Introjection,
Psychic Presence
and Parent Ego States:
Considerations for Psychotherapy
Richard G. Erskine, Ph.D.
Institute for Integrative Psychotherapy
& University of Derby, U.K.
In a memorial
tribute to Eric Berne, Franklin Ernst (1971) declared that Berne’s
most significant contribution to the profession of psychotherapy was
in identifying Parent ego states and differentiating them from Adult
or Child ego states.
This significant differentiation provides a theoretical framework for
clinical Transactional Analysis that suggests a psychotherapeutic focus
that may relieve many manifestations of anxiety, depression, and low
self-esteem stemming from intrapsychic conflict. Yet, most of the
clinical Transactional Analysis literature has either focused on freeing
the Child ego states from a compulsion to adapt, strengthening Adult
ego state control, replacing a lethal introjected message with a benevolent
introjected message or making behavioral changes that facilitate Adult
to Adult “ego state” transactions.
A few articles or books have emphasized an in-depth psychotherapy of
Child ego states. Very little has been written on the treatment
of Parent ego states and the resolution of intrapsychic conflict. The
purpose of this chapter is to clarify and elucidate the intrapsychic
functions of Parent ego states and to outline methods of an in-depth,
integrative transactional analysis psychotherapy of introjected Parent
ego states.
The chapter that follows, “Resolving Intrapsychic Conflict: Psychotherapy
of Parent Ego States”, is co-authored with Rebecca Trautmann; it
includes a verbatim transcript of an actual psychotherapy session along
with my annotated comments about the process of the psychotherapy.
Prior to Berne’s
writings on ego states (1957, 1961) previous psychoanalytic writers had
identified the distinction between adult-like and child-like “personalities”,
“conditions”, or “states” and had developed the
analytic methods of free association, non-gratification and interpretation
as a means of both providing understanding and alleviating internal distress. Much
has been written on the psychological effects of “parental influence” or
Superego, however, the psychoanalytic literature lacks in an adequate
description of the treatment of the Superego whether it is called internalized
object, parental influence, anti-libidinal ego, introjected other or
unconscious fantasy.
In 1895, Josef
Breuer and Sigmund Freud wrote in Studies in Hysteria about Anna
O’s “two entirely separate states of consciousness”,
which alternated frequently and spontaneously – one relatively
normal and a keen observer, the other was child-like and naughty. In
the case they presented about Emmy von N., Breuer and Freud described
how she alternated “states of consciousness” between describing
her primal experiences and making comments to Freud about how he was
conducting the analysis (1950).
In Ego
Psychology and the Psychosis, Paul Federn (1953) observed that
his patients exhibited a current ego that both identifies with internal
sensations and at the same time, identifies with or discriminates from
environmental stimuli.
In addition, this ego manifests a feeling of identity and a response
to the environment which is like that of a young child. He described
these different manifestations as subdivisions or states of the
ego, i.e., different identities. In addition, he referred to the
internalization of parental figures in his patients as “acquired
ego attitudes” and related this constant psychic presence to the
psychoanalytic concept of the superego.
Federn’s views on the ego and states of the ego significantly differed
from those of other ego psychologists within the psychoanalytic movement,
such as Hartmann (1939, 1964), Kris (1951, 1979), and Rapaport (1967).
Although using somewhat different terminology, Federn influenced the
theories of Guntrip (1961), Berne (1957, 1961), Jacobson (1964), Kernberg
(1976), Kohut (1977), Watkins (1978), and Winnicott (1965).
John Watkins,
like Eric Berne, also studied with Federn but developed his ideas of
ego states without an awareness that Berne was developing similar concepts.
John and Helen Watkins’ book, Ego States: Theory and Therapy (Watkins
& Watkins, 1997) defines an ego state as “an organized system
of behavior and experience whose elements are bound together by some
common principle, and which is separated from other such states by a
boundary that is more or less permeable” (pp. 25). They describe
both a “core ego” as that which the person and others perceive
as “self” and “other ego states”
as “segments of self” that are “differentiated for
adoptive purposes”.
These consist of either “introjects of significant others” or
ego states
“split off from the core ego because of trauma” (pp. 26).
In An Outline
of Psychoanalysis, Freud described the development of the Superego
as occurring in the long period of childhood, during which the growing
human being lives in dependence upon his parents. This dependency
forms within the child’s ego a special agency in which this parental
influence is prolonged. The parents’ influence includes
not merely the personalities of the parents themselves but also the
racial, national, and family traditions handed on through them (1949). In
essence, because of the child’s dependency, internalized elements
of the parents’ personality influence the ego (the person’s
sense of “me”) and cause the person to psychologically
function differently and under stress.
In the development
of psychoanalytic object-relations theory Fairbairn (1954) and Guntrip
(1961, 1968) dispensed with Freud’s concept of Superego. Instead
they theorized that in the presence of fear a child may split off parts
of him or herself and form an ego state that is a combination of an internalized
parental control and a child’s fearful compliance with that control.
They termed this state the “anti-libidinal ego” to emphasize
how it suppresses and controls the “libidinal ego” – an
ego state that has the remnants of what would have been the natural nature
of the person. They describe this conflict as occurring interpsychicallyfor
the purpose of maintaining a semblance of relationship by keeping the
natural nature of the person suppressed. Their “central ego” is
the state which functions in the external world and may serve as a cover
for intrapsychic conflict.
Edoardo Weiss
prefers the term internalization since to him it refers to an “inclusion
within the ego” of an identification with aspects of the others
personality (1950, pp. 76). “Internalization is complete
when it substitutes, within one’s own ego, the bodily and
mental aspects of a person. This substitution may be an autoplastic
egotized duplication or only the egotized imagination of the physical
and mental features of another personality”
(1950, pp. 95). In 1912, “Ferenczi introduced the term introjection,
as a synonym for “incorporation” to indicate the egotization
of the autoplastic duplication of the object” (Weiss, pp. 76). Weiss
does not like the term
“introjection” because in his way of thinking it does not
adequately describe how the person is both changed by the other and how
the internalization is also not exactly the same as the other.
In Gestalt
Therapy the concept of psychological introjection - the internalization
of elements of another person - is central to understanding the core
theory of the need for internal and external contact. Introjection
is defined as an unconscious defensive identification with another. The
maintenance of an introjection prohibits full contact with both self
and others (Perls, Hefferline & Goodman, 1951).
The concept
of the Parent ego state may indeed be Berne’s great innovative
gift to our profession. In 1957 Berne quoted Freud’s description
of Superego and added that both Superego and Parent imply that a portion
of the external world has become an integral part of the internal world,
hence both are in origin exteropsychic. Berne often uses the term
exteropsyche interchangeably with Parent ego states. Berne states
that the idea of an exteropsyche has interesting neurological connotations
but he does not say what they are (Berne, 1957). Forthcoming research
in neurobiology may map the basic circuits and identify the brain’s
defensive identifications with others, or their psychic presence, and
perhaps even identify second and third levels of exteropsychic material.
Berne (1961,
chapter 16) described theoretically the second and third order of the
Child and Parent ego states. He referred to the second and third
order Parent ego states as containing “genealogical material”. It
is my opinion that this influencing material can be brought to the client’s
awareness through a respectful and attuned therapeutic relationship and
a phenomenological inquiry that facilitates the client’s discovering
their experiences, fantasies, ideas and meaning making about their present
lives. This is accomplished through an analysis of the transference
and is often the prerequisite to an in-depth theory of a Parent ego state. Berne’s “particular
interest”
in working with characterological problems was in “the persistent
stringency”
of a Parent ego state, specifically “the Child segments of the
Parent and the Adult parts of the Child” (1961, pp. 196-197).
