Transactional Analysis Journal

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To Change or Not to Change

Reflections on the Role Games Play in Maintaining Psychic Equilibrium

Lis Heath & Steff Oates

To cite this article: Lis Heath & Steff Oates (2015) To Change or Not to Change, Transactional
Analysis Journal, 45:2, 91-103, DOI: 10.1177/0362153715588522

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Article

Transactional Analysis Journal

2015, Vol. 45(2) 91-103
To Change or Not to Change: ª International Transactional Analysis
Association, 2015
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DOI: 10.1177/0362153715588522
Play in Maintaining Psychic ta.sagepub.com

Equilibrium

Lis Heath and Steff Oates

Abstract
This article considers whether a legacy in transactional analysis of overinvesting in change and the
analysis or avoidance of games can lead to a foreclosure of important emergent processes in psy-
chotherapy. The authors do not advocate a preferred way of working with games, recognizing that
offering an antithesis often leads to establishing further doctrine. Instead, they describe two ways of
understanding clients’ need to maintain equilibrium and relate this to game theory. They explore the
dialectic between interpersonal analysis of games and the value of giving more space to clients’
intrapsychic processes.

Keywords
change, game, psychological equilibrium, psychological stability, resistance, defense, advantage,
thinking Martian, projective identification, intrapsychic tension

Transactional analysis was developed in the mid-twentieth century as part of the humanistic psy-
chology movement. Carl Rogers and Abraham Maslow, along with Alfred Adler and Rollo May,
introduced a set of values they considered different from those espoused by psychoanalysis. These
values concerned self-development and self-understanding and encompassed higher human motives
such as self-actualization. This term was coined by Kurt Goldstein, a German neurologist and psy-
chiatrist, to describe the attainment of one’s highest potential (Modell, 1993). Rogers, Maslow,
Adler, and May saw the development of humanistic psychology as a challenge to both psychoanaly-
sis, which they saw as overly concerned with neurosis and disturbance, and behaviorism, which they
viewed as too mechanistic (Reber, 1985, p. 330). At the same time, Eric Berne (1966) was raising
questions about psychoanalysis by suggesting inspirational ideas such as everyone has the capacity
to think, people decide their own destiny, and those decisions can be changed.
We also want to offer a challenge, this time to a prevailing idea in transactional analysis today.
Our concern is with what we consider to be a lingering overemphasis on positive (i.e., in the direc-
tion espoused by the practitioner) change and in that, the making of value judgments regarding what
is healthy or not in the teaching and application of TA. We hope to encourage reflection and

Corresponding Author:
Lis Heath, 24 Wordsworth Street, Penrith CA11 7QY, United Kingdom.
Email: lis.heath@gmail.com
92 Transactional Analysis Journal 45(2)

discussion about the importance of the client’s need to maintain his or her psychological balance or
equilibrium. We will invite examination of how a therapist’s overenthusiasm for change or moves to
analyze, understand, and even halt games may influence or interfere with the client’s own process.
We postulate that when the therapist shows interest in and pays attention to the importance of main-
taining equilibrium, it fosters a more organic emergence of the client’s development. We also
encourage flexibility in working with games and value making space for attending to the client’s
interior world as well as his or her interpersonal dynamics.

