Integrative TA

1. Introduction

Version followed: Richard G. Erskine's developmentally based, relationally focused Integrative Psychotherapy (also called integrative transactional analysis), as set out in Erskine, Moursund & Trautmann (1999), Beyond Empathy; Erskine & Moursund (2004; 2nd ed. 2022), The Art and Science of Relationship; and Erskine (2015), Relational Patterns, Therapeutic Presence. Parent ego state therapy follows the Erskine–Trautmann procedure as reconstructed from Erskine's transcripts by Zaletel, Potočnik & Jalen (2012). The eight relational needs follow Erskine et al. (1999) and Erskine (2015) as summarised by Žvelc et al. (2020).

What it is. Integrative TA is Erskine's extension of transactional analysis, begun in the mid-1970s with Rebecca Trautmann. It brings together TA ego-state and script theory, Gestalt contact theory and experiments, redecision methods, Reichian/body psychotherapy, object relations, self psychology, attachment theory and developmental research. It integrates four dimensions of functioning: affective, behavioural, cognitive and physiological. [source: Bekier 2024; O'Reilly-Knapp 2015 review of Erskine 2015] Erskine and Zalcman's 1979 racket system (later the script system) won the Eric Berne award. [source: Bekier 2024] Erskine's own 1997 selected-articles volume uses the title Theories and Methods of an Integrative Transactional Analysis. [source: book title only]. The Institute for Integrative Psychotherapy (New York) is Erskine's training institute. [uncertain: founding date and location not verified]

Core idea of change. Health is full contact, both internal (with one's own sensations, feelings, needs and thoughts) and external (with others and the world). In Erskine & Moursund's words: "Contact, with self and with others, is what healthy functioning is all about." [source: Erskine & Moursund 2022, p. xiv] When relational needs repeatedly go unmet, the child interrupts contact and builds protective, unconscious relational patterns. These are introjected Parent ego states, fixated Child ego states and a self-reinforcing script system. "Scripts protect the individual from perceived harm or danger." [source: Erskine & Moursund 2022, p. xviii] Change happens through a contactful therapeutic relationship. The therapist uses inquiry, attunement and involvement to restore awareness of what was disavowed. The client is helped to re-experience, rather than relive, archaic states, and to grieve and decommission introjects. The aim is a client who integrates these experiences into a here-and-now Adult ego state. [source: Bekier 2024; Finlay 2016 citing Erskine 1991/2015; Erskine, Mauriz-Etxabe & Pérez Burgos 2020 abstract]

2. Framework

Erskine does not publish a fixed, numbered phase protocol. The structure below is assembled from the sequence of chapters in Erskine & Moursund (2022): beginning, moving in, interventions, a focus on relationship, termination. It also draws on Erskine's three-part ego-state strategy and his published case sequences. [synthesis of sources cited]

Overall treatment strategy (three prongs). [source: Finlay 2016, p. 66, citing Erskine 1991, 2015; Bekier 2024]

Deconfuse the Child ego state. Bring archaic unmet needs, feelings and defences into awareness and relax them.
Decommission or amend the Parent ego state. Resolve intrapsychic conflict with introjected significant others.
Integrate into the Adult (neopsyche). Assimilate the positive parts of Parent and Child, and the lessons of past experience, into here-and-now functioning.

Phases as practised (assembled).

Phase	Goals	Main methods	Move on when
A. Beginning: contact and contract [source: Erskine & Moursund 2022, ch. 5, 7]	Establish safety and security-in-relationship, agree a contract, form an initial picture of the script system	Phenomenological inquiry, attunement, acknowledgment, contracting (renegotiated as needed)	Client returns consistently, can tolerate some inquiry, and the working alliance holds through minor ruptures
B. Building the working alliance [source: Erskine 2013, pp. 21–22]	Security-in-relationship and the client feeling valued. In one long case this phase took about the first seven months	Mostly phenomenological inquiry, validation, normalization, presence	Client can name inner experience and survive therapist errors being discussed
C. Moving in: script system and Child work [source: Erskine & Moursund 2022, ch. 8–9; Erskine 2013]	Identify script beliefs and disavowed affect, work through transference, deconfuse the Child ego state	Ratio of roughly 10–15 phenomenological to 1–2 historical or transferential inquiries (Erskine 2013, p. 20), experiments and enactments, therapeutic regression, body-focused inquiry	Shame and self-regulation are sufficiently addressed before introject work (Erskine 2013, p. 24)
D. Parent ego state therapy [source: Zaletel et al. 2012]	Resolve intrapsychic conflict with the introjected parent	Parent interview leading to Parent therapy, then Child–Parent dialogue	Child work is done first and a solid alliance exists, so that weakening the Parent does not leave the Child unprotected
E. Integration and termination [source: Erskine & Moursund 2022, ch. 10–11]	Integrate the work into the Adult, grieve, practise new relationships, end well	Focus on the relationship itself, truth-telling, grief work	Contract goals met, as defined at the start by asking how both will know

Session count and format.

