Transactional Analysis in Psychotherapy (27->36) - Chapter Four

Transactional Analysis in Psychotherapy (27-36) - Chapter Four

I will now begin talking about pages 27-36 or Chapter Four - Psychopathology

It is not until we see what could go wrong with a personality that we really see how this method works. That's not completely true, but we certainly see a lot when confronted with specific problems and their answers. I would have always liked to have seen what Dr. Berne's philosophy was regarding other subjects. He seems so "spot-on" when it comes to human beings. Surely he would have some insights concerning other philosophical subjects. The deeper we go into Transactional Analysis, however, it is revealed the capacity it has for all types of healing and self-analysis.

I respect other methods of self-analysis as well and one day I hope to understand how they all fit together. Ken Wilber's Integral Approach seems to be a total view of the entire universe which includes everything in all philosophies. When it comes to Integral Psychology, I've noticed that many of the ideas correlate with Transactional Analysis although they are worded differently.

For example, when someone is transcending to a more advanced level of self-cultivation, it is possible that he or she will include or exclude aspects of their own personality. When these aspects are excluded, they become part of a person's shadow and cause problems. I have not discussed yet the phenomenon of "exclusion" as it pertains to Transactional Analysis, but one can imagine that if a person excludes their Child, then they will have certain troubles: inability to "have fun," inability to view things from a fresh perspective, inability to be spontaneous. In the Integral Approach method, it is possible to reconnect with these parts by engaging in a dialogue with them. This is like Gestalt therapy and most likely that's where the influence came from, although I'm not sure. Dr. Berne mentions Fritz Perls’ Gestalt Therapy Verbatim as a reference in What Do You Say After You Say Hello? when he is discussing how different parts of the body are always in "dialogue" with each other. People are just unaware of these dialogs.

I'm interested in connecting Integral Approach with Transactional Analysis as they both seem to be correct. Perhaps I would need expertise in both of these fields before embarking on such a journey. As for now I will continue with Transactional Analysis.

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We are still on the subject of structural analysis which "is concerned with the segregation and analysis of ego states" (2). In the setting of psychotherapy, a therapist will be concerned with how "to establish the predominance of reality-testing ego states and free them from contamination by archaic and foreign elements" (2-3).

As I understand it, what Dr. Berne is saying is that the Adult ego state(s) should be "on top." The Child and Parent are useful and necessary to the personality but if they are governing the person's behavior, he or she will be disconnected from reality. The person will be vulnerable to deception from their own personality parts and the personality parts of others. It is important to know the truth so that one can properly express oneself and understand the expressions of others. I don't want to go the specifics of why knowing the truth is important. It does not seem necessary for this endeavor. I'm interested in knowing the truth for myself simply because I'm interested in the truth. Truth is something I value intrinsically.

Personally I like things to be spelled out in basic terms. That's partly why I like Dr. Berne's works so much. While there is an abundance of technical terms, he usually explains them in ways that are easy to understand.

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Psychopathology

Pathology in general has to do with "the reactions of living organisms to injury" (27). In this chapter Berne discusses two psychic reactions to injury: exclusion and contamination.

Exclusion

"Exclusion is manifested by a stereotyped, predictable attitude which is steadfastly maintained as long as possible in the face of any threatening situation" (27).

That is how it is manifested. What's happening is that one ego state is preventing the other two ego states from contributing to the personality.

If the Parent is excluding, one possible defense mechanism used will be religiosity; If the Adult is excluding, it will be intellectualization; If the Child, then flattering pseudo-compliance (31). These are just examples. Other defenses will be used as well.

Excluding Parent

Mr. Troy is a case of an excluding Parent. He maintained a fault-finding attitude toward any exhibition of child-like behaviors in himself or others. Under certain conditions, when the group setting was 'safe,' then his Adult would make an appearance and he could discuss things in a more respectable way...Instead of saying "kill the little bastards," he had more balanced views on "the weather, the news, the times, and the ironies of his personal affairs" (28). When listening to the therapist, however he would act as an adapted child ...unless the therapist exhibited qualities his Parent disapproved of such as boisterousness, in which case he would return back to his Parent state with his standard attitude.

