In what follows, I compare and contrast the main theoretical features of two approaches to counselling (or psychotherapy) that, while they share unmistakable similarities, appear to encompass markedly divergent theoretical sources: transactional analysis (TA) and cognitive behavioural therapy (CBT). Firstly, I will outline the principal theoretical characteristics of each ‘school’ of therapy. I will then proceed to examine the validity of the widely held claim that TA and CBT are complementary approaches to counselling and psychotherapy. I begin by focusing on TA.
Transactional analysis was developed by Canadian-born psychiatrist Eric Berne, in the late 1950s (ITTA 2012). Also trained as a Freudian psychoanalyst, Berne parted company from the mainstream of orthodox psychoanalysis when his phenomenological commitment to advancing a theory of ‘ego states’ saw him seek ‘observable behavioural clues’ to personality (Stewart and Joines 1987: 17). ‘An ‘ego state’’, Berne wrote
may be described phenomenologically as a coherent set of feelings related to a given subject, and operationally as a set of coherent behaviour patterns; or pragmatically, as a system of feelings which motivates a related set of behaviour patterns (Berne 1961: 17).
As well as being proffered as an advanced theory of communication, child development and psychopathology, TA’s reputation also rests on its theory of personality, to which the ego-state model is key (Stewart and Joines 1987: 3). Indeed, as Berne himself insisted, ‘If you can’t break it down to ego states, it is not Transactional Analysis’ (Berne 1973: 71).
Largely as a consequence of TA’s absorption into the often reductionist ‘pop psychology’ movement of the 1960s and 70s, there remains a commonly held misconception that Berne’s P-A-C (Parent, Adult, Child) ego-state model is synonymous with Freud’s conceptualisation of superego, ego and id (Stewart and Joines 1987: 18; Harris 1967; Gildebrand 2001: 28). For Berne, however, it was essential to stress that ego-states are not ‘unobservable, theoretical states’, but ‘phenomenological realities’ (Stewart and Joines 1987: 17; Totton 2010: 13; Berne 1961: 4; Steiner 2006). Rather than ‘universal’ categories, in the sense that superego, ego and id were for Freud, ego-states are ‘eminently observable’ manifestations of the re-enactment of thoughts, feelings and behaviours originating in specific childhood experiences (Steiner 2005; Stewart and Joines 1987: 17).
According to Berne, the Child (‘archaeopsyche’) and Parent (‘exteropsyche’) ego-states ‘are fixations of early reactions and experiences or unaware internalizations.. of significant others’ (Erskine and Moursund 1988: 21). That is to say, they encapsulate thoughts, feelings and behaviours either ‘replayed from childhood’ or ‘copied from parents or parental figures’ (Stewart and Joines 1987: 12). By contrast, to be in the Adult (‘neopsyche’) ego state is to be in the ‘here and now’, seeking a balanced negotiation of ‘internal and external forces' and 'attempting to deal objectively with external reality’ (Berne 1957: 301, cited in Heathcote 2010: 258-259).
The Parent and Child ego-states are subdivided into Controlling Parent/Nurturing Parent and Adapted Child/Free Child. In turn, each of these four functional subdivisions is divided into positive and negative variants (Stewart and Joines 1987: 21-26). From this model follows the analysis of transactions between ego-states. Berne (1964: 15) defined a transaction as ‘a unit of social intercourse’, or, ‘an exchange of strokes’, where a ‘stroke’ is a ‘unit of interpersonal recognition’ (Steiner 2005). Such transactions may be ‘complementary’, wherein ‘the ego-state addressed is the one which responds’ (Adult to Adult, Parent to Child, Child to Parent, and corresponding subdivisions and variants); or it may be crossed, ‘in which the ego-state addressed is not the one which responds’ (Stewart and Joines 1987: 60, 63).