Literature Review and Setting the Stage

The tension between the client’s desire to change and his or her desire to keep things the same has
been the subject of much thought over the years since Freud began his work. He identified resistance
to change, or defense, as a cornerstone of psychoanalysis and linked it with the need to maintain
stability (Freud, 1922/1955). Just as the individual experiences this tension, there has also been ten-
sion within and between psychotherapy modalities about how to view the pull to change versus the
desire to defend. Does an approach champion change and pathologize defense, or does it favor
examining defenses? Does it seek to break through defenses or soften them? These are dialectics:
the tension between opposites that negate one another and yet inform and preserve one another.
We see this in all aspects of life: good/bad, life/death, cold/hot, and so on (Ogden, 1992).
In transactional analysis, the dialectic tension between cure and making progress was highlighted
by Berne, who clearly articulated his preference for the former: ‘‘Transactional Analysis is interested
in cure not progress’’ (Berne as cited in Haimowitz & Haimowitz, 1996, p. 116). We might consider
Berne’s emphasis on cure to be his emphasis on change. It was his rebuttal to the psychoanalytic
approach, which he regarded as focusing on making progress. In his wry, cynical story about the
person who had a splinter in his toe, he was derogatory about those practitioners who take their time
to investigate the problem when they could just remove the splinter (Berne, 1971, p. 11). However, it
is clear elsewhere that Berne viewed structural analysis as preparation for psychoanalysis (Peck,
1978, p. 206). Although he may have appeared to be throwing the proverbial baby out with the bath-
water in much of his writing, it is also clear that he saw the benefit of further analysis once social
control had been attained.
We appreciate Berne’s ambiguity because it encourages us to be flexible in our own thinking. For
example, in some instances we agree with Berne (1961) and see social control (in which the Adult
retains the executive in dealing with self or others) as the first step in treatment. However, in other
cases we wonder whether such a problem-solving approach may be used routinely when more time
and interest in understanding the client’s problem would be beneficial. As transactional analysts, we
often feel as if we have to choose whether to identify with a classical or a relational approach. In fact,
we think both have value, and rather than identifying with one side or another, we need to be aware
that there are always choices: With this client, at this stage, am I a doctor or a priest? Am I a parent, a
colleague, an expert, or a companion? Am I a missionary or an anthropologist (Haimowitz & Hai-
mowitz, 1996)? We find it hard to concretize our thinking in terms of what we do or who we are to
our clients because our approach carries more of an attitude or an essence that is dynamic and ever
changing between moments and between people.
Cornell (2010) highlighted what he considered to be an unresolved conflict in Berne’s work: the
‘‘lifelong tensions between the psychological power of aspiration versus adaptation’’ (p. 243). We
are interested in how an overemphasis on gaining social control and personal power may foreclose
deeper desires and/or aspirations, especially those that are not yet formulated.
Woods (1996, 2000, 2001, 2002) usefully wrote about how important it is not to cut short a game
and how projective identification reveals the unconscious defensive function, which we see as an
important communication. Like Weil (1985), who appreciated that ‘‘resistance is the best choice
Heath and Oates 93

of options which the client believes to be available’’ (p. 159), we are interested in resistance to
change and what this can tell us.
Bary and Hufford (1997) wrote that ‘‘the homeostatic balance maintained by these patterns comes
to feel as necessary to survival as air and water’’ (p. 38). We appreciate this respectful consideration
and also take inspiration from Terlato (2001), who urged consideration of the defensive advantages
of games and advocated ‘‘a shift in attention away from the analysis of advantages to a consideration
of motivations’’ (p. 112).
In this article, we invite practitioners to consider involving themselves with clients in a process
that may allow often unarticulated and yet important communications to bring forth a deeper under-
standing. Holding this attitude allows us to develop an interest in and compassion for those clients
who may have been unfairly defined as difficult or disordered. Our view is that ambiguity—that is,
being open to more than one interpretation—not only allows for flexibility but also provides a poten-
tial space in which the new can emerge. An unresolved problem can be a source of anxiety but also a
rich resource for creativity if the tension can be tolerated.

The Difficult Client

Because transactional analysis is a often considered a decisional model based on the decisional
aspects of script theory, it has become a core element of transactional analysis philosophy that peo-
ple can decide to change. However, some clients do not change easily, and with them the work may
seem repetitive or unsatisfyingly comfortable. How do we explain this? Do we blame ourselves for
doing a poor job or do we blame the client for being difficult? We want to offer a framework for
thinking about this problem.
Game theory in transactional analysis is rooted in the psychoanalytic theory of defense (Berne,
1961, 1964, 1966), and Berne’s theory of games offered a rich understanding of human interaction.
His lively, witty, humorous way of writing about games enabled people to recognize and classify
patterns of behavior that leave them feeling bad each time. However, Berne’s real gift to practi-
tioners was that he operationalized the ways in which people play out their script issues. Transac-
tional analysts are taught how to analyze games using what Berne (1972, p. 24) referred to as the
game formula or Formula G: Con þ Gimmick ¼ Response ! Switch ! Crossup ! Payoff. They
are also taught the drama triangle (Karpman, 1968) and the transactional analysis of games by which
to identify ‘‘the ongoing series of complementary ulterior transactions progressing to a well-defined,
predictable outcome’’ (Berne, 1964, p. 44).
Thus, the emphasis in transactional analysis became confronting defenses. Woods (1996), citing
Novey, wrote that as transactional analysts became skilled at identifying and confronting the first
move in a game, games could more easily be cut short. The treatment direction was to gain social
control and give up games. In that spirit, in our early training experiences games were viewed as
messing things up and complicating life, thereby making people feel bad and furthering their script.
Games were unwanted, and the task was to get them under control. Behaviors so identified were
pathologized and referred to as gamey. This approach helped clients become functional and practi-
tioners avoid difficult transference/countertransference entanglements.

