I'm OK. You're OK. By, Thomas A. Harris M.D.  24:27

9b. P-A-C and Children, Part 2 of 2.

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This is reminiscent of an editorial that appeared in the Kansas City Star referring to a certain public official who had declared that there were too many minors in the beer taverns. Stated the editorial: 'He says there are too many minors in the beer taverns, but as usual he fails to point out how many minors would be about right.'

Following an address on Transactional Analysis to a group of educators I was told, 'We've got to get this into the schools.' I certainly agree. Many parents agree, too. The question 'Should Transactional Analysis be taught in the schools?' was asked of 66 parents who had just completed an eight-week Transactional-Analysis lecture series. In response 94 per cent of the parents said yes for high school and 85 per cent said yes for junior high school and elementary school.

Education is heralded as the greatest medication for the ills of the world. Those ills, however, are deeply embedded in behaviour. Therefore education about behaviour through an easy-to-understand system like P-A-C could well be the most important thing we can do to solve the problems which beset us and threaten to destroy us. The task involved is almost beyond comprehension; yet in some way and at some point we have to make some kind of break in the relentless march of the generations towards insanity or other forms of self-destruction which originate in childhood.

Preadolescents in Treatment

Preadolescence is viewed by some parents as the time of the last-ditch stand before the hormones and hairdos of adolescence appear, complicating what may already be a difficult relationship between youngsters and their parents. This is a time when youngsters are receiving maximum exposure to new ideas of the world about them, in school and in social contacts. It is a time when youngsters implement their early games by new inventive moves, which drive some parents to distraction and others to the doctor. We must keep in mind that the Child needs the security provided by relatedness, consistency, stroking, recognition, approval, and support. Some children have found that the successful way to achieve this security is to conform and cooperate and, if their parents allow it, create. Others who have not learned to get stroking this way will continue to use the early manipulative techniques of the three-year-old, such as acting out, testing, rivalry, evasion, stealing, and seduction. These techniques can be disorganizing to the family, particularly when the preadolescent applies his sharp mind to their perfection.

In 19641 started a group for preadolescents, nine to twelve years old. The group met once a week. A group for their parents met every two weeks in the evening. These groups continued throughout the school year. At the end of the year each child, with his parents, was invited to come in for a survey of results. The changes were striking. Even the physical appearance of most youngsters had changed; many children wear their not ok in their: facial expression and posture, and there was noticeable improvement in both. All families reported an improvement in communication.

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The youngster felt he could talk about his feelings and explain his point of view without provoking a parental storm or a sulky impasse. Parents discovered they were able to make  realistic demands and impose realistic limits without provoking a siege of acting-out behaviour. The preadolescents and their parents were urged to use the 'contract' concept, which is a statement of mutual expectations drawn, discussed, and restated from time to time at the Adult-Adult level. Where the contract was clear, where it contained the do's and don'ts as well as the consequences of the broken contract, the relationship between parent and child improved markedly.

The contract is one of the best instruments I know of for assuring consistency in direction and discipline; yet, because it is drawn by the Adult, it can be re-examined from time to time by the Adult with the further benefit of keeping it up to date and flexible enough to meeting changing realities. Many parents treat their preadolescents in the same way they treated them when they were four years old. Often it is because they wish to maintain strict parental control, but more often it is simply because they do not appreciate how much the child changes from year to year and increases his ability to use his Adult. It is, after all, with the Adult that the youngster learns realistic inner control. The appreciation that he does have an Adult and is not still just a "stupid little kid' immediately takes a great deal of the friction out of family transactions.

My preadolescent patients learned P-A-C quite easily and found it exciting and useful. Backed up by the approval of interested and concerned parents, their understanding of Transactional Analysis developed rapidly. As the internal and external Parent-Child dialogue became less critical, there was a freeing up of the Adult to go to work on the important business of finding out about life. This is the time when boys and girls daydream about what they want to be, when they begin to develop intense idealism and feel a new closeness in relationships with their friends. It is the time when they begin to ask difficult questions about right and wrong. It is a time of Tom Sawyers and Huckleberry Finns who 'promise in blood' and who want more and more and more of life. This is a time when the youngster is particularly sensitive to the kind of life his parents lead. It becomes apparent during the preadolescent years that it is not enough to be a good parent, as if that is the only function of being grown-up, but of being a good person, with vast and creative interests in all of life, not merely introverted worry and concern about 'my child, my family and whether or not lama good parent'.

