Ego State Therapy

Gordon Emmerson's "Ego State Therapy" is a concise, well-organized handbook of the therory, techniques, and specific applications of ego state therapy. Assuming that the reader has had some experience with clinical hypnotherapy, he or she could quite quickly and easily learn the practice of ego state therapy from reading this book. It outlines and extends the pioneering work of John G. Watkins (author of the 1949 work, "Hypnotherapy of War Neuroses") who also provides the introduction to this book. Reading Emmerson's remarkably practical work would benefit any hypnotherapist, addictions counselor, or trauma therapist. If not for its many typographical errors and the absence of an index I would have given it 5 stars instead of 4. It is otherwise superior to, less reductionistic than (and ultimately more readily useful to therapists than) Marlene Steinberg's "The Stranger In the Mirror," which I would now rate less enthusiastically than I did five years ago when reviewing it on amazon.com. What are ego states? According to Emmerson, "An ego state is one of a group of similar states, each distinguished by a particular role, mood and mental function, which when conscious assumes first person identity. Ego states are a normal part of a health psyche and should not be confused with alters (multiple personalities in dissociative identity disorder). Ego states start as defense coping mechanisms. With repetition they develop into compartmentalized sections of the personality that become executive (conscious and overt) when activated. Ego states may also be traumatized during a single incident of trauma ... [such as] a rape [or] robbery ... Our unconscious contains our ego states that are not executive, and some ego states have not been executive for many years. They maintain their own memory and communicate with other ego states to a greater or lesser degree" (p. 3). One could conceptualize ego states as mini-personalities or sub-personalities. What C.G. Jung called "feeling-toned complexes" are essentially these same phenomena. Ego states are different from the alternate personalities exhibited by persons with multiple personality disorder (now known as dissociative identity disorder). Those alternate personalities are more markedly compartmentalized, separated by "amnesia barriers," and consequently more complex, having had to assume more functions. Often DID/MPD patients experience total dissociative amnesia ("missing time") for periods when their "alters" are in the executive. One might say that all alternate personalities are ego states, but not all ego states are alters. The difference is perhaps best understood as one of degree rather than kind. Other ways to think of ego states are as neural pathways "that have been formed by intense use" (p. 8) or as specific instances of what E. L. Rossi and D. B. Cheek have called state-dependent memory, learning, and behavior (SDMLB). The presence of multiple ego states or "parts" is not itself pathological or problematic. The parts make up the whole, and every whole person is comprised of various "parts." Problems arise when ego states are in conflict with each other or otherwise oppose or subvert the conscious personality's aims. Each ego state's original purpose was to promote the well-being of the whole person, but their actual methods of doing so might have an opposite effect. For example, an ego state that intends to soothe and comfort the individual might smoke cigarettes or overeat, resulting in heightened anxiety about health and appearance that triggers even more need to self soothe. Some hypnotherapists speak of "parts therapy" rather than ego-state therapy. As far as I can tell, the two are identical in all essential respects. The primary difference seems to be in the terminology, not in the aims or techniques. Although there are non-hypnotic techniques for gaining access to ego states--an example being the Gestalt therapy "empty chair" technique--hypnosis provides the deepest, most effective means of communicating with clients' ego states. Emmerson speaks of surface states--those states that are relatively conscious and most often executive in daily functioning--and underlying states--states that come to the executive only rarely and to which it is difficult to gain access without hypnosis. Through hypnosis it is possible not only to communicate directly with the various ego states or parts, but also to help desensitize them to traumatic material and negotiate more functional relationships with each other. Each person has an "inner family of states." In some respects ego state therapy is like doing family therapy. The therapist seeks to understand each state's role and intention; to educate the states about the actual impact of their behavior (which is often quite different from the intention), and to renegotiating the roles and relationships. Basic principles of good therapeutic communication apply to communication with ego states: conveying respect; establishing rapport; obtaining history; validating feelings; clarifying intentions and motivations while also pointing out ways in which actual consequences are at variance with these (note: in this respect, I have come to think of Miller's Motivational Interviewing as a form of what Emmerson calls non-hypnotic access to ego states); renegotiating roles and relationships; and facilitating more functional communication. Emmerson identifies three goals of ego state therapy: 1.) To locate ego states harboring pain, trauma, anger, or frustration and facilitate expression, release, comfort, and empowerment; 2.) To facilitate functional communication among ego states; and 3.) To help clients learn their ego states so that the states may be better used to the clients' benefit. This therapeutic approach has application in many areas including: resolving fears, phobias, panic attacks and posttraumatic stress; managing anger and pain; overcoming the ambivalence that undermines so many attempts at addiction treatment; and promoting peak performance and overall well-being. Emmerson speaks of its use in addressing "situational neurosis," which he defines as "a repeated inappropriate response to a particular type of life situation ... a neurotic reaction ... directly tied to a lack of resolution being held by an ego state that becomes executive when cued by some situational cue" (p. 79). Ego state therapy is useful with both MPD/DID patients and with patients who do not otherwise present with signs and symptoms of dissociation. Here is worthwhile to recall M. G. Edelstein's findings (reported in his 1981 "Trauma, Trance, and Transformation") that--rather than deepening their dissociation and disintegration--ego state therapy effectively promoted more integrated functioning in his patients. Emmerson notes that some physical pain originates from ego states and so can be alleviated using ego state therapy. He cites his own research indicating that underlying ego states often cause menstrual migraines. Negotiating with these states reduced the average number of migraine days per month in his research sample from 12.2 to 2.5. Ego state therapy permits access to much deeper levels of the self than does the currently dominant and more widely researched cognitive-behavioral therapy (CBT). However, its use would not necessarily replace CBT. CBT techniques could be used to complement ego state therapy (and vice versa). Although not discussing ego state therapy specifically, George Gafner, in his "Clinical Applications of Hypnosis" (2004), cited a 1995 meta-analysis of studies comparing cognitive-behavioral therapy (CBT) to the same therapy supplemented by hypnosis. He acknowledged that CBT has a solid empirical foundation and that many have benefited immensely from it, but he added these striking words: "let's face it: manualized or `solution-focused' approaches alone are rote, lack heart and soul, and often fail to address problems at their core which is the unconscious" (p. 122). Emmerson says, "There is a place for Cognitive Behavioral Therapy in assisting clients. Often CBT techniques mixed with ego state techniques can speed the process of therapy. When a problem that brings a client to therapy is based in a trauma of the past, is based in an internal conflict between states, or could be accessed by greater access to little used states, CBT is not enough" (p. 195). When therapists and addictions counselors talk about the defense of "splitting," a patient's "inner child," "the addict part" of a person, or "egomaniacs with inferiority complexes," they're implicitly acknowledging the presence of ego-states, but not typically going far enough toward addressing, negotiating with, and integrating them. British esotericist Gareth Knight once said, "Basically, all human problems are problems of communication, either with others, or between the fragmented parts of the self." Ego state therapy provides powerful, transformative tools for promoting the communication needed to overcome such internal conflict, division, and fragmentation.