The Latin
origins imply that the word introjection means “thrown inside”. However
neither the Latin nor the Greek “exteropsyche” – outside
the sole or mind – explain how it happens. In Integrative
Psychotherapy (Erskine and Moursund, 1988; Erskine, Moursund and Trautmann,
1999) the following definition is used as an operational definition based
on child development literature and clinical observations: Introjection
occurs in the absence of relational needs being met; it is a defensive
unaware identification with elements of the personality of the other
as compensation for unmet relational needs. All introjections,
because of their defensive nature, are dysfunctional in meeting today’s
relational needs, even though the content may sometimes be nurturing
or effective. When external behavior or interpsychic influence
is the result of introjection, it is the manifestation of a defensive
internalization of a foreign object and is an impediment to full internal
and external contact (Gobes & Erskine, 1995).
Eric Berne
(1961) extended psychoanalytic thought with his elaboration and application
of Paul Federn’s (1953) concept of states of the ego. Berne’s
contribution to the theory of ego states produced the possibility for
a dramatic change in the practice of psychotherapy and predated by several
years the more recent changes in psychoanalytic theory and practice (Bollas,
1979; Greenberg
& Mitchell, 1983; Guntrip, 1968; Kernberg, 1976; Kohut, 1971, 1977;
Masterson, 1976, 1981; Miller, 1981; Stolorow, Brandchaft & Atwood,
1987).
In the popularization
of transactional analysis that has occurred since Berne’s death
in 1970, many of his original theoretical concepts have been presented
simplistically.
Often, Berne’s examples and explanations have been used as definitions
of ego states and the therapeutic richness and depth of his original
concept of ego states has been overlooked.
In this chapter,
we will begin by returning to Berne’s original conceptualization
of ego states as the theoretical base for the psychotherapy of the contact-interrupting,
defensive process of introjection and the resolution of the resulting
intrapsychic distress.
The Ego
and States of the Ego
In Ego
Psychology and the Psychoses, Paul Federn (1953) described the
ego as a real, experienced state of feeling and not simply a theoretical
construct.
The Latin word “ego,” as used in the English translation
of early psychoanalytic writings, replaced Freud’s “Das Ich” – “the
I.” The ego is the identifying and alienating aspect of the
self; it is our sense of “This is me” and
“That is not me.” The ego discriminates and segregates
internal sensations from those originating outside the organism. The
ego is our identity
– the “I am hungry,” “I am a psychotherapist,” or “I
am not a bus driver, although I can drive a bus.”
Berne assumed
throughout his early writing (pre-1966) that the reader was familiar
with a working definition of ego; he described a state of the ego “phenomenologically
as a coherent system of feelings related to a given subject, and operationally
as a set of coherent behavior patterns” (Berne, 1961, pp. 17).
Berne further
used a colloquial description of ego states (Parent, Adult, and Child)
to refer to phenomenological manifestations of the psychic organs
(exteropsyche, neopsyche, and archaeopsyche), whose function it is to
organize internal and external stimuli. Exteropsyche, archaeopsyche,
and neopsyche refer to the aspect of the mind taken from an external
source, the early mind from a previous developmental period, and the
current mind.
Throughout Transactional Analysis in Psychotherapy (1961) Berne
used the psychic organ terms interchangeably with the term “ego
state”
to “denote states of mind and their related patterns of behavior” (pp.30).
Berne (1961)
stated, “The Adult ego state is characterized by an autonomous
set of feelings, attitudes and behavior patterns which are adapted to
the current reality” (pp.76). In this description Berne’s
use of the term “autonomous”
refers to the neopsychic ego functioning without intrapsychic control
by an introjected or archaic ego state. When in the Adult ego a
person is in full contact with what is occurring in a manner appropriate
to that developmental age. This neopsychic (current mind) function
of the ego accounts for and integrates: 1) what is occurring moment-by-moment
internally and externally, 2) past experiences and their resulting effects,
and 3) the psychological influences and identifications with other significant
people in one’s life. This Adult ego consists of current
age-related motor behavior; emotional, cognitive and moral development;
the ability to be creative, and the capacity for full contactful engagement
in meaningful relationships. Berne (1961, pp. 195) emphasized these
aspects through the use of the Greek terms Ethos and Pathos – to
which I add Logos, the ability to use logic and abstract reasoning, and
Technos, the ability to create – to describe the full neopsychic
capacity of the Adult ego to integrate values, process information, respond
to emotions and sensations, and be creative and contactful (Erskine,
1988).
The term “Adult
ego” is used in Integrative Transactional Analysis theory rather
than the more popular “Adult ego state” to denote that it
is not a state of the ego but symbolizes the full neopsychic capacities
of an individual without the intrapsychic control of introjected parent
or archaic child ego states. Parent and child ego states are non-integrated
fixations of unresolved previous experiences that drain psychic energy
and distract an individual from spontaneity and flexibility in problem
solving, health maintenance or intimate relationships with people. Through
corrective life experiences or an effective healing psychotherapy Child
and Parent ego states can be fully integrated into the adult’s
ego. With integration the past experiences of childhood and the
introjected experiences of significant others are now in one’s
awareness, are de-energized as separate entities, and no longer serve
their defensive functions. They can now function like a valuable resource
library rather than as separate states of the ego that influence, control,
and produce intrapsychic conflict.
The neopsychic
ego was contrasted by Berne with archaic ego states which consist of
fixations at earlier developmental stages. In Berne’s (1961)
words, “The Child ego state is a set of feelings, attitudes, and
behavior patterns which are relics of the individual’s own childhood” (pp.77). When
in a Child ego state the person perceives the external world and internal
needs and sensations as he or she did in an earlier developmental stage. Although
the person may appear to be relating to current reality, he or she is
actually experiencing what is happening with the intellectual, social,
and emotional capacities of a child at the developmental age of unresolved
neglect, trauma, or confusion, i.e., a psychological fixation.
It should
be noted that using the term Child ego state in the singular form is
somewhat misleading. A child develops through a number of phases
and stages (Erikson, 1950; Mahler, 1968; Mahler, Pine & Bergman,
1975; Piaget, 1936/1952; Stern, 1985), and repression and fixation may
occur at any of them. Under the influence of one set of stressors,
we may think, feel, and act much as we did when we were six years old;
under another we may perceive ourselves or the world around us as we
did as infants.
The archaeopsychic
state of the ego is much more complex than implied by various writers
who use simple examples of spontaneity, intuition, compliance, or emotive
capacity to describe the Child ego states. The Child or archaic
states of the ego are the entire personality of a person as
he was in a previous developmental period of time. This includes
the needs, desires, urges, and sensations; the defense mechanisms; and
the thought processes, perceptions, feelings, and behaviors of the developmental
phase where fixation occurred.
The archaic
state of the ego is the result of developmental arrest which occurred
when critical early childhood needs for contact were not met. The
child’s defenses against the discomfort of the unmet needs became
egotized – fixated; the experience cannot be fully integrated into
the Adult ego until these defense mechanisms are dissolved.
Berne (1961)
also explored Federn’s observations that in many of his clients
there was a constant psychic presence of parental figures influencing
their behavior. This parental influence is from real people who
years before interacted with and had responsibility for this particular
individual when he or she was a child. This parental presence is
more tangible than the Freudian construct of “superego” (“Uber-Ich”). Through
historical investigation it is possible to trace what was actually said
or done, by whom, and at what time during the person’s childhood. Through
introjection (an unaware defensive identification and internalization)
the child made the parental person part of the self, i.e., ego.
