EdTA

Relational Transactional Analysis

The development of relational TA has been one of the most significant themes in the TA community, and a controversial one at that. In the past twenty years what began as a tentative exploration of the influence of psychoanalytic theory on TA practice has become firmly established as a potent and distinct school of TA. To understand the importance of the impact of relational TA it is necessary to consider the prior history of TA and the relationship of Berne to psychoanalysis.

In the beginning...

When Berne was developing TA he had also been preparing to be qualify as a member of the American psychoanalytic community. Having initially entered the medical profession as a young man, Berne had been pursuing several years of additional study and practice in conventional psychoanalysis. As well as undergoing personal analysis he also provided classic style work with his patients. At the same time he was also experimenting with his own ideas and introducing new techniques into his practice. This was the genesis of TA psychotherapy and throughout the 1950s the work of the San Francisco seminar was the workshop for classic transactional analysis.

As Berne’s experiment gained credibility and influence he began to emphasize how different TA was from conventional psychoanalysis. He made it clear that curing patients did not have to take years and that the most important challenge for the therapist was to carry swift and immediate intervention to relieve the discomfort of the patient. His approach was to cure first and then analyze. This directness was reflected in the language Berne used to describe his theoretical models. If the patient could be taught ideas about communication (transactions) to understand patterns of relationships (games) and gain insight into self-perception (script), the individual would be able to make different choices. The nature of Berne’s approach represented a departure from conventional psychoanalysis to the extent that Berne began to position TA as the antithesis of convention theory and practice. This went so far as Berne publishing critical papers on the psychoanalytic community. He attacked the defensive nature of psychoanalysis, obscuring their practice with overwrought theory and drawing patients into prolonged periods of treatment.

In an effort to create a clear distinction with conventional psychoanalysis, Berne chose to play down references to conventional Freudian concepts, such as unconscious, drives, transference and counter-transference. Instead, Berne talked about awareness and ‘out of awareness, hungers and symbiosis. In doing so he claimed a new language to describe a radically new way of working with patients. Simultaneously Berne was establishing a contra-position to the psychoanalytic community. In retrospect it is not surprising that Berne was refused admission to the American Psychoanalytic Association although he was bitterly disappointed at being rejected. This proved a watershed moment for Berne and thereafter was vociferous in promoting TA as an effective and accessible alternative to conventional analysis. This movement was supported by the early TA founding practitioners, including the Gouldings, Jacqui Schiff, Muriel James, Steiner and Karpman. These people also incorporated the radical spirit of Berne’s anti-psychoanalytic position. The emphasis was to focus on precise diagnosis and swift impact, a combination that proved highly effective whilst giving patients access to information and insights about their experience.

The emergence of relational TA

Given this back-story it was regarded as highly controversial when individual TA practitioners began to refer to psychoanalytic concepts in describing their work and incorporating it into their writing. The first references emerged in the work of Carlo Moiso (1985) and Michele Novellino (1984). During the 1990s a series of articles were published in the TAJ and by 2000 a body of work was emerging that represented a consistent interest in psychoanalysis and transactional analysis. Influenced by the earlier work of Richard Erskine on relational needs and the emerging neurological literature contributed by James Allen and constructivist philosophy, a growing group of practitioners created the concept of relational TA.

Charlotte Sills and Helena Hargaden are the two foremost proponents of relational TA. Based at the Metanoia Institute in London, Sills and Hargaden are well-established TA trainers and experienced psychotherapists. Drawing on their years of client work and reflections on conventional TA theory and practice they began to combine a number of strands to create a contemporary framework for clinical practice. However, relational TA provoked a number of negative responses, especially amongst traditionalists, who argued that the approach was a serious transgression from Berne’s original stance regarding psychoanalysis.