Alan Watts, former Anglican priest and an expert on Eastern philosophy, speaks of the self-defeating attitude of the parent who 'sits home worrying about whether you're doing the best thing for your child and living as if the only thing you have to give is a well brought- up child'. He says: 'The trouble is that in so many families the father and mother have been made to feel guilty over whether they are bringing up their children properly. They think the only reason for doing their respective jobs well is to produce a good result in the child. It's like trying to be happy just to be happy. But happiness is a byproduct ...{6}

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Just as is a good child. If the only thing the youngster has to look forward to when he becomes a grownup is being a parent who will have to 'take care of a brat' (like himself), why bother? Here is where the parents might better ask: What kind of a person am I around my child? rather than, What kind of a parent am I? I want him to be happy. Is there cheer in our home? I want him to be creative. Do I get excited about new things? I want him to learn something. How many books have I read in the past month, year,  ears? I want him to have friends. How friendly am I? I want him to have ideals. Do I have any? Are they important enough to show in what I do? Have I ever told him what I believe? I want him to be generous. Am I compassionate about the needs of anyone outside my own family? People attract not that which they want but that which they are. People also raise not the children they want but the children who reproduce what they, the parents, are. It is in the 'outgoingness" of the parents that the youngsters can begin to see a road that leads away from their own preoccupation with not ok. It is 'out there', in the world and with people, where the action is, and where, with the stronger and stronger Adult in charge, experiences can take place which begin to produce the ok feelings to counteract the early feelings of not ok and despair.

The Adopted Child

The time of preadolescence is particularly difficult for youngsters who struggle with additional burdens. This is the time, for instance, when the adopted child suddenly may break out in bitter rebellion towards his parents in spite of all the well-intended stories he was told about 'being chosen'. It has long been the standard position of adoption agencies that the little child must be told he is adopted as early as possible, actually long before his Adult is equal to the transaction. All he gets out of it is that he is different. He does not possibly have sufficient data at age three or four to comprehend what adoption means. All he needs to know is that he belongs to someone, to his parents. The finer points of biological birth have insufficient meaning to him at this age. Yet some adoptive parents make such an issue of adoption, of the fact that 'we chose you from among all the others', that the little person is left with an obligation he can't possibly pay back. How can I ever be good enough to you when you were so good to choose me? It is the same kind of indignity we see when one person feels the need to say 'thank you' to another person for extending the simple courtesy of treating him as a human being - for instance, an elderly person who says 'thank you' to a young person for saying 'hello' to him.

The adopted child's feeling of difference can magnify the not ok position until he is a mass of screaming, disorganized frustration. My position in this regard is that discussing adoption should be delayed until the point where the youngster has a sufficiently strong Adult, perhaps at six or seven years of age. Parents may recoil at this and plead the need for 'complete honesty with my child'. Perhaps a more important principle applies here than abstract honesty, and that is true concern for the little person, who cannot possibly process all the complicated data of this transaction. We step in and protect children from other things they are too young to understand. Why not step in here and protect them from a 'truth' they cannot comprehend.

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'But he will hear it from the neighbour children!' protest the parents. True, he will. But how this data registers with the little person depends to a large extent on how his parents react. If the four-year-old comes in and reports that the other kids say he is adopted and 'what does "adopted" mean?' Mother can relegate this to something relatively unimportant as she reassures the child that 'you belong to us.' I honestly believe that it would be better for the child to be told 'yes, you grew in mummy's tummy', even with the implications of dishonesty, than to go into great detail about growing in some other mummy's tummy. If the little person is made to feel he truly belongs, he will have a strong enough Adult a little later in life to comprehend why his parents may have lied to him: out of love for him, to avoid burdening him with confusing and troubling truth.

