We only think when we are confronted with a problem.

- John Dewey

If a person sprains an ankle he can hobble along and eventually the ankle will get well. He still has some use of it while he hobbles. If he breaks a leg he needs support for. it while the bone is healing. One problem is an impairment. The other is crippling. Medical attention would have been helpful in the first case; it was imperative in the second.

We can view the need for treatment of emotional problems in somewhat the same way. A person's Adult may be impaired by old recordings from the past, but he may manage to get over difficulties or through problems without treatment. Treatment could make it easier. But he manages. For some people, however, the Adult is impaired to the point where they cannot function. They are crippled by repetitious failure or immobilized by guilt. Frequently there are physical symptoms. Mothers cannot function as mothers, workers cannot do their job, children give up at school, or some persons' behaviour becomes inappropriate to the point where they break the law. For these people treatment is required; yet everyone could benefit from it.

All persons can become Transactional Analysts. Treatment simply speeds the process. Treatment with Transactional Analysis is essentially a learning experience through which an individual discovers how to sort out the data that goes into his decisions. There is no magic applied by an omnipotent expert. The therapist uses words to convey what he knows and uses in his own transactions to the person who comes into treatment, so he can know and use the same technique. One of my psychiatrist friends said, 'One of the best Transactional Analysts I know is a truck driver.' The goal is to make every person in treatment an expert in analyzing his own transactions.

Many forms of psychiatric treatment are quite different. The public image is assuredly different. For this reason the decision to go to a psychiatrist generally is not made without a great deal of internal debate. Many patients experience unpleasant feelings over the thought of exposing themselves to someone, even though that someone is an 'expert' or professional helper, such as a psychiatrist. As the patient opens the door to the office for the first time, he frequently feels alone, fearful, and ashamed over the implication of failure.

Even if the Adult in the individual gets him to the psychiatrist's office, the Child soon takes over and a Parent-Child situation develops. The patient's Child expresses feelings and anticipates a relationship with the psychiatrist's Parent in the transactions of the first hour. The psychoanalysts refer to this as transference - that is, the situation provokes a transfer of feelings and related behaviour from the past, when the patient was a child, into the present, in which the Child in the patient responds as it once did to the authority of the parent.  This unique transaction is fairly common in life, and there are elements of it present in any contact with authority, as, for instance, when one is stopped by a highway patrolman. Psychoanalysts maintain that the patient has improved when he has succeeded in avoiding this kind of transfer of feelings from childhood.

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At this point in analysis, the patient does not have to pick and choose what he is going to reveal about himself to his analyst. In other words, the patient no longer must be afraid of the analyst's Parent. This is referred to in traditional psychoanalysis as overcoming resistance.

In Transactional Analysis we bypass much of the retarding effects of transference and resistance by the mutually participant format and content of P-A-C. The patient soon finds he is relating on equal terms to another human being to whom he has come for help, a human being interested in advancing the patient's knowledge of himself at once so that, as quickly as possible, he can become his own analyst. If the patient is hampered by transference and resistance feelings, these are handled directly with him in the initial hour after he has become acquainted with Parent, Adult, and Child.

In my practice the initial hour has developed into a fairly set pattern in which roughly half of the hour is devoted to hearing the patient's account of his problem and the other half to introducing him to the basics of P-A-C. After the patient understands the meaning of Parent, Adult, and Child, his problem is discussed using the language he has just learned. This transaction 'hooks his Adult', to use one of the colloquial expressions Transactional Analysis abounds with, and the patient usually is eager to hear more. The troubled Child doesn't give up easily, however, and may persist or reappear (resistance) in subsequent individual sessions or in the treatment group. An Adult-Adult interpretation is made at each appearance of the Child, pointing out the nature of the transaction originating in the Child and its problem-making burden to the individual's transactions in living.

In the initial phase, Transactional Analysis is essentially a teaching and learning method with the aim of establishing certain specific meanings as a basis for a mutual exploration of how Parent, Adult, and Child appear in today's transactions. This process of establishing a language with specific meanings in the initial phase of treatment is, I believe, unique to this method of treatment and is responsible for expressions of change such as 'I feel much better' or 'This gives me hope', frequently heard at the end of the first hour.

