Transactional Analysis Journal http://tax.sagepub.com/ The New Emerges Out of the Old: An Integrated Relational Perspective on Psychological Development, Psychopathology, and Therapeutic Action Ray Little Transactional Analysis Journal 2013 43: 106 DOI: 10.1177/0362153713499541 The online version of this article can be found at: http://tax.sagepub.com/content/43/2/106 Published by: http://www.sagepublications.com On behalf of: International Transactional Analysis Association Additional services and information for Transactional Analysis Journal can be found at: Email Alerts: http://tax.sagepub.com/cgi/alerts Subscriptions: http://tax.sagepub.com/subscriptions Reprints: http://www.sagepub.com/journalsReprints.nav Permissions: http://www.sagepub.com/journalsPermissions.nav >> Version of Record - Oct 2, 2013 What is This? Downloaded from tax.sagepub.com by Ray Little on October 15, 2013 Article Transactional Analysis Journal 43(2) 106-121 ª International Transactional Analysis The New Emerges Out of the Association, 2013 Reprints and permission: Old: An Integrated Relational sagepub.com/journalsPermissions.nav DOI: 10.1177/0362153713499541 Perspective on Psychological ta.sagepub.com Development, Psychopathology, and Therapeutic Action Ray Little Abstract This article considers how new ways in which a client and therapist relate emerge out of old ways the client related to others, with the subsequent transformation of maladaptive schemas and ego state relational units (Little, 2006) into more adaptive schemas. The author explores the nature of the client’s pathology and maladaptive relational schemas and the therapeutic action that might be transformative for the client. He also examines a modern perspective on the transference- countertransference matrix and explores further the concept of optimal neutrality. Keywords relational, ego state relational units, transference-countertransference matrix, needed relationships, repeated relationships, optimal neutrality, assimilation, accommodation, therapeutic engagement, interpretation Psychotherapy unfolds in a relational context. Both the therapist and the client bring to the rela- tionship their own subjectivities, motivations, relational needs, and pathologies. In addition, both parties have their conscious and unconscious expectations and phantasies (Lemma, 2003). Many contemporary theorists believe that the outcome of therapy is related to the successful elaboration and reevaluation of patterns of relating that become accessible through the analysis of the transference-countertransference matrix (Lemma, 2003; Sandler & Sandler, 1997). This article is my attempt to account for the process of change when working within an integrated relational transactional analysis orientation. I consider how the transformation that takes place within the transference-countertransference matrix occurs largely at the level of implicit uncon- scious processing. This entails working mindfully with unconscious processes through the transference-countertransference matrix, with the aim of having ‘‘one foot in and one foot out’’ (Eusden, 2011, p. 275), which includes both reenactments and enactments. I will develop and incor- porate Zˇ velc’s (2010) excellent work into my thinking on ego state relational units (Little, 2006), Corresponding Author: Ray Little, 4/2 Oxford Street, Edinburgh, EH8 9PJ, United Kingdom. Email: [email protected] Little 107 transference-countertransference, and therapeutic action. I also describe my understanding of the integration of healthy relational experiences into the integrating Adult ego state. Although this article repeats some of what I have written previously, it integrates various strains of my thoughts and concepts into a more coherent whole. My intention is for this article to be able to stand alone, without reference to previous publications. Psychological Development Adaptive and Maladaptive Relational Schemas. Zˇvelc (2009, 2010) has described how infants grow, develop, and learn to relate to their environment and to those who occupy it as well as the way in which they internalize these experiences as relational schemas. Various authors support the notion that it is relationships that are internalized as self-other configurations (Beebe & Lackmann, 1988; Loewald, 1970), and these representations influence the child’s behavior (Horner as cited in Schore, 1997). Schore (1997) connected with neurobiology when he said, ‘‘Representations are distributed in the orbi- tal cortex and its cortical and subcortical connections, and ...they act as templates guiding interper- sonal behavior’’ (p. 828). The infant internalizes the experience of the whole relationship with the other at a particular moment in time. These early internalizations are laid down