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How is his adapted child capable of escaping the dominance of his Parent?

Is the manifestation of his adapted child under the "alert Parent" still a manifestation of his Parent?

Which ego state has the executive power?

Berne talks about the difference between Parental influence and an active Parental ego state. I'm imagining that while in his case there is a strong Parental influence, the executive power belongs to the adapted child in that particular circumstance. Under normal circumstances, his Child and Adult are weakly cathected and his Parent is strongly cathected. (Once again, cathexis is psychic energy. Berne cites the words of Paul Federn when he describes how the Self is perceived..."It is the cathexis itself which is experienced as ego feeling" (23).) The cathexis seems to shift to his adapted child while he is listening to the therapist and his Parent's psychic energy is unbound and influences the adapted child. The free cathexis seems to reside with the Child ego state during this time while the Parent in Mr. Troy stays alert (or exerts unbound psychic energy).

It is the reverse when his Parent has free cathexis; the unbound psychic energy comes from his Adult and Child and influences the Parent in various ways. Dr. Berne gives an example of Mr. Troy nearly driving himself off a cliff (or actually driving himself off a cliff, I'm not sure). He attributes this to either the Parent trying to get rid of the Child or the Child trying to get rid of the Parent. I'm not sure if Dr. Berne is saying that Mr. Troy consciously tried to kill himself or if he unconsciously tried to kill himself. Either way, this example highlights the dangers of having an excluding Parent. One's Child will be "exasperated" by trying to follow the impossible standards of the constant Parent. The constant Parent, it seems, employs unnecessarily rigorous, harsh or impertinent rules that the person must follow or else. The Child and the Adult are afraid to change their beliefs because all new beliefs are compared first with a set of rules and if the belief seems to contradict one of these rules, then it is thrown in the waste bucket.

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The idea of the excluding Parent corresponds with Ken Wilber's theory of pathology. In Wilber's theories, a healthy person will transcend through different epochs of development and as development gets more and more complicated, there is more possibility for problems. When a person transcends an epoch, he or she can either include the previous epoch in their new found consciousness or repress it. As Mr. Troy grew from a child into an adult, he repressed his Child and Adult ego states so all that was left was the Parent.

(I'm starting to believe that the labels Parent, Adult and Child actually refer to three separate groups of ego states, plural. I discussed this before, but it doesn't make sense that we would only have three ego states in total. I don’t know whether we have 30 ego states or 3,000 but it seems that from now on, in my understanding, "Parent" will refer to either a Parental type ego state or the general group of ego states that are of the Parental variety; likewise for Adult and Child)

How exactly the Child and Adult were repressed, I'm not sure. It probably follows the same process of how they are un-repressed but in reverse. First the Child is repressed by the Adult, then the Adult is repressed by the Parent. Perhaps as a child when we follow what Berne calls The Electrode (or the Parent part of the Child), we then repress the Adult and Child simultaneously. If we continuously follow The Demon (or the Child part of the Child), then we end up excluding our Adult and Parent. This is all speculation.

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Excluding Adult

Dr. Quint is a case of an excluding Adult. He functioned like a computer and this helped him in his job as a social scientist, but he lacked certain qualities that would help him in other areas of life. In the words of Dr. Berne, "On the one hand he was devoid of the charm, spontaneity, and fun which are characteristic of the healthy child and on the other he was unable to take sides with the conviction or indignation which is found in healthy parents" (29).

I can identify with both of those traits: inability to have fun, inability to have convictions. Maybe I am an excluding Adult (or maybe I'm just exaggerating because I'm having fun making this blog and I feel somewhat assured of what I'm talking about.) Sometimes I wish I functioned more like a computer in order to get my work done. To me, this highlights the possibility of certain Child ego states being excluded and other Child ego states being integrated (...unless it's more complicated than that and certain parts of the Child ego state are excluded while certain parts are "included." I haven't delved too deep into advanced structural analysis so I can't really tell for sure yet.)

