TRANSACTIONAL ANALYSIS:
Transactional Analysis (or TA as it is often called) is a model of people and relationships that was developed during the 1960s by Dr. Eric Berne. It is based on two notions: first that we have three parts or 'ego-states' to our 'personality. The other assumption is that these converse with one another in 'transactions' (hence the name). TA is a very common model used in therapy and there is a great deal written about it.
We each have internal models of parents, children and also adults, and we play these roles with one another in our relationships. We even do it with ourselves, in our internal conversations.
Parent
There are two forms of Parent we can play.
The Nurturing Parent is caring and concerned and often may appear as a mother-figure (though men can play it too). They seek to keep the Child safe and offer unconditional love, calming them when they are troubled.
The Controlling (or Critical) Parent, on the other hand, tries to make the Child do as the parent wants them to do, perhaps transferring values or beliefs or helping the Child to understand and live in society. They may also have negative intent, using the Child as a whipping-boy or worse.
Adult
The Adult in us is the 'grown up' rational person who talks reasonably and assertively, neither trying to control nor reacting. The Adult is comfortable with themselves and is, for many of us, our 'ideal self'.
Child
There are three types of Child we can play.
The Natural Child is largely un-self-aware and is characterized by the non-speech noises they make (yahoo, etc.). They like playing and are open and vulnerable.
The cutely-named Little Professor is the curious and exploring Child who is always trying out new stuff (often much to their Controlling Parent's annoyance). Together with the Natural Child they make up the Free Child.
The Adaptive Child reacts to the world around them, either changing themselves to fit in or rebelling against the forces they feel.
When two people communicate, each exchange is a transaction. Many of our problems come from transactions which are unsuccessful.
Parents naturally speak to Children, as this is their role as a parent. They can talk with other Parents and Adults, although the subject still may be about the children.
The Nurturing Parent naturally talks to the Natural Child and the Controlling Parent to the Adaptive Child. In fact these parts of our personality are evoked by the opposite. Thus if I act as an Adaptive Child, I will most likely evoke the Controlling Parent in the other person.
We also play many games between these positions, and there are rituals from greetings to whole conversations (such as the weather) where we take different positions for different events. These are often 'pre-recorded' as scripts we just play out. They give us a sense of control and identity and reassure us that all is still well in the world. Other games can be negative and destructive and we play them more out of sense of habit and addiction than constructive pleasure.
Conflict
Complementary transactions occur when both people are at the same level. Thus Parent talking to Parent, etc. Here, both are often thinking in the same way and communication is easy. Problems usually occur in Crossed transactions, where the other person is at a different level.
The parent is either nurturing or controlling, and often speaks to the child, who is either adaptive or ‘natural’ in their response. When both people talk as a Parent to the other’s Child, their wires get crossed and conflict results.
The ideal line of communication is the mature and rational Adult-Adult relationship.
So what?
Being a Controlling Parent can get the other person into a Child state where they may conform with your demands. There is also a risk that they will be an Adaptive 'naughty child' and rebel. They may also take opposing Parent or Adult states.
Be a Nurturing Parent or a talk at the same level as the other person to create trust.
Watch out for crossed wires. This is where conflict arises. When it happens, first go to the state that the other person is in to talk at the same level.
For rational conversation, move yourself and the other person to the Adult level.
Eric Berne, (1964), Games People Play: The Psychology of Human Relationships
TA concepts are used by people who want to:
· Think clearly and raise their emotionally intelligence
· Develop new options and outcomes
· Analyze difficult situations and change those that happen over and over
Key Concepts of Transactional Analysis
Ego States
Eric Berne made complex interpersonal transactions understandable when he recognized that the human personality is made up of 3 “ego states”, each of which is an entire system of thought, feeling, and behavior from which we interact with each other. The Parent, Adult, and Child ego states and the interaction between them form the foundation of transactional analysis theory.
Transactions
Transactions refer to the communication exchanges between people. Transactional analysts are trained to recognize which ego states people are transacting from and to intervene in the interactions so that they can improve the quality and effectiveness of communication.