The initial hour also includes a discussion of the 'treatment contract'. We use the word 'contract' as a statement of mutual expectations (I am here to teach you something and you are here to learn something). It does not imply a guarantee of a cure. It simply states a promise of what the therapist will do and what the patient will do. If either strays from the original expectation, it is a simple matter to review the contract. This dialogue is facilitated by the new language, which opens a way to be specific. The patient agrees to learn the language of Transactional Analysis and to use it in examining his everyday transactions. The goal of treatment is to cure the presenting symptom, and the method of treatment is the freeing up of the Adult so that the individual may experience freedom of choice and the creation of new options above and beyond the limiting influences of the past.

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Diagnosis

Occasionally during the course of the first hour a patient will ask, 'What is my diagnosis?' in a strained voice, braced as if for a pronouncement from on high. This is a provoker for a Parent-Child transaction, which I bypass with a question such as, 'Do you need a diagnosis?' or 'What would a diagnosis do for you?' It is my belief that more people have been hindered than helped by psychiatric diagnoses. Karl Menninger agrees: 'Patients do not come to us to be plastered with a damning index tab. They come to be helped. People can recover from the symptoms of mental illness, but they don't recover from a label.'

In the medical tradition diagnosis is an efficient way for physicians to communicate. Knowing the diagnosis helps them to know what to do. Acute appendicitis, bursitis, carcinoma of the lung, myocardial infarction - these terms communicate a specific condition and call for a specific treatment. In psychiatric practice the diagnostic tradition has been carried on, but it largely fails in the original purpose of communication. There are many pages of diagnoses in the manual of the American Psychiatric Association, and, with some exceptions, the information each communicates is as vague as the terms Superego, Ego, and Id. To say that a person has a Pseudo-Schizophrenic Obsessive - Compulsive Passive-Dependent Anxiety Neurosis, Chronic does not tell you very much except that this is going to take a long, long time. To say that a person suffers from schizophrenia doesn't really tell you much either, because there is no clear definition of schizophrenia. It may give some comfort to the patient to know that he has such a strange and difficult malady. Few therapists agree on how you treat schizophrenia anyway, or even what the basic unit of observation should be. So diagnostic terms such as these are meaningless and serve mainly to give psychiatric efforts medical respectability and to fulfill the requirements of the hospital records department. Any word that fails in communication is useless and should be discarded. In the final analysis it is what we know that makes a difference. Words that obscure the truth must be discarded for those that say it simply, accurately, and directly; and truth about how we are put together, in large measure, is what makes us free.

The language of Transactional Analysis, the observations of an agreed-upon unit (the transaction), and the specific definitions of Parent, Adult, and Child make possible a new, meaningful, colloquial way of communication, not just between doctors who use it but between doctors and patients. A Parent-dominated person with a blocked-out Child knows where his problem lies and can become emancipated from the past without any reference to his being obsessive-compulsive and chronic. When a group member insists on knowing his diagnosis ('What am I, anyway?'), I usually respond with a formulation he can understand based in my knowledge of him, which I have gained from observing him in the group. Such a formulation might be as follows: 'You have a lot of not ok in your Child with a fairly sizeable contamination of your Adult, which lets you come on inappropriately at times and gives your hovering Parent an opportunity to beat on your Child. Where do you think all that guilt comes from?'

Dreary preoccupation with symptoms can be just as detrimental as a need for a diagnosis. We have never been able to validate the assumption that a repetitious discussion of symptoms such as depression, headache, insomnia, or abdominal Pain did anything for the symptom.

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We have been able to validate that reducing inner conflict can do wonders for a belly pain. The essential point is that diagnoses and symptoms lend themselves to the rather unfortunate human trait of gaming, or one-upmanship, like 'Mine Is Better' or 'Nobody Knows the Trouble I've Seen'. If a person has problems in his living, regardless of what they are, and he wants help with his problems, he can be taught Transactional Analysis to examine his current transactions in living, as a result of which he can uncover the influences from the remote past that are at the bottom of his troubles.

"How long is this going to take?' is a frequently asked question in the first hour. In many, if not most, psychiatric practices the response to this kind of question has been, at the least, 'guarded'. The implication has been a long time. Jerome D. Frank has pointed out that patients' expectations of the duration of their treatment are primary factors in determining the length of time it takes to achieve similar therapeutic results. He cites two groups of similar 'psychosomatic' patients who arrived at the same end point, one in six weeks and the other in one year, depending upon their anticipations regarding the length of time that would be needed. I think the key to anticipation is an understanding of therapeutic results to be achieved.