We have to examine our absolutes. Is complete honesty always the best? It would seem to be. However, as Trueblood points out, 'We are always guilty of oversimplification when we stress only one of several relevant principles.' {7} He illustrates in the following way that perhaps the concern for the welfare of man or of men is a higher standard and more precious than abstract honesty:

Consider the consequences of telling the truth in every circumstance. Suppose you are in a totalitarian country, in which a man of high principles and courage has been imprisoned. You happen to see him escaping down a certain street and soon afterwards you notice that the prison guards are looking for him. You are reasonably certain that if he is caught and returned to prison, he will be tortured, You are asked whether you saw him go down the street, your only possible answers being Yes or No. What then, in this particular situation, is your moral duty?

Here is a situation in which our decisions clearly must be made by weighing comparative difficulties. This is what parents must do when facing the problem of what to tell the adopted child. It is difficult to tell him he is adopted, and it is difficult not to tell him. Eventually he will know. But the parents can modify the telling in such a way as to protect him from the not ok implications by choosing the time, the means, and the details. It might be easier for the child, when he has developed an Adult, to accept 'we lied because we loved you' than the proclamation at an early age that he is profoundly, importantly different from everybody else. It is not possible to outline what to say. But it is possible to help the parents recognize the situation of the not ok Child and the varying influences of their own P-A-C. With this knowledge these parents can proceed to 'play it by ear' in the following context, again as outlined by True-blood in the same book:

The 'best' in any concrete situation is identical with the 'least evil!' There is a certain evil in all lying, because it tends to break down the basis of trustworthiness, and there is evil in returning a good man to unjust imprisonment. The good man must weigh these as best he can, and the lesser evil is his duty, because the only alternative is worse. Often in such a situation, we wish we could avoid the cruel choice, but we cannot, for we are faced with what William James called a forced option. The very failure to decide is itself a decision and perhaps a decision for the worse of the only alternatives. The man who refuses to decide is not thereby freed from responsibility but is obviously culpable. We are just as responsible for the evil we allow as for the evil we commit.

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We must, therefore, proceed hopefully on the basis of what we know. An understanding of the situation of the small child is one body of knowledge that will help parents make those decisions which will produce the maximum stroking, the maximum alleviation of the not ok, the maximum support of the truth that 'you belong to us'. Such understanding also will help adoptive parents to be sensitive to their own not ok Child. Many people who cannot have children feel so not ok that they become excessively demanding of the adopted child: This child is not going to bring shame on the family, etc.

The not ok burden is even greater for the foster child, but, as with any child, we must start where we are. We cannot go back and reconstruct circumstances into something that did not exist. The usefulness of P-A-C lies in bringing order out of the chaos of feelings, in separating the Parent, Adult, and Child, and in making possible a choice. In my work of many years as consultant to the Child Welfare Division of the Sacramento County Welfare Department, I had the opportunity to work with a great many foster children and their foster parents. I found that if we could develop a sensitivity in both parents and children to the influences of the Parent and Child in both, we could begin to work out the best ways to help these youngsters overcome the powerful, subversive not ok recordings made in their early traumatic months and years.

The children of divorce are the orphans of still another storm: the frightening, depressing, emotional storm that tore the family apart. At best divorce is a not ok situation, guaranteed to hook the not ok Child of all concerned. There is usually very little Adult operating in one of these unfortunate human episodes. This is the major problem. Mother and Father are so totally embattled in crossed transactions that the children are left to muddle through on their own. Even though the parents may be concerned, they frequently are not able to provide sufficient help to enable the children to live through the family breakup without the fears and humiliations which greatly reinforce the not ok. In this situation, as in all situations where children live through periods of great stress, there still is the possibility of their extricating themselves from the tangle of the past if they are helped to recognize that they do have an Adult, which can help them find their own reality and their own way out of the jungle of feelings in which they live.