Dr. Quint functioning solely as a data-processor gave him certain difficulties: "at parties he was unable to join in the fun," "in time of need he could neither father his wife nor offer his students paternal inspiration," and he had sexual difficulties (29-30).

Pertaining to his sexual activities, Dr. Berne says that "the excluded aspects became so highly charged with unbound cathexis that the Adult lost control" (30). This leads me to wonder: Why did sexual activities specifically cause his Child and Parent to become "highly charged with unbound cathexis"? Is there something special about sex or would any activity that put stress on one's personality cause the excluded parts to become active?

For example, if Dr. Quint was at a party, his Child would be put under stress to joke around or "loosen up." Is this the same kind of stress that sex would put on him? It sounds like he would be hyper-focused on keeping his composure. Perhaps he would hide in the corner or find people who would be willing to engage in low-key discussions about scientific topics. Is this because he's ashamed of the Child aspects of his personality? Or afraid of them? Or is this "exclusion" completely unconscious and he's simply afraid of the unknown?

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And as far as his Parent is concerned, he doesn't feel comfortable giving his students or wife "paternal inspiration." I'm imagining that this means instead of encouraging them with compassion and conviction, he'd try to comfort them with rationalizations that would ultimately not serve their purpose. This leads me to recognize the function of the Parent more clearly. Before it seemed to me that the Adult could do everything that the Parent could do. Now I'm starting to see how with the Parent, it is possible to be more assured of things and to identify what's important in a situation.

I'm very interested in principles. Part of me wants to say that "everything is relative," but another part is telling me that "some things are certain." This is relevant because that seems to be how the Parent operates. One can only encourage another if one feels confident in one's beliefs. You would think Dr. Quint would have convictions, since he is a master data-processor. He must have come up with something certain in all that processing. Maybe it is not only about certainty in one's beliefs, but certainty in another's ability to succeed as well. In line with what I have read in What Do You Say After You Say Hello?, children think and speak in "Martian" terms. Perhaps the function of the Parent is to understand "Martian."

For example, I had Kung Pao Shrimp yesterday. I'm quite certain of this because it looked like shrimp, tasted like shrimp. I've had shrimp before. I have no good reason to believe that what I ate yesterday was not Kung Pao Shrimp. My Child is offering up the suggestion that maybe it was a dream. That's a nice thought, but I can tell my dreams from reality most of the time. So where does the Parent exist in all this? My Parent is simply saying "You shouldn't eat shrimp" ... "Shrimp is a dead animal and you call yourself an animal lover" ...My Parent seems to be of no help in this debate... My Adult thoughts are that there are certain underlying rules that govern space and time, and if I could only learn these rules, I could free my Parent to actually help me instead of criticizing my every thought and behavior. The Parent could adopt these rules as beliefs and then be of service. I'm not really sure how this all works. With that I'll move on to my next subject.

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Excluding Child

In this type of exclusion, it is the Child which predominates over the Adult and Parent. There may be weak appearances of the Adult and Parent ("which scatter easily in the face of threats") or they may be completely excluded. I would've like Dr. Berne to present a case history for one of these types of patients because I'm most interested in the Child, but he gives two examples where one would likely find the excluding Child: "certain types of 'high class' prostitutes," "some types of active schizophrenia." In a broader generalization it would be found in "narcissistic impulsive personalities"(30).

It may appear sometimes that these types of people are manifesting their Adult personality part, but in reality it is still the Child. Berne has not discussed the further divisions within the Child yet, but as I've mentioned, the Child has other divisions besides the adapted and natural parts. The Child may act with "surprising manifestations of 'native' shrewdness and basic morality." These most likely come from The Professor part of the Child, although shrewdness may be a more general property of the Child itself. (What is the difference between Adult shrewdness and Child shrewdness?)

