used respond to a representation of the psyche and its traumas as proposed by advances in neuroscience;
– the methods used aim at bringing into play neuroplasticity, reprogramming of the NS, and reorganizing it based on present day data.
This is a new heading in the field of psychotherapy, conceptualized by the founder of the IR model.
The theater of action of PNB is the body: the wounded body, self-aware, relational and capable of healing. Its aim is to take advantage of psychological injury to enable the individual to bring body and mind back into coherence, thanks to a nervous system that regains the ability to regulate itself. It's a transformative approach in which the individual is considered in his or her bodily, relational and social dimensions.
The objective of NBP is to heal an organ, the brain, in order to treat the psychological difficulties that the individual encounters.
The objective of the IR method can be considered both clinically (symptom improvement) and neurobiologically. The primary focus of IR intervention at the neurobiological level is to treat dissociation. This can be manifested structurally (Nijenhuis and van der Hart 2011) or in the form of parts in the IFS sense. It is neuroplasticity that enables this work of association to take place. This is not symbolic work, or work aimed at suppressing traumatic episodic memories. The tools developed, in the forefront of which is co-regulation, aim to enable the SN to rediscover the conditions in which it can associate information stored within it, but kept at a distance from one another (due to the traumatic nature of the individual's experiences).
The therapist does not approach the patient with a preconceived notion of the level of dissociation. The therapist learns to detect the clinical signs that will indicate this and then only to apply the appropriate tools.
If the dissociation appears to be structural,the therapist brings into play co-regulation in the form of therapeutic involvement (see below):
- either physical with recalibration of the ANS inspired by the work of Deborah Dana (Dana 2018)
- or cognitive/emotional with metacognition inspired by the work of Deirdre Fay
These interventions aim at restoring relational security and thus internal security through the correction of attachment disorders.
Co-regulation is primarily based on the use of bottom-up regulation. .
If the dissociation appears to be non-structural (i.e. manifesting in the form of parts of which the patient is aware) the therapist brings self-regulation into play. This is mainly based on top-down regulation. In short, the disorders that are treated here fall within the field of post-traumatic stress syndrome. The methods used in this context are largely inspired by the IFS model.
Using this methodology, it appears that most patients' SNs require a great deal of co-regulation before they can achieve self-regulation. This finding is consistent with the With this methodology, it appears that most often the SN of patients requires a lot of co-regulation before self-regulation can be achieved. This finding is consistent with the bottum-up hierarchy of SN.
Metacognition (MC) consists of the ability to be aware of mental operations and mental states for self and other, and to apply this awareness to a variety of mental operations (Brown and Elliot 2016, p 293). For Brown et al. the capacity for metacognition is all the more developed the more secure the attachment.
The practice of IR is largely based on the use of CM, according to a methodology specific to this method. When practised between therapist and patient, CM proves to be a highly effective tool in situations where co-regulation is appropriate because the disorder to be treated relates to an attachment difficulty, but the patient's defense system is opposed to this intervention. These situations are typical of attachment disorders, which appear to be a dead end, since the appropriate remedy is rejected at first sight by both the patient's psychic system and his or her SN.
In fact, these frequent situations do not reflect a refusal of co-regulation as such, but rather a refusal of co-regulation in a direct mode, as it reactivates the trauma that caused it. The therapist's reflection, made possible by metacognition, is an indirect co-regulation modality that enables these defenses to be dealt with.
An original methodology is developed in this model. It enables dissociation to be treated directly, using coregulation to mediate the neurobiological association between two pieces of information that have been kept at a distance in the psyche and the SN as a result of the trauma.
This is not a tool in itself, but what the implementation of co-regulation in the IR model achieves. Indeed, the combination of ANS recalibration and metacognition used in co-regulation leads the therapist to make a physical and/or cognitive (and even emotional) commitment to the patient. The methodology developed here is very rigorous, as it must avoid counter-transferential projections. On this condition, it enables us to overcome major difficulties in the course of therapy, linked to structural deregulations in the SN. The position of neutrality frequently advocated in psychotherapy proves counter-productive in such cases, as it is perceived by the patient's ANS as analogous to the deficient involvement of his own attachment figure.
IV - Conclusion
The IR method is rooted in the neurosciences of attachment and trauma, and follows on from the IFS model. It is not, however, a simple combination of techniques. Its vision of psycho-trauma is firmly rooted in neurobiology. It uses an original, flexible methodology designed to adjust to the patient's SN configuration at each moment of the session and during the course of the therapy. It also proposes original tools (metacognition and relational association) that enable the therapist to deal with particularly difficult situations and respond to the need for the CNS to leave behind the survival modalities generated by past experiences and regulate itself with information from the present.
This method is recent, having been introduced at the end of 2017. Practitioners in France and French-speaking Canada are very interested in it.
- Brown, Daniel P., and David S. Elliott. 2016. Attachment Disturbances in Adults. W. W. Norton & Company.
- MacLean, Paul D. 1972. “Cerebral evolution and emotional processes: New findings on the striatal complex”. Annals of the New York Academy of Sciences 193 (1 Patterns of I): 137‑49. https://doi.org/10.1111/j.1749-6632.1972.tb27830.x.
- Nijenhuis, Ellert R. S., and Onno van der Hart. 2011. “Dissociation in Trauma: A New Definition and Comparison with Previous Formulations”. Journal of Trauma & Dissociation 12 (4): 416‑45.
- Perry, Bruce D. n. d. “The Neurosequential Model”, 18.
- Porges, Stephen W. 2011. The Polyvagal Theory: Neurophysiological Foundations of Emotions, Attachment, Communication, and Self-regulation (Norton Series on Interpersonal Neurobiology). WW Norton & Company.
- Schwartz, Richard C. (ed.) 1995. Internal Family Systems Therapy. New York: The Guilford Press.
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