Life scripts
A large part of your life story unfolds like the script of a drama or play. When Shakespeare said "All the world's a stage and all the men and women merely players" he alluded to the repetitive predictable aspects of life scripts. You are "in script" when your life follows family influences and childhood decisions. The nature of your script, whether positive or negative, depends on the kinds of permissions and prohibitions you received as a child, and the resulting early decisions you made.
The Philosophy of Transactional Analysis
Transactional Analysis is a humanistic social psychology. The underlying philosophical assumptions that form TA's foundational principles are:
· People can be responsible for their choices and thoughts
· People are OK, worthwhile, and deserve to be treated with dignity
· People make decisions about their lives
· People can change
The general Goal of Transactional Analysis is Autonomy which Eric Berne defined as the recovery of three human capacities: Spontaneity, Awareness and Intimacy.
RATIONAL EMOTIVE THERAPHY:
Rational emotive behavior therapy focuses on uncovering irrational beliefs which may lead to unhealthy negative emotions and replacing them with more productive rational alternatives.
Underlying Theory of Rational Emotive Behavior Therapy
Rational emotive behavior therapy (‘REBT’) views human beings as ‘responsibly hedonistic’ in the sense that they strive to remain alive and to achieve some degree of happiness. However, it also holds that humans are prone to adopting irrational beliefs and behaviors which stand in the way of their achieving their goals and purposes. Often, these irrational attitudes or philosophies take the form of extreme or dogmatic ‘musts’, ‘shoulds’, or ‘oughts’; they contrast with rational and flexible desires, wishes, preferences and wants. The presence of extreme philosophies can make all the difference between healthy negative emotions (such as sadness or regret or concern) and unhealthy negative emotions (such as depression or guilt or anxiety). For example, one person’s philosophy after experiencing a loss might take the form: "It is unfortunate that this loss has occurred, although there is no actual reason why it should not have occurred. It is sad that it has happened, but it is not awful, and I can continue to function.
"Another’s might take the form: "This absolutely should not have happened, and it is horrific that it did. These circumstances are now intolerable, and I cannot continue to function." The first person’s response is apt to lead to sadness, while the second person may be well on their way to depression. Most importantly of all, REBT maintains that individuals have it within their power to change their beliefs and philosophies profoundly, and thereby to change radically their state of psychological health.
REBT employs the ‘ABC framework’ — depicted in the figure below — to clarify the relationship between activating events (A); our beliefs about them (B); and the cognitive, emotional or behavioral consequences of our beliefs (C). The ABC model is also used in some renditions of cognitive therapy or cognitive behavioral therapy, where it is also applied to clarify the role of mental activities or predispositions in mediating between experiences and emotional responses.
The figure below shows how the framework distinguishes between the effects of rational beliefs about negative events, which give rise to healthy negative emotions, and the effects of irrational beliefs about negative events, which lead to unhealthy negative emotions.
In addition to the ABC framework, REBT also employs three primary insights:
- While external events are of undoubted influence, psychological disturbance is largely a matter of personal choice in the sense that individuals consciously or unconsciously select both rational beliefs and irrational beliefs at (B) when negative events occur at (A)
- Past history and present life conditions strongly affect the person, but they do not, in and of themselves, disturb the person; rather, it is the individual’s responses which disturb them, and it is again a matter of individual choice whether to maintain the philosophies at (B) which cause disturbance.
- Modifying the philosophies at (B) requires persistence and hard work, but it can be done.
Therapeutic Approach of Rational Emotive Behavior Therapy
The main purpose of REBT is to help clients to replace absolutist philosophies, full of ‘musts’ and ‘shoulds’, with more flexible ones; part of this includes learning to accept that all human beings (including themselves) are fallible and learning to increase their tolerance for frustration while aiming to achieve their goals. Although emphasizing the same ‘core conditions’ as person-centered counseling — namely, empathy, unconditional positive regard, and counselor genuineness — in the counseling relationship, REBT views these conditions as neither necessary nor sufficient for therapeutic change to occur.