The Battered Child

The battered child is programmed for homicide. This is the child who has been repeatedly beaten in so brutal a manner that skin and bones are broken. What is being recorded in the Child and what is being recorded in the Parent of this little person at the time of such a beating?

In the Child are recorded catastrophic feelings of terror, fear, and hatred. The child struggling and thrashing in this nightmare (put yourself in his place) rages inside. If I were as big as you I would kill you! Here is a shift in position to the psychopathic I'm ok - you're not ok. In the Parent is recorded the permission to be cruel, if not to kill, as well as the finer points of how.

In later life this person, under sufficient stress, may give way to these old recordings: He has the desire to kill (Child) and the permission (Parent). And he does!

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Many states have enacted battered-child laws, which require that physicians who suspect brutality from the injuries they treat report these suspicions to the authorities. The question is, What happens next? I would say the prognosis is poor unless the child, by the time he is a preadolescent, receives intensive treatment, so he can understand the source of his murderous feelings and further understand that despite his past, he can have a choice about his future. For society to offer less than this to the battered child is to toy with a loaded pistol.

There are, of course, degrees of battering. I believe strongly that all physical abuse of children produces replayable feelings of violence. The injunction recorded is: When all else fails, hit! The final court of appeals is violence. I do not believe in spankings, with one exception: when the child is too little to comprehend danger. A spanking may be the only way to condition him from going into the street. It is most effective in this situation if it is not used daily for non-dangerous infractions like spilling the milk or hitting sister. It is not possible to teach non-violence with violence.

Parents, being more human than not, however, occasionally swing out at their children. The feelings in both parent and child can be talked about with P-A-C so that something constructive may come from the incident: how to keep it from happening again, for instance. It is important for parents to see physical punishment as a take-over by the Child and not as a positive attribute under the heading of discipline.

Bruno Bettelheim says,

Let's stop for a moment and perform the simple exercise of actually defining the word 'discipline'. If you go to Webster's, you'll find it has the same root as disciple. Now a disciple isn't somebody you beat over the head. It is somebody who apprentices himself  to a master and learns his craft by working at the same vocation. This is the concept of discipline. So if you show your children, 'When you're angry you beat; it's a good way to get things', they're going to copy that. And then you complain about violence in our cities. {8}

Teaching P-A-C to the Retarded

When we recognize that all children struggle under the load of the not ok, we begin to appreciate what an oppressive burden is carried by the retarded child. He not only feels not ok, he is in fact, less ok in intellectual endowment than other children. His mental retardation frequently is accompanied by other physical handicaps and visible deformities, which evoke from others responses that underline his low estimate of himself. In competition with other children, his position is continually reaffirmed, and the acting out of boiling emotions multiplies his problems. He, in fact, has difficulty using the defective computer he has, because it is further impaired by the continuing, subversive influence of the not ok.

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His inability to hold his own in a society of comparison and competition will sometimes create conflicts requiring institutional care, in which this competition is minimized. Yet his emotional turmoil continues to torment him and those around Mm. The effectiveness of psychotherapy with the retarded is a much debated subject. There is very little in psychiatric literature about treating the retarded. Group treatment has had little trial. The traditional techniques employed in most residential programmes include kindly parental control, structured time, avoidance of excessive competition, and an opportunity for relative success with jobs he is able to do. Such techniques have been reasonably successful in providing a secure and sometimes happy life for the retarded. These techniques, however, have been made up mostly of Parent-Child transactions, having but limited effectiveness in helping the youngster to develop inner control by strengthening his Adult. A continual problem for the residential staff has always been the time consuming business of dealing with emotional episodes.

In Sacramento a new programme of teaching P-A-C to the retarded was undertaken in January 1966 by Dennis Marks, a paediatrician, who is the director of Laurel Hills, his recently completed, one-hundred-bed residential centre for the retarded. Marks, who is a Member of the Board of Directors of the Institute for Transactional Analysis, came to feel that P-A-C was a system that was so easily understandable that it could be taught to the residents of his centre. The age range is from six months to forty-seven years and represents the full range of retardation. Those who attend the P-A-C groups are in the 30 to-75 IQ range. One-third have significant to profound physical handicaps, and many have convulsive disorders. One-third are privately placed, and two-thirds are referred by public agencies such as welfare departments and, occasionally, the probation department They come from private homes, foster homes, and occasionally state hospitals or juvenile detention centres. In terms of chronological age, most are teenagers and young adults.