Individual therapy is the core format. Both time-limited and long-term work are described. One case had seven months of time-limited, problem-focused work (behaviour change, managing acting-out), and further in-depth work on archaic fixations was deferred. [source: O'Reilly-Knapp 2012, p. 39]
In-depth cases run for years. In the Theresa trilogy, year 1 built a consistent validating relationship, years 2–3 worked at the borderline, and years 4–5 brought relational healing. [source: O'Reilly-Knapp 2015 review of Erskine 2015, chs 13–15]
Frequency in a published case was twice-weekly sessions, with brief between-session phone contact by contract. [source: Erskine 2013, p. 19]
About 90 minutes is recommended for Parent ego state work. [source: Zaletel et al. 2012, p. 18]
Erskine also works in groups and training workshops, often doing individual work within a group. [uncertain: group format not described in the sources]
Contracts can be short- or long-term and are often renegotiated. They define goals and how achievement will be recognised. [source: Erskine & Moursund 2022, pp. xix–xx]

Criteria for pacing (all phases).

Slow down at a juxtaposition reaction. This is when the contrast between the therapist's attentiveness and past neglect overwhelms the client. It signals that the work is moving too fast. [source: Bekier 2024, pp. 81–82; Aguado Rodríguez 2021]
Treat resistance as a sign that the work is close to the script. Slow down and validate rather than push. [source: Zaletel et al. 2012, pp. 22, 28]

3. Guiding principles

[source for this section unless tagged otherwise: Erskine & Moursund 2022, pp. xiv–xx; Bekier 2024; Erskine 2013; Aguado Rodríguez 2021; Žvelc et al. 2020]

Contact is the touchstone. Track moment to moment where the client interrupts contact with self or with you. The interruption is the clinical material.
The relationship is the primary vehicle of change. Prioritise the quality of contact over technique. Techniques are used inside a relationship, never instead of one. [source: Bekier 2024, p. 75]
Listen with, not to. Erskine & Moursund describe a stance of listening "with the client rather than to the client" (p. xviii). Resonate from inside the client's frame rather than observing from outside.
Empathy must be communicated. Feeling empathy is not enough. Say what you sense in a way the client can take in. [source: Erskine & Moursund 2022, p. xviii]
Assume nothing about the client's inner experience. Inquire rather than interpret. Interpretation can rob the client of discovering the insight for themselves. [source: Erskine 2013, p. 22; Aguado Rodríguez 2021]
Every behaviour has a function. Treat symptoms, defences and script displays as creative solutions that once organised experience (regulation, stabilisation, reparation, enhancement). Ask what they do before trying to change them. [source: Erskine 2013, pp. 22–23; Erskine 2015 via O'Reilly-Knapp review, six functions of scripts]
Work alongside, not opposite. Stand with the client against the problem. Do not confront the client from across the room; confrontation-first risks re-traumatisation. [source: Erskine 2013, p. 21]
Relational needs are lifelong and normal. The eight relational needs are present across the lifespan. Diagnose relational disruption, not pathology. [source: Žvelc et al. 2020; Aguado Rodríguez 2021]
Past needs cannot be fully met now. They can be validated and grieved. Do not set out to re-parent the client into completeness. Acknowledge, validate and normalise the need, and support the grief that follows. [source: Žvelc et al. 2020]
The therapist is responsible for their own errors. Own misattunements and inconsistencies first, then explore the client's reaction and its history. [source: Erskine 2020, p. 220; O'Reilly-Knapp 2015 review]
Negative transference is an unconscious call for help. Respond to attacks and devaluation with interest in the need behind them. [source: Erskine 2013, p. 21]
Allow yourself to be impacted. Being visibly moved by the client meets the need for impact. Distance does not. [source: Erskine 2020, p. 226; Žvelc et al. 2020]
Use your own experience as data. Introspect on what is stirred in you, and distinguish responsive countertransference (care, protection) from reactive countertransference (dislike, irritation). [source: Erskine 2013, p. 25; O'Reilly-Knapp 2012, p. 39]
Integrate all four domains. Inquire into affect, behaviour, cognition and body. A cure is not complete if only one domain changes. [source: O'Reilly-Knapp 2015 review; Erskine 2015, p. 79]
Pacing and rhythm belong to the client. Follow the client's tempo, including silence. A few historical questions per session is enough. [source: Erskine 2020, p. 223]
Re-experience, do not relive. Regression is supported only inside an attuned relationship and only to the degree the client can remain in contact. Reliving without contact can retraumatise. [source: Erskine, Mauriz-Etxabe & Pérez Burgos 2020 abstract]
Child before Parent. Do not weaken an introject before the Child ego state has a secure relationship to lean on. [source: Zaletel et al. 2012, pp. 16–17; Erskine 2013, p. 24]
Equality with protection. Be an equal and, at the same time, a stronger, wiser, protective other when the client needs one. [source: Aguado Rodríguez 2021 (secondary)]

4. Intervention inventory

Erskine's core methods are three interwoven relational methods: inquiry, attunement and involvement (Erskine, Moursund & Trautmann 1999). Sources disagree slightly on the sub-types. O'Reilly-Knapp (2015) lists four kinds of attunement (affective, cognitive, developmental, rhythmic). Bekier (2024) adds attunement to relational needs, and so does this guide. Involvement has four components: acknowledgment, validation, normalization and presence. [source: O'Reilly-Knapp 2015; Bekier 2024; Erskine & Moursund 2022, pp. xix, 104, 120, 124] The detailed chapter text of Beyond Empathy is not drawn on. The steps below are reconstructed from the sources listed and from Erskine's published case material. Wording marked (illustrative) is mine.

