In recent years there have been many reports of a
growing impatience with psychiatry, with its seeming
foreverness, its high cost, its debatable results, and
its vague, esoteric terms. To many people it is like a
blind man in a dark room looking for a black cat that
isn't there. The magazines and mental-health
associations say psychiatric treatment is a good thing,
but what it is or what it accomplishes has not been made
clear. Although hundreds of thousands of words about
psychiatry are consumed by the public yearly, there has
been little convincing data to help a person in need of
treatment overcome the cartoon image of psychiatrists
and their mystical couches.
Impatience has been expressed with increasing concern
not only by patients and the general public but by
psychiatrists as well. I am one of these psychiatrists.
This book is the product of a search to find answers for
people who are looking for hard facts in answer to their
questions about how the mind operates, why we do what we
do, and how we can stop doing what we do if we wish. The
answer lies in what I feel is one of the most promising
breakthroughs in psychiatry in many years. It is called
Transactional Analysis. It has given hope to people who
have become discouraged by the vagueness of many of the
traditional types of psychotherapy. It has given a new
answer to people who want to change rather than to
adjust, to people who want transformation rather than
conformation. It is realistic in that it confronts the
patient with the fact that he is responsible for what
happens in the future no matter what has happened in the
past. Moreover, it is enabling persons to change, to
establish self-control and self-direction, and to
discover the reality of a freedom of choice.
For the development of this method we are pre-eminently
indebted to Dr Eric Berne, who, in developing the
concept of Transactional Analysis, has created a unified
system of individual and social psychiatry that is
comprehensive at the theoretical level and effective at
the applied level. It has been my privilege to study
with Berne for the past ten years and to share the
discussions of the advanced seminar in San Francisco
which he conducts.
I first became acquainted with Berne's new method of
treatment through a paper that he presented at the
Western Regional Meeting of the American Group
Psychotherapy Association in Los Angeles in November
1957. It was entitled 'Transactional Analysis: A New and
Effective Method of Group Therapy'. I was convinced that
this was not 'just another paper', but indeed a
blueprint of the mind, which no one had constructed
before, along with a precision vocabulary, which anybody
could understand, to identify the parts of the
blueprint. This vocabulary has made it possible for two
people to talk about behavior and know what is meant.
Page 5.
One difficulty with many psychoanalytic words is that
they do not have the same meanings for everybody. The
word ego, for instance, means many things to many
people. Freud had an elaborate definition, as has nearly
every psychoanalyst since his time; but these long,
complicated constructions are not particularly helpful
to a patient who is trying to understand why he can
never hold a job, particularly if one of his problems is
that he cannot read well enough to follow instructions.
There is not even agreement by theoreticians as to what
ego means. Vague meanings and complicated theories have
inhibited more than helped the treatment process. Herman
Melville observed that 'a man of true science uses but
few hard words, and those only when none other will
answer his purpose; whereas the smatterer in science ...
thinks that by mouthing hard words he understands hard
things'. The vocabulary of Transactional Analysis is the
precision tool of treatment because, in a language
anyone can understand, it identifies things that really
are, the reality of experiences that really happened in
the lives of people who really existed.
Also the method, which is particularly suited to the
treatment of people in groups, points to an answer to
the great disparity between the need for treatment and
the trained people available to do the work. During the
past twenty-five years, beginning with particular
intensity in the years immediately following World War
II, the popularity of psychiatry would seem to have
created expectancies far beyond our capacity to fulfill
them. Continual outpourings of psychological literature,
whether printed in psychiatric journals or the Reader's
Digest, have increased this expectancy yearly, but the
chasm between this and cure seems to have widened. The
question has always been how to get Freud off the couch
and to the masses.
The challenge to psychiatry to meet this need was
expressed by Mike Gorman, the Executive Director of the
National Committee Against Mental Illness, in an address
to the annual meeting of the American Psychiatric
Association in New York in May 1965:
As you have escalated from a small cell of some 3,000
psychiatrists in 1945 to a large specialty organization
with 14,000 members in 1965, you have of necessity been
increasingly drawn into participation in the major
issues of our time. You can no longer hide in the
discomfort of your private office, appropriately fitted
with an over-stuffed couch and a picture of Freud
visiting Worcester, Massachusetts, in 1909.
I submit that psychiatry must develop a 'public'
language, decontaminated of technical jargon and suited
to the discussion of universal problems of our society.
I realize that this is a very difficult task; it means
taking leave of the comfortable, secure, and protected
words of the profession and adjusting to the much
breezier dialogue of the open tribunal. As difficult as
this task is, it must be done if psychiatry is to be
heard in the civic halls of our nation.
Page 6.
I am heartened by the recent writings of a number of
young psychiatrists which demonstrate a healthy aversion
to spending an entire professional life treating ten to
twenty patients a year.
The comment of the psychiatrist Dr Melvin Sabshin is
typical:
'One simple question is whether or not psychiatry can
accomplish these new functions or roles by utilizing its
traditional skills, its standard methodology, and its
current practices. My own answer to the question is no.
I believe these do not provide an adequate basis for new
functions and configurations.'
Psychiatry must face up to the fact that it cannot begin
to meet the demands for psychological and social help
from the poor, the under-achieving in our schools, the
frustrated among our blue collar workers, the
claustrophobic residents in our crowded cities and so on
almost ad infinitum.
