The only theory paper worth writing is how to cure patients

This week’s lecture was the concluding one on Transactional Analysis.

Dr Eric Berne’s seminar group from the 1950s developed the term transactional analysis (TA) which described therapies based upon his work. This expanded into the International Transactional Analysis Association. While still largely ignored by the psychoanalytic community, many therapists have put his ideas into practice and swear by the effectiveness of the ideas and methods.

Unlike other therapies Berne was not interested in merely listening.  Carl Rogers, for instance, is best known for his contribution to client centred counselling and ‘non directive’ therapy.  This is very different to what Berne advocated as he was interested in psychological cure and wanted to affect change in the client. For Berne the cures will be noticed in the following ways:

1. Symptomatic: I was depressed, now I am not.
2. Societal: Those who know you say you are looking and sounding better.
3. Transference: Introject the therapist in the client.
4. Rewrite the script:  Ultimately the aim of the therapy sessions for Berne is to make conscious the script and then to rewrite it.

From a trans-personal perspective the therapy is about developing the good qualities in oneself.

Some interesting quotes from Dr Eric Berne:

The task of the therapist is to perform as rapidly as possible whatever operation is necessary to cure the patient. Otherwise the term therapist is a misnomer.”

The only theory paper worth writing is how to cure patients. That’s the only paper worth writing if you’re doing your job properly.”

There are two kinds of therapeutic goals. The first tries for something that is getting better or showing progress, which in effect is making more comfortable frogs out of people.  The second aim of getting well is to cast off the frog skin and take up the interrupted development of the prince or princess“.

For Berne, the most effective way of dealing with grievance:

1). When you do xyz (You are stating facts of what was said or done by the offender)
2). I feel this (No one can argue with how you feel)
3). I want you to do this instead. (This is where you are asking for changed behaviour from others).

Case study: A man in a position of authority (the boss) pokes fun at and is demeaning to another employee in front of co-workers in a team meeting. The employee would address a grievance with the boss by stating that when the boss pokes fun and acts in a demeaning way to the employee it makes them feel embarrassed and demotivated in the workplace.  In the first instance, you are stating fact, and in the second instance you are stating how it makes you feel which no-one can argue with. The third aspect of dealing with the grievance would be to say what you want instead i.e to be treated with respect. This is the bit where you are not dealing with the facts about what was said and how you felt but with your stated requirements for changed behaviour. There are power hungry bullies who would resent such a tactic and might seek to dismiss any approach so perhaps you need to pick your battles accordingly.   But at least you know where you stand when the offender continues to behave in a certain way knowing that it causes offence.

The question then is why is TA not the norm if it is so successful? Therapists who use TA talk highly of knowing where you are yourself and where you are with the client. TA provides a model to demonstrate where somebody is going wrong in their life and in their relationships. However, perhaps the success of any therapy depends on (a) the skills and knowledge of the therapist and (b) the nature of the relationship between client and therapist. It could certainly be a component of any basic toolkit carried by the therapist but it is important to remember that people enter therapy for all sorts of reasons and some do not wish to change.

Related post

Transactional Analysis – Born to win

Transactional Analysis: I’m ok you’re ok

This week’s very interesting lecture was on Transactional Analysis (TA). When it comes to TA we have a lot to thank Eric Berne. TA is observational and is to do with time structuring. How do clients spend their time? What script are clients using? Berne believed that our script personality was established by age 7. TA is most researched and discussed, more so than psychoanalysis.

I have been reading Adler in the past few days and am trying to digest where his pre-occupation with the need to co-operate fits in with TA but more of that digression at another time.

What is the personality theory for Berne?

1. I’m okay, you’re okay:  This was after all the 1960s, flower power and the Beatles.
2. I’m okay, you’re not okay: This is the paranoid position.
3. I’m not okay but you’re okay: This is the classic victim position.
4. I’m not okay and you’re not okay: This is the borderline psychotic position and what Berne says gets you in jail.

Its worth taking a moment  to assess where you are in relation to these theories.

Ego states

As outlined in the previous post, the initial meeting with the client could comprise of the following questions:

1. What do they want from the sessions that would really change their lives?
2. What changes were needed to be made in order to accomplish this?
3. If they agree to change, what would they will be willing to do?
4. How much do they sabotage themselves?
5. How would the counsellor know if they were getting better?

