ASSIGNMENT ON

EGO STATE
1. Explain in brief with the help of a diagram the personality structure as outlined by Transactional
Analysis, i.e. the Parent, Adult and Child ego states (5 marks)

Ans.

Transactional analysis (TA) is a psychoanalytic theory and method of therapy where in social
interactions (or “transactions”) are analyzed to determine the ego state of the communicator
(whether parent-like, childlike, or adult-like) as a basis for understanding behavior. In transactional
analysis, the communicator is taught to alter the ego state as a way to solve emotional problems.
The method deviates from Freudian psychoanalysis which focuses on increasing awareness of the
contents of subconsciously held ideas. Eric Berne developed the concept and paradigm of
transactional analysis in the late 1950s

An ego state is a way in which we think, feel and behave, making up our personality at a given
time. These states are thinking and feeling as a:

 Parent
 Adult 
 Child

P A C

1. Parent
The Parent ego state refers to the behaviours, thoughts and feelings that are copied, learned or
even borrowed from our parents, parental figures, or significant others. Parental figures ,significant
others are not necessarily biological, but maybe someone with power, authority or influence that
have had an impact on us during our childhood.  These may be teachers, priests, or even movie
heroes.

The Parent is divided into Critical Parent (and Nurturing Parent.

Critical Nurturing
parent
parent

2. Adult

The Adult ego state operates in the here and now and rationally processes what we are thinking
and feeling, which is based on facts without interference of unconscious contamination. We are
thinking and responding appropriately, displaying logical and consistent behaviour.  Put
simply, this is us being us, without those external influences of our Parent and Child ego states.

3. Child

The Child ego state is not when we are acting childish, or what others perceive as childish
behaviour. It is how we behaved, thought and felt, replayed out as we did as a child. These
adaptive behaviours can be immediate and act as a survival instinct within us, putting obstacles
in the way of our own growth. These are  memories that we are unable to remember on a
conscious level, but lie within our unconscious.

The Child is divided into Adapted Child and Free Child.

Adapted Free
child child

2. Use the following case study to further illustrate your answer. 

Anita is a 16 year old female who is admitted to the hospital with severe stomach pain, loose
motions and vomiting. She is unable to eat solids and has no bowel movements for 3 days. 

When she was admitted she was crying constantly. She tries to eat solids but vomits soon after.
She is constantly asking someone from the hospital (nurse/ doctor / ayah) to be by her bedside or
she starts crying. 

From the last two days she is not cooperative with nurses  and shows irritability. You have to take
her for a sonography test and since she has not had a sonography done ever, she tells you that
she is not sure she wants to go ahead with it.  

Her mother is staying with her and she insists that Anita eat something every two hours but Anita
is not able to do that. Mother keeps coming to the nursing station to ask for the menu of the next
meal and what food could be given to Anita. 

   
 a. Which ego state is the patient coming from? How is this ego state manifested behaviourally
by the patient? Why do you think she is behaving in this manner? (5 marks) 

Ans. The patient is coming from adaptive child ego state. As she is irritable and restless due to her
illness she is not able to cooperate with the staff and showing lack of trust, insecurity and fear.
Because of fear and insecurity she is showing lack of trust towards staff and patient is behaving in
this manner because she is in state of anger due to hunger and irritability.

b. Which ego state is the mother coming from? How does the mother behave in relation to her
manifest ego states and Why? (5 marks)

Ans. The mother is coming from nurturing parent ego state. As she cares about her daughter and
worried about her nutrition and health. Mother shows anxiety , curiosity and worry because her
child is not eating properly so she must take care that her child must eat every 2 hourly and
questions nurses what would be the next meal.

3.. As a nurse, how would you deal with the situation? (10 marks)  

a. Which ego state / s would you use while communicating with the patient and why? Give
examples of the same. 

Ans. While communicating with patient I would use adult and nurturing parent ego state.

Adult
In this adult behaves more rationally and listen carefully and with respect to understand the
problem of patient. So that the nurse will come to find some solution for it.
For example: nurse will ask patient why you don’t want to go for sonography and find the
reason and will state the use of sonography after listening to patient.

Nurturing parent
In this nurse will act sympathetically to provide proper care and attention to patient as patient is in
fear and irritable. This ego state will help nurse to act like a parent to understand the patient’s
behaviour as patient is 16 year girl and will act accordingly

For examples: nurse will encourage patient to be calm as she cries continuously due to fear and
will provide proper food and medicines to prevent vomiting and maintain nutrition.

b. What kind of statements and questions would you use with the relative? Give examples of
the same.

Ans. As a nurse,

1.She must collect the history of patient as well as family history “may I know what caused
this to your daughter or how this symptoms started ??”
2. I would like to ask you what is her health history and any other family history along with
illness?”

3. Does she behave like this every time as she is crying all the time and and crying for
company?

4. I will tell you what are the importance of the sonography and how it will help to treat her
accordingly

5. nurse will console patient as she is in a state of crying and fear , nurse must minimize
her fear about hospitalization and also make relative comfortable by orienting them to
hospital policy and diet timings

6.nurse will take round as and when possible to show that staff of hospital care about
patient and she is safe in the hospital.

7.nurse will monitor and observe the patients condition to evaluate diagnosis