Berne (1961)
concluded that the introjected parents also became a state of the ego
which he defined as “a set of feelings, attitudes, and behavior
patterns which resemble those of a parental figure” (pp. 75). However,
the phrase
“resemble those of a parental figure” is somewhat misleading. From
Berne’s examples and descriptions in Transactional Analysis
in Psychotherapy (1961) and from my own clinical observations it
is apparent that Parent ego states are an actual historical internalization
of the personality of one’s own parents or other significant parental
figures as perceived by the child at the time of introjection. Berne
emphasized this point:
“The patient whose (mother)
parent habitually or at a given moment is not acting as though her
mother
“observes, orders, corrects, and threatens,” but instead
is acting just like how mother did, perhaps even with the same
gestures and intonations.
She is not acting with one eye on her Mother, so to speak [which is likely
to be Child ego state]; she is reproducing her mother’s total behavior,
including her inhibitions, her reasoning, and (this is a crucial factor)
her impulses” (1957, pp. 300).
Parent
ego state contents are taken in, i.e., introjected, from parenting figures
in early childhood – and, to a lesser degree, throughout life – and,
if not reexamined in the process of later development, remain unassimilated
or not integrated into the neo-functioning ego of an adult. Since
the child’s perceptions of the caretaker’s reactions, emotions,
and thought processes will differ at various stages of development, so
also will the actual content and intrapsychic function of the Parent
ego state vary in relation to the developmental age when the introjection
occurred.
Introjection
is an unconscious defense mechanism (involving disavowal, denial, and
repression) frequently used when there is a lack of full psychological
contact between the child and the caretakers responsible for his or her
psychological needs. The significant other is made part of the
self (ego), and the conflict resulting from the lack of need fulfillment
is internalized so the conflict can seemingly be managed more easily
(Perls, 1978).
In addition
to the various physical needs of childhood (Maslow, 1970), a child’s
relational-needs require the attuned involvement of parents or significant
others. (Erskine, 1998; Erskine, Moursund & Trautmann, 1999). These
relational needs include:
1) security
within a relationship – a physical closeness and the freedom from
humiliation and physical violence;
2) validation
of the child’s feelings, thoughts, fantasies and various needs;
3) being
in the presence of someone on whom the child can rely for protection,
support and guidance;
4) having
a shared experience such as playing and learning together;
5) self definition
within the relationship;
6) making
an impact – influencing the other, at least some of the time to
respond in accordance with the child’s wishes;
7) or desires and
respond accordingly; and
8) the
expression of gratitude and love to the caretaker – the manifestation
of bonding and loyalty.
When these
relational-needs are not acknowledged, validated and normalized by significant
others there is a rupture in interpersonal contact – the bond between
child and caretaker is disrupted and a conflict ensues between the caretaker’s
mis-attunement, invalidation, emotional neglect, or physical abuse and
the child’s desperate attempts to have his or her relational-needs
satisfied.
As a biological
imperative children require both a physical and psychological attachment
to maintain psychological health (Bowlby, 1969, 1973, 1980). When needs
are not met the resulting anxiety stimulates an unconscious defensive
identification with the other. The external conflict is solved by internalizing
the other and disavowing one’s own needs, thereby the child can
stay attached, bonded and loyal. This is often accompanied by a
sense of resignation and the formation of a compensating script
belief such as “If I can’t get my needs met then I don’t
need” the external conflict of relational-needs not met becomes
internal where it is handled within the individual rather than continue
the external relational conflict. Metaphorically, the conflict
of needs-not-met is as though there was a psychological vacuum in the
relationship. That psychological vacuum – the absence of
interpersonal contact – is filled by unconsciously identifying
with the significant other.
Brown says,
“Introjection allows a person to avoid her painful feelings associated
with the loss of a person, place, or event by creating within herself
an image of the lost object. Her unconscious fantasies maintain her association
with the lost object and prevent her from working through the painful
emotions connected to the loss” (1977, p.5).
Introjected
elements may remain as a kind of foreign body within the personality,
often unaffected by later learning or development but continuing to influence
behavior and perceptions. They constitute an alien chunk of personality,
embedded within the ego and experienced phenomenologically as if they
were one’s own, but, in reality, they form a borrowed personality
(Erskine, 1988, 1997).
Ego State
Determinants
Berne said,
“Transactional Analysis consists of determining which ego state
is active at a given moment in the exhibition of a transactional stimulus
by the agent, and which ego state is active in the response given by
the respondent”
(1966, pp. 223). Verification of which ego state is cathected is
only possible with a four-part correlation of the behavioral, social,
historical, and phenomenological determinants of ego states. “The
complete diagnosis of an ego state requires that all four of these aspects
be available for consideration, and the final validity of such a diagnosis
is not established until all four have been correlated” (italics
mine), (Berne, 1961, pp.75).
Berne (1961,
pp. 74-76) described the four diagnostic determinants of ego states in
the order he saw them in psychotherapy: behavioral, social, historical,
and phenomenological. From a perspective of facilitating an integration
of the fragmentation of the ego, I have supplementally defined the identifying
criteria and listed them in the following order of clinical significance
(Erskine & Moursund, 1988/1998):
1. The
identifying criterion of the phenomenological determinant is the subjective
experience of the person. It includes the sensations, desires and
needs, feelings, and beliefs that shape the person’s perspectives
– the how and what it is like to live in his or her
experience.
Included in the phenomenological criteria are the physiological, emotional,
and cognitive associations of significant life events and the times when
elements of the personality of another were introjected. Also included
is the subjective experience of the internal defense mechanisms fixated
at times of neglect, traumatic experience, or cumulative devaluation.
2. The
historical determinant is gleaned primarily from memories of the dynamic
events between oneself and others, or the relationship between mother
and father or other important family members. These can provide
essential information regarding early conflicts. The who and when of
early life may reveal memories of similar feelings and behavior in childhood
or memories of the parental person who offered the prototype behavior. Included
is an inquiry into the distinction between the person’s own fixated
childhood defenses and the defense mechanisms possibly introjected from
significant others.
3. The
behavioral determinant involves a developmental focus (Berne,
1961, pp. 154) on gestures, posture, vocabulary, tone of voice, or other
mannerisms, and the content of what is communicated. The assessment
of the person’s current observable behavior is compared with information
about human development regarding early mother-child interaction; motor
and language development; emotional, cognitive, and social development;
defense mechanisms; moral development, and adult life transitions. All
of this comparative information provides a background of data to assist
in determining the stage of development at which emotions, behaviors,
or interactions have become fixated. Behavior that is not congruent
with the current context may have been normal and appropriate for a child
at a specific developmental age or may be an indication of how the patient
defended himself or herself in a traumatic situation.
Childlike behavior may be an indication of the person’s own active
Child ego state, or just as likely, an indication of the Child ego state
of an introjected parent. Interweaving the developmental assessment
with the historical or phenomenological may be necessary to determine
if a specific defensive reaction, behavioral pattern, or emotion is the
manifestation of an exteropsychic ego state or of an archaeopsychic fixation.