The basic process of change which REBT attempts to foster begins with the client acknowledging the existence of a problem and identifying any ‘meta-disturbances’ about that problem (i.e., problems about the problem, such as feeling guilty about being depressed). The client then identifies the underlying irrational belief which caused the original problem and comes to understand both why it is irrational and why a rational alternative would be preferable. The client challenges their irrational belief and employs a variety of cognitive, behavioral, emotive and imagery techniques to strengthen their conviction in a rational alternative. (For example, rational emotive imagery, or REI, helps clients practice changing unhealthy negative emotions into healthy ones at (C) while imagining the negative event at (A), as a way of changing their underlying philosophy at (B); this is designed to help clients move from an intellectual insight about which of their beliefs are rational and which irrational to a stronger ‘gut’ instinct about the same.) They identify impediments to progress and overcome them, and they work continuously to consolidate their gains and to prevent relapse.
To further this process, REBT advocates ‘selective eclecticism’, which means that REBT counselors are encouraged to make use of techniques from other approaches, while still working specifically within the theoretical framework of REBT. In other words, REBT maintains theoretical coherence while pragmatically employing techniques that work.
Throughout, the counselor may take a very directive role, actively disputing the client’s irrational beliefs, agreeing homework assignments which help the client to overcome their irrational beliefs, and in general ‘pushing’ the client to challenge themselves and to accept the discomfort which may accompany the change process.
Criticisms of Rational Emotive Behavior Therapy
As one leading proponent of REBT has indicated, REBT is easy to practice poorly, and it is from this that one immediate criticism suggests itself from the perspective of someone who takes a philosophical approach to life anyway: inelegant REBT could be profoundly irritating! The kind of conceptual disputing favored by REBT could easily meander off track into minutiae relatively far removed from the client’s central concern, and the mental gymnastics required to keep client and therapist on the same track could easily eat up time better spent on more productive activities. The counselor’s and client’s estimations of relative importance could diverge rather profoundly, particularly if the client’s outlook really does embody significant irrationalities. Having said all that, each of the preceding sentences includes the qualifier ‘could’, and with a great deal of skill, each pitfall undoubtedly could be avoided.
Perhaps more importantly, it would appear that the need to match therapeutic approach with client preference is even more pressing with REBT than with many others. In other words, it seems very important to adopt the REBT approach only with clients who truly are suitable, as it otherwise risks being strongly counter-productive. On this point, however, it is crucial to realize that some clients specifically do appreciate exactly this kind of approach, and counselors who are unable or unwilling to provide the disputation required are probably not right for those clients.
REBT is much less empirically supported than some other approaches: the requisite studies simply have not been completed yet, and the relevant data points for determining the best match with clients are therefore thin on the ground. However, one may envision clients responding particularly well who are both willing and able to conceptualize their problems within the ABC framework, and who are committed to active participation in the process of identifying and changing irrational beliefs (including performing homework assignments in support of the latter). Clients will also need to be able to work collaboratively with a counselor who will challenge and dispute with them directly, and a scientific and at least somewhat logical outlook would seem a pre-requisite. REBT would be less suitable for clients who do not meet one or more of the above. And as hinted above in the section on Criticisms, one might also speculate that clients who are already highly skilled in philosophical engagement could find the approach less useful.
COGNITIVE APPROACH
Cognitive therapy (or cognitive behavioral therapy) helps the client to uncover and alter distortions of thought or perceptions which may be causing or prolonging psychological distress.
Underlying Theory of Cognitive Therapy
The central insight of cognitive therapy as originally formulated over three decades ago is that thoughts mediate between stimuli, such as external events, and emotions. As in the figure below, a stimulus elicits a thought — which might be an evaluative judgment of some kind — which in turn gives rise to an emotion. In other words, it is not the stimulus itself which somehow elicits an emotional response directly, but our evaluation of or thought about that stimulus. (Some practitioners use Ellis’s ABC model, described in the section on rational emotive behavior therapy, to describe the role of thoughts or attitudes mediating between events and our emotional responses.) Two ancillary assumptions underpin the approach of the cognitive therapist: 1) the client is capable of becoming aware of his or her own thoughts and of changing them, and 2) sometimes the thoughts elicited by stimuli distort or otherwise fail to reflect reality accurately.
Thought --> Emotion." border="0" width="362" height="78">
A common ‘everyday example’ of alternative thoughts or beliefs about the same experience and their resulting emotions might be the case of an individual being turned down for a job. She might believe that she was passed over for the job because she was fundamentally incompetent. In that case, she might well become depressed, and she might be less likely to apply for similar jobs in the future. If, on the other hand, she believed that she was passed over because the field of candidates was exceptionally strong, she might feel disappointed but not depressed, and the experience probably wouldn’t dissuade her from applying for other similar jobs.
