Ego State Psychotherapy

Ego state psychotherapy is based on the premise that we all have many parts of the self (ego states) that function with varying degrees of autonomy. Most psychopathology can be formulated in terms of a dysfunction of one or more of these parts or in terms of conflict(s) among the parts. The therapist’s task is first to identify and access these dysfunctional or conflicted parts. The therapist must then help the client resolve the dysfunction and integrate these parts harmoniously into the rest of the ego state system.

This process is complicated by the fact that these dysfunctional or conflicted parts are usually dissociated to some degree — not to the extreme of Dissociative Identity Disorder, but sufficiently dissociated to create “hidden ego states” and to make it difficult to identify and access these hidden ego states. Consequently, the therapist must understand how to work with dissociative processes to access these hidden ego states. This task is made more difficult by the fact that dissociation is designed to protect against anxiety and that reducing dissociation may increase anxiety.

To accomplish this, ego state psychotherapy seamlessly integrates concepts and techniques from hypnosis, Somatic Imagery, Gestalt therapy, EMDR, and object relations theory. Ego state psychotherapy concepts and techniques inform the work of the therapist so as to facilitate a more precise formulation of the client’s problem. In addition, they provide the clinician a model for choosing the most optimal strategy and therapeutic tactics to achieve resolution. This model can be integrated with any other psychotherapeutic approach.

Ego state psychotherapy can be used with virtually any psychotherapeutic client. These concepts and techniques are probably essential in working with clients with a history of trauma or abuse. They are also extremely effective with clients with phobias, anxiety disorders, depression, compulsions, addictions, impulsive behavior, and all personality disorders, especially borderline personality disorder.

To learn more, read the extensive article on ego state psychotherapy

Rreview our training in training in ego state psychotherapy

Mark Lawrence, M.D.