Counterproductive transactions can take the form of recurring, and self-sabotaging, patterns of communication: ‘games’. Because these games evoke emotions ‘learned’ in childhood (‘racket feelings’) they are deemed ‘maladaptive as an adult means of problem-solving’ (Stewart and Joines 1987: 6, 209). People engage in games, according to TA, to ‘further their life script’ (Stewart and Joines 1987: 244). This ‘life-script’ is understood as something akin to a self-fulfilling prophecy or ‘unconscious life plan’, formed in childhood but maintained thereafter in order to prevent re-experiencing the unmet needs and fear of abandonment present at the time of the script’s formation (Berne 1961: 123; Stewart and Joines 1987: 100, 101-102).
TA advocates behavioural diagnosis as a means by which to detect ego-states, games, and so on; it is also employed to reveal a tendency towards ‘discounting’ (‘selectively ignor[ing] information… relevant to the solution of a problem’) and ‘redefining’: misrepresenting reality to ensure it conforms to the life-script (Stewart and Joines 1987: 39, 5, 173). Similarly, ‘drivers and miniscripts’ (‘’I’m OK as long as I… am perfect, please others, etc.’’), brought into play via the negative Nurturing Parent ego-state, can be exposed as further indicators of dysfunctional, self-defeating patterns of behaviour (Stewart and Joines 1987: 164, 167).
The avowed therapeutic goal of TA is to strengthen the Adult ego state, to allow for ‘one’s full contactful capacity for engagement in meaningful relationships’ (Erskine and Moursund: 21). The extent to which this objective is consistent with that of CBT is the subject to which I now turn.
CBT is not a single therapy, but instead a generic term for at least sixteen approaches to psychotherapy (Kinsella and Garland 2008: 2; Neenan and Dryden 1999, cited in MacInnes 2003: 53). Its origins lie both in the behaviourism of Pavlov, Watson and Skinner, in the early part of the 20th century, and in the Rational Emotive Therapy (RET) pioneered by Albert Ellis in the 1950s (Rachman 1997; Sanders 2002: 22-24; Ellis 1975).
From a behaviourist perspective, human personality and behaviour – however complex – can be understood in terms of conditioning and ‘basic learning principles’ (Sanders 2002: 24). Consequently, emotional distress and behaviour disorders are ‘viewed as learnt maladaptive patterns and not as symptoms of a presumed underlying cause’ (Davies-Smith 2006: 28). For Ellis, meanwhile, the source of self-defeating behaviour lies in our ‘cognitions’: thoughts, beliefs and assumptions. This ‘cognitive principle’ can be traced to ancient Stoic philosopher Epictetus’ maxim, ‘Men are disturbed, not by things, but by the principles and notions which they form concerning things’ (Westbrook, Kennerley and Kirk 2007: 5). The subsequent synthesis of behavioural and cognitive principles arose from an understanding that behaviour is ‘crucial in maintaining – or in changing – psychological states’ (Westbrook, Kennerley and Kirk 2007: 5).
Ellis developed the A-B-C model (activating events, beliefs, emotional and behavioural consequences) to explain how irrational beliefs (B), not adverse events (A), are largely responsible for precipitating distressing emotional consequences (C) (Ellis 1962; Ross 2006). This cognitive approach was elaborated by Aaron Beck in the 1960s and 70s (Beck 1967, 1976; Beck at al. 1979). Beck identified ‘cognitive distortions’, or, ‘thinking errors’ (e.g. selective abstraction, arbitrary inference, dichotomous thinking) as the vehicles for ‘negative automatic thoughts’ (NATs). In the case of depression, these spontaneous negative cognitions are directed towards the self, the world and the future (the ‘negative triad’) and take the form of ‘hopeless and self-critical thoughts’ (Jarvis and Russell 2002: 37-38).
‘Dysfunctional assumptions’, or, ‘rules for living’ describe the second level of cognition (Kinsella and Garland 2008: 8). Often inferred from behaviour, dysfunctional assumptions are encapsulated in conditional, ‘if… then…’ statements, such as, ‘If people get to know me, then they will find out how useless I am and reject me’ (Westbrook, Kennerley and Kirk 2007: 8-10). These rigidly held assumptions may have evolved ‘in order to maintain self-esteem and a sense of safety’, and yet ‘living up to’ them, as a protective measure, will ensure that low self-esteem lies dormant at the third level of cognition: negative core beliefs (‘I am a failure’, ‘people are not to be trusted’) (Kinsella and Garland 2008: 8-9).