4. The
fourth determinant in verifying ego state cathexis is the social or transactional. The
analysis of transactions provides data to indicate which ego state is
active, the nature of the intrapsychic dynamics, and what stimulus from
the psychotherapist served to trigger the cathexis. The intrapsychic
dynamics include the influence of the introjected Parent ego state and
Child ego state’s need for a contactful relationship. Transactions
between the person and psychotherapist, or, in group or family psychotherapy,
between any two people, may reflect a transference either from an exteropsychic
or archaeopsychic ego state. These transferences may take the form
of
“roles” such as child-like “compliance,” “impertinence,” or “rebelliousness”;
adult-like roles of “problem solver” or information exchange,
or parental roles of “comforting” or “controlling” (Berne,
1961, pp. 93-96). It is essential in diagnosing ego state cathexis
and intrapsychic conflict to evaluate these transactional roles or social
entities within the context of a correlated phenomenological, historical,
and developmental (behavioral) assessment. It is only through
the careful and systematic use of the four-part correlated diagnosis
that it is possible to verify which ego states are influencing and which
are cathected and proceed with the appropriate psychotherapeutic interventions (Erskine,
1991/1997).
The Functions of Influencing
and Active Parent Ego States
An
introjected Parent ego state may be either active or intrapsychically
influencing.
An active Parent ego state communicates with the outside world while
an influencing parent ego state operates internally. Berne (1961)
described the active Parent ego state as reproducing the feelings,
attitudes, and behavior of the introjected parent or other significant
persons in actual transactions with people. The psychological function
of an active Parent ego state is that the person diminishes anxiety and
experiences some interpsychic relief from the internal influence of the
introjection.
For example, a mother may scream at and criticize her children in the
same way her father screamed at and criticized her when she was young.
She is able to feel some temporary relief from the pressure and anxiety
of father’s psychic presence and internal criticism by externalizing
the verbal abuse. Others in her life, such as her children, may
suffer the effects of the rage and criticism that is an expression of
an active Parent ego state. She most likely remains unaware that
the quality of her contact both with self and others is under the dominance
and control of a Parent ego state. Clients seldom describe this
externalization as a problem except to report their discomfort regarding
what others say about their behavior. Family members may complain
how “mother acts just like or even worse than grandfather.”
In
psychotherapy, it is much more typical that the client will describe
the phenomenological experience of self-doubt, a constant sense of being
controlled, the loss of knowing what one desires, and/or chronic anxiety,
and/or depression. The phenomenological experience of some clients
is as if they were criticizing themselves or under an internal control. Other
clients may be aware of the presence of an influencing introjection or
psychic presence of another person; they hear another voice that is criticizing,
warning, or rule-making.
Berne referred to the influencing Parent ego state as “the voice
of an actual person” that the client may misidentify as a hallucination
(1961, pp.32).
“The
Parental influence can be inferred when the individual manifests
an attitude of child-like compliance” (Berne, 1961, pp. 76) and/or
may make use of childhood defenses such as avoidance, freezing, or fighting
(Fraiberg, 1982/1983); ego splitting (Fairbairn, 1954); transformation
of affect and reversal of aggression (Fraiberg, 1982/1983), and archaic
fantasy (Erskine, 1988/1997, Erskine
& Moursund, 1988/1998). The “child-like compliance” resulting
from parental influence may be evidenced in the reactions of shame:
· a
sadness at not being accepted as one is with one’s own urges,
desires, needs, feelings, and behaviors;
the fear of abandonment because of who
one is;
· a
diminished self-concept, a lowering of one’s self-worth in compliance with
introjected criticism, and
· a
sense of “something’s wrong with me”.
Shame
is often an internal expression of an intrapsychic conflict between a
reactive Child ego state and an influencing Parent ego state (Erskine,
1994/1997). When a Child ego state is either active or internally
cathected (either behaviorally observable or subjectively reportable),
by theoretical inference a Parent ego state is cathected and intrapsychically
influencing. Berne (1961) described the intrapsychic dynamics
of ego states as representing “the relics of the infant who once
actually existed, in a struggle with the relics of the parents who once
actually existed” for it “reduplicates the actual childhood
fights for survival between real people, or at least that is the way
the patient experiences it” (pp. 66).
The intrapsychic conflict emerges from
a child’s need for relationship (Fairbairn, 1954), attachment (Bowlby,
1969), or contact (Erskine, 1989/1997). When those needs are repeatedly
not satisfied, a child may defend against full awareness of contact,
attachment, and relationship needs and the resulting psychological discomfort. These
needs are evident in a Child ego state’s psychological loyalty to
an intrapsychically influencing Parent ego state (Erskine, 1988/1997,
1991/1997). The loyalty is in the defensive avoidance of the realization “My
psychological needs were unmet” or in the unconscious fantasy “If
I’m good enough, I’ll be accepted and loved” (Stolorow &
Atwood, 1989). The interpsychic functions of forming Parent
ego states is to lessen the external conflict and have a semblance of
relationship
– at least an illusion of being accepted and loved – but
the price of the internalization of the conflict is a loss of valuable
aspects of self
– a loss of spontaneity, flexibility and intimacy. The psychic
presence or Parent ego state is maintained over the years because, like
script beliefs and obsessions, the intrapsychic conflict functions to
provide a sense of predictability, identity, continuity, and emotional
stability (Erskine, 2001).
Theory
into Practice
Berne stated that “the ultimate
aim of transactional analysis is structural readjustment and reorganization... Reorganization
generally features reclamation of the Child, with emendation or replacement
of the Parent. Following this dynamic phase of reorganization,
there is a secondary analytic phase which is an attempt to deconfuse
the Child” (1961, pp. 224). Most of Berne’s descriptions
of psychotherapy emphasize his first phase, the decontamination of the
Adult ego from Child or Parent ego states. Berne (1966) defined
eight therapeutic operations; six are interventions used to facilitate
decontamination and strengthen ego boundaries – the structural
readjustment of phase one.
Only one therapeutic operation, psychoanalytic interpretation, is used
to “decode and detoxify” the Child ego states’ past
experiences, “rectify distortions, and help the patient regroup
the experiences” (Berne, 1966, pp. 242-243).
It is primarily through his clinical
examples that one can infer Berne’s use of a second analytic phase,
a therapeutic deconfusion of the Child ego states. In the chapter
on “Regression Analysis” Berne rather poetically says, “when
a previously buried archaic ego state is revived in its full vividness
in the waking state, it is then permanently at the disposal of the patient
and therapist for detailed examination. Not only do ‘abreaction’ and ‘working
through’
take place, but the ego state can be treated like an actual child. It
can be nurtured carefully, even tenderly, until it unfolds like a flower,
revealing all the complexities of its internal structure” (1961,
pp. 226).
The reader is left to assume that Berne is applying psychoanalytic methods
in this “secondary analytic phase”. Yet he also experimented
with and encouraged an active psychotherapy: “The optimal situation
for the readjustment and reintegration of the total personality requires
an emotional statement from the Child in the presence of the Adult and
Parent” (1961, pp. 224).
Other Transactional Analysis writers have developed or described active
treatment methods effective in deconfusing child ego states (Goulding
& Goulding, 1979; Clark, 1991; Clarkson & Fish, 1988; Cornell
& Olio, 1992; Erskine, 1974/1997, 1993/1997; Erskine & Moursund,
1988/1998, Erskine, Moursund & Trautmann, 1999; Hargaden & Sills,
2001).
