Institute for Integrative Psychotherapy

Integrative Psychotherapy Books

English language books by Richard Erskine may be ordered from Karnac Books at


Relational Patterns, Therapeutic Presence:
Concepts and Practice of Integrative Psychotherapy

Richard G. Erskine
 Published by Karnac Books, London, England 2015
275 pages
ISBN 978-1-78229-190-8

Reviewed by: Edward T. Novak
DOI: 10.1177/0362153715601865a



Richard Erskine is a Teaching and Supervising Transactional Analyst (psychotherapy) who has published extensively in the Transactional Analysis Journal and elsewhere. His newest book on integrative and relational psychotherapy has something for practitioners at all experience levels because it reads as both a basic text on integrative and relational psychotherapies and as an essay on the ways Erskine uses these constructs in working with clients. He integrates 21 chapters of material from over 20 years of publications and conferences into a book of collected works that is ideal for teaching trainees and also serves as a rich reference source on contemporary relational psychotherapy for all clinicians.

The book is first and foremost about relational patterns and how they are viewed and experienced in the therapeutic relationship. Through many case examples, Erskine demonstrates integrative theory and his style in working relationally. In the introduction, he outlines eight principles that form the foundation for the theory and methods, principles that originated from his own value system and personal attitudes toward psychotherapy and his clients. These eight principles are not overtly identified elsewhere in the book, but their influence can be felt in all the case material.

The first eight chapters detail the theory of integrative and relational psychotherapy developed by Erskine and his colleagues. He writes that his integrative frame

melds the ideas and concepts of Carl Rogers’s client-centered therapy, Eric Berne’s transactional analysis, Fritz and Laura Perls’s Gestalt therapy, Heinz Kohut’s psychoanalytic self psychology, various writers from the British object relations school of psychoanalysis, the intersubjective viewpoint in psychoanalysis, and the theories and research in human development. (p. xxvi)

Specifically, these chapters address contact in relationship, ego states, and life script, three concepts Erskine finds central to integrative psychotherapy. They also explore concepts such as attachment patterns, attunement and empathic relating, and unconscious experience, all within the frame of integrative relational therapy. This sets the stage for what Erskine details in the next 13 chapters.

Following this detailed examination of integrative concepts and theory, the book takes on a more essay-like quality that provides readers the chance to move through the book based on their own interests. Many of these chapters offer glimpses into how Erskine incorporates relational integrative psychotherapy in his work. His writing style places readers directly in the therapy room and invites them to experience the sessions from both sides, at times resonating more with the client as he or she is moved or challenged by Erskine and at others experiencing the sting of a client’s anger or the moving quality of his or her vulnerability as elicited, in part, by Erskine’s empathic attunement.

For an immersion into working with integrative psychotherapy, chapters 13, 14, and 15 offer a case study trilogy that details Erskine’s work with one client, Theresa, over 5 years. The reader follows the often nonlinear progression of Theresa’s work and is drawn into anticipating with Erskine whether and how she will return to continue her treatment each fall following the summer break. Throughout the case, the reader is witness to both Erskine’s empathic presence and the ways he makes use of the multiple theoretical frames that comprise integrative psychotherapy, including transactional analysis.

With regard specifically to transactional analysis, practitioners will recognize the thread of TA theory throughout the book, with an emphasis on life scripts and their interaction with relational patterns. The book advances the movement within TA of making use of concepts and research from other theories and disciplines in the practice of transactional analysis.

There are also chapters directly related to a specific theory or concept. The primary focus in chapter 11 is on gestalt therapy as it works with shame and self-righteousness. Chapter 12 explores the schizoid process. The book also includes a chapter devoted to body-oriented therapy, which resonated with my own use of body psychotherapy. I appreciate Erskine’s inclusion of both touch and nontouch interventions. These include a focus on the client’s breathing, body movement, and the actual informed physical contact between Erskine and his clients.

As often happens when one reads a professional book from a well-respected author, one discovers that the writer’s voice finds its way into one’s own work with clients. In my case, during and after reading Erskine’s book, I found his voice added to the collective Parent voice of supervisors and mentors in my mind. I find myself rethinking the ways I am working with specific clients and making adjustments that seem to align more with what the client needs. At times, I have found myself using a phase or sentence borrowed from Erskine. In these ways, I know both my clients and I have and will benefit from Erskine’s book. I suspect this will be true for other clinicians who read this book as well.

Author Biography

Edward T. Novak, MA, is the book review editor for the Transactional Analysis Journal and a member of the editorial board. He has been interested and engaged in transactional analysis psychotherapy for 20 years. He is also a graduate of the National Institute for the Psychotherapies’ National Training Program in Contemporary Psychoanalysis and maintains a private practice in Akron, Ohio. He can be reached at 1653 Merriman Road, Suite 212, Akron, OH 44313, USA; email:

The Institute for Integrative Psychotherapy is approved by the American Psychological Association to sponsor continuing education for psychologists, by the National Board of Certified Counselors for counselors and by the American Board of Examiners in Pastoral Counseling for pastoral counselors. The Institute for Integrative Psychotherapy maintains responsibility for this program and its content.