A Transactional Analysis Substance Abuse Group

Where to begin!? I’ll start off by disclosing that I’m more than partial to Dr. Eric Berne’s theory of Transactional Analysis. TA conceptualizes problems from an interpersonal perspective, viewing these as they’re experienced in relation to the people in our lives. According to TA, we act out of specific ego states that manifest as either Parent, Child, or Adult ego states, and we’re not necessarily always acting out of the same one, even within one particular interaction. These interactions we have are transactions, and when we respond in a transaction we do so out of a specific ego state. There are also different kinds of transactions: complementarycrossed, and ulterior. TA further posits that people take life positions, or have life scripts, which essentially motivate the choices we make and how we interact with others throughout our lives, although scripts (and lives) can be altered. For a more detailed description of TA you can visit this GoodTherapy article on TA (sorry, I’m still working on my “theories” tab).

TA Transactions

TA Grid

Most of the time I take a pretty directly cognitive-behavioral approach with my clients, unless this seems to be getting nowhere or they voice another preference. But, recently I was thinking – Most of the time my clients come referred through CPS, and in my Wednesday women’s group I haven’t had any that don’t. What this tells me is that my clients have significant relationships – with their children, spouses, partners, parents, etc. – that are currently at risk, and one of the greatest reasons these relationships’ and my clients’ overall well-being is at risk is because of their substance-using behavior. Because my groups are open groups, a topic doesn’t typically carry over from one session to the next, so I seized on the flurry of ideas remembering Dr. Berne inspired in me, and planned out my next two hour group session. At the end, this is what it looked like:

TA Group

My thought tornado went something like this: My clients are trying to stay sober, but inevitably they will experience some conflict with another, and this poses a threat to their sobriety. But what if they’re able to see which state they tend to interact from and are being interacted with – might this help decrease the frequency of conflict and facilitate its resolution? I don’t have time to go into a lengthy script analysis with my group members, because that would take more than one session and they may not attend the group next week, but they know themselves best – I can show them the life scripts/life positions, and maybe this can get them exploring if their substance use is contributed to by how they see themselves in the world and in relation to others! And if they can see this, then maybe they can change the script that isn’t working!

You might see by my use of exclamation marks that I was excited!! But toward the end of our session came the real reward, when one group member was speaking about her son and said, “If I’m okay, he’s okay.” I’m at a loss for words to explain how I felt when she said that, except to write that I felt a jolt of satisfaction course through my brain. Without going into a script analysis, having provided only a cursory description of some TA concepts, she got it! She realized that she can change her script, she can be okay, and this can help her son be okay, too.

For those present who weren’t feeling all that “okay,” I did what I could to inject some motivation and self-esteem into the picture. The final activity was group members writing, “I’m okay because _________,” and filling in the blank with as much positivity as they could. We closed with, “I’m okay because I’m doing the best that I can.”

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