In all of Berne’s writing he says
surprisingly little about therapeutic methods. He does not adequately
describe a course of treatment for the Parent ego states. He writes
about an “emendation” – an alteration designed to correct
or improve – “or replacement of the Parent” (Berne,
1961, pp. 224). But, no guidelines for an in-depth and integrating
treatment are suggested. It is as if Berne, like many in both the
psychoanalytic and Gestalt therapy traditions, did not know what to do
with the pain, fear, anger, and defensive strategies of an influencing
Parent ego state and the intrapsychicpressure and distress it causes
in the client. He primarily follows the psychoanalytic tradition
of identifying the interpsychic influence and then goes a bit further
with therapeutic operations such as confrontation and explanation aimed
at decontaminating the Adult ego. He also suggests the use of a
therapeutic interposition such as illustration or confrontation, “an
attempt by the therapist to interpose something between the patient’s
Adult and his other ego states in order to stabilize his Adult and make
it more difficult for him to slide into Parent or Child activity” (Berne,
1966, pp. 237).
In Berne’s writings the theory of Parent ego states is not sufficiently
related to or correlated with therapeutic methods that decommission the
influence of an introjection.
For Transactional Analysis to be a comprehensive
theory of personality and methods, it is essential to integrate the theories
of personality with a theory of methods: The development of an in-depth
therapy of Parent ego states would be one example of the further refinement
in the congruence of methods and theory in Transactional Analysis. To
this end I would like to propose an addition to the quotation from Berne
used earlier about “the ultimate aim of Transactional Analysis”: following,
or in some cases concurrent with, a deconfusion of the Child ego states
there may be an additional psychotherapeutic phase which decommissions
a Parent ego state for the purpose of eliminating its toxic influencing
effect on Child ego states and eventually integrating it into the Adult
ego as a memory and historical resource.
The decommissioning of a Parent ego state
may be described by paraphrasing Berne’s (1961, pp.226) poetic
comment on the treatment of Child ego states: when a previously introjected
exteropsychic ego state is revived in its full vividness and made conscious,
it is then available to the client’s full awareness and to the
therapist for either an in-depth therapy of the Parent ego state or at
least an effective introposition. The Parent ego state can be treated
like an actual client – even a client in regression. It can
be nurtured carefully, or confronted or guided in how to adequately parent
in accordance with his or her actual child’s needs. This
is one aspect of a comprehensive theory of methods (Erskine, 1997/1998)
for an active, in-depth psychotherapy
“for the readjustment and reintegration of the total personality” (Berne,
1961, pp. 224).
I think that the “replacement of
the Parent”, as Berne (1961, pp. 224) phrased it, with another
introjection is not therapeutic. This would be akin to replacing
one toxic introjection with another somewhat more benign introjection – but
it is still a contact interrupting introjection. Rather, I would
like to augment Berne’s (1961, pp. 224) previous statement about
an in-depth psychotherapy of Child ego states: “the optimal situation
for readjustment and reintegration of the total personality requires” in
addition to “the emotional statement from the Child in the presence
of the Adult and Parent,” an emotional statement from a Parent
ego state that either apologizes to or deconfuses Child ego states. This
allows egotized and fixated identifications
– introjections – to be externalized, decommissioned, and
integrated into an Adult ego. An in-depth psychotherapy for “reintegration” of
the total personality includes relaxing the Child ego states’ defenses,
allowing the natural inclination of the client to be expressed, decommissioning
the introjections, resolving the intrapsychic conflicts, and facilitating
an awareness and integration in the client of his other need-fulfilling
experience with parents.
I have been using parents in this text,
but the reader is to be aware that parents may not be the only ones introjected;
teachers, clergy, aunts, uncles, grandparents, older siblings, any one
in authority, even other teenagers, may be introjected in the absence
of need-fulfilling contact. The chapter, “Robert: Challenging
a Cultural Script” in Integrative Psychotherapy in Action (Erskine
& Moursund, 1988/1998) is a detailed example of a psychotherapy for
an introjection of a culturally imposed value.
Experiential
and Written Background
In
1974, I was conducting a weekend therapy marathon with another therapist. He
informed me that one of the women in the group was severely depressed
and she was convinced that she was possessed by the devil. Halfway
through the evening the woman began to snarl and growl at me and then
in a harsh low voice threatened to kill “her”. At first
both group members and I were shocked! I then remembered hearing
a similar voice before at a Pentecostal religious-healing service I attended
as a child on the Southside of Chicago. One of the evangelists
was well known for “casting out devils”. I had watched
with child-like awe as a person was brought in restraints, snarling,
growling, threatening. The evangelist “called out the devil” and
proceeded to “pray over him”.
The memory of the healing-evangelist’s
active encounter with the “devil” person was swirling in
my mind. At the same time, I was also thinking about how to make
sense of the client’s bizarre behavior. I wondered if this “devil” person
was a manifestation of the Gestalt therapy concept of introjection and
Berne’s concept of Parent ego states as representing the personality
of another. I began to talk to the “devil” voice. He
continued to curse at me, repeatedly threatened to kill me or “her”,
hissed, growled, and raged. He refused to talk to a “crazy
therapist”. I continued to talk to “him”, inquiring
about his message and purpose.
During the next half hour, the voice
gradually became that of an angry, drunken man – a man with a secret. He
had threatened to kill his daughter if she ever revealed the incestuous
rape and choking he had inflicted on her. After about two hours
of a combination of both empathetic and confrontative therapy the “father” began
to apologize to his “daughter”. Subsequently, that
confession and apology stimulated in the women client, over the next
few months, several memories that had previously been repressed. The
active therapy directly with a Parent ego state opened the door for the
client to do some intense regressive therapy both in individual sessions
and subsequent weekend marathons. The Child ego state regressions
were accompanied by the slower, ongoing work at resolving her experiences
of distrust and a lack of protection as it emerged both in the transferential
transactions and the absence of interpersonally contactful transactions.
This serendipitous therapy experience
with the “devil” who was a manifestation of the psychic presence
of her father opened a whole new perspective for me in doing psychotherapy.
I no longer saw a Parent ego state only as a depository of injunctions.
Nor could I any longer see the resolution of serious intrapsychicconflict
as occurring in a 20 or 30 minute two-chair dialogue alternating between
the client’s Child and Parent ego states. Rather, I became
increasingly aware of the possible complexity of psychic presence or
introjections to include not only the attitudes and thoughts of significant
others, but also their emotions, defensive processes, physiological reactions,
age regression, and relational needs. This can all be internalized
by a child through an unconscious defensive identification when there
is an absence of need-fulfilling contact, and the child’s dependency
is such that the other is introjected as a way to have a semblance of
relationship.
The Transactional Analysis literature
provides a few theoretical articles on Parent ego state problems, but
there is not much written about an in-depth therapy. Bill Holloway
described theoretically the “crazy child in the Parent” and
related the harshness, frequency, and consistency of the parent’s “craziness” to
the formation of hamartic life scripts (1972, pp. 128). In 1976,
John McNeel published “The Parent Interview” which described
a two-chair therapy with a Parent ego state wherein the therapist elicits
feelings and experiences of a Parent ego state in response to requests
made by a son or daughter.
“In this way, the therapist demonstrates to the client how his
wants or behavior were once threatening to the parental figure. This
investigation is based on the belief that the original parent did not
act with malice”
(pp. 66). McNeel designed the Parent Interview to be part of the
final stage of psychotherapy, where the individual becomes aware of the
internal conflicts of the internalized Parent and, through understanding
him or her, achieves some level of forgiveness and acceptance of that
person.
McNeel warned that if the client’s introjected other was “crazy” then
the therapist should not engage in a parent interview.