Our goal in treatment is clearly stated with the new language just learned, and thus the patient knows what he is undertaking. I like to help my patients think of limitations imposed by the realities of time and cost as a challenge rather than a depriving imposition. This often is stated in the proposal, 'Let's schedule you to come to the two o'clock Tuesday group for ten sessions and see how much we can do in that time.' If the patient wants to continue after this series, we can set up another ten sessions. He knows he can come back. The average length of time in a group in my practice is twenty hours. There are variables, of course, beginning with individual differences. We vary in Parent, Adult, and Child. We vary in difficulties in our living situation: marital problems, unsatisfying work, no leisure-time outlets, etc. There have been patients who have achieved a breakthrough in three or four group sessions; that is, they were able to free enough of their Adult that they could begin to accurately differentiate their Parent from the Child and both from reality - the outside world.

One of the first indications of this differentiation is the statement by the patient, 'My not ok Child was ...' or 'is ...' The use of this expression signals the achievement of an understood, authentic, and real separation of the patient's Child from his Adult - that is, it is both intellectually and internally and externally integrated into his personality.

Why Group Treatment?

The treatment of individuals in groups is the method of choice by Transactional Analysts. Is this good or bad? Is the treatment of individuals in a group 'bargain-basement psychiatry'? Many people react to the word 'group' as they reacted to Franklin Roosevelt's term 'the common man'. Who wants to be common? Who wants to be depersonalized into a statistic or into mere membership in a group? What goes on in group treatment? What goes on in group treatment using Transactional Analysis?

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One common impression is that in group treatment people come to express feelings, 'get it out of their system', tell other people what they think of them, and 'anything goes'. In fact, many writings about group treatment have encouraged this point of view. S. R. Slavson, one of the pioneers in the development of group treatment methods, stated in his book The Practice of Group Therapy.

The chief and common value of the group is that it permits acting out of instinctual drives, which is accelerated by the catalytic effect of the other members. There is less caution and greater abandon in a group where the members find support in one another and the fear of self-revelation is strikingly reduced. As a result, patients reveal their problems more easily, and therapy is speeded up. Defenses are diminished, the permissiveness of the total environment and the example set by others allow each to let go with decreased self-protective restraint. Although groups lessen the defenses of adults as well, this is particularly true of children and adolescents. Free acting out and talking through yields satisfaction. At the same time it brings patients face to face with their problems quite early in treatment. The defences against injury to one's self-esteem are also reduced. The friendly group climate and the mutual acceptance do not require one to be on the defensive. All have the same or similar problems and no negative reactions are anticipated by anyone. Status is assured. There is no fear of retaliation or debasement. {1}

In my own clinical experience, I have not been able to validate the above statement. Allowing the Child to act out its own instinctual impulses, and play games at random in the treatment group is a waste of the group's time and invasion of the rights and purposes of each individual group member, If permitted to continue, it sabotages the therapeutic contract of Transactional Analysis. Until each member has at least started to free his Adult self-revelation, the confessional will contribute very little, if anything, towards the curing of individuals in the group. Treatment is speeded only by keeping the Adult in charge. Only the Adult can spot the Child or the Parent. Revealing problems is an invitation to play, 'Why Don't You, Yes But'. Expressing feelings and 'talking through' may yield satisfactions to the Parent and the Child, as in everyday life, but in the treatment group such transactions interfere with the acquisition of basic understandings and concepts essential to achieving an emancipated Adult.

There is no magic in the word 'group'. Since in its initial phase Transactional Analysis is a teaching-learning experience, the group setting has several distinct advantages over the traditional one-to-one setting of individual treatment. Everything that is said in the group needs to be seen and heard by every other member of the group - every question, every answer, every transaction. The subtle and multiple ways the Parent reveals itself in transactions need to be identified and learned. Both the inner and outer threats to the Child need to be recognized in a general sense at first, then the unique and specific characteristics of the Child in each individual in the group. There is a mutual confrontation of games, of realities 'where you live', which is quite different from the essentially seclusive and permissive 'ear' in one-to-one therapies. In group treatment people are seen in the natural milieu, involved with other people, instead of all by themselves in a separateness that can never be duplicated on the outside.

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The primary benefit of treating people in groups with Transactional Analysis is that they move faster towards getting well, starting to live, beginning to see and feel what is real, or 'growing up', however the individual's goal in treatment might be expressed. At the end of an exciting hour in the group, one member said, 'I feel like I'm ten teet tall'.