4.1 Contracting (initial and ongoing)

Purpose / when: At intake and whenever the focus shifts. Contracts give direction and protect autonomy. They can be short- or long-term and are routinely renegotiated. [source: Erskine & Moursund 2022, pp. xix–xx, ch. 7]
Steps:
1. Ask what the client wants to change, in their own words.
2. Clarify what each of you will do.
3. Agree how you will both know the goal has been reached. Erskine & Moursund include the question "How will we know when you have accomplished your goals?" (p. xix).
4. Agree practical arrangements: frequency, and limits on contact between sessions. In one case Erskine allowed brief phone calls of up to about 5 minutes, only to get out of an argument or a crying spell or to schedule a session. This ended late-night calling. [source: Erskine 2013, p. 19]
5. Revisit the contract when the work moves to a new layer, such as regression or Parent work.
Example language (illustrative): "If our work goes well, what will be different for you in six months? How will you and I notice it?"
Watch for: The contract is set out as four questions in the source. Only one was available verbatim. [uncertain: the other three questions are not drawn on] Watch for contracts made from an over-adapted Child (to please you). Explore those before you agree to them. [synthesis]

4.2 Phenomenological inquiry

Purpose / when: This is the main method throughout. It helps the client discover their own affect, body sensations, fantasies, associations and meanings, which restores internal contact. Erskine describes using roughly 10–15 phenomenological inquiries for every 1–2 historical or transferential ones. [source: Erskine 2013, p. 20; Erskine & Moursund 2022, p. xix, ch. 6]
Steps:
1. Start from what the client has just said or shown, such as a word, a gesture or a change in breathing.
2. Ask open, respectful questions about present experience in each domain: sensation, emotion, image, thought, impulse.
3. Follow the answer down. Ask about its quality, where it is felt, and what it means to the client.
4. Weave statements and reflections in with the questions. Inquiry is not limited to questions. [source: Erskine & Moursund 2022, p. xix]
5. Keep your own hypotheses private. Let the client make the discovery.
Example language: Finlay (2016, p. 72) quotes these Erskine-style questions: "How are you experiencing this in your body?" and "What part of you is talking now?" (illustrative additions:) "As you say 'fine', what happens in your chest?" "What is that tightness like?"
Watch for: Inquiry turning into interrogation, which is a rapid run of questions without attunement. [source: Aguado Rodríguez 2021] It is working when the client slows down, notices more, and starts to inquire into themselves.

4.3 Historical inquiry

Purpose / when: Builds an inferential picture of early relational experience, including periods the client says they cannot remember. Use it sparingly, a few questions per session. [source: Erskine 2020, pp. 218, 223, 230]
Steps:
1. Link a present sensation or pattern to the question of when it was first familiar.
2. Ask about family atmosphere and parents' relationship. Where relevant, ask what the client knows of their conception, the pregnancy, early feeding and caregiving. [source: Erskine 2020, pp. 218, 223]
3. If the client has no memories, ask about family stories, photos, or how the body reacts.
4. Return to phenomenological inquiry after one or two historical questions.
Example language (illustrative): "When did you first know that feeling of having to be very quiet?"
Watch for: A flood of affect. If it comes, switch back to present-moment grounding (see 4.15).

4.4 Relational (transferential) inquiry

Purpose / when: Explores how the client experiences you and the relationship right now. It brings transference and relational needs into the room. Use it sparingly and in measured doses. [source: Erskine 2013, p. 20]
Steps:
1. Notice a shift in contact with you, such as averted eyes, compliance or irritation.
2. Ask how the client is experiencing you or your intervention.
3. Receive the answer without defending yourself. If you contributed to the shift, own it (4.13).
4. Later, and only if useful, explore whether the experience is familiar.
Example language: Erskine's examples (2013, p. 20) include "What is it like when I ask you about your feelings?" and "What do you experience inside when I look you in the eye?"
Watch for: Too much relational inquiry can feel intrusive to schizoid or avoidant clients. Track the client's tolerance. [synthesis]

4.5 Bifurcating questions

Purpose / when: Used when a client asks a loaded question, for example about the therapist or the future. Exploring both possible answers reveals disavowed affect and script beliefs. [source: Erskine 2013, pp. 24–25]
Steps:
1. Do not answer the question at once.
2. Invite the client to imagine the answer being "yes" and to notice the feeling, belief and body response.
3. Then do the same for "no".
4. Inquire into what each branch reveals about expectations of self and others.
Example language (illustrative): "Suppose I said yes, I do get tired of you. What happens inside? And if I said no?"
Watch for: The branch that produces the strongest reaction often points to a script belief.

4.6 Cognitive attunement

Purpose / when: Shows that you follow the client's logic and meaning, especially their way of making sense of experience. [source: O'Reilly-Knapp 2015; Bekier 2024, pp. 79–80]
Steps:
1. Track the client's reasoning, including how their conclusions were rational at the time they were formed.
2. Communicate that understanding in the client's own terms.
3. Check whether you have it right.
Example language (illustrative): "So if asking for help always led to being laughed at, it makes sense that you decided to work it out alone."
Watch for: The client correcting you. That is useful, and further inquiry follows.