Dashiell (1978) also described therapy
with a Parent ego state. She wrote about “minimal resolution”
wherein the therapist provides permission or reparenting to a Parent
ego state that allows for an introjection to be disconnected. Such
interventions free Child ego states for further therapy. “Maximum
resolution” included working with a Parent ego state to resolve
archaic events in the parent’s life, the release of stored feelings
in the Parent ego state, or challenging the crazy or hostile Parent ego
states while not abandoning the client’s Child ego states. Concurrently,
(1978/1997) I wrote a theoretical synopsis about the necessity of doing
Parent ego states therapy in which I describe the “Fourth Degree
Impasse” as representing the confusion within the client between
the feeling introjected and forming a Parent ego state and the person’s
own feelings in a Child ego state.
Mellor and Andrewartha (1980) expanded
on working with the emotions in a Parent ego state and gave several short
examples. Their focus, like Dashiell’s, was also on reparenting – providing
a new program for a Parent ego state. They also advocate making
direct interventions with the internalized parent: confronting, supporting,
and giving permission as necessary, to facilitate a redecision being
made by the client. This was seen by Mellor and Andrewartha as
especially important when a Parent ego state was experienced as having
the power to sabotage or exert a harmful influence on the individual
who was about to change his or her life decisions, usually decisions
which maintained the family system or protected the parent. Unlike
McNeel who warns against working with a “crazy” Parent ego
state they suggest that the technique works well when the Parent ego
state is “disoriented, confused, and/or ‘crazy’ … the ‘craziness’ goes
when the needs, feelings and wants stimulating apparently incoherent
or bizarre responses are identified and are accounted, when the ‘craziness’ is
affirmed as the person’s best effort to deal with these feelings,
needs and wants, and when new methods, experienced as effective, are
provided and tried” (Mellor & Andrewartha, 1980, pp.201).
Bruce Loria in his careful review of
Berne’s writings made a plea for clinicians to remain consistent
with Berne’s original “core concepts” (1988, pp. 39)
and to be mindful of the interpsychic complexity of both child and Parent
ego states. Loria summarizes: “Berne is stating that a person
takes into their Parent ego state the complete personalities of significant
parental figures, including their level of pathology (contamination). Therapists
working to decontaminate the Adult ego state are likely to succeed only
after they have assessed fully the extent of the introjected parental
figures. Concomitantly, specific treatment strategies are needed for resolving
the contaminations of the introjected Parent and archaic Child in
the Parent ego state in the offspring” (1988, pp. 41).
In writing about the therapy of relationship
problems, Landy Gobes identified that the treatment of abandonment or
engulfment issues involve an evaluation of “the form and the degree
of pathology in the Parent ego state” and then possibly
“therapy with the Parent ego states of the client” (1985,
pp.217). In describing how she does Parent ego state therapy Gobes
says, “The therapist can proceed as though the entire personality
of mother or father were in the person’s body and can ask the person
to sit in another chair and be mother or father … A client who is her
mother seems to experience greater depths of mother’s thoughts
and feelings than one who role-plays her mother” (1990, pp. 164).
In Beyond Empathy: A Therapy
of Contact-in-Relationship, the methods of an in-depth psychotherapy
of both Child and Parent ego states are provided in detail (Erskine,
Moursund
& Trautmann, 1999). The client’s gaining an awareness
and appreciation of the psychological function of introjection is essential
to the process of an indepth psychotherapy of Parent ego states. Fred
Clark identified an intrapsychic function of introjection: “What
is internalized is the thinking, feeling and behaviors of significant
others (Parent ego state) as a defense against the loss of relationship
with those persons. This concept, common to object relations theory,
differs from psychoanalytic theory where defenses are used in service
of protecting against Id drives. In relationship therapy, defenses are
understood to be used in service of avoiding the pain or loss of contact
(neglect) or painful contact (abuse), both being disturbances in relationship
(1990, p. 42).
The
Fantasy Parent
In Integrative Psychotherapy in Action, (Erskine & Moursund
1988/1998) we described Berne’s original theoretical model of ego
states and how to use his four-part diagnostic system to identify Parent
ego state influence in clients’ lives.
Four chapters are devoted to both an explanation of the Parent ego state
psychotherapy and verbatim examples from actual clients; the other chapters
emphasize psychotherapy with Child ego states. The concept of a “self-generated
Parent” – the fantasy of a young child that functions like
a controlling or punitive Parent ego state, was also described (pp. 21-23).
As a normal developmental process in
early childhood, children will often create an imago, a fantasy
figure, as a way to provide controls, structure, nurturing, or whatever
that young person experienced as missing or inadequate. Some children
create their own personal “boogeyman,” a frightening creature
who threatens them with dire consequences for minor misdeeds. Investing
the “fantasy parent” with all the bad and scary aspects of
being parented allows them to keep Mom and Dad as perfectly good and
loving. Throughout his elementary and junior high school years,
Richard was haunted by the boogeyman. As he developed into a teenager,
the boogeyman ceased to be a concern; however, there was always the possibility
of a stern teacher or policeman who could punish him if he got out of
line. In his late twenties, Richard’s grandmother died and
he helped the family clean out her house. As he cleaned under her
bed and in her closet, he felt extremely anxious. He anticipated
some terrible punishment and, although he told himself that his thoughts
were not rational, he kept expecting to find the remains of the boogeyman. Working
with his therapist, Richard began to remember that as a young child he
thought the boogeyman “lived” in grandmother’s bedroom,
and that he also had the capacity to follow Richard to school or at play. If
Richard misbehaved, the boogeyman was sure to punish him. In the
process of therapy, Richard began to remember a spanking at age 4, which
was administered by his mother, in grandmother’s bedroom, during
a family party. Shortly after the spanking, Richard developed his
belief in the boogeyman and could then turn to his mother for comfort,
protection, and reassurance. The fantasy of the boogeyman helped
the four-year-old Richard remain adapted to external parental controls
and at the same time experience his mother as all loving and fully tolerant
of his behavior.
Others may create a fairy godmother
sort of fantasy parent who loves and nurtures them even when the real
parents are cold or absent or abusive. This created image serves
as a buffer between the actual parental figures and the desires, needs,
and feelings of the young child. The inevitable discomforts of
growing up in an imperfect world are more tolerable because the fantasy
figure provides what was missing with the real parents.
Anne-Marie, for example, had periods
of depression in which she would eat a large amount of food.
During this time, she would long for her dead grandmother, whom she described
during her therapy as affectionate, understanding, consoling, and who
she said used to bring her wonderful food to eat. The therapist,
our of curiosity, asked how old Anne-Marie had been when her grandmother
died and she replied, “14 months”. A fourteen-month-old
infant was not likely to have the experiences with a grandmother that
Anne-Marie reported.
As the therapist began to explore the discrepancy between Anne-Marie’s
longing for her grandmother and the fact that the grandmother had been
dead since infancy, the client began to remember experiences from childhood
that had been lost from memory for many years. Anne-Marie had repeatedly
been abused by both mother and father and had often been locked in the
wine cellar for days at a time without food. Anne-Marie related
how the grandmother would “appear” to her after the beatings
or in the dark wine cellar to comfort her, to encourage her, and to promise
her wonderful meals. By creating these images of grandmother, Anne-Marie
was able to satisfy in fantasy some of the needs for appropriate nurturing
that were drastically lacking in her parents’ behavior toward her.
As they mature to later developmental
phases, children often let go of their self-generated images.
But when the child represses his or her awareness of needs, feelings,
and memories in order to survive in the family, the self-created image
is fixated and does not become integrated with later developmental learning.
