Book Review: Transactional Analysis: A Relational Perspective

This comprehensive book sets out to reveal and expand the significance of the relationship between client and therapist. It does this by providing a theoretical and practical model of relational psychotherapy with an integrative approach grounded in transactional analysis (TA). Helena Hargaden and Charlotte Sills strive, with theoretical assistance and applied methodology of TA, to chart dimensions of uncertainty and the unknown, which they describe as 'deconfusion of the Child ego state', where they believe the 'self' is located. The authors have used their experience as practitioners to illustrate their relational model and the book is peppered with clinical vignettes from their client population in an attempt to bridge theory with practice.

The book covers several areas and is separated into four main stages. In stage one - The Approach, the reader is introduced via a story of a client, to the developmental theory of self, aided by several diagrams intended to provide a visual demonstration of theory. Here, Hargaden and Sills highlight the significance of empathy for the development of the 'healthy' self and facilitation of a therapeutic relationship. They describe empathy as '…a combination of skill and technique and a reflection of who we are and how we are ourselves' (p.35).

In stage two – The Dynamics of the Relationship, the authors examine intersubjectivity in relational psychotherapy with specific focus on the transferential relationship about which they propose three categories of phenomena: projective, introjective, and transformational transferences. They describe counter transference thus:

In the relational model of transactional analysis…we think of the therapeutic relationship as the interactional field between two people. The therapist's response within this energy field, commonly known as countertransference, will therefore be significant in therapy (p.63).

The importance of the therapist's use of self in the relationship is examined here and acknowledged as necessary for therapeutic change to occur.

In stage three – Therapeutic Transactions, the role of the therapist and their 'empathic transactions' comes into the authors' focal point in which they demonstrate how an analysis of the countertransference provides an opportunity for the client to experience and express more fully their unimagined thoughts and feelings. They believe that an accurate analysis of these transactions will facilitate the crucial work of deconfusion. Emphasis is placed on the therapist's intuition and skill in pacing as well as the ability to explain and interpret internal processes of the client. Here the authors assure us that, "…these interventions are not about the therapist assuming a superior knowledge to the client, but are more linked to a collaborative exploration in which the therapist is required to use her 'self' in the pursuit of understanding another 'self'" (p.123).

The Parent ego state is also discussed here as they describe the application of the TA model to group psychotherapy.

In stage four – Wider Implications, the book offers some ethical and professional implications for TA therapists working in a relational way, making some arguments for brief-therapy, by saying it does not have to be outcome-based in order to be effective. As well as research findings to support their relational model, Hargaden and Sills, lastly, discuss endings and the termination of the therapeutic relationship, noting that, 'the best type of endings come about through a co-created transferential relational relationship where the time for ending emerges as appropriate and natural' (p.186).

Aimed at practitioners with a high level of existing knowledge, Transactional Analysis: A Relational Perspective, does what it says on the tin. Hargaden and Sills are successful in providing the post-graduate reader with a clear, wide-ranging yet detailed exposition of the relational dimensions of psychotherapy within a TA frame.

For those unfamiliar with the fundamentals of TA this book will make for difficult reading for the first two or three chapters where it is complicated by the many diagrams linked to the various dynamics of the ego states. An existential practitioner, certainly one who has specifically moved away from the developmental and medical models, may well feel uncomfortable with the diagnostic underpinnings and treatment planning espoused by Hargaden and Sills. There is particular focus on Object Relations theory and the authors, uncritically, draw on evidence in neuroscience to add clout to their arguments for certain interventions, techniques and treatment plans, all of which are based on the developmental theory of self. A single caveat is offered: '… we might need to adapt our practice in the light of further evidence as it emerges' (p. 184).

While clearly out of kilter with a purely existential approach to psychotherapy, the reader will find many references to existential thought in connection to therapeutic practice, revealing the importance of acknowledging and working with the 'givens' in their relational model. The authors state, for example that, '…the provision of the empathic relationship…attains another level of importance as both therapist and client engage in an encounter with… the global container of unmitigated existential realities' (p.162).

Transactional analysis is underpinned by an existential/humanist maxim: I'm 'OK'; You're 'OK'. The 'I'm' bit is existential, the 'OK' is humanist. Sills and Hargaden are, I'm pleased to say, realistic about the leap of faith that such a maxim requires for this to make any sense. In fact they note that maintaining such a position is untenable if important work in therapy is to be done:

For transactional analysis, our insistence upon keeping the patient and ourselves OK could be understood as a version of…grandiose expectation. If we expect of ourselves that we be 'paragons of mature functioning'… then…we might be therapeutically ineffective in those instances where we are required to be emotionally responsive in the 'risky' area of hate. (p.74)

Hargaden and Sills are adept at weaving together many elements of theory that at face value seem incompatible. However, they offer, I believe, a wide range of possibilities for conceptualising the phenomenological world of the client and indeed the therapist. This I believe is a crucial element to the book. Both authors are very keen to assess their own attitudes and processes in-relation-to their clients, which reveals a responsibility and open-mindedness not seen in traditional TA of more objective models of therapy. Overall, this is a richly informative book and readers will be encouraged by the authors' reflection, honesty, and human approach to their work, regardless of which modality they may feel they 'belong' to. I would recommend this book to any serious practitioner who has an interest in how the 'nitty-gritty' of the relationship not only influences, but is central to, the process of psychotherapy. Without doubt, this must include the existential psychotherapist.

Neil Gibson