I would think this would be the most popular dysfunction compared with the excluding Adult and excluding Parent because the Child is the first ego state that is available to the human being. I can imagine difficulties arising when later ego states form and the Child doesn't want to "let go." Dr. Berne also mentions that the Child is "almost indefatigable," as compared with the weaker Adult, and the Parent, the weakest, so I would assume there would be more instances of the Child exerting its influence to the detriment of the other ego states.

I think this is the first time Dr. Berne mentions the nurturing aspect of the Parent. Although it's only a brief mention, it seems important to recognize because later he discusses a dichotomy between the nurturing Parent and the controlling Parent.

Another funny example he mentions to highlight the excluding Child phenomenon is the classic case of the impatient man trying to persuade the narcissistic impulsive woman with rational argument. The image this conjures in my mind is of a man trying to convince his girlfriend (or a stranger) to have sex with him instead of appealing to her emotions. In the movie "A Beautiful Mind," John Nash uses reason to appeal to Alicia:

"I find you attractive.

Your aggressive moves towards me indicate that you feel the same way.

But still, ritual requires that we continue with a number of platonic activities...

...before we have sex.

I am proceeding with those activities...

...but in point of actual fact...

...all I really want to do is have intercourse with you as soon as possible.

Are you going to slap me now?"

Alicia was not an impulsive narcissistic woman as shown by the fact that she stayed with her husband throughout many an ordeal, so the resulting kiss was not entirely unbelievable. She probably found his intelligent and honest appraisal of the situation to be quite endearing.

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So we have the excluding Parent, excluding Adult and excluding Child. These are three ways the personality can be dysfunctional. I’m interested in the difference between roles and exclusion. Actors will practice a role, but that doesn’t mean they are excluding other aspects of their personality, at least in the same way. This seems more like a serious problem, then a matter of simply “snapping out of it.” Dr. Berne talks about a personality type known as the Sulk. We can all imagine how a sulky child behaves. Basically the person sulks until the time comes when they want to change their attitude. The Sulk seems stuck, however, with the same attitude until something promising comes along. This differs from the mechanism of exclusion by the fact that the attitude of the excluding Child does not change, but remains “stuck” in the perspective of the Child.

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Contamination

The two forms of contamination are prejudice and delusion. Prejudice happens when the Parent merges with the Adult. Delusion happens when the Child merges with the Adult.

Prejudice

While "in" Adult, the person will have a Parent thought, so it's like the Parent is influencing the Adult but it's different than merely unbound cathexis of the Parent "pressuring" the Adult. The boundaries are actually confused within the person's mind, so the thought that seems like an Adult thought is really both a Parent and Adult thought. Is this the same as having poor evidence to back up a claim or is it more than that? For example, if I thought that all poor people were dangerous, that would be a prejudice. I would only need to befriend one genuinely friendly poor person and I would have good evidence that all poor people are not dangerous. Would that erase the prejudice or is it more like an intrinsic problem of the mind?

Surely, I could come up with plenty of excuses to support my prejudice: He was born rich. He is destined to be rich. He was only pretending to be my friend the whole time, etc…

Or I could realize that all poor people are not dangerous which would either relegate the belief entirely to its rightful spot, the Parent ...or dissolve the belief making neither my Parent nor my Adult believe it.

In the therapeutic setting, the therapist or Adult of the therapist will talk to the patient and somehow decontaminate the Adult. This seems to be the first step. Once the Adult of the patient is free from the prejudice, then the therapist can work on changing the beliefs of the Parent. However, the main objective is to free the Adult.

When the Adult is in control, then the Parent and Child beliefs do not interfere with the functioning of the person. The goal of therapy in terms of structural analysis seems to be to make the Adult strong enough to handle the self and environment. In Games People Play, in the new introduction by James R. Allen, it provides a question that Dr. Berne would ask his patients -- "What do you want to change, and how will we know when you have?" The power is given to the patient to change what he or she wants. This reminds me of Carl Roger's approach. 

Delusion

The delusion is similar to the prejudice in that it is a confusion of ego boundaries. It is different in that it is a confusion of the Child and Adult ego boundary rather than the Parent and Adult.

