Transactional Analysis Approaches to Brief Therapy

What do you say between saying hello and goodbye?

Keith Tudor

• Publisher: SAGE Publications Ltd
• Year: 2001
• Print ISBN: 9780761956815, 9780761956808
• eBook ISBN: 9781446239278
• Edition: 1
• Topic: Psychology
• Subtopic: Psychotherapy
• Index: Psychology

`This book, edited by Keith Tudor (who is also one of the ten contributors) is excellent reading for a number of reasons: for those who know nothing about TA, it is a highly informative and readily accessible introduction. For those who read or studied it some time ago, it is an excellent refresher.

I am impressed by the diversity of people and applications of TA, and the developments outlined in this book are, certainly for me, cause for hope because, as well as offering frameworks for making ?simple? sense of humans in action – and human inaction – TA is a complex and profound system that offers people a way of solving the problems of the present, re-evaluating the struggles of the past, and reshaping the future with permission and power based on a greater sense of self? - Nurturing Potential

`I wholeheartedly recommend this book to all therapists as enriching and interesting reading? - European Association for Transactional Analysis Newsletter

`It is a book which would offer helpful introductions to both the practice of transactional analysis, and the attitude needed when planning brief therapy of any kind? - The Jounal of Analytical Psychology

Of all the approaches to therapy, transactional analysis is arguably one of those most suited to time-limited work. At a time when short-term therapy is increasingly dominant as a form of practice, Transactional Analysis Approaches to Brief Therapy provides an insightful guide which both informs and challenges.

Rather than a single theory, TA has developed as a group of four schools which share a common philosophy, but place different emphasis on what occurs during the therapeutic process. Written by therapists at the leading edge of developments in TA, the book presents and differentiates each of these four approaches. Through transcripts and commentaries, it shows how theory applies to practice, for example in treating post-traumatic stress or in achieving a one-session cure. The book also includes a useful glossary of TA terms, as well as an appendix of Eric Berne?s short script-questionnaire.

In some ways critical of the zeitgeist of short-termism and the commercial pressures for therapy to be brief, the book seeks a balance between the challenge TA offers as an actionistic approach to quick and efficient therapy and the importance of relationship in therapy which is time-conscious. It will be enlightening reading for all those training and those already trained as therapists and counsellors in TA.

Part I

TA and Schools of TA

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Chapter 1

Transactional Analysis as Brief Therapy

Ulrike Müller and Keith Tudor

In this chapter we trace the theoretical elements of transactional analysis (TA) by which it may be considered as an effective approach to or even form of brief or time-limited therapy. First, the roots of TA as a brief therapy are considered, following which the interrelation between diagnosis, contracting and treatment direction is discussed in the context of what is commonly viewed as the aim and goal of TA, that is, ‘cure’. The traditional interventions of TA are illustrated with scenarios from the practice of brief therapy, and the chapter concludes with a review of ethical considerations including the indications for – and contraindications to – brief therapy. In offering an overview across various traditions within TA, the chapter illustrates key theoretical concepts and constructs with reference to brief TA therapy in practice and offers especially the lay reader an introduction to the following chapters (2–5) which then develop these traditions or ‘schools’ of TA. As with other chapters, some of the more technical TA terms and concepts used are summarised in the Glossary.

The historical roots and theoretical foundations of TA

In his last book What Do You Say After You Say Hello? Berne (1975b) cuts through the Gordian knot of what he refers to as ‘making progress therapy’, arguing instead for ‘curing patients therapy’, the slogan of which is ‘Get well first, and we’ll analyse it later if you still want’ (1975b: 377). In many ways this illustrates the concern Berne expressed throughout his career and as is evident in his writing: to find the quickest, shortest, most effective and accessible therapeutic intervention and cure. This both reflects and is supported by TA’s three basic philosophical tenets: that people are at an existential level ‘OK’; that everyone has the capacity to think; and that people can decide their own destiny – and that these (early childhood) decisions can be changed.

TA theory is built on four foundational pillars:

• The structural model of ego states – the structure of personality
• Transactions – which deal with communications between people
• Psychological games – repetitive sequences of transactions
• Scripts – life patterns.

Taking an historical view, in each of these may be seen the origins and theoretical foundation of TA as a brief therapy. A review of these is followed by a discussion of concepts of ‘cure’ in TA therapy which offers a framework for distinguishing brief therapeutic work.