Through thought-challenging and behavioural experiments (to test the validity of cognitions), these maladaptive core beliefs can be modified, according to CBT, leading to a reduction in self-defeating behaviours and excessive emotional arousal (Kinsella and Garland 2008: 104). This is the goal of CBT.
Notably, despite their roots in, respectively, Freudian psychoanalysis and the behaviourist reaction to Freud, TA and CBT overlap considerably (Sanders 2002: 15; Westbrook, Kennerley and Kirk 2007: 2). Thus, by ‘playing games’, according to TA, ‘we are following outdated strategies’ (Stewart and Joines 1987: 244). This is surely comparable to the notion that dysfunctional behaviours are determined by maladaptive core beliefs. Furthermore, ‘drivers’, ‘miniscripts’, ‘redefining’ and ‘discounting’ all appear to correspond to the dysfunctional assumptions evident at the ‘second level’ of cognition, as conceptualised in CBT.
A shared orientation towards psychotherapeutic practice is also demonstrable, through the role of the contract between therapist and client, a cornerstone for both TA and CBT and their collaborative, goal-oriented approaches (Stewart and Joines 1987: 260-265; Beazley Richards 2008). That a therapeutic approach entitled cognitive behavioural transactional analysis (CBTA) has begun to emerge in recent years only confirms the continuity between the two theories (Beazley Richards 2008). Moreover, just as advocates of CBTA believe that TA should be included under the therapeutic ‘umbrella’ of ‘cognitive behavioural therapies’, Steiner (2005) argues that TA ‘is essentially a cognitive behavioural theory of personality’ (Beazley Richards 2008).
Notwithstanding its adherence to behavioural diagnosis, TA ‘retains an interest in the psychodynamic aspect of the personality’ (Steiner 2005). However, the influence of Freudian theory on CBT is less readily acknowledged. Briers (2009: 4) credits Beck with ‘giving Freud the slip’, after the latter (working as a ‘classical’ psychoanalyst) first became aware that patients were behaving in accordance with pre-conscious automatic thoughts. Yet Beck himself has noted Freud’s ongoing influence on cognitive therapy, in relation to, for instance, ‘modes of cognitive processing’ (Beck 1993: 19). We can concur with Freud – and Berne – that, in terms of the psyche, ‘a great deal occur[s] behind the scenes’ (Steiner 2005). Yet, for the purposes of this essay, we can also conclude that, just as TA remains to the fore in exposing and modifying negative core beliefs concealed by self-sabotaging life-scripts, CBT also remains centre-stage in its endeavour to strengthen the Adult ego-state.
References
Beazley Richards, J. (2008) ‘Cognitive Behavioural Transactional Analysis’ [online]. Available from: http://www.psychologytools.org/assets/files/
TA_CBTA.pdf [27 June 2012]
Beck, A. T. (1967) Depression: Clinical, Experimental and Theoretical Aspects. New York: Harper & Row
Beck, A. T. (1976) Cognitive Therapy and the Emotional Disorders. New York: International Universities Press
Beck, A.T. (1993) ‘Cognitive Therapy: Past, Present and Future’. Journal of Consulting and Clinical Psychology. 61(2), 194-198
Beck, A. T., Rush, A. J., Shaw, B. F. and Emery, G. (1979) Cognitive Therapy of Depression. New York: Guilford Press.
Berne, E. (1957) ‘Ego States in Psychotherapy’. American Journal of Psychotherapy. 11(2), 293-309
Berne, E. (1961). Transactional Analysis in Psychotherapy: A Systematic Individual and Social Psychiatry. New York: Grove Press.
Berne, E. (1964) Games People Play. New York: Grove Press
Briers, S. (2009) Brilliant Cognitive Behavioural Therapy: How to Use CBT to Improve Your Mind and Your Life. Harlow: Pearson Education
Davies-Smith, L. (2006) ‘An Introduction to Providing Cognitive Behavioural Therapy’. Nursing Times [online], 102(26), 28-30. Available from:
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