Dr. Berne highlights an example of a woman who believed people were spying on her in the bathroom. She seemed to be prone to delusions, so it was already suspect that this was a delusion. There was also material from her childhood to further validate that this belief was a delusion. After spending time in therapy she first recognized that she had archaic elements in her perception that were different from her "Self." Then after more time she was able to specifically recognize how she was wrong in perceiving the spies.

After such realizations had taken place, her Adult was then capable of being decontaminated and her "delusional system relegated to the Child" (33).  It seems as if she still had the delusions, but they were latent in her Child which was no longer interfering with the Adult data-processing. As long as her Adult stayed "on top" then her delusions would remain latent, but if her Adult was decommissioned then her delusions could come back. With more therapy the Adult ego boundary was "strengthened and clarified," rendering her able to withstand longer and longer intervals of stress with her Adult remaining in power.

It's interesting to me the difference between a prejudice and a delusion. They just seem to be terms that mean the same thing but in different worlds. Both deal with irrational claims that are supported by false evidence. The term delusion seems to imply a more serious condition as opposed to a prejudice which would seem to be rectified by a simple experience of the claim being false. It is more complex than this because both prejudice and delusion seem pervasive and not easily healed with one or two experiences of the claim being perceived as irrational. Many people can intellectually understand that what they believe is irrational, but nevertheless they will believe it anyway.

Why do people persist in believing things that they know are false?

...It is not a simple matter of making a convincing argument to someone who has a serious phobia or obsession. That is the problem. The sufferer, in most cases, understands that their beliefs are non-rational. The solution seems to come from the fact that people have multiple ego states, multiple belief systems and certain systems operate at different times. The Adult system needs to remain in control, lest the archaic or borrowed systems override the objective attitude. Surely when a painter is painting, they will need to allow their Child system to "take over" but this should be a conscious act by the Adult system.

Changing beliefs seems to be a long and arduous process most of the time, but with the tools of structural analysis, it can possibly be shortened and made easier. In order for the therapist to decontaminate the Adult of the patient, it seems as if he needs to be able to talk to the Adult, the Child, and the Parent specifically without confusing which he is talking to. Once again, the methods that are used have not been spoken about and I trust Dr. Berne when he says, "The therapeutic techniques, mechanisms, problems and precautions involved in changing the situation [...] will be discussed in their proper places" (34).

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Functional Pathology

Besides structural pathology, there is something known as functional pathology which involves the cathexis.

The fact that the same person can both be "stubbornly persistent" and "shift opportunistically between ego states" shows that there is another variable involved in structural pathology besides having either rigid or lax ego boundaries. That is the cathexis which can fall in between labile and sluggish.

A person may have rigid ego boundaries and a labile cathexis in which case the shifts between ego states can be rapid, however the person will be able to maintain one ego state for a long duration of time. With rigid ego boundaries and a sluggish cathexis, the person can maintain one ego state for a long duration of time, but when it comes time to shift ego states, the shift will be slow.

I'm not sure what the case would be for the person with lax ego boundaries and a sluggish or labile cathexis. I imagine there would be more confusion about which ego state is in control at what time. Exclusion is only available to those who have rigid ego boundaries, and I would imagine contamination is more prone in people with lax ego boundaries.

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It seems to be called functional pathology because it involves the person's awareness as opposed to the explicit structure of the personality. I'm wondering how functional pathology is experienced by the person. Also, what makes the cathexis pathological? Just because the person is shifting fast between ego states or not shifting fast, does this imply a problem?

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I’m sure there are more complexities involved in structural and functional pathology but this outlines the general problems. To properly understand pathology, it seems necessary to understand how a person would properly function. If a person wants to be a clown for a living, that’s different than having an excluding Child. A person needs to be able to function in many different types of situations in order to support and structure their life. These different pathologies seem to prevent “happy” living. In the next Chapter Dr. Berne goes more into the origins of pathology and the idea of “happy” living.