Ego states

Berne originally trained as a psychiatrist and in 1941 began training as a psychoanalyst. Between 1940 and 1943 he was in the US Army Medical Corps, during which, as a part of his work, he examined servicemen returning from the Second World War. Due to the conditions of these examinations, Berne became interested in and adept at quick and accurate psychiatric and psychotherapeutic diagnosis. For this he drew on his studies of the ego psychology of both Federn (1952) and Weiss (1950) (see Berne, 1957). To Federn’s notion of ego states, Berne added a significant amendment: that, as well as being experienced internally, each category of ego states was shown in a distinctive set of behaviours (Stewart, 1992). This is the origin of the behavioural diagnosis of ego states.

Berne conducted most of his own therapeutic work in groups and formulated TA theory based on this experience (see Berne, 1966) – indeed, TA has traditionally been viewed as essentially a group therapy. Observing group members, Berne realised that they interacted by repeating certain patterns or psychological games (analogous, in psychodynamic terms, to repetition compulsion). If one group member behaved in a parental way, they would get a complementary childlike reaction from another group member and vice versa (the stimulus and response comprising the transaction). Mostly, these reactions did not fit or were incongruent with here-and-now ‘reality’. In order to explain what he observed, Berne developed a model which allowed the inner differentiation of the ego; this was his structural analysis of the personality which he termed the ego-state model. Depending on the specific stimulus in the group and cathexis of the individual, one ego state becomes active and ‘acts out’; either the Child ego state or the Parent ego state dominates the situation and other group members react in a complementary way. In those situations, the person’s reality-testing capacity almost completely disappeared. Berne called this reality-testing capacity of the ego the Adult ego state. By contrast, the Child ego state comprises early introjections and fixated traumas which, when activated, create a distorted perception of reality and includes the concomitant feelings associated with that archaic reality. The Parent ego state similarly comprises introjections which, in this case, generally symbolise the identification with normative sentences and social role behaviour as modelled by the subject’s original parents/carers and/or parental, caring and authority figures.

Ego state diagnosis is a precise science, ‘a matter of acuteness and observation plus intuitive sensitivity’ (Berne, 1975a: 69), based on the observation of total behaviour and experience. The complete diagnosis of ego states involves observation of behaviour as expressed through a person’s demeanour, gestures, voice, vocabulary, etc. This diagnosis is corroborated both by others’ responses such as a childlike reaction (the social or operational diagnosis) and by the client reporting historical information i.e. which parental figure was the prototype for their behaviour. Finally, the diagnosis is validated if the person can re-experience the assimilated parental ego state – the phenomenological diagnosis. On the basis of this sophisticated yet accessible model it is easy to confirm an ego state diagnosis with the client and within a few minutes is a procedure which provides the basis both of a model of health and of psychopathology (including excluding and contaminated ego states).

Transactions

Berne was concerned to develop a theory of social action; indeed, especially in its early years TA was also referred to as a ‘social psychiatry’ (e.g. Berne, 1975a). Berne defines a transaction ‘consisting of a single stimulus and a single response, verbal or non verbal [as] the unit of social action. It is called a transaction because each party gains something from it, and that is why he engages in it’ (1975b: 20). It is the analysis of transactions as a basic social unit of communication in terms of ego states (also referred to as ‘TA proper’) which forms the basis of this theory of social action and interaction. In this we can again see Berne’s emphasis on observability. Given that the behavioural clues to ego states are observable (behavioural diagnosis) so too are the changes or shifts in ego states which occur when people communicate. From his observation and analysis of transactions, Berne (1966) developed three rules of communication:

1. If one person overtly acts from Parent ego state and another from Child ego state, both behave in a complementary way which excludes the here-and-now reality-testing capacity (Adult ego state). With such complementary transactions, which may also be Parent–Parent, Adult–Adult, Child–Child, etc., communication can proceed indefinitely (first rule of communication).
2. Complementary transactions come to an end if one participant changes ego state; this often leads to some confusion and a ‘crossed transaction’ which results in a break in communication (second rule of communication).
3. If on an overt or social level, people are transacting, e.g. Adult–Adult or Child–Parent but their non-verbal, hidden messages come from one of the other ego states via covert ulterior transactions then the outcome of the transactions and indeed the communication is determined at this psychological level (third rule of communication).

Transactions reflect and, indeed, are the relationship between people; thus it is helpful to understand the transactional patterns within relationships – for example, as a couple, between parents and children, as well as at work – as, having understood them, the parties involved have the chance and options to change such patterns. This, of course, is also the case for the therapeutic relationship between client and therapist.

