EMDR as a Special Form of Ego State Psychotherapy
Ego State Therapy Model
The Development of Personality Structure
The fundamental basis for the structure of personality derives from the neuronal connections developed out of the state-dependent learning process. Rossi (1986) discusses how processes become “hard wired” together as a result of state-dependent learning processes. “Learning” in this context refers to the fact that biochemical and neuronal associations are made among components of a “state,” linking them together. These interconnected components can be conceptualized as the simplest form of “ego state” – the totality of all that a person is in a single moment of time, incorporating all the components of the self. These components can be categorized according to Braun’s BASC model – Behavior, Affect, Sensation, Cognition (Braun, 1988). Or, they might be categorized according to the broader acronym proposed by Lazarus (1989) BASIC ID – Behavior, Affect, Sensation, Imagery, Cognition, Interpersonal, and Drugs (which may be reformulated as Biology).
The high intensity of the terror of a traumatic experience tends to promote the creation of more enduring ego states. Chronicity or repetitiveness of an experience also tends to promote more enduring, strong ego states; hence, repetitive family patterns, including trauma, have a more powerful effect on the personality.
But associational linkages also develop among momentary ego states which occur sequentially in close proximity. These linkages are also stronger when associated with intense affect or regular repetition. Thus, for example, when we uncover the memory of an early childhood sexual trauma, the patient will experience a whole series of different affective ego states in close sequence, paralleling the initial experience, going from intense apprehension, to outright terror, to feelings of dejection and helplessness. These momentary ego states unfold one by one, as if played on a video tape.
As one might expect, these neuronal linkages through time can get increasingly complicated, such that elaborate combinations of affect, behavior, cognitions, etc., become interconnected in consistent, repetitive ways. These elaborate patterns may be called subpersonalities. It is this aspect of ego state phenomenology that is reflected in the definition of ego state by H. H. Watkins (1991, cited above). The common theme of an ego state (subpersonality) may consist of the person at a certain age, which would then include different affects; or it might include a common mood or affect, with different behaviors; or it might be a certain type of interpersonal strategy.
In summary, it is the biological sub-stratum underlying ego state phenomenology, based on state-dependent learning processes and their derivatives, that gives power to ego state phenomenology and to the therapeutic use of the ego state model in working with psychological symptomatology. Previous writers have not emphasized this biological underpinning of ego state phenomenology. It is this biological sub-stratum for ego state phenomenology that may ultimately lead us to understand how EMDR impacts on ego state pathology.
Most previous ego state conceptualizations refer only to sub-personalities or parts. In this paper, the term “ego state” will be used to refer to all ego state phenomenology, including the sub-personality or part of the self, as well as the ego state as the state of the ego in one moment of time, as might happen in a flashback.