in implicit memory, which consists of procedural knowledge of relationships and the rules of how to be with someone as established through a process of trial and error. Schemas (Piaget, 1952; Wadsworth, 1989) are described as the mental structures by which individ- uals intellectually adapt to and organize the environment; schemas adapt and change with mental development. Relational schemas are, therefore, a particular grouping of structures that consist of self in relation to another. Eagle (2011) described how ‘‘on the basis of repeated interactions early in life with parental figures [the infant/child forms] implicit representations that constitute abstractions or generalizations of prototypic interactions’’ (p. 126). Once formed, they influence the individual’s expectations and representations of self and others. This notion is similar to D. N. Stern’s (1985) ideas of RIGs (representations of interactions that have been generalized), which could be described as rela- tional schemas. These representations belong to the category of ‘‘procedural knowledge’’ (Boston Change Process Study Group, 2010, p. 31), which Lyons-Ruth (1999) described as ‘‘implicit relational knowing’’ (p. 605). This perspective on development constitutes a relational model of the mind. The infant internalizes a memory of self in relation to another, thus creating a schema. This usually occurs during ‘‘peak affect states’’ (Kernberg, 2004, p. 9). Kernberg and his colleagues (Yeomans, Clar- kin, & Kernberg, 2002) described these experiences as coalescing into those with pure positive affect and those with pure negative affect. At this stage, self and others are perceived in extreme, absolute terms. Gradually, through normal development, the extreme positive and negative segments of the mind become integrated into more complex and nuanced representations of self, others, and affects. Ambivalence, acceptance, flexibility, and the notion of good enough will guide the individual’s per- ceptions of self and others. Psychopathology Ego State Relational Units and Maladaptive Schemas. When we examine the nature of the relation- ship, we can distinguish between tolerable and intolerable experiences that have been internalized as relational schemas. Those internalizations that consist of the tolerable, good-enough experiences in nonconscious implicit memory are nonstructuring internalizations and an aspect of the integrating Adult ego state. These represent autonomous, here-and-now functioning from an open system (Little, 2006, 2011b), with the capacity for assimilation and accommodation (Piaget, 1952; Zˇ velc, 2010). In Summers’s (2011) dynamic model of ego states, the term unconscious is reserved for those experiences that have become repressed or dissociated from and reside in ego state relational units 108 Transactional Analysis Journal 43(2) (Little, 2006). These experiences were described by Freud as the dynamic unconscious. Noncon- scious is used by Summers (2011) to describe those experiences that are not conscious, not defen- sive, and do not reside in ego state relational units but nevertheless influence our behavior. If there is insufficient holding and containment or the child experiences trauma, or if there is a predominance of all-bad, aggressive internalizations, then the child may not be able to integrate its experiences, and these will remain as a dissociated structure. These constitute defensive schemas (Zˇ velc, 2010), which others call maladaptive (Eagle, 2011). From a transactional analysis perspective, these defensive schemas are described as ego state relational units, which ‘‘develop defensively in response to unbearable or unmanageable experi- ence’’ (Summers, 2010). Although we internalize both the tolerable and intolerable experiences, it is the intolerable and unsatisfactory experiences that have been introjected and fixated in Child-Parent ego state relational units (Little, 2006). Such structuring internalizations are uninte- grated and result in a closed script system, located in unconscious, implicit memory and forming the foundation for characterological structure and defenses. Characterological Structure as Ego State Relational Units. Psychopathology can be seen, therefore, as manifesting in the persistence of early modes of relating and consisting of defensive relational schemas. This entails clinging to early self-other schemas that may result in a conflict between a desire to merge, on the one hand, and strivings for autonomy and separateness, on the other. Psycho- pathology includes the absence of affect regulation, which arises out of a lack of good object experi- ences and a secure base (Eagle, 2011). As Schore (1997) wrote, ‘‘Grotstein (1986) has asserted that all psychopathology constitutes primary or