The presence of helplessly handicapped children necessitates the exclusion of children who cannot control aggressive behaviour. The open nature of the facility (no locked doors) also requires the exclusion of children who are either extremely destructive or severely antisocial, or those intent on running away. The structure does, however, give exceedingly active and noisy children considerable freedom and acceptance.

The two most urgent problems, therefore, are how to calm the severely agitated, combative child and how to prevent the child from running away. In these two situations, particularly, Marks reports considerable success through the use of Transactional Analysis.

The group of thirty youngsters (we use the term 'youngsters' to refer to the entire age range for want of a better generic term) meet once a week in a large living-room at the centre. They sit in a circle, two deep, from which Marks and the blackboard are visible to everyone. The contract (a term they are comfortable with) is, 'We are here to learn P-A-C, which will help us understand how people tick so that we can trade a lot of the uproar for pleasant pastimes and activities.' The group is first introduced to the basics of P-A-C: the identification of three parts of a person, represented by the three circles, Parent, Adult, and Child. Marks helps the children identify 'what part is talking' when a member of the group makes a statement. For instance, he will ask the group, 'Now who's talking?' 'Is this John's Parent, or his Adult, or his Child?' In this manner they also learn to identify words.

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If you look at a piece of fruit and it's spoiled and you say "that's bad", that is Adult. If you look at a picture someone is drawing and you don't like it and you say "that's bad", that isParent. It is critical and you are making a judgement. If you come running into the playroom in tears and cry "everyone is bad to me", that is Child. The youngsters very quickly learn to identify words and actions in this way. They find it satisfying and an experience which helps them recognize they have an Adult, or a computer.'

The word "computer' is another word with which the children are comfortable. Their understanding of their Adult as a computer has made it possible to talk about retardation, a subject which rarely is mentioned in most institutions. The way Marks presents this to the group is:

Some guy may have a million-dollar computer and some guy may have a ten-thousan ddollar computer but we're not going to worry about that. All we have to do is find out the best way to use the computer we've got. After all, you don't have to have a million-dollar computer to be nice to people or to do a good job.

Underlying the entire programme is the often repeated statement I'm ok- you're ok. The youngsters repeat this in unison at the beginning and end of each session, and it becomes in their daily living a key that turns off emotions and turns on their Adult. They are helped to understand that comparing is what the Child wants to do. Marks explains:

The Child wants to say 'Mine is better' and 'I've got a better computer than you have'. That is one way the Child feels better. It is the Child who always is worried about who is smarter. But the Adult can see that, if being smart were the most important thing in life, there would then be only a few happy people in the world: the best painter, or the best mathematician or the best musician; and all the rest would be unhappy because they were not so good. The group grasps and appreciates this approach.

Concerning the problem of controlling aggressive behaviour, Marks reports that a severely agitated, combative child can be calmed within two or three minutes. He explains that the groundwork is laid in the group. The methods of restraint are explained as being of three kinds: Parent, Adult, and Child. He has a youngster get up and pretend that he is going to strike him.

'Then I grab his arm and hold it,' Marks says, 'and ask the group, "How am I restraining Joe?" ' They will agree that this is Adult restraint in that he is merely stopping him from hitting. Then Marks will pretend to hit the child back and they readily identify this as Child restraint. Then Marks will pretend to take him over his knee and give him a spanking, which readily is seen as Parent restraint. The way this understanding is put to use in problems of emotional control was related by Marks as follows:

I walked into a room one day where there were three people holding one youngster who was in tremendous agitation trembling with rage, and struggling to hit everyone around him. He was a boy with an IQ of 50 and, on most occasions, was attractive and pleasant. I walked over to him and put my arms around him tightly to restrain him.