This is the best little book that everyone in the helping professions such as Hypnotherapists, counselors or for behavior change therapists!! I saw Tony Robbins on Oprah's Master Class and he was employing the use of this kind of therapy. Hypnotherapists know it as "Parts Therapy". We are made up of many parts or ego states and we may go through many of these states back and forth several times throughout the day. If my House cleaning Ego State is in the Executive position, I am complelled to clean the house, but my singer or creative part can only stand so much of that and it is going to stop cleaning house and start practicing a new song. So there are conflcting parts of us that vie to take charge. And NO it is not multiple personalites disorder!!!! Ego States is a natural part of all of us. One Part of us want feels compelled to do one thing, but another part wants to do something else. How many of us are health food nuts for a couple of days, but then a part of us comes in to break out the beer and Pizza and kick back and watch a movie and go to bed feeling regrets. Wake up in the morning determined to stick to our good diet only to find out that "part" of us got usurped and taken over by our munchy eating "I gotta have this!!" part of ourselves. So this book will give you some help with clients who do not understand why one behavior and practice can take control and mess up one's best intentions. This book will show you how to interact with and help your client.This book should be read by everyone, not just therapists if they want to take charge of their own lives and not continue to sabotage themselved. Learning to understand why we have this "mean" side of ourselves (the part that is maybe trying to be the protector")which is so totally different from out "nice" self. Makes you wonder how those Nazi's could go out and torture and murder innocent people and be such loving father's and husbands at home!! Because we are multifacited humans. And sometimes we do things out of FEAR which stands for False Evidence Appearing Real. This book can change the way you look at yourself and other people and help you to understand it all!!! So we all have protector parts of us, but sometimes they are inappropiate in the way that aspect of ourself would prefer by other apects of our nature. We can now negotiate those conflicts and give different perspectives of a behavior. This author is brilliant and so nicely written. Not complex or boring but holds your interest and thrills us with the delight of solving the mystery of the human nature.Janie Martin Hypnotherapist and Singing entertainer.

Great read and a must read for any psychotherapist or counselor.

It's a great book that I have used to bridge ego state theory, EMDR, and hypnosis together. I have referred a number of professionals to this book. I like the author's examples that show how to use ego state theory with or without hypnosis. It's a very good read.

This is a fair introduction to the subject, but slow going, repetitive and, for me, too boring to finish. Also, overpriced. Try something else.JLL author of Reading Thomas Merton

I've long admired this therapy method, which I have studied since 1992. It is a method that is typically difficult to describe, yet extremely powerful when used by an adept counsellor. Even so, Dr Emmerson does a brilliant job at describing ego state therapy methods, and encouraging adequate flexibility for counsellors devoted to provisioning empathetic, change-oriented counselling.If you are a therapist seeking to maximise session value, client-desired changes and fully client-focused therapies, this is a must read. Five stars.

Easy reading and a passionate subject. I was so passionate about the subject that I decided to do training with Dr. Emmerson. He is a wonderful and insightful human being who shares all he knows with such humility.

Sad that what could have been a really great book is marred by lots of unnecessary repetition and many, many typos. This is a book in search of a decent editor. However, setting aside these criticisms it does have some good material.

Perfect

great book well worth reading.

The book surely presents groundbreaking (relatively) new discoveries of the human psyche. Unfortunately for me, i see no use for it, as it is an intended read for therapists and medical hypnotists. As a patient i do not find any technques for self-applications. Nevertheless, a crucial step forward for the sciences of mental health