Despite opposition, relational TA has gained momentum and credibility as a distinct approach amongst many clinical TA practitioners. In 2005 Hargaden edited a volume of the TAJ on TA and psychoanalysis which included articles from established TA practitioners as well as relatively new clinicians, including Heather Fowlie (who is now director of Metanoia). Recognition of the perspective was confirmed in 2007 when Sills and Hargaden were awarded the Eric Berne Memorial Award for their work, Transactional Analysis: A Relational Approach (2002). In December 2009 a new TA institute was founded – the International Association for Relational TA (IARTA). Representing application across all fields of application, the institute is also open to membership from non-TA practitioners who are interested in the relational method.

Relational Transactional Analysis

So, now we turn to the detail of relational TA, its principles and practice. It will become clear that it marks a significant departure from key aspects of earlier transactional analysis. It is important to note that perhaps unlike previous new schools of TA, the emergence of relational TA has generated a polarisation in the TA community. Consequently when describing the approach and offering comparison observations, the tendency can be to invite further polarity. Relational TA has been a provocative development and here are some of the features that fuel the debate;

Methodological implications

The cultural and philosophical shifts that fuel the rise of relational TA have significant implications for the practitioner and which contrast sharply with earlier TA methodology. Perhaps most importantly is the core concept of inter-subjectivity. Whereas in early practice the therapist focussed on diagnosis of the patient, in the relational approach the involvement of the therapist is critical in co-creating a growthful relationship. In classical, re-decision and cathectic work, the therapist remains at one-step removed from the patient, orchestrating the shape and direction of the therapy, albeit within the boundary of a clear contract. There is no such distancing for the relational therapist. There is the subjective experience of the patient to consider but the therapist also has a subjective experience that is utilised in the process – hence the frequent reference to the inter-subjective principle of relational work.

Leading on from the above observation, because of the constructivist context, it is important for the therapist to be fully aware that the relationship with the patient is co-created – their ‘stuff’ is the mix too! The mechanism through which this is done is partly because of the transferential and counter-transferential phenomenon. Both of these terms are crucial in the work of relational practitioners and draw directly from psychoanalytic theory. Transference refers to the early experience which the client brings to the therapeutic relationship. Counter-transference refers to the therapist’s response to the relationship with the client. So, the therapist is regarded as a co-respondent, a proactive engaged partner in the work, with all their limitations and fallibility becoming part of the process. Relational work is involves a two-person psychological frame of reference – a marked departure from the one-person psychology of early TA practice in which the patient was the subject of the work.

Transferential phenomenon refers to the unconscious process that is created between the client and therapist and which forms the central working material for the therapy. The principle is that only by engaging explicitly with the covert (ulterior) co-created communication that cure can be possible. Consequently relational work is characterised with references to working with the unconscious – a feature that is broadly absent in Berne’s original work.

Perhaps most importantly – and obviously – the relationship is regarded as the key to successful work. An empathic connection between therapist and client is the objective of the work. This means connecting with the client at the most deep, felt level, beyond the conscious. This also involves working with experience that is rooted in non-cognitive processes. Berne’s method is characterised by its highly precise diagnostic approach; if the therapist can raise the patient’s awareness of their condition, provide them with some accessible tools to think about their experience they can then choose different – script breaking – options and will be cured.

The relational practitioner understands that the transferential, unconscious level more than cognition is needed to forge a therapeutic alliance that brings about change. Hargaden refers to an over-reliance on cognitive method as being typical of a patriarchal frame of reference;

... theory in which thinking, concreteness and certainty is often valued above feelings and the more intangible domains of the psyche that are less accessible to concrete thought…we hypothesis that a reclaiming of the logic of imagination could take us to a place where the impossible happens, where irreconcilable opposites can coexist.
(Ibid. p. 7)

