Stages of Cure

Cure according to Berne

• Cure is a progressive process than a once off process.

• Cure is a matter of progressively learning to exercise new choices.

• The client will likely pass through a series of stages of improvement, distinct in their nature although the boundaries between them might not be sharply recognizable.

Cure according to Berne• Each stage represented a

genuine gain as compared to the one before it.

• Therapist and client might agree to terminate treatment at any one of these way stages if the client found it satisfactory.

• However, only the last stage represented the most fundamental degree of change in the client.

Stages of cure

1. Social control

2. Symptomatic relief

3. Transference cure

4. Script cure

Stage 1 – Social Control• In this first stage of cure, the

person takes control over her

behaviors, employing an Adult

ego – state.

• She amends her social

interactions to avoid the ones that

had been causing her difficulty or

pain and to substitute other

behaviors that will produce more

congenital results for her.

Stage 1 – Social Control

• At this stage of cure, the person does not

set out to make any change in unresolved

child feelings or confront outdated

parental commands.

• She simply overrides these past

influences by here and now behavioral

control.

• It is by these change in behavior, together

with the client's reports of outcomes,

that we can observe the attainment of

this first stage of cure.

Stage 2 – Symptomatic Relief

• At this second stage, the

person still maintains Adult as

the ego state in charge of the

process.

• However, now she goes on to

address some of the

problematic content of Child

or Parent ego state directly.

Stage 2 – Symptomatic Relief• For example, she may reopen and express some of

the unfinished feeling she is still carrying from

moments of childhood trauma, always monitoring

from the Adult ego state.

• In consultation with the psychotherapist, she may

reappraise outdated beliefs that have accompanied

these child feelings and decide to replace these

beliefs with others that are more appropriate to her

grown up situation.

• These changes in feeling and belief serve to

reinforce, and are reinforced by , the changes in

behavior she has made at the first stage of cure.

Stage 2 – Symptomatic Relief

• Often, this process is accompanied by

some relief in psychic or physical

symptoms such as anxiety or muscular

tension. Reports of these are thus one

objective indication of this stage of cure.

• The observer may also note changes in

the person’s posture and muscle tone. A

decrease in the frequency and intensity

of game playing will provide still

another clue to this stage of cure.

Stage 3 – Transference Cure• Here, the client substitutes the

psychotherapist for the original parent. She

now sees the psychotherapist as fulfilling a

role in her script.

• But she experiences him as doing so in a

more benign way than the actual parent did.

• The client may experience considerable relief

from child fears and anxieties now that she

has this more benevolent parent to relate to.

Stage 3 – Transference Cure

• She may also break free from some of her

original destructive parental messages,

substituting for them the positive

messages she takes on board from the

psychotherapist.

• This stage , however, does not represent

the final goal of cure, since the client still

has to keep the psychotherapist around in

her head in order to maintain her change.

Stage 3 – Transference Cure• Berne acknowledged the work of the

psychoanalyst Fenichel (1945) in elucidating

the nature of such “transference

improvement”.

• A diagnostic clue of this third stage of cure is

that the client will shift the main focus of the

game – playing on to the psychotherapist.

• Often, this will be accompanied by a

corresponding reduction in game – playing

outside the therapy room.

Stage 4 – Script Cure

• Berne described script cure as follows:

“ At a certain point, with the help of the therapist and his

own Adult, the patient is capable of breaking out his script

entirely and putting his own show on the road, with new

characters, new roles, and a new plot and payoff. Such a

script cure, which changes his character and his destiny, is

also clinical cure, since most of his symptoms will be

relieved by his re- decision.”

Final stage of cure according to Berne

Transactional analysis in psychotherapy (1961)Psychoanalytic Cure

Games People play (1964)Autonomy

What do you say after you say hello (1972)Script Cure

Final stage of cure according to Berne

• Berne’s concept of the final stage of cure underwent some important changes during his career.

• In his early writing, for example, in Transactional Analysis in Psychotherapy, he still saw formal psychoanalysis as the ultimate route to personal change.

• Thus he spoke of the final stage of cure as psychoanalytic cure.

Final stage of cure according to Berne• By the time Berne wrote What Do

You Say After You Say Hello?, he and his associates had accumulated a decade of experience in the psychotherapeutic application of script analysis.

• He had reached the view that TA’s own techniques could be used to facilitate even the most complete stage of cure, which he now called script cure.

• He now believed that the person could reach this end goal without the need of psychoanalysis.

Final stage of cure according to Berne• Berne stressed that the TA

practitioner’s job was to cure the patient , not merely help him make progress.

• In his book Principles of group treatment, Berne uses the metaphor of “frogs and princes” to underline his own concept of cure. He suggests that cure means casting off the frog skin and resuming the interrupted development as prince or princess, where as making progress means becoming a more comfortable frog.

Different views on cure• A few years ago, the TA journal

produced a symposium issue in which various TA writers gave their own interpretations of cure.

• There were almost as many different views as there were contributors. Here are just a few of the ideas that emerge from that discussion.

Different views on cure

• Some writers take the down to earth view that cure can best be defined in terms of contract completion.

• Rather than have any global goal for change, the practitioner and client simply work together until the client has completed as many mutually agreed contract goals as she wants.

Different views on cure• Most widely held is the view

that, in therapy applications at least, cure must entail some kind of movement out of script.

• Such script cure can be behavioral, affective or cognitive or a combination of the three. In other words, someone who moves out of script can do so by acting, feeling or thinking in new ways.

Different views on cure

• Several writers suggest a fourth dimension to script change : somatic cure.

• This means that the person moving out of script will change the ways she uses and experiences her body. For instance, she may release chronic tensions or be relieved or psychosomatic ailments.

There is a hole in my side walk The romance of self discovery

Poem by Portia Nelson

I walk down the street.

There is a deep hole in the sidewalk.

I fall in..I am lost... I am helpless.

It isn't my fault.

It takes forever to find a way out.

I walk down the same street.

There is a deep hole in the sidewalk.

I pretend I don't see it.

I fall in again.

I can't believe I am in the same place.

But, it isn't my fault.

It still takes me a long time to get out.

I walk down the same street.

There is a deep hole in the sidewalk.

I see it is there. I still fall in. It's a habit.

My eyes are open.

I know where I am.

It is my fault. I get out immediately.

I walk down the same street.

There is a deep hole in the sidewalk.

I walk around it.

Next time,

I walk down another street.

Prepared byManu Melwin JoyResearch Scholar

SMS, CUSAT, KeralaPhone – 9744551114

Mail – manu_melwinjoy@yahoo.com