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Médecins Sans Frontières (MSF) is a humanitarian medical care association that leads missions in some 50 countries. It is headquartered in Paris, with about 150 employees working there. A first action research study in 1988 was the point of departure for formalizing a method of intervention known as the “mirror intervention” (Ortsman 1994). A second intervention, in 1999, took place in three departments of the headquarters. A detailed presentation of this 1999 intervention, and the comparison of the success of the mirror operation in two of these departments with the difficulties met in the third one, allows us to better understand the nature of organizational problems encountered by an institution in a phase of expansion, and to account for the psychic as well as the institutional dimensions of action research.