Cognitive therapy suggests that psychological distress is caused by distorted thoughts about stimuli giving rise to distressed emotions. The theory is particularly well developed (and empirically supported) in the case of depression, where clients frequently experience unduly negative thoughts which arise automatically even in response to stimuli which might otherwise be experienced as positive. For instance, a depressed client hearing "please stop talking in class" might think "everything I do is wrong; there is no point in even trying". The same client might hear "you’ve received top marks on your essay" and think "that was a fluke; I won’t ever get a mark like that again", or he might hear "you’ve really improved over the last term" and think "I was really abysmal at the start of term". Any of these thoughts could lead to feelings of hopelessness or reduced self-esteem, maintaining or worsening the individual’s depression. Usually cognitive therapeutic work is informed by an awareness of the role of the client’s behavior as well (thus the term ‘cognitive behavioral therapy’, or CBT). The task of cognitive therapy or CBT is partly to understand how the three components of emotions, behaviors and thoughts interrelate, and how they may be influenced by external stimuli — including events which may have occurred early in the client’s life.
Therapeutic Approach of Cognitive or Cognitive Behavioral Therapy
Cognitive therapy aims to help the client to become aware of thought distortions which are causing psychological distress, and of behavioral patterns which are reinforcing it, and to correct them. The objective is not to correct every distortion in a client’s entire outlook — and after all, virtually everyone distorts reality in many ways — just those which may be at the root of distress. The therapist will make every effort to understand experiences from the client’s point of view, and the client and therapist will work collaboratively with an empirical spirit, like scientists, exploring the client’s thoughts, assumptions and inferences. The therapist helps the client learn to test these by checking them against reality and against other assumptions.
Often this process will continue outside the therapeutic session. For instance, a client whose fear of dying in a car crash is causing them great anxiety when it comes time to drive to work might record on a slip of paper their estimate of the odds of dying in a car crash at various points in the morning — when they first get up, when they are nearly ready to leave the house, when they are almost to the car, and when they are actually driving. (For someone experiencing such anxiety, these odds might go something like: 1,000 to 1 against when first getting up; 20 to 1 against when nearly ready to leave the house; 2 to 1 against when almost to the car; 5 to 1 in favor of dying in a car crash when actually driving.) This can help the client to see that their estimated odds of actually dying in a car crash are changing just as they move about the house and complete the morning routine. This can be the first step toward making those estimates more realistic and reducing the anxiety which accompanies the thought that one is very likely to die in a crash while driving.
Because of the interrelationship between thoughts, feelings and behaviors, therapeutic interventions frequently involve the client’s behavior. For instance, a client with a strong fear that squirrels will jump onto their head if they walk under trees may go to great lengths to avoid walking under trees. This behavior will prevent the client from acquiring information that contradicts their thought that "if I walk under a tree, a squirrel will jump onto my head" or perhaps their mental image of a squirrel jumping onto their head the moment they step under a tree. The therapist may help the client to overcome this avoidance of walking under trees as part of the process of correcting the distorted thought that walking under trees will lead to squirrels jumping on the client’s head.
Throughout this process of learning, exploring and testing, the client acquires coping strategies as well as improved skills of awareness, introspection and evaluation. This enables them to manage the process on their own in the future, reducing their reliance on the therapist and reducing the likelihood of experiencing a relapse.
Criticisms of Cognitive Therapy and CBT
On first hearing of the basic cognitive therapeutic approach, many people will observe that simply being told that a view doesn’t accurately reflect reality doesn’t actually make them feel any better. They might say, "I know squirrels aren’t likely to jump on my head, but I can’t help worrying about it anyway". But to suggest that a cognitive therapist merely tells the client something is wrong is to caricature the approach (and, in fact, few cognitive therapists would actually tell a client some view doesn’t reflect reality anyway; they would help the client to explore whether it reflects reality). This would be like criticizing the person-centered approach on the grounds that a therapist merely telling a client they are free to discuss anything they like, without judgment from the therapist, doesn’t make it feel any easier to talk about difficult problems.