Before this primary benefit is examined, however, it may be well to point to the answer group treatment provides to the widely acknowledged high cost of individual treatment and the disparity between the number of people who need help and the number of people available to give it. We live in an age of cost and time consciousness. We are surrounded by a sense of urgency to help people in trouble, many people in trouble. In finding a solution we must examine one of the principal criticisms of psychiatric treatment: It costs too much; it takes too long for the uncertain results achieved. We cannot dismiss this criticism simply by countering with the judgment that people who hold this view do not have realistic priorities, as, for example, the individual in real trouble who sees his solution in owning a new model car rather than seeking much-needed help.

There are many people today who, although they may wholly accept the idea that 'mental health is important', still have not the means to add the burden of long-term psychiatric treatment to their already consumptive costs of living. In this category fall many of the middle class and all those in low-income groups. Is mental health for the wealthy? Is psychiatric treatment, as I heard a physician colleague define it recently, 'a luxury'? Or can many more people be helped by group treatment? Can psychiatric care be considered as realistic a part of the treatment as emergency surgery?

Dr Leonard Schatzman, a medical sociologist at the University of California Medical  Center, in 1966 completed a field study of fifteen medical centres over a period of eight years concentrating on psychiatrists and their staffs. He observed in an article in 1966, published in the San Francisco Chronicle;

The older, one-to-one medical treatment model for the wealthy, and the efficient neglect of the masses of the poor, are no longer seen as adequate. Upgraded populations today are demanding more psychiatric goods and services. The psychoanalytically oriented psychiatrist sticks close to his office, provides personal service to a very limited clientele and has to deal with wealthier people in order to cover the cost of his operations. Good, bad, or indifferent, the service is tailored to the client, and with great pride and finesse. But who is buying tailor-made suits? Who is regularly dining in gourmet restaurants with candlelight and wine? Who drives custom-made cars?

The treatment of individuals in groups can reduce treatment ' costs to the point where most wage earners can afford it. It has been my experience, also, that group treatment using Transactional Analysis has reduced the duration of treatment, which also has resulted in a reduction in cost to the patient. A third factor is that the 'contract' for treatment, and the procedures used, are so specific that I believe this treatment format would be insurable on a large scale. If we can buy insurance to provide our children education, it would seem that we can insure a special kind of education about behavior also.

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More important than these considerations, however, is the fact that, in my experience, individuals get well faster in group treatment using Transactional Analysis than in the traditional one-to-one treatment relationship. By 'get well' I mean achieving the goals stated in the initial hour contract, one of which is the alleviation of the presenting symptom (eg, marriage breaking up, fatigue, headaches, job failure, etc) and the other of which is to learn to use P-A-C accurately and effectively. One measurement of the patient's cure is whether or not he can report what happened in any transaction in a way understandable to others in the group. If someone tells me he was in therapy for a long period of time and 'it was very helpful', yet cannot answer my question, 'what happened in therapy?' then I do not feel he has achieved mastery over his own actions. Applicable here is the Aristotelian idea that 'that which is expressed is impressed'. If a patient can put into words why he did what he did and knows how he stopped doing it, then he is cured, in that he knows what the cure is and can use it again and again.

Once a patient has learned the fundamentals of P-A-C, he can see the Transactional Analysis group as something much different from that which he is conditioned to see by his Parent and Child. He may have been taught early not to 'wash your dirty linen in front of others' or 'don't give out the family secrets'. This comes through as a clearly recorded tape from the Parent. The Child on the other hand 'wants the floor the whole hour' in an ongoing game of 'Poor Me'. An individual who wants to play 'Confession', 'Psychiatry', 'Ain't It Awful', and 'It's All Him' soon finds no one in the group cares to play with him. The role of the therapist is that of a teacher, trainer, and resource person with heavy emphasis on involvement. The group is the setting of activity, involvement, and movement with sustained permission for laughter to provide a relaxing release from any tendency to see the experience as 'grim business indeed'.

The goal for each member of the P-A-C group is clear, concise, and easily stated: to cure the patient by freeing his Adult from the troublemaking influences and demands of his Parent and Child. The goal is achieved by teaching each member of the group how to recognize, identify, and describe the Parent, Adult, and Child as each appears in transactions in the group.