Many of its most thoughtful leaders are giving
increasing thought to the new role which psychiatry must
play the next several decades, in not only broadening
its own parochial training, but in joining with other
behavioural disciplines on an equal footing in
establishing training programmes for the thousands upon
thousands of new mental health workers we will need if
we are to achieve the goals which President Kennedy
proclaimed in his historic 1963 mental health message.
{1}
Training programmes of thousands of mental-health
workers in a ' "public" language, decontaminated of
technical jargon and suited to the discussion of
universal problems in our society' is being made
possible today by Transactional Analysis. More than
1,000 professionals have been trained in this method in
the State of California, and this training is spreading
rapidly to other parts of the country and to foreign
countries. About one-half of these professionals are
psychiatrists; the other half includes medical doctors
of other specialties (obstetrics, paediatrics, internal
medicine, general practice), psychologists, social
workers, probation officers, nurses, teachers, personnel
managers, clergymen, and judges. Transactional Analysis
is now being used in group treatment in many of
California's state hospitals, prisons, and Youth
Authority institutions. It is used by increasing numbers
of therapists in marital counseling, treatment of
adolescents and preadolescents, pastoral counseling and
family-centred obstetrical care, and in at least one
institution for the mentally retarded, Laurel Hills of
Sacramento.
A central reason why Transactional Analysis offers such
promise for filling the gap between need for and supply
of treatment is that it works at its best in groups. It
is a teaching and learning device rather than a
confessional or an archaeological exploration of the
psychic cellars. In my private practice of psychiatry
this has made possible the treatment of four times as
many patients as before. During the past twenty-five
years in my work as a psychiatrist - in the treatment of
patients and in the administration of large
institutional programmers nothing has excited me so much
as what is happening today in my practice. One of the
most significant contributions of Transactional Analysis
is that it has given patients a tool they can use. The
purpose of this book is to define this tool. Anybody can
use it. People do not have to be 'sick' to benefit from
it.
Page 7.
It is a profoundly rewarding experience to see people
begin to change from the first treatment hour, get well,
grow, and move out of the tyranny of the past. We base
our even greater hope on the affirmation that what has
been can be again. If the relationship between two
people can be made creative, fulfilling, and free of
fear, then it follows that this can work for two
relationships, or three or one hundred or, we are
convinced, for relationships that affect entire social
groups, even nations. The problems of the world - and
they are chronicled daily in headlines of violence and
despair - essentially are the problems of. individuals.
If individuals can change, the course of the world can
change. This is a hope worth sustaining.
I wish to thank a number of people for their support of
and contribution to the effort involved in writing this
book. Mostly I owe the reality of this book to my wife
Amy, whose writing skill and phenomenal thought
processes have put into this final form the content of
my lectures, research, past writings, observations, and
formulations, many of which we worked out together.
Evidences of her philosophical, theological, and
literary researches are sprinkled throughout the book,
and the chapter on moral values is her original
contribution. Also I express appreciation to my
secretaries Beverly Fleming and Connie Drewry, who
prepared the typescript and study copies of the
manuscript; to Alice Billings, Merrill Heidig, Jean Lee,
Marjorie Marshall, and Jan Root for their valuable
assistance; to my children for their delightful
contribution;
To my colleagues who joined me in founding the Institute
for Transactional Analysis: Dr Gordon Haiberg, Dr Erwin
Eichhorn, Dr Bruce Marshall, Rev J. Weaver Hess, and
John R. Sal-dine; to the directors who joined us as the
Institute Board expanded: Dr David Applegate, Laverne
Crites, Mrs. Donis Eichhorn, Dr Ronald Fong, Dr Alvyn
Freed, David Hill, Dr Dennis Marks, Larry Mart, Dr John
Mitchell, Richard Nicholson, Rev Russell Osnes, Dr
Warren Prentice, Berton Root, Barry Rumbles, Frank
Summers, Rev Ira Tanner, Leroy Wolter, and Dr Z.O.
Young;
To the late Rev Dr Robert R. Ferguson, Senior Pastor of
Fremont Presbyterian Church of Sacramento and consultant
in field education at Princeton Theological Seminary; to
Dr John M. Campbell, Chairman of the Department of
Anthropology at the University of New Mexico; to James
J. Brown of the Sacramento Bee; to Eric Bjork for wisdom
and generous commentary; to Dr Ford Lewis, Minister of
the First Unitarian Society of Sacramento, whose
devotion to truth and compassion has been a rich source
of encouragement;
To Dr Elton Trueblood, Professor of Philosophy at
Earlham College, for the significant new data he made
available to me; to Bishop James Pike, Resident
Theologian at the Center for the Study of Democratic
Institutions at Santa Barbara, for his contagious
enthusiasm and generous assistance; to two special
persons who provided years of training and stimulation,
Dr Freida Fromm-Reichmann and Dr Harry Stack Sullivan,
in whose tutelage I first heard the term 'interpersonal
transactions'.
And finally to my patients, whose creative and
emancipated thinking has provided much of the content of
this book. It is at their request that I have written
it.
T.A.H.
Institute for Transactional Analysis Sacramento,
California June, 1968
