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Open Wednesdays From Week Commencing 9th July 2018
Bridges of the Psyche
Look after yourself

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My Blog

Open Wednesdays From Week Commencing 9th July 2018

Welcome to my blog page!!

I have been working Mondays, Tuesday and Thursdays since I moved into my St Andrews office at the end of last year.

Recently new and existing clients have been asking if I had mid week appointments which would work well for them and having given this some thought decided this new arrangement would work well for me too!

Appointments on Monday, Tuesdays and Wednesdays start at 10 am and I usually finish my last appointment at 6.30pm. Each appointment is 60 minutes.

The St Andrews Counselling and Psychotherapy practice premises is situated in 14 A Woodburn Terrace, just off Lamond Drive and St Mary's so you can access the practice from either road. Parking is on road and there's usually plenty of space. Being just off the bus route means we are accessible from public transport and are just a 10 minute walk from the centre of St Andrews.

If you would like to talk about booking an appointment with me then please phone 07824700980, if I don't answer then please leave a voicemail message and I will return your call as soon as I can.

Or do email me on [email protected] I will reply to your email as soon as I can.

I do like to have a quick chat with you when booking your first appointment, this is to answer any questions you might have and for me to ask you a few things which will help me to find out if I am the right person for you. It's also an opportunity for us to get to know one another before we meet and for me to let you know a little bit about how I work.

Once we decide to work together we can then plan your first appointment, usually within 7-10 days and I can send you more detailed information about how I work, my business terms and conditions, confidentiality policy, information sharing policy and ethical framework for my practice. I also like to send a leaflet about the type of therapy I use which is Transactional Analysis.

Is there anything else you'd like to know? Please get in touch. I look forward to hearing from you.



Bridges of the Psyche

I was in Port Edgar earlier today, between the 2 road bridges, watching the Forth flow past, onwards under the rail bridge.
The view is iconic and the photo (Courtesy of the Guardian) catches the scale and drama astride the River Forth. Two of the bridges are for road and one for rail traffic, the county of Fife and city of Edinburgh see a daily flow of thousands of people and vehicles. Both places need this arterial connection of bridges for daily life, commuting, work, travel and leisure.
It occurred to me as a metaphor for the 3 ego states, Parent, Adult and Child and how we need all 3 to function effectively. When I look at the river I see how the unconscious ripples in waves, sometimes calm and then stormy and tempestuous and how the energy flows between the bridges and ego states. The Ego States can be activated and busy in the same way as when the traffic and trains are working at peak times or shut down and deactivated when there are faults on the line or when an accident or repairs are required.
Boats of many kinds and sizes bob and sail up and down the river, buoyed along by the tides, currents and winds, tacking and turning to make headway. I began to think about the boats as our thoughts, feelings and behaviours which ebb and flow, sometimes pushed along by the currents and breezes which weave between the bridges and how our attention can focus on a particular craft whilst others fade into the background, still there but unnoticed.
I then thought about how the nautical charts and maps out the safe course for marine vessels and makes clear where the hazards lie, such as sandbanks and wrecks, strong dangerous currents and jagged rocks on which the vessels can founder. The analogy fits the role of the therapist and how the work we do, brings all these factors together in a 3 dimensional view, to spot where the difficulties are to steer a safe and successful course through the journey towards the destination, together.
The 3 bridges need regular checks and maintenance to keep them safe and working well, the Forth Road Bridge was closed for several months, inactive whilst traffic started to use the new Queensferry crossing.
The metaphor might be understood as the Forth Road bridge as the Adult ego state, quiet and underused, the Rail bridge as the Parent and the Queensferry crossing as the Child ego states. The Parent dominating the landscape, powerful and imposing. The Queensferry crossing, busy and bustling, getting attention when there's and accident or incident, stopping traffic!The Adult under repair and strengthened and open for business, each bridge and each ego state making their contribution in smooth functioning and well being.

Look after yourself

I can't recall where I saw this but it was along the lines of "self-care doesn't mean scented candles".Maybe that's where we go when we think about "treating ourselves". However, looking after ourselves requires us to look after our most basic of needs.