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He was trembling and screaming, 'Leave me alone, leave me alone ...' After about twenty seconds, I said,

'Now, Tom, how am I restraining you? Is this Parent, Adult, or Child?'

He shouted, 'Parent!'

I said, 'Not really, Tom. I'm not spanking you. That would be Parent. And I'm not fighting with you. What would that be?' That would be Child," he said.

'So how am I restraining you, with my Parent, Adult, or Child?'

'With your Adult,' Tom replied.

"OK, that's good, Tom,' I said. 'Now we'll show these people how we can do it. Now you take my hand and we'll say what we always say.' He took my hand, and mumbled, 'I'm ok - you're ok', and we walked together into the TV room, where I suggested he join the youngsters who were in there watching a programmer.

The whole episode, from encountering a trembling, adrenalin-charged, furious child, to walking into the TV room together took exactly three minutes. The key was to turn off the Child and turn on the Adult. This was done by the simple question, 'How am I restraining you?' There was no way to deal with this angry, boiling mass of feelings called his Child; there was certainly no way at that moment to get to what was bothering him. My objective at the moment was simply to modify his behaviour and get past the episode. Nothing 'reasonable' could be said or heard while his Child was in control.

The traditional Parent dealing with this situation would have taken considerably longer, with the not ok Child suffering more acutely than ever from having been such a 'bad boy'. As it was, some ok was introduced in the form of mastery by the Adult, the achievement of self-control, and the return to the group activity.

The youngsters easily respond to the imageries of 'plugging in the Adult' and turning off the frightened Child or the accusing Parent (as one would a TV set).

Another example Marks gives is one of handling a runaway situation. This is the case of a shy eighteen-year-old girl, with an IQ of 68, who speaks with a tiny voice and usually has very little to say. One day Marks walked by her room and found she was all packed, ready to leave. When she saw him, she blurted, through the tears streaming down her face, 'I don't need this place any more. I'm going away!'

The usual parental approach would have been to deny her feelings by something like: 'Of course you're not leaving. Now you go to lunch with the other children. You are not going any place. And besides, where is your transportation?'

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This would only have made her Child more determined and more obstinate and more angry. There is no way to 'reason' with the mass feelings in the Child when the Child is in control. Marks instead sat down on the girl's bed and said, 'You're sure not feeling ok today, Carolyn. Somebody must have really hooked your Child.'

'Yes,' she responded quickly.

'Well, what happened?' Marks said.

'They won't let me buy a pocketbook,' said Carolyn.

'You know,' said Marks, 'I like your not ok Child, but now I want to talk to your Adult. So I'll tell you what... you grab my hand and we'll say I'm ok - you're ok.' Which they did. This was the key which had been shaped in the weekly sessions since the beginning of the year. Then Marks was able to talk to her Adult, and her Adult could recognize there was nobody there who could take her shopping that day to get the pocket-book she wanted, and that they perhaps could go tomorrow or the next day. This was simple, once her Adult was back in commission, but impossible as long as the Child was in control. She put her suitcases aside and went into lunch. Elapsed time, four minutes.

'In both of these cases," Marks commented, 'we accomplished what we wanted. We subdued the emotional episode and we enriched our relationship. I venture to say that if these youngsters had a sufficient number of these relationships, in a period of a few months, perhaps years, they could learn enough self-control and data processing to enable them to feel and act ok.'

Summarily, we may say that the solution to the problems of all children, regardless of their situation, is the same solution that applies to the problems of grownups. We must begin with the realization that we cannot change the past. We must start where we are. We can only separate the past from the present by using the Adult, which can learn to identify the recordings of the Child with its archaic fears and the recordings of the Parent with its disturbing replay of a past reality. Parents who have learned to do this through their understanding and application of P-A-C will find themselves able to help their children differentiate between life as they observed it or were taught it (Parent), life as they felt it (Child), and life as it really is and life as it can be (Adult). They will find that this same procedure will be of the greatest value in the period of change that lies ahead, the years of adolescence, which we examine in the next chapter.


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