Ego state therapy is a parts-based psychodynamic approach to treat various behavioural and cognitive problems within a person. It uses techniques that are common in group and family therapy, but with an individual patient, to resolve conflicts that manifest in a "family of self" within a single individual.
The concept of segmentation of personality has been around for many years, and that of ego states was highlighted by the psychoanalyst Paul Federn. The creation of ego-state therapy is attributed to John G. Watkins, an analysand of Edoardo Weiss who was himself analysed by Federn. [1] The first research on the efficacy of Ego state therapy was conducted by Gordon Emmerson. Emmerson conducted his research [2] during a sabbatical from Victoria University. In this research he showed that the therapy could reduce menstrual migraines 5-fold in just 4 weekly sessions. It further indicated that Ego state therapy could not only reduce the occurrence to menstrual migraine, but participants also showed a significant reduction in both Anger and Depression on the MMPI-2. This quasi-experimental study was the only causal study included in the Watkins, book, Ego States: Theory and Therapy. [3]
Distinct ego states—in the most rigorous sense—do not normally develop except in cases of dissociative identity disorder. However, Ego state therapy identifies and names facets of a patient's personality, e.g., the "frightened child" or "control freak". After the characteristics and function of each ego state are identified, the therapist uses various psychotherapeutic techniques (e.g. behavioral, cognitive, analytic, or humanistic therapies) to achieve a kind of integration or internal diplomacy. [4] Ego state therapy may use hypnosis, but is not necessarily required to do so, employing conversational technique instead. [5]
In the development of the human personality, there are two processes that are essential: integration and differentiation. Through integration a person learns to put concepts together, like a shirt and a pair of trousers, to build more complex units known as clothes. By differentiation the person separates general concepts into specific meaning, such as the differences between a comfortable shirt and an uncomfortable shirt. Such differentiation allows humans to experience one set of behaviours in a different situation to another.
Psychological processes do not exist on an either/or basis. Things such as moods and emotions like depression, anxiety, and fear exist on a continuum with differing degrees of intensity. It is the same with differentiation-dissociation. Disorders such as dissociative identity disorder are often in the extreme end of the continuum that begins with normal differentiation. It is a matter of intensity. Therefore, the general principle of personality formation in which the process of separation has resulted in discrete segments, called ego states, with boundaries that are more or less permeable. Where however an ego state is a response to psychological trauma, it may remain completely walled-off from the rest of the personality. [6]
Ego states exist as a collection of perceptions, cognitions and affects in organised clusters. An ego state may be defined as an organized system of behavior and experience, whose elements are bound together by common principle. When one of these states is invested with ego energy, it becomes "the self" in the here and now. This state is executive, [7] and experiences the other states which are then invested with object energy.
Ego states vary in their volume. A large ego state may include all the various behaviors activated in one's occupation. A small ego state are the behaviours one experiences in a simple action, such as using a mobile phone. They may represent current modes of behavior and experiences or, as with hypnotic age regression, include many memories, postures, feelings, etc. that were apparently learned at an earlier age. They may be organised into different dimensions. For example, an ego state may be built around the age of 10. Another one may represent patterns of behavior toward a father or authority figures and thus overlap with experiences from the age of 10. Behaviors to accomplish a similar goal may be uniquely different from one ego state to another, especially in true multiple personalities.
Hypnosis is a human condition involving focused attention, reduced peripheral awareness, and an enhanced capacity to respond to suggestion.
Hypnotherapy, also known as hypnotic medicine, is the use of hypnosis in psychotherapy. The efficacy of hypnotherapy is not well supported by scientific evidence, and, due to the lack of evidence indicating any level of efficacy, it is regarded as a type of alternative medicine by reputable medical organisations such as the National Health Service.
Psychotherapy is the use of psychological methods, particularly when based on regular personal interaction, to help a person change behavior, increase happiness, and overcome problems. Psychotherapy aims to improve an individual's well-being and mental health, to resolve or mitigate troublesome behaviors, beliefs, compulsions, thoughts, or emotions, and to improve relationships and social skills. Numerous types of psychotherapy have been designed either for individual adults, families, or children and adolescents. Certain types of psychotherapy are considered evidence-based for treating some diagnosed mental disorders; other types have been criticized as pseudoscience.
Transactional analysis is a psychoanalytic theory and method of therapy wherein social interactions are analyzed to determine the ego state of the communicator as a basis for understanding behavior. In transactional analysis, the communicator is taught to alter the ego state as a way to solve emotional problems. The method deviates from Freudian psychoanalysis, which focuses on increasing awareness of the contents of subconsciously held ideas. Eric Berne developed the concept and paradigm of transactional analysis in the late 1950s.
Psychology is an academic and applied discipline involving the scientific study of human mental functions and behavior. Occasionally, in addition or opposition to employing the scientific method, it also relies on symbolic interpretation and critical analysis, although these traditions have tended to be less pronounced than in other social sciences, such as sociology. Psychologists study phenomena such as perception, cognition, emotion, personality, behavior, and interpersonal relationships. Some, especially depth psychologists, also study the unconscious mind.
Abnormal psychology is the branch of psychology that studies unusual patterns of behavior, emotion, and thought, which could possibly be understood as a mental disorder. Although many behaviors could be considered as abnormal, this branch of psychology typically deals with behavior in a clinical context. There is a long history of attempts to understand and control behavior deemed to be aberrant or deviant, and there is often cultural variation in the approach taken. The field of abnormal psychology identifies multiple causes for different conditions, employing diverse theories from the general field of psychology and elsewhere, and much still hinges on what exactly is meant by "abnormal". There has traditionally been a divide between psychological and biological explanations, reflecting a philosophical dualism in regard to the mind–body problem. There have also been different approaches in trying to classify mental disorders. Abnormal includes three different categories; they are subnormal, supernormal and paranormal.