Again, as with the diagnosis of ego states, the analysis of transactions is an accurate, accessible and quick form of analysis and diagnosis. It also provides an accessible and transactional way of analysing transference and countertransference as they are classically conceptualised – or ‘co-transferential relating’ (see Summers and Tudor, 2000). Thus, if a person is crossing an Adult–Adult transaction with a response from their Child ego state, s/he is relating to that other person as if they were in their childhood and thus projecting some qualities, experience, fantasy or phantasy onto that other person. As Stewart observes: ‘Berne’s second rule of communication does not simply deal with the rather trivial question of whether communication is comfortable or otherwise. More importantly, it points out that the “break in communication” will always be related to transference or countertransference’ (1992: 37).

Games

It follows from this that all transactions which are not clear Adult–Adult (overt or covert) transactions can be understood (in terms of the ego state structure of the personality) as an unconscious repetition of early interactions which have failed to satisfy needs, analogous to Freud’s concept of ‘repetition compulsion’. When observed in present everyday life, such repetitions do not fit the actual situation and appear as a hiccup in clear communication. The stimulus and/or response are based on script beliefs and feelings. This hidden, unconscious aspect of communication is a paradoxical one: with the hope that unmet needs may finally be fulfilled juxtaposed with disappointment (even expectation) that the discourse ends up as usual without getting the desired result and satisfaction. A game usually follows a series of complementary transactions which is broken by one party, perhaps out of an unconscious resentment, who then crosses the communication, with resulting confusion and ‘bad’ feelings on both sides. Berne called such a sequence of transactions a game, i.e. ‘an ongoing series of complementary ulterior transactions progressing to a well-defined, predictable outcome’ (1968: 44). Significantly, he chose an expression which has the association of winning. The gain (or ‘pay off’) in a transactional game, however, is generally the confirmation of one’s script beliefs and feelings rather than the experience of a satisfying solution.

In the therapeutic situation the therapist must not label or discount the client’s behaviour as ‘gamey’ (which in itself could be a game!), but rather understand the (hi)story behind it. Indeed, the client needs to ‘play the game’ in therapy in order that the therapist may help them:

(a)	to be aware of the hidden aspects of the game including its advantages (see Berne, 1968)
(b)	to understand their pattern of behaviour as a game.

Transactional and game analysis – naming the game rather than shaming the client – is the basis of developing the client’s awareness, understanding and ability to change through having different (behavioural) options and satisfying the unmet psychological need or human hunger which led to the game in the first place. In order to be able to analyse the games a client will offer or attempt to play within the therapeutic situation and relationship, the therapist has to know their own script patterns as well as the hooks by which they are likely to get drawn into a game.

Transactions	Therapist’s comments
Client (C): What shall we talk about today?
Therapist (T): Is there anything you want to talk about?	This is crossing the invitation to be symbiotic, to be active for the client.
C: I’m sorry. Perhaps I’m wasting your time. I don’t feel as if I have anything to talk about.	The client appears to be apologising for not having a problem or issue.
T: It seems as if you have to entertain me.	This crossed transaction (identified through the use of the word ‘entertain’) reveals the way in which the therapist used to have to please his mother.

In any case it is important that the therapist considers the level of anxiety which has been shown by the client. Behavioural change is only possible if the level of anxiety is relatively low. Only then will the client be willing to try new patterns to gain the fulfilment they long for such as intimacy when and through playing games. Only then will they be willing to create new patterns which are more appropriate to getting present unmet needs met and to stop the old repetitive patterns by exposing or ignoring the games.

Game analysis is especially helpful in a family context which is often rich in patterned transactions. A nine-year-old daughter invites her parents to get into a game around waiting for her to come to dinner every evening. The parents, for their part, wait, get angry and resentful. The therapist involved with the family exposed this interaction as a ‘power play’ and offered alternatives: for the parents to inform their daughter early enough about dinner time and to stay with the consequences of their decisions, e.g. to eat dinner without her and not to offer her dinner if she comes after dinner time; and for the daughter to express her views about food, diet and eating times. In offering these options, it was useful to inform the parents that a nine-year-old girl would not starve if she misses a meal, that is, they would not do her harm by being consequent and having consequences. Often knowledge leads to decontamination (see pp. 36–7 below)

Scripts

There are ...

Table of contents

• Cover Page
• Title Page
• Copyright Page
• Contents
• List of Contributors
• Introduction
• Part I TA and Schools of TA
• Part II Applications
• Appendix: TA Script and Therapy Check Lists
• Glossary
• Author Index
• Subject Index