Whatever the characteristics of the fixated self-created Parent, over
the years it comes to operate similarly to the Parent ego state described
by Berne. It functions like an introjected personality; however,
it is often more demanding and illogical and unreasonable than the actual
parent was (after all, it had its origin in a small child’s fantasy). The
self-created parent made from fantasized images provides and encapsulates,
a nonintegrated package of thoughts and feelings and behaviors to which
the person responds as if they were truly internalizations from the big
people of early childhood.
Treatment
Planning
Psychotherapy of an introjected ego
state or a self-generated parental fantasy may become part of the psychotherapist’s
treatment plan after much therapeutic work has been done on the various
Child ego states. Such Child ego state therapy may include the
use of a wide variety of methods to facilitate the client’s:
· relaxing
of habitual defenses;
· increased
awareness and perhaps expression of feelings and needs that were
repressed, and
· resolution
of both specific or cumulative traumatic experiences.
Although some of this Child ego state
therapy may include active methods, such as redecision work or the dramatic
expression of sadness or anger, much of the therapy occurs by working
within the client-therapist relationship. By working with the unconscious
process of the client’s transferences, the developmentally aware
and affectively attuned psychotherapist can help the client identify
the archaic interruptions to either internal or interpersonal contact.
These minute interruptions to contact and their related images and fantasies
constitute the subtle dynamics of transference.
Transference is a constant attempt by
the client to reparatively enact fixated childhood experiences by simultaneously
repeating both archaic defenses and developmental needs in a current
relationship. These subtle unconscious enactments are an expression
of an intrapsychicconflict between elements of an influencing Parent
ego state and the developmental needs thwarted and fixated in Child ego
states (Erskine, 1991/1997).
The intrapsychicconflict between Parent
and Child ego states continues years later because of a child’s
biologically-driven needs for relationship and the resulting, though
often unconscious, loyalty to his or her parents or significant others. Therefore,
it is essential to establish a solid therapeutic relationship with any
client prior to therapeutically engaging Parent ego states: the psychotherapist
must be fully protective of the Child ego states’ vulnerabilities.
The effectiveness of a therapeutic relationship is built upon the therapist’s:
· attunement
to the client’s affect and psychological rhythms;
· sensitivity
and responsiveness to both various Child and Adult ego state needs;
· a
constant inquiry into the client’s phenomenological experience;
· facilitating
the client’s appreciation of his or her style of coping, as well
as,
· honoring
of the vulnerabilities of both childhood and adulthood.
Much of this is accomplished by working within the transference
and by the therapist not personalizing the client’s defensive reactions.
Just as effective psychotherapy of Child
ego states produces major reorganization of psychological processes,
experiences, and meaning making, so also psychotherapy of a Parent ego
state produces major psychological reorganization. The client’s
Child ego states have been loyal to the intrapsychicinfluence of Parent
ego states because of children’s natural need for contact, attachment,
and relationship. This biological imperative for relationship must
be accounted for and respected by the therapist and, in most situations,
a sufficient therapy relationship established prior to the treatment
of Parent ego states or a self-generated fantasy. It is generally
advised to only engage in decommissioning a Parent ego state when the
client has an ongoing experience of “this therapist is there for
my welfare”. If therapists engage in an in-depth psychotherapy
that decommissions Parent ego states without such an involved relationship,
then the Child ego states may be without a significant other to whom
they feel a sense of protection and attachment.
Metaphorically, it is akin to creating an orphan and may result in increased
anxiety or depression. In some clients, the intrapsychic relationship
disrupted by a premature intervention may result in increased clinging
to the intrapsychicallyinfluencing Parent ego state or self-generated
fantasy out of a desperate need for attachment. The quality of
the therapeutic relationship, as experienced by the client, is a central
factor in determining when to proceed with treatment of either a self-generated
fantasy or a Parent ego state. The therapist’s phenomenological
inquiry throughout the duration of the therapy and the constant investigation
and repair of breaches in the therapeutic relationship are two of the
best monitors for both identifying the subtle transferences and determining
the degree to which the client can rely on and draw emotional support
from the therapist.
In the “devil” example at
the beginning of the previous section I actively intervened with a Parent
ego state prior to developing a consistent and reliable therapeutic relationship. This
is a rare situation where neither my colleague nor I, during the early
hours of the therapy-marathon, could establish a therapeutic alliance
with her Child ego states. Her Parent ego state was interfering
with the psychotherapy, primarily through intrapsychic influence and
then in the marathon group, by externalization - the active cathexis
of the
“devil voice”. The client had been in therapy with
my colleague for the treatment of her depression and she had gained a
trust in him and, by association, a degree of trust in me. This
was coupled with an idealized hope for “therapy magic”; such
idealization is often an expression of the relational need to be in the
presence of someone who is both protective of the Child ego states’ vulnerabilities
and potent enough to stop interpsychic abuse.
The therapy of her depressed Child ego
states had reached an impasse. In the process of witnessing other
people’s therapy in the marathon the psychic presence or influencing
Parent ego state became externalized. It was an opportune moment
to actively engage the Parent ego state: to keep it externalized rather
than allow it to retreat to a position of interpsychic abuse, and to
provide psychotherapy to that psychic presence just as I would with an
actual client. This instant intervention with an active Parent
ego state is particularly helpful when the influencing Parent ego state
is interfering with the psychotherapy, psychologically beating up on
a Child ego state, or is so controlling that the Child ego states cannot
express or even sense feelings or needs.
In most clinical situations, psychotherapy with a Parent ego state is
initiated only after a protective therapeutic alliance is established
with various Child ego states.
In some situations, a Parent ego state
may become threatened by or envious of the blossoming relationship between
the client’s Child ego states and the psychotherapist’s reliable,
consistent, and dependable involvement. This may result in an increase
in anxiety, the activation of internal voices, or self-criticism that
interferes with Child ego state therapy. It may then be effective
to identify the internal criticism through the interweaving of a phenomenological,
transferential, and historical inquiry. Such a detailed inquiry
is to determine if the internal voice or criticism is either that of
a specific other person, a self-generated Parent-like ego state based
on a child’s fantasy, or a self-criticism that preempts another’s
criticism. Such identification and differentiation of these possibilities
along with a well-timed explanation may provide the client with cognitive
awareness of the source of the internal conflict and anxiety and thereby
some temporary respite. A description of the treatment of self-generated
Parent-like ego states or self criticism that preempts another’s
criticism is beyond the scope of this chapter. However a differential
diagnosis may be useful before proceeding with Parent ego state therapy. Sometimes
the self-generated fantasy is clearly evident after the Parent ego state
therapy is successfully completed. The Child ego states hold on to a
fantasy as an expression of attachment. Preemptive self criticisms are
related to shame and self-righteousness (Erskine, 1994/1997).
Sometimes a Parent ego state is continually
or even increasingly influencing, particularly following regressive therapy,
a redecision, or the resolution of a transferential expression of conflict
and needs. I have found it more effective to address the criticizing
voice on behalf of a Child ego state by speaking as though the actual
parent were sitting next to the client. An example of what I have
said with one woman’s father is: “Stop talking to her like
that; I will not let you berate her. Don’t punish her for
having normal child needs; let her be natural. I know life is hard
for you, but you cannot solve your problems by taking it out on her. Be
quiet now; later you and I can talk.” This is but one of
many examples of an interposition wherein the therapist protectively
interposes him or herself between the client’s Parent and Child
ego states. This often provides a large measure of relief from
the intrapsychic influence, particularly if the therapeutic relationship
is well developed. The client’s sense is often one of the
therapist being fully protective.