Depersonalization is a dissociative phenomenon characterized by a subjective feeling of detachment from oneself, manifesting as a sense of disconnection from one's thoughts, emotions, sensations, or actions, and often accompanied by a feeling of observing oneself from an external perspective. Subjects perceive that the world has become vague, dreamlike, surreal, or strange, leading to a diminished sense of individuality or identity. Sufferers often feel as though they are observing the world from a distance, as if separated by a barrier "behind glass". They maintain insight into the subjective nature of their experience, recognizing that it pertains to their own perception rather than altering objective reality. This distinction between subjective experience and objective reality distinguishes depersonalization from delusions, where individuals firmly believe in false perceptions as genuine truths. Depersonalization is also distinct from derealization, which involves a sense of detachment from the external world rather than from oneself.
Self-hypnosis or auto-hypnosis is a form, a process, or the result of a self-induced hypnotic state.
Dissociation is a concept that has been developed over time and which concerns a wide array of experiences, ranging from a mild emotional detachment from the immediate surroundings, to a more severe disconnection from physical and emotional experiences. The major characteristic of all dissociative phenomena involves a detachment from reality, rather than a false perception of reality as in psychosis.
Nicholas Peter Spanos, was professor of psychology and director of the Laboratory for Experimental Hypnosis at Carleton University from 1975 to his death in a single engine plane crash on June 6, 1994. Spanos conducted multiple studies that challenged common beliefs. He tried to distinguish the difference between common beliefs about hypnosis and what was actually occurring. These studies conducted by Spanos led to the modern understanding that hypnosis is not an altered state and is actually suggested behaviors that the participant chooses to go along with or not. Along with this, Spanos conducted studies regarding dissociative identity disorder in which he stated that multiple personalities are not a product of trauma but are based on social norms.
Splitting is the failure in a person's thinking to bring together the dichotomy of both perceived positive and negative qualities of something into a cohesive, realistic whole. It is a common defense mechanism wherein the individual tends to think in extremes. This kind of dichotomous interpretation is contrasted by an acknowledgement of certain nuances known as "shades of gray".
The developmental needs meeting strategy (DNMS) is a psychotherapy approach developed by Shirley Jean Schmidt. It is designed to treat adults with psychological trauma wounds and with attachment wounds. The DNMS is an ego state therapy based on the assumption that the degree to which developmental needs were not adequately met is the degree to which a client may be stuck in childhood. This model aims to identify ego states that are stuck in the past and help them get unstuck by remediating those unmet developmental needs. The processing starts with the DNMS therapist guiding a patient to mobilize three internal Resource ego states: a Nurturing Adult Self, a Protective Adult Self, and a Spiritual Core Self. The therapist then guides these three Resources to gently help wounded child ego states get unstuck from the past by meeting their unmet developmental needs, helping them process through painful emotions, and by establishing an emotional bond. The relationship wounded child parts have with these Resources is considered the primary agent for change.
Paul Federn was an Austrian-American psychologist who was a native of Vienna. Federn is largely remembered for his theories involving ego psychology and therapeutic treatment of psychosis.
Age regression in therapy is a psycho-therapeutic process that aims to facilitate access to childhood memories, thoughts, and feelings. Age regression can be induced by hypnotherapy, which is a process where patients move their focus to memories of an earlier stage of life in order to explore these memories or to access difficult aspects of their personality.
John Goodrich Watkins was a United States psychologist best known for his work in the areas of hypnosis, dissociation, and multiple personalities. With his wife, Helen Watkins, he developed ego-state therapy, which uses analysis of underlying personalities, rather than traditional talk therapy, to find the causes of psychological problems.
Transference focused psychotherapy (TFP) is a highly structured, twice-weekly modified psychodynamic treatment based on Otto F. Kernberg's object relations model of borderline personality disorder (BPD). It views the individual with borderline personality organization (BPO) as holding unreconciled and contradictory internalized representations of self and significant others that are affectively charged. The defense against these contradictory internalized object relations leads to disturbed relationships with others and with self. The distorted perceptions of self, others, and associated affects are the focus of treatment as they emerge in the relationship with the therapist (transference). The treatment focuses on the integration of split-off parts of self and object representations, and the consistent interpretation of these distorted perceptions is considered the mechanism of change.
A subpersonality is, in humanistic psychology, transpersonal psychology and ego psychology, a personality mode that activates to allow a person to cope with certain types of psychosocial situations. Similar to a complex, the mode may include thoughts, feelings, actions, physiology and other elements of human behavior to self-present a particular mode that works to negate particular psychosocial situations. American transpersonal philosopher Ken Wilber and English humanistic psychologist John Rowan suggested that the average person has about a dozen subpersonalities.
Schema therapy was developed by Jeffrey E. Young for use in treatment of personality disorders and chronic DSM Axis I disorders, such as when patients fail to respond or relapse after having been through other therapies. Schema therapy is an integrative psychotherapy combining theory and techniques from previously existing therapies, including cognitive behavioral therapy, psychoanalytic object relations theory, attachment theory, and Gestalt therapy.
Imagery Rescripting is an experiential therapeutic technique that uses imagery and imagination to intervene in traumatic memories. The process is guided by a therapist who works with the client to define ways to work with particular traumatic memories, images, or nightmares.