TA is an analysis of transactions. How does the client deal with the therapist? How does the client deal with all other relationships in their lives?

When two people sit down to transact there is a minimum of 12 people in the room.  This is comprised of the following:

Parent NP (nurturing parent) and CP (critical parent).

Adult The observing of reality.

Child CC (creative child) AC  (adopted child) RC (rebellious child).

How do we get in touch with the ego states in the client? This comes from watching how the client enters the room, what they say, how they say it, observing body language, the way they sit and so on.  Therefore, in TA the first job for the therapist is to identify which ego state is in play.

Here are 4 ways to help identify and recognise ego states:

A. The therapist can notice the ego state and feedback to the client.
B. Social: what are others saying about the client, such as family, employers. workmates etc. That is the beauty of group work. If everyone in the group says you are a jerk, then perhaps you have been behaving like a jerk.
C. Historical: The client recites the histories of certain ego states in their past.
D. Phenomenological: Re-experiencing the history as if its happening now. Some clients are stuck at a certain age.

To understand people better Berne was interested in time structuring. There were 6 possible ways to spend time in life:

1. Withdrawal: Can be with good reason and this can be in life and in therapy. Indeed a therapy session is often a microcosm of a client’s life.
2. Rituals: Asking people how they are in a ritualistic way.  Have a nice day! See the Truman Show.
3. Past-times: Chit chat in the pub or in other social situations.
4. Activities: Shall we go bowling?
5. Unconscious games playing:  Ain’t it terrible? Colluding with the client following the outline of a terrible back-story. The wooden leg game: don’t expect much from me as my mother had a nervous breakdown.
6. Intimacy: the pathology of the therapy is often in the inventor. Berne met clients in the back of his garden and was not particularly social. Some would say he was quite co-dependent.

Strokes Berne 1971: “A stroke is a unit of recognition”. The foundation for TA therapy and practice.

Berne noticed that people took 4 positions:
i. Good at giving strokes
ii. Good at taking strokes
iii. Good at asking for strokes
iv. Good at refusing (to take) strokes

Scripts

According to Berne we acquire a script by age 7.  Ask a kid what age they will be when they die and they will give you a definite answer. A script is an unconscious life plan based on the power of parental information.   There are three types of scripts:

A. Winning scripts: these are positive
B. Losing scripts: these do not serve the person well. Jimi Hendrix, James Dean, Jim Morrison, Phil Lynott are examples.
C. Non winning: Not playing to win or to lose.

The factors that influence the scripts: Drivers: these are ‘should do’s‘ Injunctions: ‘shouldn’t do‘. We receive these subconsciously as children from our families and at school.

Drivers

1. Be perfect: Nothing will do unless I get an A grade. The curse of this driver is that there is no pleasure taken from anything.
2. Be strong: Stop crying. Pull yourself together.
3. Try hard: Rarely achieves. Stop trying and do it.
4. Hurry up: Where’s the dog?  I don’t know. Why don’t you know?
5. Pleasing others: perhaps the psychotherapists disease.

Injunctions

1. Don’t exist: Kids should be seen and not heard. This often comes from parents who never wanted children in the first place. Children who are brought up in this environment can often form a high percentage of attempted suicides. This could mean they are seeking to collude with their (subconscious) wishes of their parents.
2. Don’t be yourself: be like your grandmother. This is a form of brain programming.
3. Don’t be a child: Grow up. Take care of your (drunken) parents or mentally ill parents.
4. Don’t succeed: No-one has ever amounted to anything in this family.
5. Don’t do anything: This can often be part of the benefits culture.
6. Don’t be important: You’re getting too big for your boots sonny.
7. Don’t belong: Better to stay in your room all evening like your brother does.
8. Don’t be close: People can hurt you.  Don’t get close to people.  I know someone whose wife ran off with another man.
9. Don’t be well: Everyone in our family is a drunk or everyone is crazy.
10. Don’t think: Don’t have your own opinions.
11.  Don’t feel: Slapping a crying child in the supermarket.

It could be useful to try to identify which ego state you are most familiar with. Which injunctions and drivers have been prominent in your life and how much do they govern you? How do you structure time in your life?  What about your strokes?

TA works equally well in an organisational setting as well as in one-to-one work.

Resources:

The Games people play 
The International Transactional Analysis Association
TA Journal