4.7 Affective attunement (affect resonance)

Purpose / when: The therapist responds with the reciprocal affect that the client's emotion calls for. [source: Erskine 2015, p. 190 via O'Reilly-Knapp 2015]
Steps:
1. Sense the emotion beneath the words.
2. Respond with the complementary affect. Meet sadness with compassion and anger with being taken seriously. Meet fear with security and protection, and joy with shared pleasure.
3. Express this in tone, face and words, not only in content.
Example language (illustrative): For anger: "You are furious, and I take that seriously. Something wrong happened."
Watch for: Mirroring the same affect, for example answering fear with your own anxiety, instead of giving the reciprocal response.

4.8 Rhythmic attunement (pacing)

Purpose / when: Matches the client's tempo of processing, including long silences and slow retrieval of affect. This applies always, and especially with withdrawn or schizoid clients. [source: O'Reilly-Knapp 2015; Erskine 2013, p. 20; Aguado Rodríguez 2021]
Steps:
1. Slow your own speech and pauses to match the client's.
2. Allow silence. Inquire gently about it rather than filling it.
3. Use fewer words per turn as affect deepens.
Example language: Erskine asks how a client experiences his quietness (2013, p. 20). (illustrative:) "Take whatever time you need. I'm here."
Watch for: Speeding up when you feel uncomfortable. It is working when the client stays with an experience longer.

4.9 Developmental attunement and the developmental image

Purpose / when: Attunes to the age at which a feeling or reaction was formed, and responds as appropriate to that age. Use it when the client's expression seems younger than their years. [source: Erskine 2020, p. 215; Aguado Rodríguez 2021; O'Reilly-Knapp 2015]
Steps:
1. Silently form an image of the age the reaction seems to come from, such as an infant, a toddler or a young school-age child.
2. Adapt your voice, vocabulary and protection to that age while also speaking to the Adult.
3. Where useful, invite the client to imagine themselves at that age, for example being fed or playing with toys. [source: Erskine 2020, p. 230]
Example language (illustrative): "It sounds as if a very small part of you is frightened right now. What would a four-year-old need from me?"
Watch for: Being infantilising. Keep a working alliance with the Adult at the same time.

4.10 Attunement to the eight relational needs

Purpose / when: Identify which relational needs went unmet historically and which are emerging now in the room, then respond to them. [source: Žvelc et al. 2020, citing Erskine et al. 1999 and Erskine 2015; Bekier 2024] Labels vary between versions. Bekier lists "valuing" and "mutuality" where Žvelc lists validation and confirmation of personal experience.
The needs and the therapist's response (paraphrased):
1. Security: protection of physical and emotional vulnerability. Respond with consistent safety, predictability and protection.
2. Validation, affirmation and significance (valuing): respond by valuing the client's experience and the function of their inner processes.
3. Acceptance by a stable, dependable, protective other: be reliably stable. Allow idealisation as an expression of this need rather than interpreting it away.
4. Confirmation of personal experience (mutuality): let the client feel understood by someone who knows similar experience. Selective self-disclosure is sometimes used.
5. Self-definition: consistently support the client's difference, uniqueness and disagreement, including disagreement with you.
6. Making an impact: let yourself be visibly affected, and change your behaviour in response to the client.
7. Having the other initiate: sometimes take the lead. Reach out, offer direction, and remember and bring up what matters to the client.
8. Expressing love: receive gratitude, gifts of appreciation and affection without deflecting or interpreting.
Steps:
1. Notice which need is active, for example through repeated testing, clinging, idealisation, argument or gift-giving.
2. Respond to the need in the present relationship within ethical boundaries.
3. Where the need relates to the past, acknowledge, validate and normalise it. Then support the grief that the original need was not met.
Example language (illustrative): For self-definition: "You see it differently from me. I want to hear your view." For impact: "What you've just told me moves me."
Watch for: Trying to meet archaic needs in full. That is not possible and fosters dependency. [source: Žvelc et al. 2020] The relational needs list is described as not closed. [source: Bekier 2024]

4.11 Acknowledgment

Purpose / when: Shows that you see and hear the client's experience, including what is shown only non-verbally. Acknowledge interruptions to contact and how the client copes with relational disruption. [source: Bekier 2024, p. 80; Erskine 2013, pp. 20–21]
Steps: Name the observed affect, sensation or behaviour aloud, without interpreting it. Pause for the client's response.
Example language (illustrative): "Your voice dropped as you said her name."
Watch for: The client feeling exposed. If so, slow down and ask how it was to be noticed.

4.12 Validation and normalization

Purpose / when: Validation links the client's feelings, behaviour or symptoms to their personal experience, so the reaction becomes understandable. Normalization reframes it as a normal response to abnormal circumstances rather than as pathology, which reduces shame and self-criticism. [source: Bekier 2024, pp. 80–81]
Steps:
1. Identify the reaction the client judges in themselves.
2. Link it to the circumstances that made it necessary (validation).
3. State that most people would react similarly in such circumstances (normalization).
Example language (illustrative): "Of course you froze. With no one coming, freezing was the safest thing you could do. Many children in that spot do exactly that."
Watch for: Normalizing too early can sound dismissive. Validate the specific experience before you generalize.