Between Camps
The recent development of a relational paradigm in transactional analysis has articulated a challenge
to the classical stance around games. Stuthridge (2006) articulated the classical approach as follows:

[Berne] encouraged the therapist to act as a Martian observer (Berne, 1966, p. 84) who detects the client’s
discounts, games, and script from an objective stance. Using a classical or redecision transactional
94 Transactional Analysis Journal 45(2)

analysis approach, the therapist confronts an enactment as a game, thus refusing the transference; the
therapist remains safely on Mars, outside the relationship. (p. 277)

We have appreciated the challenge that Stuthridge offered, which is that thinking Martian can be
used as a defense. However, we think that there are times when the therapist remaining safely on
Mars is of genuine service to the client and can actually inform and even deepen the transferential
dynamic rather than avoiding it. We believe this to be the case particularly when a client needs more
space and encouragement to examine his or her intrapsychic experience and may be drawn to the
interpersonal as a movement away from transference. The therapist who is able to hold that space,
intervening little, may find that he or she and the client are able to experience more fully and intense-
ly the transference dilemma with less concern about how that affects the therapist. Often this is
unarticulated but palpable and available for interpretation at a much later stage. As Hostie (1982)
wrote, ‘‘‘The Martian’ [is] a TA term for an observer who ‘watches what happens without ‘‘precon-
ceived ideas,’’ . . . (and who) looks at things with the eye of innocence’’’ (p. 168).
We believe that the combination of this ‘‘eye of innocence’’ and subsequent inquiry can open up a
space for intrapsychic dialogue involving the client and therapist wondering to themselves, ‘‘What is
it that has been stimulated in me?’’ or even taking time for the question to find resonance in their
own experience and to have a sense of ‘‘Does that fit?’’ without an obligation to dialogue. Alterna-
tively, or in addition, possibilities for interpersonal dialogue are opened up. Hostie took from
Berne’s idea of thinking Martian the permission to speak to the outrageous as a way of opening
up further possibilities in the dialogue.
For example, a therapist who was feeling strongly invited to be persecutory of a client used Mar-
tian speak to say, ‘‘Gosh, you look like you’re feeling captured and tortured.’’ This was a way of
sharing and trying out her observation to see if it resonated with the client. The transference dynamic
was deepened with the therapist feeling intensely irritated by the client (as was the client’s mother)
and the client feeling distressed and afraid. This may seem like an unusual, perhaps even outrageous,
articulation of the therapist’s experience, but her Martian position enabled the client to access and
give voice to the pressure she had felt as an infant with an agoraphobic mother, something she had
never spoken about before.
In another instance, it might have been appropriate for the therapist, if she had been aware enough
not to act out the Persecutor role, to make the transference/countertransference dynamic explicit. As
therapists we often have this kind of choice: Do I say what I observe from the outside, or do I enter
into and speak directly about my experience of the relationship?
Berne, with his capacity for ambiguity and complexity, seemed to inhabit both camps. At the
same time he encouraged Martian thinking, he also knew that transference/countertransference
involvements were inevitable. As he wrote, ‘‘The Parent and Child aspects of his motivations . . .
influence the therapist much more systematically and pervasively than he may realize. . . . The more
productive question is not ‘Am I playing a game?’ but rather ‘What game am I playing?’’’ (Berne,
1966, p. 22).