It is essential that the therapist make
such a confrontation caringly and with respect. After all, this
influencing voice represents the client’s parents or significant
others and any disrespectful comment or arrogant tone may threaten the
client’s loyalty and thereby reinforce the Child ego state’s
attachment to a Parent ego state. When making an interposition
I often silently paraphrase for myself an old cliché: “blood
is thicker than therapy”.
With this cliché in mind I remain respectful of the Parent ego
state even when I may feel disgusted by or ferociously angry at his or
her behavior.
For the sake of the child I’m often both firm and empathic with
the Parent ego state.
The interposition has two purposes:
to temporarily stop the intrapsychicconflict until such time when an
in-depth psychotherapy of the Parent ego state is both possible and therapeutically
prudent; and, primarily, to create an opportunity to further establish
the therapeutic relationship so that the client’s experience is: “This
therapist is thoroughly invested in my welfare.”
Once deconfusion of Child ego states
is accomplished, survival reactions relaxed, and script beliefs relinquished
then it may be essential to engage in treating the Parent ego states. There
are also times when the client experiences not being able to change;
they are still depressed, anxious, or oppressed in response to the intransigent
and destructive nature of a Parent ego state. In either of these
situations, it may become necessary to actively treat the Parent ego
state and later engage in further treatment of Child ego states.
In conducting Parent ego state therapy
the client is invited to cathect the relevant Parent ego state, in essence
to “be” mother or father and to engage in conversation with
the therapist as mother or father might. This involves the client
in taking on the body posture, the facial expression, the attitude, the
feelings, and the style of relating of that particular parent. In
essence, the internalized parent becomes externalized. The therapist
first establishes a safe and accepting emotional climate that allows
the internalized other to begin to open up and become more revealing. This
is often accomplished by realistic, straight talk in the Parent ego state’s
frame of reference.
The quality of the interaction gradually begins to shift to a more therapeutic
focus. Because the therapist already has a previous knowledge about
the actual parent and some of the family dynamics, he or she is able
to make very personal and pointed interventions which reveal areas of
conflict or emotional difficulty in the introjected parent. The
Parent ego state is then invited to work through those issues with the
therapist.
John McNeel’s (1976)
“Parent Interview” was designed the last stage of a short
term redecisional therapy. The goal of the recent interview was forgiveness
and acceptance of the parent through understanding his or her internal
conflicts. McNeel’s therapeutic caveats included a warning against
working with a “crazy”
Parent ego state.
Sharon Dashiell (1978) as well as Mellor
and Andrewartha (1980) encourage therapy with the “crazy”
Parent ego state. However, their approach is one of reparenting the Parent
ego state; this involves replacing a lethal introjection with a more
benign introjection. As stated earlier in this chapter the replacement
of a Parent ego state with another introjection is not therapeutic.
Rather, this chapter describes both the theoretical necessity and the
practical considerations of an in-depth psychotherapy of introjections
for the purpose of relieving intrapsychic conflict in our clients. In
my clinical experience, I have found that an empathetic, relationally-oriented
psychotherapy aimed at dissolving defenses, honest expression of attitudes
and feelings, and therapeutic respect for the individual’s desires,
frustrations, and conflicts provides for the decommissioning of Parent
ego states, the end of intrapsychic conflict and the opportunity for
the person to engage life with awareness, spontaneity and intimacy.
The same methods of inquiry, attunement,
and involvement that are used with many clients may be used to treat
a Parent ego state, including regression therapy and even, sometimes,
treatment of the parent’s Parent ego states. Examples of
in-depth therapy of a Parent ego states include: 1) psychotherapy for
a frustrated and angry 35 year old mother dealing with an alcoholic husband
and blaming her kids for her plight, 2) facilitating a regression to
a father’s childhood experiences, and working through memories
of early physical abuse, 3) using the variety of methods suitable for
deconfusion or redecision, and 4) psychotherapy for the Grandparent or
Great-grandparent ego states – 3rd and 4th generational therapy. If
the Parent ego state is unwilling to engage in this process and continues
to be destructive, the therapist may then continue to relate with that
ego state in order to advocate for the client’s Child ego state. This
is often experienced by the Child ego states, especially in situations
of child abuse, as a kind of protection the child never had and
can be a very powerful experience that brings about change.
The historical accuracy of the portrayal
is not particularly relevant. What is important is the parent-as-experienced
by the client. A person introjects not so much what his or her
parents “actually” thought and felt and did, as what he or
she experienced them thinking and feeling and believing about the child,
about themselves, and about the world. As the Parent ego state
begins to respond to the therapeutic challenges to his or her life script,
the introject loses its compulsive, entrenched position and the client
begins to experience that it doesn’t have to be this way. “The
thinking process, attitudes, emotional responses, defense mechanisms,
and behavioral patterns that were introjected from significant others
no longer remain as an unassimilated or exteropsychic (Parent) state
of the ego but are decommissioned as a separate ego state and become
integrated into an aware neopsychic (Adult) ego.” (Erskine & Moursund,
1988/1998).
Conclusion
The experience of treating a Parent
ego state feels very real: to the therapist, to observers, and most especially
to the client. It is not an “as if” experience once
the person gets fully involved. Therefore certain precautions are
suggested:
1. It
is essential that the client experience a therapeutic alliance with the
therapist first. As a client’s Child ego states, though not
active, observe the understanding, sometimes empathic interaction between
therapist and Parent ego state, he or she may experience that the therapist
is taking the parent’s “side” and has effectively abandoned
the child.
For this reason it is also imperative that the therapist come back to
both Child ego states and the Adult ego of the client before the work
is completed in order to re-establish the relationship. It also
re-affirms that the purpose of the procedure is only for the client’s
benefit (although benefits to the actual physical parents have been reported
as a consequence of this experience).
2. After
the therapeutic work with Parent ego states, make sure that the client,
whether in Adult ego or Child ego states, has an opportunity to respond
to the Parent ego state. This strengthens the sense of self as
separate from the parent and allows for meaningful interpersonal contact
that may have been interrupted or perhaps never present. Failure
to do so sometimes results in headaches or a sense of confusion and disorientation.
3. Keep
in mind the loyalty of a child towards its parent, no matter how abusive
that parent may be or have been. Even if a client is angry at or
ambivalent about a parent, if the therapist confronts too strongly or
is in any way disrespectful to the parent the client is likely to feel
a pull to protect the parent.
Treating a Parent ego state can take
place in one session, an extended session, or over a number of sessions. After
a successful process, the client generally feels a combination of feelings:
relief and freedom, yet often a deep sadness as a result of knowing the
parent’s experience so closely and having it responded to empathetically
by the therapist. Often anger is stimulated and is best dealt with
immediately by having the client address a Parent ego state, as in Gestalt
two-chair work. People usually need plenty of time to process the
experience, express any residual feelings, and talk about the meaning
they have derived from it.
In the process of treating a Parent
ego state, the conflict with that significant person is claimed, experienced,
and dealt with (albeit in fantasy, since the real parent is not actually
present). The result is that the client regains the self that was
lost in the process of avoiding the external conflict by internalizing
it instead. They are less likely to act out their Parent ego states
towards others and, without the internal influence, will also be in a
Child ego state less. In addition, as the content of the Parent
ego state becomes integrated with the Adult ego the client now has the
possibility of dealing with the real person of the parent differently. Therapists
may also find that previously unresolved transference issues with the
therapist are now more easily resolved. In-depth, reintegrating
psychotherapy of Parent ego states is Transactional Analysis’ most
significant contribution to the profession of psychotherapy.
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