EMDR as a Special Form of Ego State Psychotherapy
EMDR Innovations and Ego State Therapy
Many EMDR therapists have in fact developed a variety of techniques and strategies to expand the effectiveness of EMDR, particularly in the face of therapeutic impasses. Many of these techniques can be conceptualized from the ego state perspective, which will make it easier for the EMDR therapist to integrate these techniques into his or her therapeutic repertoire.
The technique of resource installation (Leeds & Korn, 1998) can be thought of as an ego state interweave. An integrator or resource ego state is connected with a vulnerable or frightened ego state through the EMDR processing. Even when the patient is apparently using an external resource, he or she is actually accessing an internal imagistic representation of it. These internal representations are also ego states within the patient’s system, albeit underdeveloped or not well integrated with the vulnerable ego states.
By conceptualizing the resource as a preexisting ego state, already within the patient, the therapist is freer to invite the patient to discover the most appropriate resource for a specific problematic ego state. The patient is invited to image the problematic/traumatized ego state and is asked, “What needs to happen to give relief to that part?” The patient can usually identify what needs to happen and what ego state resources are necessary to facilitate the process. The patient can then play with the image accordingly, modifying it as necessary to achieve the desired outcome. At this point, EMDR installation can be done without fear of stimulating an adverse reaction. Once the image has unfolded successfully there is no danger of stimulating too much adverse affect with EMDR.
The integration of the resource ego state with the problematic ego state can be further reinforced by inviting the patient to take the ego state back in time (ego state bridge) to its first appearance and then installing the resource ego state after appropriate imaging. This process can be repeated for each of the major historical “nodal” points for that ego state.
Wildwind’s (1998) technique of helping the patient “change” his/her childhood experience by imaging the childhood experiences/traumas as the patient would have liked it to have been can be understood in the same way as resource installation. The problematic/traumatized ego state is identified. That ego state is asked, “What needed to have happened to alleviate the pain?” The patient can then let that unfold imagisticly, and the new image can be installed with EMDR.
Parnell (1998) proposes the use of a variety of interweaves beyond the cognitive –- educational, imagistic, affective, a wise being, “power” animals, etc. All of these interweaves can be thought of as resource or integrator ego states. But again, if the therapist understands that these ego states all reside within the patient, then he/she can invite the patient to discover the appropriate ego state as described above.
Grand (1998) uses the dynamic interweave or questioning interweave to elicit covert ego states by asking questions inspired by his understanding of the patient’s psychodynamics. He then uses EMDR to install or amplify the response. By amplifying hidden ego states in a complex ego state system, he is then able to do indirect parts work to integrate the system.