The Stabilizing Function of Games

In the process of writing this article, we read Berne aloud to one another as a way to hear him with a
different ear. In our prior, individual readings we had often come across what we felt were unfair
judgments in Berne’s descriptions of games. For example, in Games People Play, Mrs. White
(Berne, 1964, p. 46) was used as an example of someone playing ‘‘If It Weren’t for You’’ when she
complained that she had never learned to dance because her husband severely restricted her social
activities. Each of us (defensively, with hindsight) had felt protective of Mrs. White and recruited to
side with her. We felt the tension and impulse to polarize, to keep Mrs. White good and make Berne
Heath and Oates 95

bad for attributing motivation to her game playing. In our joint, careful rereading aloud, we discov-
ered in Berne a mind paying serious attention to the depth and complexities of human interaction and
the dilemma of equilibrium versus change. For example, he wrote this about Mrs. White:

As it turned out, however, contrary to her complaints, her husband was performing a very real service to
her by forbidding her to do something she was deeply afraid of, and by preventing her, in fact, from even
becoming aware of her fears. (p. 46)

Berne (1964) went on, ‘‘The general advantages of a game consist in its stabilizing (homeostatic)
functions. Biological homeostasis is promoted by the stroking, and psychological stability is rein-
forced by the confirmation of position’’ (p. 50). This is the defensive function of the game: defensive
as in maintaining the familiar. Berne elaborated the Freudian notion of defense to include advan-
tages in order to extend the concept to the advantages gained from social relationships: ‘‘Experience
has shown that it is more useful and enlightening to investigate social transactions from the point of
view of the advantages gained than to treat them as defensive operations’’ (p. 18). Berne also wrote
that

the advantages of social contact revolve around somatic and psychic equilibrium. They are related to the
following factors: (1) the relief of tension [the primary internal advantage] (2) the avoidance of noxious
situations [the primary external advantage] (3) the procurement of stroking [the secondary advantage] (4)
the maintenance of an established equilibrium [the external advantage]. (p. 18)

Perhaps it is a combination of Berne’s style together with his treatment prescription to ‘‘get better
first, and we can analyse later’’ (Berne, 1966, p. 303) that has led to a trivialization of games. We are
concerned that some practitioners remain almost evangelical in their approach to change, using
transactional analysis as a metaphorical stick to beat clients into changing. To use Berne’s example
of Mrs. White, the risk in exposing her motivation might lead to her being misunderstood as a silly
woman at the same time her real vulnerabilities are passed over. We want to articulate our passion
for reestablishing respect for those advantages or defenses. Berne’s suggestion that people should
become functional first and then get analyzed may, indeed, mean that analysis is needed for a client
to recover from an overinsistence on functionality. Each of us has experienced in our practice some
clients who appear to have achieved autonomy by overadaptation and who, in subsequent therapy,
need to find their autonomous desires beneath the behavioral adaptations.
We think more consideration and respect needs to be given to the importance of defenses for
maintaining psychological equilibrium. It is with those clients who have a greater need to maintain
psychological balance that the work can feel stuck or as if there is no progress. We need a different
emphasis when working with such individuals.

Desire and the Dread of Change

We are inspired by the work of Kleinian analyst Betty Joseph in thinking about this different empha-
sis. Joseph wrote compassionately about clients who come to psychotherapy because they are dis-
satisfied with their lives and yet she discerned a dread of change: ‘‘Unconsciously they know that
the change they ask for involves an internal shifting of forces, a disturbance of an established mental
and emotional equilibrium’’ (Joseph, 1989, p. 193).
In our view, resistance to change has been pathologized in transactional analysis to the detriment
of genuine and profound change. At one time in our history, as described earlier, this took the form
of blatant criticism. More recently, it might take the form of a more subtle invitation to become
acculturated to the therapist’s frame of reference. Either way, it is possible for a client to adapt and
96 Transactional Analysis Journal 45(2)