Attending to our very basic needs when depressed or anxious can seem overwhelming.
By basic needs I mean, enough sleep and rest, nutrition and fluids, personal hygiene and physiological homoeostasis (bodily functions).

Maslow's Hierarchy of Needs (diagram on the left) illustrates how we need to have our basic physiological needs attended to before we can move up to the next level (Safety).

I have found that often these needs are neglected when anxious or depressed and stressed clients come to therapy. People come to see me with issues such as Love/Belonging and Esteem levels further up the Hierarchy of Needs

Good enough self-care starts with sleep hygiene, setting regular times to go to bed and get up, even at the weekends! Keeping your bedroom cool and dark and only using your bedroom for sleeping. Having a warm bath or shower before bed to help your body produce sleep hormones and avoiding caffeine and alcohol in the afternoon and evenings. Exercise is helpful but not 3/4 hours before bedtime and avoiding the use of blue screens on phones, laptops or tablets.Breathing techniques can also help, both for initiating sleep but also a useful technique to cope with anxiety/overthinking:

Breathing in through your nose until you feel your lungs full, don't force this and then open you mouth and breathe out fully. Follow this link for a helpful graphic.

Sleep is vital for our physical and mental health and well being, it's so much more difficult coping day to day with low mood or anxiety when tired.

Looking after yourself can also include counselling or talking therapies to attend to these very basic needs and then to work on Safety, Love and Belonging and Esteem.

Take care of yourself!!!!


Well, I've been in my new office for a couple of months now and in the beginning I felt slightly out of place. I don't think I had factored in to moving premises, after several years working from my office at home, the impact this would have on me. To start with I thought I had made a mistake, this move felt wrong in some way, I felt a loss of comfy cosiness and familiarity. Moving involved a geographical relocation but also a psychological moving on and I guess I hadn't accounted for this.

At best I would liken this to starting a new job, getting used to driving here, a new routine, finding a place for things and then finding them again!

Having the furniture in different places, changing locations has more to it than I had imagined and had taken for granted.

Then there was my clients who had got used to coming to my office at home, they had to relocate and find me for the first time, where to park, how to let  me know they were there, could they come right in or use the waiting room first? Where would they sit? How would they be somewhere else?

To begin with the newness felt awkward and clunky, did I belong here?

I connected with my past and my childhood of moving every 2 or less years around the world and having to settle in and find my place there, of feeling out of place and not belonging. To get to know a new location, people, settings and routine and how hard this was for me as a child, to get settled only to be uprooted and move again. This was the familiar feeling of loss, and one I know my clients feel, of being "out of place", grief and bereavement, loss of relationship, loss of a sense of self and place in the world.

Yes I had underestimated the power of moving and being moved and the loss of the familiar and change in routine. This has helped my reflect on what has happened to me and how this connected me to my past and the importance to account for this when being in the present and considering the future. 


I have lately been reflecting on my new office and consulting space. 

Work starts soon, in the next couple of weeks, and I have been thinking of this new beginning as a metaphor. The office, as it is, is empty, run down, shabby and needing major upheaval to change. The effort to change into something else is considerable. Just putting a quick coat of paint, new blinds and carpets will simply not be enough. The fundamental shift required to change from a hairdressers shop (where we are)into a safe, secure, comfortable and therapy space (where we want to be) requires planning, expense and investment of time and money.

And so it is for those who recognise their lives have become mundane, banal and empty and have tried to make changes, to put a surface coat of normality and functioning but its' really not worked. they become stuck, not sure where to start with their life renovation and recognise they need some support in this project planning " to put a new show on the road" (Berne).

I might liken the process of therapy to the client as the existing office, absolutely OK in their essence and recognising a deep sense of unease as to how they feel or function in their own skin. They can continue to operate as a run down shop or hairdressing establishment, not really getting anywhere or undergo a refurbishment which entails considerable commitment and motivation. As with any change it's not easy. The therapist could be seen as the architect of change"What is it you want to do here?", what needs to be done first, and then next? The therapist offers the client their training and expertise in turning the client's "building" into somewhere soothing and settled, somewhere to be themselves, to find what they need.
The metamorphosis of the caterpillar into the butterfly takes time, energy and enormous reorganisation of their internal world. The metamorphosis of the individual in therapy is no less profound.