4.13 Presence and taking responsibility for therapist errors

Purpose / when: Presence means you stay in full contact with your own inner experience while remaining responsive to the client, providing security and remaining alongside. Taking responsibility for errors includes misattunements, inconsistencies and missed sessions. [source: Bekier 2024, p. 81; Erskine 2013, p. 21; Erskine 2020, p. 220; O'Reilly-Knapp 2015 (ch. 9: therapist's responsibility for errors)]
Steps for an error:
1. Inquire into the client's experience of your error.
2. Acknowledge your part plainly, without over-apologising or explaining it away.
3. Ask about the impact on the client.
4. Only later explore the earlier experiences the error echoed.
Example language (illustrative): "I moved on too quickly just now, and I think you felt dropped. That was my mistake. What was that like?" Erskine's own phrase in a case is "It is my pleasure to be here for you" (2013, p. 26).
Watch for: Defensiveness in yourself. Repair is working when the client can bring up the next disappointment more directly.

4.14 Therapist introspection and use of countertransference

Purpose / when: Use this throughout, especially with aggressive transference or strong pulls in yourself. [source: Erskine 2013, p. 25; O'Reilly-Knapp 2012, p. 39]
Steps:
1. Privately ask what the client's material is stirring in you.
2. Distinguish responsive countertransference (care, protectiveness), which can guide involvement, from reactive countertransference (dislike, irritation), which you need to process outside the session or in supervision.
3. Turn the insight into a better-aimed inquiry. Do not use it as a disclosure by default.
Example language: Internal only.
Watch for: Acting reactive countertransference out as confrontation or withdrawal.

4.15 Returning to Adult contact (grounding and de-roling)

Purpose / when: Use this at the end of any regression, chair work or Parent work, and whenever affect overwhelms the client. Zaletel et al. (2012, p. 39) state that returning the client to the Adult is essential even if earlier phases were skipped. They report that omitting it can cause ruptures, headaches and disorientation. The general grounding steps below are my synthesis.
Steps:
1. Ask the client to return to their own chair if they moved.
2. Invite orientation to the present: today's date, the room, their age now, their feet on the floor. [synthesis]
3. Ask what they experienced and what they take from it.
4. Discuss how they will use the insight before the next session.
Example language (illustrative): "Come back to your own chair. Look around the room. How old are you now? What stands out from what just happened?"
Watch for: Spontaneous shifts into other ego states after the work. These need processing before the client leaves. [source: Zaletel et al. 2012, p. 39]

4.16 Script system analysis (mapping)

Purpose / when: Builds a shared map of the client's self-reinforcing, unconscious relational pattern. It is derived from Erskine & Zalcman's racket system. Use it in phase A and C, and whenever a pattern repeats. [source: Bekier 2024, p. 78; O'Reilly-Knapp 2012, p. 37; IFP NYU abstract of Erskine's script system article]
The four components:
1. Script beliefs about self, others and the quality of life, together with the original script decisions. Behind them lie the repressed needs and feelings present when the decision was made (the intrapsychic process).
2. Script displays: observable behaviours, reported internal experiences including physiological ones, and fantasies.
3. Reinforcing experiences (memories): selected old emotional memories and current events that seem to confirm the beliefs.
4. The loop: the components feed one another in a closed system.
Steps:
1. Start from a recent concrete incident.
2. Use phenomenological inquiry to gather what the client did, felt in the body, imagined and told themselves.
3. Ask what the incident proved about them, about others and about life. These are the script beliefs.
4. Ask when they felt that way before. This gives the reinforcing memories.
5. Inquire into the need or feeling that could not be expressed at the time.
6. Draw the loop together with the client.
Example language (illustrative): "When he didn't call back, what did that tell you about yourself? About people? About how life goes?"
Watch for: Using the map only intellectually. It works when the client can catch a display or belief as it happens.

4.17 Intervening at each script system component

Purpose / when: Interrupts the loop at whichever point is accessible. Life script cure requires developmentally focused relational psychotherapy that integrates all four domains. [source: Erskine 2015, p. 79 via O'Reilly-Knapp 2015; Bekier 2024] The detailed component-by-component intervention text in Erskine's script-system chapter is not drawn on. [uncertain] The list below is a reconstruction.
Steps (reconstruction):
1. Script beliefs: explore them through inquiry and bifurcating questions (4.5), and test them in experiments (4.18). [synthesis]
2. Repressed needs and feelings: use attunement, regression (4.19) and grief work (4.25) to bring the disavowed affect and need into contact.
3. Script displays: track the behaviour, body tension and fantasy moment to moment, and support the client to try alternative behaviour. [source: O'Reilly-Knapp 2012, p. 36, on support for behavioural change]
4. Reinforcing memories: re-examine selected memories in the light of the newly contacted need. Notice disconfirming current events. [synthesis]
5. Function: ask what the pattern protects against, using Erskine's six functions of scripts: self-regulation, compensation for unmet needs, self-protection, orientation of self to others, insurance against loss of relationship, and maintaining integrity. [source: Erskine 2015, ch. 8 via O'Reilly-Knapp 2015]
Example language (illustrative): "If you stopped believing you're too much for people, what would you be afraid might happen?"
Watch for: Removing a script display before its protective function is understood. This raises anxiety.