A more salient criticism for some clients may be that the therapist initially may fulfill something of an authority role, in the sense that they provide problem solving experience or expertise in cognitive psychology. Some people may also feel that the therapist can be ‘leading’ in their questioning and somewhat directive in terms of their recommendations.
Clients who are comfortable with introspection, who readily adopt the scientific method for exploring their own psychology, and who place credence in the basic theoretical approach of cognitive therapy, may find this approach a good match. Clients who are less comfortable with any of these, or whose distress is of a more general interpersonal nature — such that it cannot easily be framed in terms of an interplay between thoughts, emotions and behaviors within a given environment — may be less well served by cognitive therapy. Cognitive and cognitive-behavioral therapies have often proved especially helpful to clients suffering from depression, anxiety, panic and obsessive-compulsive disorder.
FAMILY THERAPY
Family therapy is based on the belief that the family is a unique social system with its own structure and patterns of communication. These patterns are determined by many factors, including the parents' beliefs and values, the personalities of all family members, and the influence of the extended family (grandparents, aunts, and uncles). As a result of these variables, each family develops its own unique personality, which is powerful and affects all of its members.
Family therapy is based on the following concepts as well.
- Illness in one family member may be a symptom of a larger family problem. To treat only the member who is identified as ill is like treating the symptom of a disease but not the disease itself. It is possible that if the person with the illness is treated but the family is not, another member of the family will become ill. This cycle will continue until the problems are examined and treated.
- Any change in one member of the family affects both the family structure and each member individually.
Health professionals who use the family systems model in caring for people always consider the whole family. They view any problem in one member as a symptom of change or conflict in the group.
A family therapist:
- Teaches family members about how families function in general and, in particular, how their own functions.
- Helps the family focus less on the member who has been identified as ill and focus more on the family as a whole.
- Assists in identifying conflicts and anxieties and helps the family develop strategies to resolve them.
- Strengthens all family members so they can work on their problems together.
- Teaches ways to handle conflicts and changes within the family differently. Sometimes the way family members handle problems makes them more likely to develop symptoms.
During therapy sessions, the family's strengths are used to help them handle their problems. All members take responsibility for problems. Some family members may need to change their behavior more than others.
Family therapy is a very active type of therapy, and family members are often given assignments. For example, parents may be asked to delegate more responsibilities to their children.
The number of sessions required varies, depending on the severity of the problems and the willingness of the members to participate in therapy. The family and the therapist set mutual goals and discuss the length of time expected to achieve the goals. Not all members of the family attend each session.
What to Expect After Treatment
People who participate in family therapy sessions learn more about themselves and about how their family functions.
Why It Is Done
Anyone who has a condition that interferes with his or her life and the lives of family members may benefit from family therapy. Usually, the better the family functions, the lower the stress level for the person with the health problem.
Family therapy has been used successfully to treat many different types of families in many different situations, including those in which:
- The parents have conflict within their relationship.
- A child has behavior or school problems.
- Children or teens have problems getting along with each other.
- One family member has a long-term (chronic) mental illness, such as an alcohol use problem or severe depression
· Family therapy can also be useful before problems begin. Some families seek this type of therapy when they anticipate a major change in their lives. For example, a man and woman who both have children from previous marriages may go to family therapy when they marry to help all family members learn how to live together.
· The concepts of family therapy can also be used in individual therapy sessions and are particularly helpful for people who come from families in which there is illness and/or other problems. Adults who lived in poorly functioning families as children may benefit from individual therapy using family therapy concepts.
· How Well It Works
· Family therapy is useful in dealing with relationship problems within the family and may help reduce symptoms such as eating disorders or alcohol use problems. However, more specific types of therapies, such as cognitive-behavioral therapy or medications, may be needed as well.
Risks
- Family therapy can make some problems worse if it is not guided appropriately by a well-trained counselor.
- Therapy may not sufficiently resolve issues if it is stopped too soon.
- Family therapy may be less effective if one family member refuses to participate
BEHAVIOR THERAPY:
Behavior therapy is a type of psychotherapy that focuses on changing undesirable behaviors. Behavior therapy involves identifying objectionable, maladaptive behaviors and replacing them with healthier types of behavior. This type of therapy is also referred to a behavior modification therapy.