I will keep you posted on how the office metamorphosis goes!Work in progress!! here's the before photos.

Being Busy

I have been reflecting recently about how client's have been presenting with what seems to be surface issues such as a general feeling of unhappiness or dissatisfaction with relationships.
Scratch the surface and under this veneer lies stuff that's been hanging around for years going back to early childhood or even infancy.
Client's manage these feelings into adulthood by filling time with being busy, working hard, achieving high grades at school, getting a good degree, high achievers at work, being the brightest and best at what they do. 
Often they are the envy of their friends, appearing to "Have it all", and yet............
They come to see me feeling depressed and anxious, lacking joy and happiness realising these feelings have been dogging them for years. They have tried pushing these feelings down "maybe if I work harder, achieve more I will feel better?" as if working harder, longer will make these feelings disappear.
Sometimes client's will "self-medicate" with drugs, alcohol, food, shopping, tobacco, gambling, sex and overworking to "fill a hole in their soul".
They sort of know something is wrong or there's something wrong with me? Why aren't I happy? From all appearances and the outside world I have everything, but inside I feel worthless, empty.
Something happens that slows things down or speeds this up; the breakdown of a relationship, a partner leaves, someone close dies suddenly or diagnosed with a terminal illness, work becomes too much with work-related stress, they can't sleep or function anymore and thoughts of suicide emerge. The client visits his GP and is diagnosed with anxiety and depression and given medication. They think "I must be weak" something else to chastise themselves over!
Perhaps someone close to them suggests they see a counsellor "What me?" "I just need to pull myself together""talk to a stranger!!". They think about this suggestion and do a quick Google search to see who what where there are counsellors nearby or maybe further away from home. They find me on myVistaprint website, Counselling Directory, Adwords or NaturalTherapyForAll. 
Clients often comment on the warmth of my photo and the content of what I write strikes a chord with them.
This is a fairly typical case study of clients who come to see me.
So what do I do? First and foremost I listen and hear about how they have been feeling and thinking and find out about their lives, struggles and achievements, what has made them the person they are today. What happened to them over the years and how did they decide to be the person they are today?
We then make a plan together for the work ahead... sound OK to you?

Moving and Transitions

It occurs to me that there are times in all our lives when we are moving on whether in our relationships, careers or making/ changing decisions. 
During this time of change we may make big or little steps in the transition as we change from one way of being to another.
Perhaps most of the time we don't consciously notice or even reflect on these important milestones in our lives. We may respond unconsciously to a feeling of restlessness or dissatisfaction or an urge to get away and so miss an opportunity to recognise a old familiar feeling or pattern in our lives.
I have had cause to think about these issues recently. I have felt comfortable and settled in how and when I work but have experienced feelings of stress and tension about continuing to work this way. I work with The Women's Rape and Sexual Abuse centre in Dundee which I have been since 2009, and started student counselling with the local university last year as well as in my own private practice.
An opportunity surfaced to look at renting an office space in St Andrews which got me thinking and when the office came up for sale I begin to consider that there may be more options open to me than I first thought.
Well, here I am now, with support from my family, to buy the office and focus my private practice,which has been fairly remote and rural, to being part of the town of St Andrews.
This has meant making important decisions about how I want to work now.
I have taking time to reflect, speak to peers, colleagues, family, friends and my close TA buddies. I could continue to keep everything going, to make sure all the plates keep spinning or I could do something very different, to make a move out of script.
So.... here goes....I have spoken to WRASAC and the University and given them notice of my moving on, which i do feel sad about.
I am going to work in my new office space in St Andrews as from late summer, early autumn, depending on the progress of the renovation work. I plan to be there 3 days a week, which will give me structure for my week and also increase access to therapy for local people. Here it is, the "before photo"!!
My new place is in a quiet residential area of St Andrews with a lovely park behind the building. The office has a main consulting room, a waiting area, toilet and a small kitchenette. The front window will be changed to be opaque and there will be a small discrete plaque on the door saying "St Andrews Counselling & Psychotherapy". There is on road parking.
What do you think about my new venture? Will you come and see me here?
Watch this space for the "after photo"!!!!