Since the essential characteristic of the group is that of teaching, learning, and analyzing, the effectiveness of the Transactional Analyst rests in his enthusiasm and ability as a teacher and his alertness in keeping abreast of every communication or signal in the group, verbal or otherwise. In the setting of the group the Parent appears in a multitude of ways: the wagging index finger, raised eyebrows, pursed lips, or statements such as: 'Don't you agree?' 'Everybody knows that...' They say ...' 'After all ...' 'I'm going to get to the bottom of this, once, and for all!'

The Child also makes its appearance in easily recognized ways: crying, laughing, coyness, nail biting, fidgeting, withdrawal and sulking, in addition to the variety of Child games such as 'Poor Me', 'Ain't It Awful', and 'There I Go Again'. The members of the group are supportive of the not ok Child in another member and seldom, in Parent fashion, accuse his activated Child. Instead there is a sympathetic approach such as, 'I can see your Child is hurt; how come?' or 'Can you tell me what hooked your Child?'

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Through multitudes of transactions in the group the patients quickly begin to fill in the gaps of information about each others' Parent, Adult, and Child. This is a 'team evaluation', not of data long since buried, but of observable data that manifests itself in the open, today, in transactions that involve each other. The team is made up of participants, however, and not of antiseptic observers called a treatment team. Few patients will tolerate the team approach, and few psychiatrists can justify it to their patients, says Avrohm Jacobson, Director of Psychiatry at the Jersey Shore Medical Center:

Clinics, however, continue to 'evaluate' patients via the team approach. This is a cruelly lengthy process for the patient, involving a ritual of data-gathering by the caseworker [Archaeology] and testing by the psychologist that contributes very little to the psychiatrist's clinical impression ... The time he must spend in conference listening to all the reports - so carefully gathered over a period of several months - could be more usefully spent in direct contact with the patient.

He referred to an earlier study of one clinic, which demonstrated that most of the clinic time was devoted to the work-up of patients who would not be seen in therapy. {2}

In the early days of my use of P-A-C some patients were wary of entering a group, insisting, according to their understanding of traditional treatment methods, that a private and repetitious recital of problems was what they had come for. Their position was: I am paying you to listen to me and somehow something will come of it. This attitude has largely changed because of the good reports of the effectiveness of group treatment. More recently they are referred directly to the group from outside sources, or they ask to be allowed to enter a group, having heard about such a group from a friend. There is no selection of members for the group according to diagnostic categories. Nor are they assigned to groups on the basis of symptomatic similarity, not only because it isn't necessary but because of the stigmatizing aspects of psychiatric diagnoses. It is not beneficial to put all alcoholics, all homosexuals, or all school dropouts in the same group, since this makes possible the development of the general tenor 'Doesn't everybody?' with the therapist the only odd one.

Thus the group may include all standard diagnostic categories, including patients with low intelligence and those lacking in formal schooling. Many 'self-taught' individuals make good Transactional Analysts. Many of my patients have had the opportunity to see a patient in the group go into and come out of an acute psychotic episode (decommissioned Adult) and the free expression of numerous delusions (takeover by the archaic Child). In the group they have observed and heard patients who were actively hallucinating describe the Parent-Child dialogue that the patient perceived as coming from outside of himself. Patients with freed Adults are not disturbed by these manifestations of transitory mental disturbance. They tend to be supportive, reassuring, and stroking, and to ignore the unusual.

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Each of my Transactional Analysis groups meets weekly except for hospital groups, which meet daily. At the end of the hospital stay, the duration of which averages two weeks, the patient enters one of the groups in my office. Group members are taught to be alert to the tendency of the Child to compare - 'I am learning faster than you", or, 'You are sicker than I'. Therefore, new patients entering a group of 'old-timers' seem to feel at ease, and quickly proceed to the business of Transactional Analysis. The setting for group sessions is comfortable and acoustically perfect. Everything can be heard, including a sigh. Occupying a prominent place in the room is a blackboard, which is used frequently in each session for structural diagrams of the symbolic rendering of important formulations.

Some people move rapidly in the acquisition of skill in identifying Parent, Adult, and Child and the ways these are involved in current transactions. Others take longer. Yet, those for whom learning may come more slowly develop the insight, in time, that their resistance to learning resides in the not ok Child that is labouring under an old reality in which the little person was not given permission to think for himself.

The understanding of the existence in oneself of the not ok Child is one of the first and most important steps in understanding the basis of behaviour. This marks the beginning of the objective evaluation of one's own personality structure. It is one thing to understand this academically. It is another to comprehend this reality in oneself. The not ok Child may be perceived as an interesting idea. My not ok Child is real.