have his or her defenses subtly reinforced, even recruiting the therapist in affirming his or her script
rather than being transformed.
Joseph became interested in patients who failed to improve in analysis and concluded that they
had a profound need to maintain their psychological equilibrium: ‘‘While the patient may appear to
attend carefully and to make use of the analyst’s interpretations, Joseph suggests that this may sim-
ply be a form of accommodation and that what takes place in the session is in fact being used to
support the preexisting balance and thus to avoid change’’ (Feldman & Bott Spillius, 1989, p. 4).
Paradoxically, the very desire to change may have at its heart the belief that ‘‘I am not OK as I
am’’ or ‘‘There is something wrong with me.’’ Working directly toward change may only reinforce
this basic self-concept.
Searles (1979) offered a cautionary note in suggesting that therapists may not attend enough to
their patients’ ambivalence: ‘‘He [the therapist] does not see that the patient has reached his present
equilibrium only after years of thought and effort and the exercise of the best judgment of which he
is capable’’ (p. 74). Searles wrote evocatively of the meaning of change for the patient and the risk
that he or she may ‘‘return to an intolerable pre-equilibrium state’’ and may have to accept ‘‘the
imposition upon him of the therapists’s values, the therapist’s personality, with no autonomy, no
individuality for him’’ (pp. 74-75). Searles wrote that ‘‘he [the patient] resents the therapist’s pre-
sumption that the patient is ‘‘pitiably eager to be rescued and, in assuming equally humiliatingly,
that the intended help is all unidirectional from therapist to patient’’ (p. 75).
Thus, we wish to stress the importance of examining our value judgments about change. Are there
standards we are using to subtly or not so subtly direct our clients? Do we know what they are?
Where do they come from? Are we doing our version of the kind of thing Novak (2008) described:
‘‘My Parental role with clients encouraged them to merely adapt to my views, or society’s, of nor-
mality’’ (p. 139). In our view, it is essential to scrutinize our personal and professional investment in
change in a particular direction, taking into account the client’s need for psychic equilibrium and the
threat that change may pose.

Psychic Equilibrium and Psychic Change

Feldman and Bott Spillius (1989) wrote about Joseph’s different perspective on change. She advo-
cated that the analyst abstain from value judgments about shifts or changes being positive or nega-
tive: ‘‘The moment-to-moment changes need to be recognized and accepted as the patient’s unique
way of dealing with his relationships and his anxieties’’ (p. 5). She wrote that we should not be so
focused on change as an achieved state but rather see it as a process of ‘‘a continuation and devel-
opment from the ‘constant minute shifts’ in the session’’ (p. 5).
Thus, in our view, setting our zeal aside allows a space to open in which minute movements can
inform us of both the client’s desire and his or her resistance to change. We can compassionately
observe and accept his or her need to restabilize when stability feels threatened, even when that
occurs because of something good.

Case Example
Jill, a long-term client who had struggled to have the energy to work for a full day, reported to her
therapist that she had done so and the day had gone well. The therapist said (in retrospect rather too
eagerly), ‘‘So, despite your belief about yourself as dysfunctional, you have managed not only to do
a full day’s work but to enjoy it!’’ The client immediately reported feeling sick and disoriented. The
therapist realized that her intervention had threatened Jill’s self-concept so that she felt destabilized.
The therapist then spoke to that with Jill to offer a nonpathologizing perspective on the process.
Heath and Oates 97

Feeling sick and disoriented were obvious signs that something was wrong for Jill, but sometimes
the signs are much more subtle. A less self-aware client might have simply gone very still at that
point, or perhaps there might have been a sense of that discomfiting, disturbing experience that
something did not feel right between therapist and client.

Paying Attention to the Subtlest of Signs

Berne (1961, p. 116) considered games to be derivatives or adaptations of infantile reactions and
experiences. We place these derivatives or infantile reactions and experiences in the realm of impli-
cit memory, which can be rooted in infantile experience or encoded at the subsymbolic level (Bucci,
1997) in adulthood. In an infant, the brain’s capacity to record an event in terms of time, space, and
context (the function of the hippocampus) is not developed until the second year of life. This means
that earlier memories are stored in emotions, sensations, and behaviors without conscious recollec-
tion (LeDoux, 1996/1998). They are beyond words, that is, unlanguaged. Certain experiences in
adulthood can also be viewed as being in the realm of the nonverbal subsymbolic. Contemporary
thinking about ego states, with which we agree (Cornell, 2003; Hine, 1997, 2005), does not restrict
implicit memory to infancy.
With hindsight, it is relatively easy to identify a relationship entanglement when events have
become unpleasant. Using Berne’s (1972) Formula G, we can analyze the transactions and switch
that led to the payoff. There are also moments when as practitioners we feel chaotic, troubled, con-
fused, or stuck. Even harder to recognize are those times when we feel vaguely dissatisfied, when the
work has gone a bit stale or we feel complacent. These clues are not direct signposts, whereas if we
were in the realm of explicit experience they likely would be. Thus, the unfolding of the story can
only be discovered through close attention to the interpersonal and intrapsychic dynamics in the
present. This can be achieved by making space and giving attention to the subtlest of signs and
through tolerating discomfort.
In our experience, what Southwell (2010/2011) referred to as rooted talking supports speaking
from feeling and embodiment. It is an associative process that helps us find those parts of ourselves
that we have put in the dark and to become rooted in our present embodied experience rather than
fleeing into making sense at the cost of making meaning. The therapist adopts a receptive stance
in body, mind, tone of voice, and breathing and encourages the client to wander and wonder. ‘‘At
certain junctures the therapist may draw a client’s attention to how they are sitting, their breathing
or body sensation, so that they have a felt experience of themselves as they speak (‘rooted talking’)’’
(p. 10).