Cognitive therapy focuses primarily on the thoughts and emotions that lead to certain behaviors, while behavioral therapy deals with changing and eliminating those unwanted behaviors. However, some therapists practice a type of psychotherapy that focuses on both thoughts and behavior. This type of treatment is called cognitive-behavioral therapy.
Behavior therapy can be used to treat a wide range of psychological conditions including, but not limited to, depression, Attention Deficit Disorder (ADD), Attention Deficit Hyperactive Disorder (ADHD), Obsessive-Compulsive Disorder (OCD), and certain addictions. Behavior therapy may also be used to treat insomnia, chronic fatigue, and phobic behavior. This type of therapy may require fewer treatment sessions than cognitive therapy. However, the length of therapeutic treatment varies with each individual patient.
In some cases, behavior therapy is used as a treatment for obesity. When used for obesity, behavior therapy starts with analyzing eating and activity patterns, as well as dieting methods and other habits. The therapist then uses information gained through such analysis to identify positive strategies for promoting weight loss, healthier eating habits, and a more positive self-image.
Behavior therapy typically begins with the analysis of a trained therapist. The therapist analyzes the behaviors of the patient that cause stress, reduce the patient's quality of life, or otherwise have a negative impact on the life of the patient. Once this analysis is complete, the therapist chooses appropriate treatment techniques.
Treatments can include such techniques as assertiveness training, desensitization, environment modification, and relaxation training. The therapist may also use exposure and response prevention to work towards controlling the patient's actions. Other commonly used techniques include positive reinforcement, modeling, and social skills training.
In some cases, paradoxical intention techniques may be used in behavior therapy. This type of technique involves encouraging the patient to continue adverse behaviors temporarily. Therapists who use this technique report that it is useful in identifying and removing a wide range of undesirable behaviors.
Another technique commonly used in behavior therapy is called aversive therapy. Aversive therapy involves associating maladaptive behaviors with unpleasant stimuli. In the past, electric shock therapy was commonly used as a type of aversive therapy. Today, however, many psychotherapy experts consider this method unethical.
HOW DOES BEHAVIOR THERAPY WORKS?
Behavior therapy works in a few different ways that serve to reinforce positive behavior and attempt to reduce negative behaviors. One way in which this therapy works is through social interactions and reinforcement and punishment through external sources, such as a therapist. Behavior therapy also works due to biological reasons and there is evidence to indicate that chemical neurological processes occur when rewards are provided to an individual.
In psychological terms, behavior therapy refers to any type of therapy that applies the principals of conditioning in a therapeutic system to help a person change his or her behavior. Behavior therapy typically involves the application of reinforcement and punishment, through positive and negative methods, to help a person learn different behaviors. This can be done to help someone learn new behavior that may be more beneficial for him or her or more socially acceptable or to cease behaviors that are destructive or harmful.
Behavior therapy can work through social modification and external sources that help apply reinforcement and punishment for behavior. This is typically provided by a therapist or other psychological professional. Positive reinforcement is the giving of some kind of reward as a result of good behavior, while negative reinforcement is taking away something undesired as a reward for good behavior. In contrast, positive punishment is giving someone a punishment he or she may not way in response to undesired behavior, while negative punishment is taking away something someone likes due to poor behavior.
For simple reasons this type of behavior therapy often works because someone wants things and situations that are desired and does not want things or situations that are unpleasant. This is the principal behind punishment systems like prison or fines, and reward systems such as payment for work. Since many of these rewards and punishments also carry social aspects to them, such as prestige for someone who makes a lot of money for his or her work and stigmas against people who have been in prison, behavior therapy can often be reinforced by society.
In a biological sense, behavior therapy is thought to work because of how the human brain responds to rewards. When good behavior is reinforced through reward, the brain releases dopamine and similar neurochemicals into a person’s body, creating a feeling of well-being and happiness. This creates a physiological response that a person wants to repeat, even though he or she may not consciously understand why the feeling occurred. A therapist typically makes a concerted effort to ensure this response occurs in proximity to desired behavior, making repeated rewarded behavior more likely on a neurological level.
ECLECTIC APPROACH:
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