Empathic transactions

Sills and Hargaden describe a series of transactions that form the technical base of relational practice. Based on Berne’s therapeutic operations (Berne, 1966), these nine transactions are designed to really embed the therapist-client relationship. Importantly Sills and Hargaden distinguish their model from Berne’s earlier interventions. The use ‘transaction’ instead of ‘operation’ or intervention’ ion order to emphasis that the therapist is not ‘doing something to’ the client, but is involved in dialogue. The transactions are intended to both de-confuse the Child and de-contaminate the Adult egostates and are described as follows:

• Enquiry
  The therapist is proactive in inviting the client to give feedback on the therapy experience in order to create an initial connection. This is so that the therapist can best ‘enter the phenomenological world of the client’ (p.120)
• Specification
  The therapist shares thoughts that helps categorise information with the client so that this can be held for consideration at a later stage. The process of specifying information is as important for the therapist to track, as the content.
• Confrontation
  Berne talked of how confrontation is used to pick up on information previously specified in order to disconcert the patient’s Child or Parent contamination. In effect this is done by drawing attention to discrepancy between what has been declared and what has been subsequently reported. For example, the client declares themselves as stupid or worthless, but later reports that they have been promoted at work. The relational practitioner not only refers to this but also connects with the feelings associated with the contamination.
• Confirmation
  This follows from confrontation and involves the therapist providing a confirming statement about the new insight gained in the confrontation. It’s a healing transaction although needs to be carefully timed to avoid “yes, but…” responses. Berne talked of not getting ahead of the client and this is especially the case in confirming empathic transactions
• Explanation and Interpretation
  Expressing the feelings and actions in a situation are not sufficient in terms of the client moving forward. The therapist offers and explanation or interpretation that enables them to ‘ultimately make sense of her experience’. It is not especially crucial that the interpretation is correct; ‘It matters that the therapist has been stirred to think about his patient and has been moved in some way. A partially accurate interpretation leaves room for the client to make further impact... Interpretation is where the therapist is involved in trying to find a voice for the Child. It is an attempt to decode and detoxify, (Berne, 1966) her contaminations. It is important to offer an interpretation rather than state it as a concrete certainty. For an interpretation to be potent it has to be based on the uniqueness of the patient’s life and not based on some theory about her life!’ (p.123/125)
• Illustration
  This is where the therapist uses images, metaphor, jokes and stories to illuminate the experience of the client. It needs to be carefully executed to avoid simply feeding the ego of the therapist. However, it can prove to be highly efficient intervention; a flippant remark or aside can trigger powerful opportunity to interpretation.
• Holding
  This is a new transaction and not one identified by Berne in his original work. It essentially means holding the space with the client, resisting the need to interpret or confront etc. It means being with the client in their rage, sadness, despair and mirroring their experience and accepted. It can also involve more risky transactions which depend on a secure bond between therapist and client and which involve the therapist feeding back to the client the expressed sense of worthlessness/sadness etc. Additionally it can be necessary for the patient to ‘hold’ the client by maintaining their own boundary in the face of attach by the client, eg. I find it hard to listen when you shout at me like that...’.
• Crystallisation
  Here is a transaction usually found toward the end of therapy that seeks to provide the client with an Adult position expressed by the therapist addressed to the client’s Adult. It may typically include reference to choices/options identified in the session, linked to previous interpretations. Berne offered a cautious note; if the therapist goes beyond mere professional advice, however, he becomes Parental and the patient’s ‘choice’ is no longer an Adult choice but an act of Child compliance or rebellion. A therapists role is to help the client discover unknown parts of his life and giving him the space to deicide whether or not he want to live them.
• Self-disclosure
  Sills and Hargaden suggest that this is a feature that can be combined with any of the previous transactions and refers to the therapist reporting back to the client their own experience. This may be an anecdote or personal experience drawn from outside of the therapy relationship. It may also refer to feeding back counter-transferential experience. In either case it is critical that the therapist self-monitors this to ensure that the disclosure serves the purpose of the client and not the script need of the therapist.

To explore how relational TA can be framed in educational work, Trudi Newton offers a particular perspective in her paper.