EMDR and Ego-State Therapy

What is an ego-state?

Having different ego-states doesn’t make your client crazy.

*In this article I use the terms ego states and parts interchangeably.

We all have different parts, or ego-states. Some people call them sub-personalities. You don’t have to have a mental disorder to have different ego-states. Just think about how you feel and act when you are with your clients and how your feelings and behaviors change when you are around your parents. There is no way you behave exactly the same, and If you do – you might need some supervision…

When everything goes well, your ego states work in collaboration, in harmony. Although your emotions and behaviors change in different situations – you still feel like the same person. But this is not the case for everyone.

Trauma, especially childhood trauma, leads to dissociation – a defense mechanism that helps the traumatized individual survive. The result of dissociation is a lack of cohesion between the different parts. Instead of working in collaboration, the ego-states start acting against each other.

Ego states have specific ages, roles, and personalities. They can protect, support or attack each other.

Since each ego state has a specific age, it operates and reacts in ways that are appropriate to that age. If a 35-year-old woman was sexually abused between the ages of 5 and 7, she may react, usually as a response to certain triggers, as a 5, 6 or a 7-year-old.

Many clients who experienced complex childhood trauma can feel their parts. They can tell you in detail about their ego states. When behaviors, thoughts, and feelings are not appropriate for the present moment – ego state therapy can be helpful. And when EMDR processing is stuck, ego-state therapy can be helpful to get the processing going.

Are ego-states real?

You only have one brain, so why do you have more than one ego-state?

In his book, The Social Brain, Michael Gazzaniga describes the human mind as a structure that contains several independently functioning parts. These parts have different and specific roles. Gazzaniga asserts that our emotional and cognitive lives are shaped by the relationship among these parts.

Ego states have a neurological basis

To some clients (and therapists), ego states can sound like a vague concept.
If your client needs a proof that she has different parts, you can tell her that PET scans of people with DID show some different patterns of neural activation when accessing traumatic memories.

But your clients doesn’t have to have DID to have ego-states.

Ego states are groups of neural networks where thoughts, feelings, and body sensations are wired together. These networks have wired together after forming strong connections in the brain – a result of repeated neural activity from a very young age.

How to talk with clients about ego-states?

When a client shares an old feeling, I sometimes ask:

how old is this feeling?

This is a good way to start a conversation about ego states. It can give your client some insight into her own ego states.

I tell my clients that we all have parts and that people who had experienced complex trauma sometimes have parts that don’t get along with each other. For clients who need a more technical explanation, I explain that ego states are memories and thoughts (and sometimes physiological sensations) that are stuck in the neural networks in the brain. Trauma changes the structure of neural networks. Severe or repeated trauma change the neuronal structure of the brain so much, that ego states can become dissociated states.

Ego-states and dissociation

When a child is exposed to trauma, especially an ongoing trauma and abuse, she learns to dissociate. It’s a defense mechanism that helps her survive the horrific reality of the continouos abuse. As the child continues to dissociate, fragmented parts, or ego states, become hardwired into her neural networks. In extreme cases, the ego states become distinct personality parts.

When EMDR processing gets stuck, it is often due to ego-states that interfere with our work.

Ego-State therapy and EMDR

Oftentimes parts take the role of an abusive parent or caretaker. The parts can intentionally interfere with our EMDR work, as they feel threatened by the possibility that the client will improve as a result of the processing.

When done in combination with EMDR, you can use ego state therapy in the preparation phase or when processing.

Using ego states as a positive resource

You can use ego states as positive resources. In the preparation phase, before you start working with child states, help your client strengthen her adult ego state. Do some grounding work and help your client connect with her strengths. It is important to establish present moment feeling of safety.

Remember: If your client is not stable – your ego state work can lead to flooding.

Make sure your client can contain. The good old container can help and should always be considered as an intervention.

When approaching younger parts – go slow. Work is small doses. Make sure you go back to the adult in the room, especially if you are dealing with polarized parts.

Ego state therapy and EMDR complement each other. They both help clients understand, on a deeper level, that their reactions, thoughts and feelings are old patterns. Clients learn to recognize these old patterns and develop a better ability to bring their adult self to the present.

In other words, both EMDR and ego state therapy help the client feel that the past is in the past.

Note: If you don’t have any experience working with complex trauma or clients with dissociation – seek consultation. Find a consultant who is experienced working with ego states, parts or dissociation.

Rotem Brayer is a certified EMDR therapist and an EMDR consultant in training practicing in Denver, Colorado. He divides his time between helping refugees to improve their mental health and maintaining a private practice.

Resources

Shapiro, Robin. Easy Ego State Interventions: Strategies for Working With Parts. W. W. Norton & Company.

DES

 

MID

 

Healing the Heart of Trauma and Dissociation with EMDR and Ego State Therapy

 

The EMDR Toolbox

 

The Haunted Self: Structural Dissociation and the Treatment of Chronic Traumatization (Norton Series on Interpersonal Neurobiology)

 

 

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