The content of group transactions is related mostly to the present-day problems of the members. What happened yesterday, or what happened last week, is much more often the point of inquiry than what happened a long time ago. The members learn to identify and know their Parent, Adult, and Child by their appearance in the transactions of the present, particularly the transaction in the group itself. This is quite different from the kinds of data we sometimes think of as coming from psychological research. In an address to the American Psychological Association in September, 1967, the Association's president, Abraham Maslow, asserted his colleagues generally are far too fond of amassing 'trivial' facts under the banner of research. 'The information they gather is useful, but it tends to be trivial, tends to be a piling up of little facts... Far too many psychologists do their work on refined subjects such as "the left quadrant of somebody's eyeball".' {3}

The ultimate value of research, whatever its form, lies in the production of information that enables people to change. The change produced in individuals as their Adult begins to take charge is readily apparent in the group. It also becomes apparent to other members of the family. Not infrequently this may present certain hazards for the individual. A husband whose wife was in one of my groups called to complain: 'What gives in that group - my wife seems happier, but our marriage is going on the rocks.' In such a case I invite the spouse in for an individual session to explain the basics of P-A-C. The usual outcome is that both husband and wife enter a marriage group. It is almost axiomatic that if one member of a family enters a group and begins to change, the whole family must become involved, because the game pattern has been disturbed.

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If, for instance, one member of a family is 'the black sheep' and he begins to move out of this role, the roles of others, particularly siblings, may become confused, reversed, or otherwise upset. This is the basis for the usually excellent results achieved with conjoint family therapy. In my adolescent groups, the contract calls for equal involvement of the parents. One of the repeated topics for discussion at these group meetings is 'How to Sabotage Therapy'. Some parents unknowingly undermine treatment efforts because they really  do not want to give up the Parent-Child relationship which they feel has 'worked so well' in the past. Their position of power is threatened when the adolescent starts operating in the Adult; unless the parents are equally Adult, the transactions will cross. These parents see autonomy in their youngster as a threat to their control of him and may decide they liked it better the way it was, before treatment. Familiar miseries may seem more comfortable to frightened parents than the risk of trusting their teenager to develop his own inner controls.

Group members are encouraged to view their relationships on the outside in a responsible and loving way. Some relationships exist by virtue of games. To stop playing is to end the relationship. This is not always kind or realistic. If visits; to Grandmother's house have been structured for the past twenty years by games of the 'Ain't It Awful' variety, it is not necessarily loving to stop visiting Grandmother because you can no longer stand 'Ain't It Awful'. The Adult has a choice: to play, to not play, to modify the game into something less destructive, or to try to explain the insights that help persons give up games. We cannot, after all, resign from the human race, game-ridden as it may be. If we are not to be overcome by evil, then we must overcome evil with good. This we cannot do if we withdraw from all the relationships in which games exist.

From time to time I refer to the built-in safeguards in P-A-C. As I write this I am confronted with rows of book shelves loaded with tomes devoted to the general topic of therapy. Much of the content is devoted to repetitious, morbid accounts of so-called 'mental illness' or human misery, with minutely detailed 'technical' discussions of the dangers involved in therapy. Much of this has to do with so-called transference and resistance problems so central to the method of psychoanalysis. Too often these writings dwell on how to protect the therapist rather than how to cure the patient. In psychoanalysis the analyst is the hero. In Transactional Analysis the patient is the hero. The safeguards in P-A-C exist in its mutually participant format with a language that forms the basis for patient-to-patient and patient-to-therapist transactions for the meaningful examination of: all aspects of behavior and feelings regardless of their nature. In the P-A-C group the members act as both a restraining and supportive influence to each other. There is nothing of the omnipotent therapist sitting in the dark corner with his poor little patient recumbent before him, both alert to the dangers in the grim business. One aspect of the P-A-C group contract allows and even encourages the Child in each member, including the therapist, to come out and laugh. P-A-C groups are characteristically laughing groups with great capacity in turn to be considerate and supportive with the nurturing Parent while looking for new answers with the alert Adult.

The danger, then, is the therapist's not knowing or, for that matter, anyone's not knowing what the I'm not ok position in the Child can do to a person's own life and to the lives of others around him. When one member in the group announces, 'You hooked my not ok Child when you said that', the way is open for the examination of one of the mysteries of our existence, the outcome of which may prove to be exceedingly beneficial to all the members of the group.