Friday, April 11, 2008

A Forgotten Therapy

The 1960s and '70s brought a great deal of innovation to psychotherapy, counseling, and human growth efforts. There were "T-groups", Primal Scream, Jungian, Gestalt and much more. Most of these have fallen by the wayside. Increasingly, behavioral therapies have demonstrated their efficacy in dealing with the major dysfunctions like depression, anxieties, phobias.

Like many psychotherapists and counselors, I went through that era learning some of these modes, but discovered Rational Emotive Therapy, the original version of Cognitive Behavior Therapy invented by Albert Ellis. (Cognitive Therapy was another version of CBT invented only about two years later by Aaron Beck.) Cognitive Behavior Therapy is by no means the only behavioral treatment mode. Since then several others have been invented including Dialectic Behavior Therapy, which has had great success with "personality dysfunctions."

Another of the innovative treatment and learning modalities of that period was Transactional Analysis. One thing distinguished TA from many others were that it was behavioral while still focused on growth and emergence in life. While many of the other techniques abandoned rigorous analysis and research, because of its behavioral focus, TA did not. Transactional Analysis prided itself on being able to see and work with the behaviors through which people exhibited their emotional reality. With some practice, one can see people behaving as a child, as a parent or as an adult.

TA was, on the one hand, a part of the 1960-70 era in that it used a more playful language, "I'm OK; you're OK." "Strokes" "Warm fuzzies" "Cold pricklies" "Games" (The initial popular book by Eric Berne was
Games People Play.) "Scripts" It was accessible to the average person. On the other, TA was often combined with insights and tools from other modalities, especially Gestalt Therapy and Decision Therapy.

The 1980s saw the abandonment of free-wheeling experiential, experimental approaches to awareness and therapy. While there was still a component that continued, it became entwined with a lot of "new-age" ideas that were completely based on personal, internal affirmation such as channeling, astrology, and the reification of jungian metaphor.

In the enthusiasm for hard-nosed, bottom-line thinking and practice, Transactional Analysis fell out of favor. It's very use of playful language made it a target of the "reality" based thinkers. The fact that its insights were demonstrated by results was insufficient. It became associated with transpersonal psychology, alternative therapies, and fuzzy-headedness.

Another, and I would suggest, major reason for TA's diminished esteem was the reification of the metaphor done by so many practitioners. Instead of seeing the Child, Adult, and Parent as ways of speaking about behaviors and feelings, some transactional analysts began to speak as though there were, in a presumed psyche, a portion that could be identified as an actual, if non-physical, child; another child; and another parent. Thus these therapists and writers made the same mistakes as the early Freudian theorists. There was a proliferation of ideas, some of them very esoteric that also got passed off as Transactional Analysis

But, in fact, Transactional Analysis has a great deal to offer. The major themes and ideas and the tools that derive from them are very helpful to many clients. (I will call those who come for counseling and therapy, "Clients" however I know that some, often wedded to a medical model, call them "Patients.")

The basic idea that Eric Berne elucidated was the game. There are many games clients (And therapists) play. TA practitioners assigned descriptive names to them. "Ain't it awful", "Yes, but", "Let's You and Him Fight" are just a few. The idea of a game is that there are three positions in a game, Persecutor, Victim and Rescuer. The bad feelings are the payoff when at least one person--and maybe two, switch roles.

But Berne also replaced the old Freudian metaphor of a posited Ego, Id and Superego, with a more useful and behavioral image of Parent, Adult and Child.


Among the differences is that one can watch as a person functions and distinguish from the behavior or thought or feeling, which of the ego states the person is "in."

The Parent and Child behaviors, thoughts and feelings are ones learned in growing up. (Clearly it is more complicated than this and if you have more interest, I will put a few links and references at the bottom of this blog entry.)

Another innovation is the recognition of the need for "Strokes", attention, acknowledgement, appreciation or other responses. Research has shown that children do not grow healthy without strokes. Infants need physical strokes, while adults can survive with verbal. Both do better with positive strokes. TA practitioners divide strokes into warm fuzzies, and cold pricklies. Even though cold pricklies do not have as much psychic nourishment as warm fuzzies, they at least acknowledge a person's existence.

When two people interact, they each do so from one of the three ego states. If they interact in complementary ways, A-A, C-C, P-C, etc. as shown in the following illustration, conversation and interaction can go on for quite some time. (There is no significance to the dash-line. It is only to make it visually separate from the others and not indicate a crossed transaction.) The PAC concept can be further refined because the Child can be adaptive and behave in the way it has decided that the Parent wants, or it can be playful and natural. (This is not to suggest that all adaptive behavior is bad.) Also the real Parent ego state can be either nurturing or critical. But all this is for another time.

You can envision two parents sitting on a park bench (Persons in their Parent ego state) complaining about the behavior of children "now-a-days." They can continue this for lengthy periods and even come back the next day to say more.

The Adult ego state deals with "facts". Of course, people's facts are sometimes wrong, but if two people are dealing in facts, they are in their Adult and can discuss the data for lengthy periods. (Of course, when the people become wedded to their ideas, they may not be dealing in fact, only beliefs masquerading as fact. Witness the current arguments about "super-string theory," which sometimes become quite heated.)

Adult people who are playing and enjoying each other's company are functioning in their Child ego states. "Let's take the boat out for a sail in the moonlight." While the actions of the couple may be appropriate for mature adults, they are operating in their Child. (Good sex is always in the child. It is when sexual behavior really involves the Parent, that people come to the sex therapist. Of course, children sometimes "play" parent and this can also be so in sex.)

Another key concept which drove an early book about TA is "I'm OK, You're OK" as the psychological position people may take who are healthily relating to themselves, others and the world. The book,
I'm OK, You're OK, by Thomas A. Harris, was immensely popular as a self-help book. The OK corral was another easy to understand image. It suggested that each of us functions from a "position" within these four positions,

as we relate to others and to ourselves. Even if this is a bit simplistic, it does help clients understand the way they relate to others.

Transactional Analysis has a quite profound and sophisticated understanding of human emotion and behavior, but it also has the genius to make it easier for people to understand and appropriate their insights.

There are many other concepts which are included in TA theory and practice, but this blog was not intended to be an exposition of all that Transactional Analysis brings to the therapeutic, counseling, coaching and educational table.

As a behavioral based therapy system, it easily translates into the concepts with which cognitive behavioral therapists (CT, REBT, ET, DBT, etc.) are familiar. But it provides another means of "hooking" the client into the therapeutic alliance and helping the client understand their own emotions and behavior.

Why have I returned to TA to take another look? I have had a couple of recent recent experiences in which I was an observer of therapy, particularly marital therapy. As I watched the therapists trying to understand the client's mental and emotion processes, I suddenly had an insight; I knew what was happening and could describe it in TA terms, perhaps easier than the actual therapists were doing. In each case, I could have used TA to help the therapeutic alliance develop. (Of course, as an observer, I could not intervene.) Watching the efforts of the therapists (And these were well-seasoned people with many years.) I became clear that Transactional Analysis still had a place in my arsenal.

I will have to relearn some of my rusty tools, but much of it has remained. I do not intend to abandon any other tools, I have seen the clear end results of the cognitive behavioral approach and have helped too many not to continue on that road, but I will be upgrading my old tool, Transactional Analysis and using it when appropriate.

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Here are a few introductory links for those who want more information. Feel free also to email me at davidpittle@turningspirit.com .
International Transactional Analysis Association
TA Tutor
A Warm Fuzzy Tale
Claude Steiner's (One of the early collaborators and still active) TA intro

You may also want to see more of my counseling information at
TurningSpirit Center

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