4.18 Experiments and enactments (Gestalt-derived, including empty chair)

Purpose / when: Lets the client test script beliefs and try new responses within the safety of the relationship. Erskine & Moursund note that almost all therapeutic engagements involve experiments and enactments. [source: Erskine & Moursund 2022, p. xx, ch. 9, p. 176; O'Reilly-Knapp 2015 (empty chair in grief work)]
Steps:
1. Propose the experiment and get the client's agreement to it.
2. Set it up concretely. Examples: saying a sentence aloud, standing up, addressing an empty chair, exaggerating a gesture.
3. Ask the client to notice body, feelings and beliefs while doing it.
4. Inquire afterwards what was discovered.
5. Return to Adult contact (4.15).
Example language (illustrative): "Would you try saying to me, 'I need you to wait for me'? Just notice what happens as you say it."
Watch for: Experiments done to comply with you. Ask about the client's experience of being asked.

4.19 Inference, re-experiencing and therapeutic regression (Child ego state work)

Purpose / when: Deconfuses Child ego states. Phenomenological and historical inquiry into body sensation and affect builds an inferential profile of early emotional experience. When the client briefly regresses, the therapist supports therapeutic re-experiencing of that age within an attuned relationship. Erskine et al. distinguish this from reliving, which can retraumatise. Erskine also notes that therapists must respond to brief age-regression expressions as they arise. [source: Erskine, Mauriz-Etxabe & Pérez Burgos 2020 abstract; Erskine 2020, p. 215; Erskine & Moursund 2022, p. xx, ch. 9, p. 179]
Steps (reconstruction; full procedure text not drawn on [uncertain]):
1. Contract explicitly for deeper regressive work and agree a stop signal. Stop signals are documented for Parent work; extending them to regression is my synthesis. [synthesis]
2. Through phenomenological inquiry into a body sensation or affect, invite the client to notice what age it feels like.
3. Speak to the younger self in age-appropriate language (4.9) while staying in contact with the Adult.
4. Inquire into what is happening, what is needed and what was missing.
5. Provide the attuned response that was absent, such as protection, validation or being taken seriously, and support expression of the disavowed affect.
6. Return to Adult contact (4.15) and integrate the experience into a narrative (4.20).
Example language (illustrative): "Stay with that feeling in your stomach. How old do you feel? ... What's happening around you? ... What do you need right now?"
Watch for: Signs of reliving rather than re-experiencing. These include loss of contact with you, dissociation, inability to hear your voice, and escalating panic. Respond by reducing intensity at once, orienting to the present and resuming contact. [synthesis based on the source distinction] Contraindications include no secure alliance, active crisis, and poor capacity to return to the Adult. [synthesis]

4.20 Narrative building

Purpose / when: Assembles fragments into a coherent therapeutic narrative. These fragments include somatic responses, family stories, fantasies and inferred early experience. Use it when there is little explicit memory, and after regressive or body work. Erskine compares it to connecting numbered dots. Erskine (2015) also aims to build a verbal narrative that reflects the body's story. [source: Erskine 2020, p. 218; Erskine 2015, p. 319 via O'Reilly-Knapp 2015]
Steps:
1. Collect the fragments over sessions.
2. Offer tentative links between them.
3. Invite the client to correct and own the story.
Example language (illustrative): "Your body's constant bracing, the story of the move when you were two, and how you brace with me ... could these belong together?"
Watch for: Presenting inferences as fact. Keep them provisional and owned by the client.

4.21 Identifying the introject: Parent vs self-generated Parent

Purpose / when: Before Parent work, determine whether an inner critical voice is an introjected historical parent or a self-generated, fantasy Parent (internal saboteur). A self-generated Parent is often harsher than the real one. Erskine uses behavioural, social, historical and phenomenological criteria for diagnosis. [source: Zaletel et al. 2012, pp. 17–20; Erskine 2015, ch. 16 via O'Reilly-Knapp 2015]
Steps:
1. Use historical and phenomenological inquiry into the parents, the script and the self-criticism.
2. Ask the client to give the critical voice words, speaking aloud to the child self. Prompt the voice to continue so that its tone and origin show. Erskine's transcript prompt is "Keep going, voice." [source: Zaletel et al. 2012, p. 19]
3. Ask whose voice, tone and phrases these are.
Watch for: Proceeding with Parent therapy if the voice is self-generated. That needs Child work instead. [inferred from source]

4.22 Parent ego state therapy (Parent interview leading to Parent therapy)

Purpose / when: Resolves intrapsychic conflict with an introjected parent who influences the client from within. Examples are chronic self-doubt, anxiety, depression or a critical inner voice. Use it only after the Child work and once the alliance is solid. [source: Zaletel et al. 2012, pp. 15–39; Finlay 2016, p. 75; Erskine 2013, p. 24]
Steps (the Erskine–Trautmann method as summarised by Zaletel et al.):
1. Agreement. Explain the method. The client will become the parent, and you will speak to that parent, not to the client. This differs from empty-chair work. Reassure a loyal Child that the work can benefit both. Agree a stop signal.
2. Stepping in. The client takes the parent's posture and expression, and you address them by the parent's name. Deepen contact, because clients step out early or at painful moments.
3. Alliance with the Parent. Tell the Parent the purpose of the work. Suspend everyday reality and engage the Parent fully at a slow pace, in interview style. If the Parent refuses after a reasoned explanation of how this helps the child, stop.
4. Therapy for the Parent. Ask many phenomenological questions. Validate the Parent and do not confront or interpret yet. Explore the Parent's own family of origin, painful memories and life stages (school, first job, marriage, the children's births) to locate the Parent's own script decisions, and normalise them. Encourage the forbidden feelings and explore the Parent's unmet relational needs.
5. The Parent–Child relationship. Now move to protecting the Child by balancing validation with confrontation. Ask how the Parent experienced the child, what the child was like, and what the Parent expected. Confront harmful behaviour and invite responsibility. Slow down and validate when resistance appears. Help the Parent identify the child's unmet needs. Invite regret and amends. If the Parent cannot change, give a cognitive explanation of the child's position.
6. Parent to Child empty chair. Ask the Parent to imagine the child in front of them and speak honestly. This covers the Parent's own history, the messages they gave, and ambivalence such as envy or anger. It moves to apology, a wish for the child's future and permission to change the script decision. The therapist can become more directive, for example with sentence stems, as long as the content comes from the Parent. Verbatim prompts include "Tell her the truth." [source: Zaletel et al. 2012, pp. 31–32]
7. Closing the Parent. Ask the Parent's consent to stop and thank them. Invite any final words. Say you will now talk to the Child and ask the Parent not to interfere.
8. Continue straight into 4.23, then 4.15.
Example language (illustrative): "Mrs. Green, thank you for being here. I'd like to understand you. What was it like for you when your daughter was born?"
Watch for: Weakening the Parent before the Child has support. This can increase clinging to the Parent. [source: Zaletel et al. 2012, pp. 16–17] It is working when the introject softens, the Parent shows empathy for the child, and the client's later self-talk changes.

