Communication Skills for Nurses
Developed by students, for students Clear, straightforward, and jargon-free Explains how to use your interpersonal skills effectively, communicate with patients with specific conditions, and handle both criticisms and compliments Features tips and advice from real life nursing students Examples and questions based on real life nursing and healthcare situations
Communication Skills for Nurses
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By the end of this chapter you will be able to understand how the way in which we present ourselves can influence our relationships.
Transactional analysis (or TA) was first developed by the psychiatrist Eric Berne in the late 1950s. Berne believed that our state of mind affects what happens when we interact with other people. The TA model helps to explain how people function and express their personality in their behaviour. It aims to find out what state of mind or 'ego' state started the communication process, which one responded and how this affects the relationship of the two people involved. The aim is to allow the adult ego to take control over the parent or child ego.
Berne (1964) described this state of mind as:
a system of feelings accompanied by a related set of behaviour patterns.
He showed us that our personalities have three different ego states. We all use these states when changing our behaviour in our communication with others. His starting point was that when two people encounter each other, one of them will speak to the other. He called this the transaction stimulus . The reaction from the other person he called the transaction response . The person sending the stimulus is the agent and the person who responds is the respondent . Figure 2.1 shows the transaction stimulus in action.
Figure 2.1 Transaction stimulus. The person on the left (agent) sends a stimulus to the person on the right. The person on the right responds (respondent). Adapted from Berne (1964). Images from
An integrative approach to the theory of psychology and psychotherapy.
THE EGO STATE
According to the TA model, there are three ego states that people use consistently:
P = parent,
A = adult,
C = child.
Transactional analysis became the method of examining the type of transaction that can be characterised by 'I do something for you, and you do something back'. Each ego state has particular verbal and non-verbal characteristics, which can be observed if you watch people. Figure 2.2 shows the three ego states.
Figure 2.2 The three ego states of transactional analysis. The person on the left interacts with the person on the right. Adapted from Berne (1964). Images from
Harris (1973) described the parent ego state as being rather like a tape recorder, in that we were conditioned by our parents or teachers, and older people. This state can be changed but it is not easy. A parent state can be caring or nurturing, such as with the reassurance that 'everything will be okay'. Or it can be judgemental and authoritarian, with the use of phrases and attitudes such as 'under no circumstances...', 'always...' and 'never forget...'. This could also include 'you will have to wait now until the end'. The parent state may use angry or impatient body language and expressions or finger-pointing gestures.
Our internal reactions and feelings to external events form the child ego state. These are the seeing, hearing, feeling and emotional responses within each of us.
The state has two sides, as follows.
Negative : when anger or frustration dominates reason, the child is in control. The child state has a sad expression or has temper tantrums. People in this state may say things like 'I want...', 'I don't care' or 'it's the worst day of my life!'