Contact me to talk about counselling; This is how it works.

Over the years I have found people contact me via various means to book a counselling appointment. Often there's a new email in my business inbox, as I have a separate account for counselling clients to make the initial contact. Sometimes the email is brief asking for an appointment or lengthy telling me all about what they are going through and how tough this is right now. Either way of getting in touch is OK with me.
I must admit I am excited when I see a new email, text or voicemail from a prospective client. I try and reply as soon as I can as I realise it's taken a great leap of faith to get in touch with me. I understand how much courage it has taken someone to summon up to pick up their phone and make the call. So an email or text makes this first step a little easier.
I do like to reply as quickly as I can by the same way of contact to thank clients and to set up a phone call.
I find client's like to hear my voice, they may have seen my photo and decided I look OK, and I find this first contact is really important for both of us for a number of reasons;
  • How do we both sound to each other?
  • Do we both feel we could work together?
  • Do we feel we both have an idea about what the problem might be?
  • Are we listening to one another?
  • Can you travel to where I work?
  • In answering your questions is there a rapport between us?
  • Is the business contract between us workable?
  • Do you have an idea about how long you are looking to work for, how flexible can you be around this or can you be open about how many sessions are affordable to you?
  • Can we agree on the date of the first appointment to meet and find out whether counselling is for you? 
  • I will need to ask you a few questions about how you see the problem, if you've had counselling before and why you are looking for counselling at this point in time. I might also ask you how you came across me such as a personal, family or friends referral or from my website etc.
Does this sound OK to you?

What questions might you want to ask me? Write them down before you call.

 I look forward to hearing from you.

Warm wishes, Carol

Do I need counselling?

Do I need counselling?

I guess if you are reading this blog then you might not be sure or you are pretty sure but not convinced. Something may have happened to you recently or in the past to start your search online to find someone who might be able to help you.
The incident or event keeps popping up in your thoughts and you can't seem to shake it off.
Or you may have had a relationship breakdown which has really hurt you.
Perhaps your relationships seem to end and you or your partner leave and you have started to notice a pattern. Maybe you always find a partner who is needy, demanding and betrays you or perhaps you tend to be unfaithful or look for excitement outside the relationship.
People decide to come to counselling for all sorts of reasons. They can have relationships problems with partners or with work colleagues, parents or their wider family. Often people find their way to counselling with a deep dissatisfaction with life or have always had a feeling of sadness or hopelessness which may have intensified recently.
"I really can't go on feeling this way for much longer" may have crossed your mind. You may have gone to see your Doctor concerned that you could be depressed as your sleep and appetite have changed and you aren't enjoying life or looking forward to the future.
Often those closest to you have noticed you have changed and tell you so, you may feel annoyed or defensive about being told this and deny you are not yourself.
A loss of some sort may have triggered your feelings of sadness, a bereavement or an upheaval in your life such as children leaving home, retirement, redundancy, chronic illness, divorce or separation.
Perhaps there's a deep feeling of being unfulfilled in life.
Let me help you. Contact me on 07824700980. Tell me what's happened to you and we can decide together if counselling can help you.

The drive for growth and mental health and wellness; Physis

“Je le pensay, & Dieu le guarit...We treat them but it is God who cures them.”

This key piece of Bernian (1963) theory awakened an interest, and then reading Petruska Clarkson’s (1992) journal article on the subject. Within this article I will look at definitions and interpretations of physis theory; critique, compare and contrast this with other self-actualisation, realisation theories and key seminal work. To then explore how physis theory underpins Transactional Analysis (TA) principles. To look at what the implications of Physis might be for diversity, social and cultural beliefs. Finally, why is knowledge of physis theory vital in clinical practice? What are the benefits for the client and TA practitioner?

Defining Physis
Physis or Phusis, as it is sometimes spelt, is derived from the ancient Greek, meaning “to grow... to be...what things really are” (Edwards, 1967). Clarkson (1992) cites a more helpful meaning as “... change or growth which comes from the spirit within the person”.
Berne (1968) adds “the growth force of nature which makes organisms evolve into higher forms, embryos... into adults, sick people get better and healthy people strive to attain their ideals”. Summarising the literature; physis is a physical, emotional, spiritual, creative and evolving growth towards self actualisation and self realisation- being the best we can be. Implicit in this growth, change or evolution is the amount of energy the individual expends. Growth and change of any kind uses a high level of energy. If we put this into a TA context, pathology has its positive and negative sides, such as script, games, rackets, or life positions, to name a few. As for advantages, Berne (1968) puts it “...a neurosis has many advantages for the individual...  what is the force which makes him want to get better?”. What advantage is there for a person to get better if their neurosis serves them well? There must be a point for some individuals when a level of consciousness starts to recognise these thoughts, feelings and behaviours as unhelpful or along a continuum to harmful. 
This stance is diametrically opposed to the Freudian and psychoanalytical belief which emphasises the death and sex energies or drives (Mortido and Libido) and the Bernian/ Jungian belief in physis as Clarkson (1992) explains “... the drive toward health, wholeness and creative evolution.” Berne uses metaphor to personify the death and sex instincts as Thanatos and Eros respectively.  
Thanatos or Thanatus is the Greek god or daimon of non-violent death. His touch was gentle, likened to that of his twin brother Hypnos or sleep (Theoi 2010).

Eros was the Greek primordial deity of procreation who emerged self-formed and was equivalent to Thesis (Creation) and Physis (Nature)

The Greek goddess Physis is used as a metaphor for life energy as it manifests in nature, in growth and healing as well as in all dimensions of creativity. Physician or physic (as in medicine) and Physics (as in Quantum and Chaos understandings of the world) are both derived from it (Clarkson, 1992). 

 Thanatos and Eros would seem to be intrapersonal, or inside the individual, opposite to one another, instinctive and appear to be basic human drives. Whereas Physis, which does function at a basic instinctive level, has yet another dimension and incorporates the transpersonal and at a higher level of being. Physis is creative, transformational, evolving and aspirational (Clarkson, 1992).
Berne (1968) explains physis as being “...some force which drives people to grow progress and do better... religious people might say it was the soul... which normally pushes living things continually in the direction of progress”.  This life force energy fits well with the three guiding TA principles:
I’m OK- You’re OK 
Everyone can think 
Anyone can change

Steiner’s (1974) definition of script is clear and unequivocal:
“The script is based on a decision made by the Adult in the young person who... decides that a certain position, expectations, and life course are a reasonable solution to the existential predicament in which she finds herself ... between her own autonomous tendencies and the injunction received from her own family group. The most important influence... originates from the parental Child... the Child ego states of the parents... are the main determining factors in the formation of scripts”. 
The script paradigm is not wholly negative as English (1977) explains:
“We all need a script... an inborn need for structuring the time, space and relationships... conceptualise boundaries... to test... ongoing experience of reality... by constructing the outline of a script..., hold together... hopes, ...  fantasies, and...  experiences.”
Physis, the creative force of nature that makes things grow and strive for perfection, is the aspirational drive for autonomy, which arises deep in the individuals Somatic Child ego state. MacDonald (1972) defines aspiration thus:
“... to desire eagerly; to aim at or strive for high things”
 The script matrix comprises of five Counterinjunctions of “Be Perfect”, “Try Hard”, “Hurry Up”, “Please Me” and “Be Strong”, Petruska Clarkson (1992). The Counterinjunctions are from the individuals Parent ego state (Figure 4). Clarkson (1992) adds:
“... the values of being fast, energetic, pleasing, strong and excellent- as prized qualities of the autonomous individual under the influence of Physis... are differentiated from the counterscript drivers”.
 The second part of the script matrix is the Program messages from the parent’s Adult ego states and instruct the individual “How to”. The parental Child to the individual’s Child ego state messages are known as Injunctions, for example “Don’t Be” and Don’t Feel”, as well as the positive Permissions “Be Close”, “Think” and “Feel”. The individual’s script is not fixed or rigid as 
Cornell (1988) explains:
“Major script decisions can be made at any point in life. Times of crisis... will likely foster more rigid and therefore more dysfunctional elements in and individual’s script”.
 Therefore, a tension must exist between the aspirational drive (Aspiration Arrow), arising in the Child ego state, towards individual perfection, self actualisation and autonomy (Physis), and the constraining force of script to keep the status quo and the individual in possession of their neurotic thoughts, feelings and behaviour. Steiner (1987) illustrates this elegantly with the script-matrix diagram.
The Aspiration arrow may be seen as a metaphor for the flow of Physis energy within all individuals which runs as a golden thread or pure water spring through their ego states. The role of the practitioner must be to enable the individual to access their Physis, together, peeling away the layers of script and associated pathological thoughts, feelings and behaviour. This can then release the energy flow to course through the Child, Adult and Parent ego states and free the individual to reach their potential. Clarkson (1992) adds:
“… these creative urges- our needs to aspire toward fuller selfhood as persons and professionals”
Barrow (2008) utilizes metamorphosis, caterpillar to butterfly as a metaphor for Physis. Unique to those creatures who undergo metamorphosis are “imaginal cells”. These cells carry the genetic blueprint throughout the process. The complete and perfect butterfly emerges from the chrysalis. Barrow (2008) relates this process to Physis as follows:
“… I am interested in the idea of an imaginal cell working at a psychological level… that there is an inherent psychological mechanism that despite adversity maintains a vision for the individual of a new way of being... it captures the possibility for thriving- the essence of physis”.
Self-actualisation Models
In considering Physis as a psychological metaphor for the individual to reach autonomy does imply that other factors are significant, influential and be established prior to achieving this status. Maslow (1962) presented his “Hierarchy of Human Needs” which supports the premise that our physical or extrinsic needs must be satisfied before we can aspire to meet our emotional and intrinsic needs. Each element of the “Hierarchy” is dependant and builds upon the last and starts from the human being’s basic survival needs.
Maslow’s Hierarchy of Human Needs is a structured, hierarchical and sequential model, again, we can visualise this paradigm as a metaphor for human needs. The model, on first sight, does lack dynamism or drive; I have added the Aspiration Arrow to illustrate the energy Physis flows from the basic Biological and Physiological needs to Transcendence. The practitioner supports the individual towards autonomy and Self-actualisation (penultimate tier); the practitioner aspires to reach Transcendence, the final tier in the “Hierarchy of Human Needs”. 
In contrast, Educational TA practitioners have taken the familiar P-A-C ego state model and reversed this to C-A-P to articulate the Developmental TA (DTA) process and purpose (Barrow, 2003).

 Barrow (2003) expounds this theory further:
“Instead of existing under the implicit repression of the Parent ego state, the Child is regarded at the “growing edge”, the arena through which individuals… will reach further potential… underpinned by Adult reality checking and the security of healthy Parent beliefs and values… physis is explicitly identified and its line runs through all three ego states… realised by the Child through aspirations… framed through Adult thinking… supported by the security of the Parent”.
Criticism of this model is mainly around seeing the individual being relatively script free in achieving autonomy through aspiration. The author does describe the model as being “hopeful” as the individual would have a “winning script”, be motivated and able to articulate what they want to become. Nonetheless, there is a close connection with the three guiding principles of TA; I’m OK- You’re OK, Everyone Can Think, and Anyone Can Change (Barrow, 2003: Berne, 1968) encapsulated within the physis life force. 
Self-awareness and Growth
The concept of Physis appealed to me on a number of levels when I first heard it mentioned within the context of the script matrix diagram. I then looked at Clarkson’s article (Physis in TA, Vol.22, No. 4, Oct 1992) in the Transactional Analysis Journal (TAJ) and some of her associated writing on the subject. There’s seems to be a paucity of recently published work around what appears to be such a key factor in TA clinical practice. Although the term Physis is an ancient one going back thousands of years it is Berne (1968) who first named this concept for TA and Clarkson who developed the paradigm (Clarkson, 1992). Physis energy runs through nature and this includes the human life force.
Clarkson (1992) suggests:
“For people to change they first need to feel well and OK, that is, in touch with their life force”.
Hence, illness disrupts the individual accessing and experiencing their life force. It appears that the life force or Physis does not disappear or snuffed out; it is only death that extinguishes Physis. A metaphor may be likened to a candle barely alight, a tiny flickering flame, not enough to see or read with, in the room next door, but there nonetheless. The challenge for the individual is how they might, open the door to Physis and enable fresh air to rush in and rekindle the guttering candle flame.
Clarkson (1992) posits:
To kindle this is perhaps the most central and important of the therapist’s tasks”.
Clarkson and Fish (1988) add:
Some ego states from earlier periods in a person’s life may be fixated in response to early unmet needs or psychological trauma...the person will be unable to remain stable under stress and may revert to script”.
Diversity, Cultural and Social Factors
The concept of Physis, though not named as such, is a common thread throughout the major religions. Berne (1969) suggests:
“Religious people might say it was the soul”.
Clarkson (1992) adds:
“… striving towards connectedness with spiritual, religious or transcendental values. The core self can be conceptualised as the organising principle of Physis”.
 The major authors within TA texts do emphasise the importance of spirituality as a step towards autonomy.  
Kandathil and Kandathil (1997) describe individual autonomy:
“… when they make consistent efforts to be free in the sense that most of their actions-especially decisive ones- are self-determined and not socially programmed”.
In other words, freedom from the constraints and confines of script, this is a social form of programming. For the therapist the diversity, social and cultural beliefs of the individual must be discovered during early work in the assessment phase and be ongoing. These beliefs may be clear during initial work with the person, but as they move through therapy, issues around spirituality may come more to the fore as they access their power for self actualisation.
Physis and Clinical Practice
Application of Physis theory to clinical practice is a fundamental prerequisite if we are to believe Berne and Clarkson’s paradigm. They describe Physis and Physis theory as a driving force, aspiration to grow progress and do better. In TA terms, they warn against the deterministic constraints of script theory and empower the therapist and individual to aspire for change. Over-reliance on the script as hamartic, banal or losing in nature fails to understand the concept of transcendence (Clarkson, 1992). Cornell suggests:
“… a second parallel term-such as psychological life plan- to describe healthy functional aspects of meaning making in the ongoing psychological construction of reality”.
The therapist can assist the individual to re-experience Physis. Clarkson (1992) advises:
… in order to facilitate healing and self-realisation… they first need to feel well and OK, that is, in touch with their life force.”
In the application of Physis within the therapeutic relationship, the therapist first needs to have an awareness and understanding of the phenomena, and be prepared to share this with their client as a powerful tool for change.
Researching this piece of TA theory has been fulfilling yet challenging, although Berne wrote extensively on the topic almost five decades ago and Clarkson reprised his work 30 years ago, there’s very little current TA literature on Physis theory. This is surprising given Clarkson’s (1992) observation:
“… as a major concept in transactional analysis… it provides a drive-oriented theoretical base for Bernian belief and TA practice”.
The script matrix diagram with the added Aspiration arrow acknowledges that whereas script analysis is a key concept in TA and shows us where we are and where we have been, it is the striving for autonomy and self actualisation that drives us forward.
This article has brought into focus, for me, the three TA guiding principles and how Physis underpins this important piece of theory and the whole of TA clinical practice. 
Finally, Clarkson (1992) expounds:
“Without the experience of physis there is not the energy, the belief, or the capacity to even use help. Thus it may be both the first requirement in psychotherapy and the last”.

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