4.23 Child–Parent dialogue, new decision and predictive envisioning

Purpose / when: Completes Parent work by reconnecting with the Child. The Child may feel abandoned when the therapist sympathised with the Parent. This step meets the Child's needs for self-definition and impact. [source: Zaletel et al. 2012, pp. 34–38]
Steps:
1. The client changes chairs and speaks as themselves to the Parent.
2. Focus on the client's own feelings, not the Parent's.
3. Help them first acknowledge what was positive in the Parent. This reduces guilt and honours loyalty.
4. Then the client states what was unwanted and what they needed, refuses responsibility for the Parent, and hands back the burden.
5. Support a new decision.
6. Optionally, invite predictive envisioning: picturing where the old and the new decision lead over 5, 10, 25 or 50 years. [source: Zaletel et al. 2012, p. 37, citing Erskine 1974]
7. If the Child shuts down under attack from the Parent, reconnect with the Parent and secure the Child before going on.
Example language (illustrative): "Tell her what you needed from her then ... and what you're no longer willing to carry."
Watch for: A redecision made under pressure from you. It should arise from the client's felt experience.

4.24 Working with shame and self-righteousness

Purpose / when: Erskine treats both as protections. Shame protects a hoped-for relationship. Self-righteousness denies the need for relationship. In a published case he addressed shame, fear of ridicule and self-regulation before working with the critical introjected mother. [source: Erskine 2015, ch. 11 via O'Reilly-Knapp 2015; Erskine 2013, p. 24]
Steps (reconstruction):
1. Acknowledge the shame non-verbally first, with a soft voice and without pressing for eye contact. [synthesis]
2. Inquire into what the shame protects: the longing to be accepted.
3. Validate and normalise the original humiliating context.
4. With self-righteousness, inquire into the disappointment and need that lie beneath it rather than confronting the stance.
Example language (illustrative): "Part of you hoped that if you were good enough, they'd finally want you close."
Watch for: Your inquiry being experienced as exposure. Shame deepens if you are not pacing.

4.25 Grief work: truth-telling and unfinished business

Purpose / when: Use this when losses, death, divorce or unmet developmental needs are being mourned. The aim is to restore the client's capacity for an honest, meaningful hello. [source: Erskine 2015, ch. 18, p. 313 via O'Reilly-Knapp 2015; Žvelc et al. 2020]
Steps:
1. Invite truth-telling about the relationship: what was good, what hurt, what was never said.
2. Use empty-chair dialogue to complete unfinished business with the lost person.
3. Facilitate disavowed feelings such as anger at the dead and relief.
4. Close with a goodbye and with what the client takes forward.
Example language (illustrative): "Tell him what you never got to say, including the parts you've kept hidden even from yourself."
Watch for: Idealisation blocking the truth, and complicated grief that needs longer support.

4.26 Body-oriented methods

Purpose / when: Bring the body's story into awareness and words. Erskine describes body-oriented methods without touch and gives guidelines for healing touch within relational psychotherapy. Therapeutically supported physiological movement is used alongside regression and affect expression. [source: Erskine 2015, ch. 19 via O'Reilly-Knapp 2015; Erskine & Moursund 2022, p. xx] The detailed procedures and touch guidelines are not drawn on. [uncertain]
Steps (non-touch):
1. Invite the client to stay with a body sensation and the affect emerging from it. [source: O'Reilly-Knapp 2012, p. 36]
2. Inquire into posture, breath and impulses to move.
3. Support completion of a movement that was blocked (for example pushing away or reaching) as an experiment (4.18). [synthesis]
4. Put the experience into words (4.20).
Example language (illustrative): "Your hands are pressing into your knees. If they could do what they want, what would they do?"
Watch for: Touch is not part of standard practice without specific training, explicit consent and your professional code's permission. Do not use touch on the basis of this guide. [synthesis]

4.27 Managing juxtaposition reactions

Purpose / when: Use this when warmth or attunement is followed by withdrawal, anger or rejection of the therapist. The contrast between present care and past deprivation brings back the pain of what was missing. [source: Bekier 2024, pp. 81–82; Finlay 2016, p. 79, citing Moursund & Erskine 2004; Aguado Rodríguez 2021]
Steps:
1. Recognise the pattern: closeness, then distancing or attack.
2. Reduce the intensity of involvement for a while.
3. Acknowledge the contrast gently.
4. Validate the grief or anger about what was not given.
Example language (illustrative): "When I'm attentive, it may remind you of how little of that there was. That can hurt more than distance does."
Watch for: Mistaking this reaction for a rupture you caused. It may still need repair (4.13).

