Visualization of Internal Working Models Through Transactional Analysis (TA) Developmental Collage Therapy: A Case Report

Bowlby's Internal Working Model (IWM) is central to understanding adult attachment-related difficulties. However, what IWM concretely consists of remains unspecified, and no method exists for directly visualizing IWM. Because IWM is formed during the pre-verbal period, it is difficult to access through language-based psychotherapy alone. A woman in her 20s with a history of childhood stuttering and subsequent interpersonal difficulties participated in Transactional Analysis (TA) Developmental Collage Therapy. She created six collage works representing "myself and my surrounding environment" across developmental stages from birth to a future after therapeutic change. Pre- and post-intervention assessments included the Tokyo University Egogram Third Edition (TEG3), which measures five ego states based on TA theory, and the Experiences in Close Relationships inventory-Generalized Other version (ECR-GO), which assesses attachment anxiety and avoidance. The collage works visually depicted the relationship between the "Child" ego state (Free Child or Adapted Child) and the surrounding environment ("Parent") at each developmental stage. Collages 1-2 expressed stable attachment with Free Child; Collages 3-4 depicted transformation to insecure attachment with Adapted Child following negative experiences; Collages 5-6 showed re-emergence of Free Child and movement toward secure attachment. TEG3 showed decreased Critical Parent (CP: 49→35) and Adapted Child (AC: 50→45), with increased Free Child (FC: 57→59). ECR-GO showed decreased Attachment Anxiety (54→48) and Attachment Avoidance (51→45). This case suggests that TA Developmental Collage Therapy can visualize IWM and facilitate its transformation. The findings indicate that ego states may constitute structural components of IWM, and that combining non-verbal collage techniques with verbal approaches may provide an effective therapeutic framework that complements language-based psychotherapy.