Temperament

E. Berne's concept: forms of communication

Hidden meanings and subtexts drastically influence the outcome of any social contact. According to E. Berne's approach, people use five main ways to structure their time:

1. Procedure. Interaction aimed at achieving a specific programmed result. This is the basis of the professional environment, where a clear goal (e.g., curing a patient) helps overcome obstacles.
2. Ritual. Traditional communication without hidden subtext or result orientation. Rituals save from awkwardness and anxiety in complex situations (funerals, meeting people), bringing relief when the plan is followed.
3. Pastime. Free contact without responsibility or goal, often with a hidden meaning (parties, friendly chats). It gives a feeling of freedom and saves from boredom, but the refusal of mutual responsibility can lead to a sense of inner emptiness.
4. Intimacy. The most candid style, based on sincerity, mutual attraction, and responsibility. It brings maximum fulfillment, making life meaningful, yet many avoid intimacy due to the fear of responsibility.
5. Game. A complex system of manipulations without sincerity. Its goal is not a practical result, but an emotional payoff. Participants declare a desire for intimacy, but subconsciously block it, pursuing hidden motives.

Psychological significance of games and the drama triangle

The concept of the "game" acts as a peculiar analogue of psychological defense in the interpersonal sphere. Games protect the individual from the awareness of failures (loneliness, unloved job) and the fear of responsibility, yet they are destructive in nature, hindering real changes in destiny. Unhappy families often maintain their existence precisely on games, compensating for the deficit of true candor.

The typical distribution of roles in such interactions is described by S. Karpman's triangle:

• Rescuer: tries to earn the Victim's love, but ultimately deprives themselves of love.
• Persecutor: strives to dominate the Victim, yet loses their power.
• Victim: portrays submissiveness, but in reality avoids control and deprives those around them of love.

During a conflict, roles constantly change. For example, in the family of a substance-dependent patient, the addict son (Victim) uses the mother (Rescuer) to obtain funds, while the father (Persecutor) punishes. Any attempts at outside intervention often lead only to a shift in roles, making real recovery impossible. Such scenarios are also common in the professional environment (e.g., the "Klutz" game, where a subordinate constantly makes mistakes and apologizes, while the boss scolds but forgives).

Age stages of cognitive development

Differences in the psyche between different age periods are of a qualitative nature. Understanding of the world changes as one grows up, which J. Piaget described in detail.

Attempts to teach children systematic knowledge (counting, writing) before the age of 7 are often unsuccessful, since in preschool age the intelligence is best adapted only for speech formation through the copying of images.

Psychodynamic approach (according to Z. Freud)

In the psychodynamic approach, childhood is considered the foundational stage of personality formation. Development is determined by how a person realizes their libido. In childhood, this happens through basic physiological processes. Freud identified five biologically determined phases:

1. Oral. Libido is associated with the mouth area (breastfeeding). The emergence of teeth causes the first forms of aggression.
2. Anal. Gratification through defecation. The foundations of patience and a craving for order are formed.
3. Phallic. Awareness of gender, interest in the body. The child identifies with the same-sex parent (Oedipus complex in boys, Electra complex in girls).
4. Latent. A period of hidden, dormant sexuality.
5. Genital. Behavior of a mature personality capable of loving without the influence of childhood complexes.

If needs at early stages are not met or are suppressed, fixation occurs. An adult begins to use childhood patterns: oral fixation leads to smoking, cynicism, or the search for protection; anal fixation leads to stinginess, pedantry, or conversely, squandering and a passion for destruction. In stressful situations, regression is possible—a return to previously passed childhood forms of behavior.

Class and exam questions

What else to study on this topic

• Clinical significance of the phallic phase and its connection with sexual dysfunctions.
• Comparison of age crises according to E. Erikson and Z. Freud.
• Family scandals as an element of the game: patterns and typical reproaches.
• The influence of extraversion and introversion on development according to C. Jung.

Other topics in "Chapter 2. Psychological mechanisms of human behavior"

Prepared by WhiteCoat Pro faculty in accordance with the medical school curriculum. For educational purposes only.