4.28 Termination

Purpose / when: Erskine & Moursund devote a chapter to ending therapy. [source: Erskine & Moursund 2022, ch. 11] The chapter's text is not drawn on. [uncertain] The steps below are my synthesis.
Steps (synthesis):
1. Review progress against the original contract criteria.
2. Name and grieve the ending as a real relational loss.
3. Invite truth-telling about the therapy, including disappointments.
4. Receive appreciation, which meets the need to express love.
5. Agree what a return to therapy would look like.
Example language (illustrative): "What have we done together that matters to you, and what do you wish we had done differently?"
Watch for: Old script displays reappearing as the ending approaches. Treat them as material, not as failure.

5. Handling problems

[source tags per item; anything not in the sources is marked [synthesis]]

Stuck client, or intellectual talk without affect.
- Shift from content to phenomenological inquiry about the present moment, especially the body. [source: Erskine 2013, p. 20]
- Ask about the function of staying in the head (4.17). [synthesis]
- Try a small experiment (4.18).
- Check whether you have been asking too many historical questions.
Resistance.
- Treat resistance as a protective function and as a sign that the work is close to the script. Slow down and validate. Do not confront. [source: Zaletel et al. 2012, pp. 22, 28; Erskine 2013, p. 21]
- In Parent work, if the Parent refuses after a reasoned explanation, stop. [source: Zaletel et al. 2012, p. 22]
Overwhelm, flooding or reliving during regression.
- Lower intensity at once. Orient the client to the present and to you, and return them to the Adult (4.15). [source: Erskine, Mauriz-Etxabe & Pérez Burgos 2020; Zaletel et al. 2012, p. 39]
- Rebuild stabilisation and self-regulation before further regressive work. [source: O'Reilly-Knapp 2012, p. 36]
- Consider a screen for dissociative disorders before regressive methods. [synthesis]
Juxtaposition reaction (withdrawal after closeness). See 4.27. Treat it as a pacing signal, not as rejection. [source: Bekier 2024]
Ruptures, and accusations that you are "not attuned" or doing the wrong therapy.
- Stay present. Inquire about the client's experience of you, own your part, and only later explore the historical echo. [source: O'Reilly-Knapp 2012, p. 39; Erskine 2020, p. 220]
- Treat negative transference as an unconscious call for help. [source: Erskine 2013, p. 21]
Aggressive transference and your reactive countertransference.
- Separate responsive from reactive countertransference and take the reactive part to supervision.
- Secure the working alliance before confronting the client's harmful behaviour towards others. [source: O'Reilly-Knapp 2012, p. 39]
Non-adherence: missed sessions, ignored contracts, late-night contact.
- Renegotiate the contract explicitly. Example: limit phone contact to brief, defined purposes. Erskine reports that this ended late-night calls in one case. [source: Erskine 2013, p. 19]
- Explore what the missed session means relationally. [synthesis]
- Integrative TA uses few homework assignments. Where you set behavioural tasks, agree them through the contract. [synthesis; uncertain]
Breaks and holidays. Discuss a long break well in advance, and explore what the absence means to the client. [source: Erskine 2013, p. 23]
Dependency and wishes for re-parenting.
- Respond to present relational needs within boundaries.
- Do not promise to make up for what was missing in childhood. Help the client grieve what can no longer be had. [source: Žvelc et al. 2020]
Loyalty conflicts in Parent work. Reassure the client that the work also helps the Parent. Affirm the Parent's positives before the Child sets boundaries. [source: Zaletel et al. 2012, pp. 20, 36]
The Child collapses during Parent work. Reconnect with the Parent, secure the Child, and give strong therapist support. [source: Zaletel et al. 2012, pp. 30, 38]
Headaches, disorientation or ego-state shifts after a session. These are often caused by skipping the return to the Adult. Process them before the client leaves. [source: Zaletel et al. 2012, p. 39]
Interpretation backfires ("you're telling me what I feel"). Return to inquiry and let the client discover the meaning for themselves. [source: Erskine 2013, p. 22]
Silence or schizoid withdrawal.
- Use rhythmic attunement. Inquire gently about the experience of your quietness and theirs.
- Do not fill the space, and expect a slow, fear-laden emergence of the self. [source: Erskine 2013, p. 20; Erskine 2015, ch. 12 via O'Reilly-Knapp 2015]
Risk, crisis and self-harm.
- Postpone deep regressive and Parent work.
- Do a standard structured risk assessment and safety planning, including lethal-means counselling (safe storage and removal), and set up crisis contacts.
- Increase session frequency or involve psychiatric care as needed. [synthesis; not addressed in the sources]
Your own limits.
- Regression, Parent ego state therapy and body work need specific training and supervision. Learn them in an Integrative Psychotherapy or TA training before using them with high-risk clients. [synthesis]

Sources

Sources: