EMDR as a Special Form of Ego State Psychotherapy
This article was written by Mark Lawrence, M.D.
Ego state therapy has become an increasingly recognized and utilized form of psychotherapy over the past 25 years, although it has been used primarily by hypnotherapists in the context of the treatment of dissociative disorders. The use of Eye Movement Desensitization and Reprocessing (EMDR) has also expanded extremely rapidly over the past ten years, primarily in the treatment of acute and chronic Post Traumatic Stress Disorder (PTSD). It is the thesis of this paper that EMDR can be conceptualized as a special form of ego state therapy. EMDR’s unique contribution to the ego state therapy process is in its subtle, but profound, impact on the associative/dissociative process, and ego state therapy can be considered a meta model for informing EMDR therapeutic interventions, particularly with regard to impasses.
J. G. Watkins and H. H. Watkins (1997), basing their work on the writings of Paul Federn, have taken the lead in developing and teaching the basic ego state therapy concepts. They define an ego state as “an organized system of behavior and experience whose elements are bound together by some common principle.”(H.H. Watkins, 1991, p. 233) Over the past 20 years, other writers (Edelstein, 1982; Fraser, 1991; Malmo, 1991; Newey, 1986; Phillips, 1993; Phillips & Frederick, 1995; Torem, 1987) have elaborated on the ego state therapy model. Most of them have approached the subject from a hypnotherapy perspective. Writers from other psychotherapeutic schools have also formulated models which can be seen as a reflection of ego state phenomenology, although the term “ego state” is not specifically used. Berne (1961, 1977),in his development of transactional analysis, talked about the parent, child, and adult parts of the self, as well as games that different parts play, all of which reflect the actions of different ego states. Assaglioli (1965), in his psychosynthesis writings, discussed the concept of subpersonalities, which can also be conceptualized as separate ego states. Schwartz (1995), coming from a family systems model, has written about “internal family systems,” which is also a reflection of ego states or subpersonalities. Young (1994), with his schema-oriented, cognitive therapy approach , discusses the schemas of patients in a way that is similar to that of an ego state model.
These are just a few examples of the many writers whose work might well be interpreted from an ego state model perspective. Similarly, EMDR can be conceptualized as a special form of ego state therapy.
This paper presents an abbreviated summary of an ego state theory of personality, psychopathology, and psychotherapy. This model is the author’s personal formulation of ego state therapy and may not reflect the views of other ego state therapy practitioners. A brief overview of EMDR theory and technique follows. Finally, EMDR is conceptualized as a special form of ego state therapy, whereby the pre-therapy dissociative barriers between and within ego states are attenuated and new associative linkages are formed, such that a more integrated ego state structure emerges.