Two Ways of Maintaining Equilibrium

We will now describe and illustrate with a case example two ways of maintaining psychological
equilibrium and relate each to game theory (Berne, 1961). They are projective identification and the
precipitation of the switch because of increasing intrapsychic tension. Both of these link interper-
sonal and intrapsychic processes. We regard the capacity of transactional analysis theory to make
such links as one of its great strengths.

Projective Identification
The concept of projective identification was developed by Melanie Klein (1946/1975) to describe
the way someone may unconsciously disown and project unwanted or unbearable aspects of the self
into another. Joseph (1989) identified this process as one of the means by which a person might
98 Transactional Analysis Journal 45(2)

maintain psychological stability. Ogden (1992) described projective identification by breaking it

down into phases and in a way that can be linked to game theory.
The projector wishes to be rid of part of himself or herself either because that part threatens the
person’s psychological stability or because it is in danger of being attacked by other aspects of the
self and must be safeguarded by being held inside another, more protective person. So, the projector,
through pressure at the energetic, unlanguaged level, gets the other to hold that unwanted or endan-
gered part. Then the recipient experiences himself or herself as that part. We consider this to be com-
parable to the first part of Berne’s game formula: Con þ Gimmick ¼ Response. Ogden’s (1992)
premise was that ‘‘projective identification is a psychological process that is at once a type of
defense, a mode of communication . . . and a pathway for psychological change’’ (p. 21).
If the recipient cannot deal with the feelings generated, perhaps because he or she has, in transac-
tional analysis terms, a script that is complementary to the projector’s script, the recipient may be
hooked (the gimmick is the hook) into the process. Then the unconscious bid by the projector to have
a new experience may fail.
In the second part of Formula G, we see the conclusion that expectations are confirmed as the
hoped for good object turns out to be the dreaded bad object: ! Switch ! Crossup ! Payoff.
Ogden (1992) described Bion’s development of Klein’s theory as follows:

Bion insists that projective identification is not only a fantasy but a manipulation of one person by
another and thus an interpersonal interaction. His work manages to capture some of the strangeness and
mystery that characterize the experience of being involved as the recipient of a projective identification,
which he suggests, is like having a thought that is not one’s own. (p. 26)

This conveys the intensity, confusion, and chaos that we know is characteristic of the game process.

Precipitation of the Switch

In the game process, the switch is precipitated by intrapsychic tension. Hine (1990) wrote of the
bilateral, ongoing nature of games and used Formula G to emphasize these two processes. In analyz-
ing Formula G, she posited that in games, ‘‘the switch is initiated by the player whose intrapsychic
tolerance is first overstepped by the tension specific to the game, that is, the one whose gimmick is at
that moment the most heavily charged and sensitive to the provocation’’ (p. 30). So, psychological
(if not interpersonal) equilibrium is maintained by the discharge of mounting tension that feels
intolerable.

Case Example
Martha was what her therapist called a ‘‘talented’’ client. Each week she earnestly brought some-
thing to work on as well as some awareness she had gained during the week following an insight
in her previous session. She was articulate and occasionally cried some about her lonely childhood
and being left to raise her younger brothers after her father left home. He was replaced by a step-
father who sexually abused Martha and ruled the household with a rigidity that bordered on a psy-
chotic defense.
Martha was, for her part, rigidly determined that the therapy not focus on the abuse and neglect
she had experienced lest she become defined as a victim. The therapist bided her time, working with
Martha on events at her work or with her husband. She knew that any attempt to penetrate the defen-
sive resilience that Martha had developed would not be welcome. One week, about 2 years into the
therapy, Martha brought in a problem she was having with a friend, who in a frank discussion had
told Martha that she found her to be overcontrolling and on the edge of being a bully. Martha was
Heath and Oates 99

deeply hurt: How could anyone call her that knowing that she had been bullied as a child and how
much she hated bullies?
The therapist felt the pull to collude in honoring Martha’s goodness and insisting that the friend
was mistaken. She also felt pulled to say, ‘‘Maybe your friend is right’’ and to use the drama triangle
(Karpman, 1968) and winners’ triangle (Choy, 1990) to tactfully put forward the inevitability of
games and a way out of them. This would have reassured both Martha and the therapist that if Martha
remained caring, assertive, and willing to be vulnerable she could get out of the game with her
friend, which could be described as ‘‘I’m Only Trying to Help You’’ (Berne, 1964, p. 125). The
therapist could offer Martha tips on how to correct her friend and not take on the cruel comment.
Had she done so, it would have felt comfortable to both the therapist and Martha as each would
have felt better. But it would have ultimately been unsatisfactory work because Martha’s defenses
would have been confirmed, and change, if any, would have been in the direction of Martha’s and
the therapist’s idea of what was functional by knowing how to get out of the game.

Discussion of the Case in Terms of Projective Identification

Although the therapist felt the impulse to come down on the side of ‘‘I’m Only Trying to Help You,’’
which felt like it would allow everyone to feel more comfortable, she was in an intense and uncom-
fortable conflict: Should she champion the good Martha or agree with the friend’s confrontation of
Martha? In simple terms, she was asking herself whether Martha was good or bad. The part that
Martha found impossible to bear and that threatened her stability was that uncertainty and vulner-
ability about her sense of self: ‘‘Am I good or bad?’’
The friend had taken one side of the good/bad split, which led the client unconsciously to try and
get the therapist to take the other.

Con: Martha wants relief: ‘‘Tell me I’m OK.’’

Gimmick: ‘‘I’m a good therapist who can help you feel more comfortable.’’
Response: ‘‘Of course you are not a bad person.’’ Both feel better.

The therapist imagined how the game might have progressed:

Switch: The therapist would have tired of enduring the good Martha.
Crossup: The therapist would have become irritated.
Payoff: The therapist would have felt bad for becoming irritated, and Martha would have
been indignant and felt confirmed in her view that ‘‘you are just like all the others.’’

Discussion of the Case in Terms of Intrapsychic Tension

In analyzing the process in supervision, the therapist could see the rise in her own and Martha’s
intrapsychic tension and confessed to feeling admiration for the friend whom Martha saw as pull-
ing a shocking switch in a game. If this had not happened, something of the sort might well have
happened between Martha and the therapist. The game, however, would have had a different qual-
ity. Instead, Martha’s attempt to take care of the therapist was silently interpreted by the latter as
an important communication rather than experienced as control. The therapist remained in role
and curious. She was able to see that the friend’s threshold of intrapsychic tension had been
reached, and she had then acted on it. By pulling the switch, the friend had made the game more
explicit.
Knowing this could have happened between herself and Martha, the therapist asked herself if
she should have brought attention to the habitual way that Martha overgave in a controlling
100 Transactional Analysis Journal 45(2)

fashion. Had she as the therapist colluded too much in only paying attention to the good in
Martha, and if so, whom should she blame now for disturbing Martha’s equilibrium: Martha?
Herself? The friend? These questions had been bouncing around in her head like ping pong balls.
During supervision, the therapist realized that Martha needed a truthful, honest, containing
response.
In the following session, when Martha, still hurting from the situation, raised it again, the thera-
pist chose to speak in an even tone, slowing down her breathing:

You are clearly hurt and shocked and angered by this, Martha, and I know how you despise bullies, yet
what has happened between you and your friend brings material to our work that is really important for us
to understand. I’d like to slow things down and take time to see what emerges in this session. See if you
can bring to me the full impact of her words on you.

During this and subsequent sessions, Martha was able to contact the terror of showing her
vulnerability, of how compelling it was for her to take care of others: to organize them, to
be seen as helpful, to avoid the complete and utter chaos inside her, and to cover the shame
she felt at being so neglected, abused, and unwanted as a child. This did not involve analyzing
transactions between Martha and her therapist or transactions between Martha and her friend.
Rather, it was a process of the therapist slowly and gently finding out, without insisting on
change or a focus on relationship, about the intrapsychic process that kept the most wounded
and lonely part of Martha under wraps through a habitually overfunctioning way of being in the
world to keep herself safe.
The therapist’s capacity to reflect on and digest the conflicting and intense forces engen-
dered in her in response to Martha was key. These were the pull to collude with the idealized
sense of self, the pull to join in the splitting of good and bad, and the pull to flee to theory and
analyze the game. This capacity of the therapist enabled her to deal with the feelings projected
into her in a different way to Martha’s habitual method. The therapist knew it was also impor-
tant for Martha to experience her own vulnerability, regardless of how unwelcome and desta-
bilizing that might be.
The therapist’s conflict was a reflection of the conflict within Martha. Martha’s complex commu-
nication contained within it both the opportunity for the emergence of the new and the resistance to
change. The rising tension was an indication that the tension between those was building. The thera-
pist’s capacity to contain rather than to avoid or act out to relieve tension enabled the conflict to be
held and Martha’s experience to be transformative.
As noted earlier, Martha’s friend had reached the threshold of her intrapsychic tolerance for what
was happening between Martha and herself. However, the therapist had not yet reached that place.
She had remained in a Martian position, observing and listening nonjudgmentally to Martha’s
accounts of her daily life and relationships. Postgame analysis of the interactions between Martha
and her friend led the therapist to reflect and question how up until then she had not consciously
realized that Martha was limiting herself in relationships by hiding her vulnerability and taking care
of others. The therapist was only just wondering why she had not been able to speak about this
before.
The therapist, consciously or unconsciously, had held the tension in the relationship with Martha,
choosing not to impose ideas about a healthier way of functioning but waiting until Martha brought
the interpersonal conflict into the room. In further supervision, the therapist was encouraged to
examine in her own therapy whether her holding the tension was facilitative or defensive of her own
goodness. On this occasion, the therapist’s unconscious wisdom did not appear to be defensive,
though she could recall many situations in which that would have been the case, times when her
patience had, in fact, been in the service of avoiding conflict.
Heath and Oates 101

Chronic Conflict, Client, and Therapist

To conclude, we refer to Soth’s (2014) work regarding the conflict in the therapeutic position
between colluding and objectifying. He wrote of how the client’s internal conflict necessarily
puts the therapist in conflict. He described the client’s conflict between the habitual and the
emergent and the pull for the therapist to defend one side or the other. He suggested that siding
with the habitual involves overidentification and collusion (this could have been the case with
the therapist and Martha), whereas siding with the emergent leads to an objectification more
aligned with a medical model of fixing. For him, the relational perspective acknowledges that
when the therapist is drawn into an enactment of the client’s wounding, there is an opportunity
for transformation.
Although we recognize these transformational possibilities, we think it is important to guard
against them developing into yet another technique whereby therapists seek out these processes
or move to interpret them before they are fully understood. We have experienced the power of hold-
ing the tension between consciously staying with the emergent and, at the same time, appreciating
the defenses that maintain equilibrium. While challenging the idea of an end goal, we espouse a dif-
ferent consideration. We are interested in how a responsible Martian contains the tension and will
know it is his or her job to observe the minute shifts in himself or herself and the other until such
time as they can be spoken about and understood. The necessary value change here is to know that
we cannot not be in conflict, but we can learn to become consciously aware of these conflicts and
thereby develop more tolerance for discomfort as well as greater flexibility.

Declaration of Conflicting Interests

The author declared no potential conflicts of interest with respect to the research, authorship, and/or publication
of this article.

Funding
The author received no financial support for the research, authorship, and/or publication of this article.

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Author Biographies

Lis Heath, BSc, is a Teaching and Supervising Transactional Analyst (psychotherapy) and a United
Kingdom Council for Psychotherapy-registered psychotherapist. She lives in Penrith in the north of
England, where she maintains a private clinical and supervision practice. She also teaches transac-
tional analysis in Romania. Lis can be reached at 24 Wordsworth Street, Penrith CA11 7QY, United
Kingdom; email: lis.heath@gmail.com.
Steff Oates is a Teaching and Supervising Transactional Analyst (psychotherapy) who maintains a
private psychotherapy practice in the northwest of England and travels to teach and learn in various
European locations. She also served as ITAA Secretary from 2009-2014 and remains involved on
various committees and as a Transactional Analysis Journal reviewer. Steff can be reached at Swal-
lowfield, Slade Lane, Mobberley, Knutsford WA16 78N, United Kingdom; email: lcfan@me.com.