DID, PTSD & Dissociation Terms · Therapies
Ego State Therapy, Trauma and DID
In short: Ego State Therapy is based on the idea that everyone’s personality is made of different “states,” and that helping those states understand and cooperate with each other can bring healing.
What is it?
Think about how you act at work, with a close friend, or when you’re scared. You may feel, talk and even think a little differently in each one. Ego State Therapy calls these different ways of being ego states.
According to the theory, everyone has ego states. Most of the time, they share memories and work together smoothly. But trauma can put stronger walls between them, so some states hold pain, fear or memories that the others don’t know about.
The idea of ego states began with psychoanalyst Paul Federn. In the 1970s, psychologists John and Helen Watkins turned it into a therapy.
How does it work?
In Ego State Therapy, the therapist talks with the different states, almost like a family therapist talks with family members. The goals are to:
- Get to know each state and what it needs
- Help states that are in conflict understand each other
- Help states that carry old pain let it go
- Build cooperation, so the whole person works more like a team
The Watkinses often used hypnosis to reach states that were hard to contact. Many therapists today use Ego State Therapy without hypnosis.
What happens in a session?
- Calming and safety first. You learn ways to feel settled and safe.
- Meeting states. The therapist invites a state to talk, or to share how it feels.
- Listening and negotiating. States are heard, and the therapist helps them work out disagreements.
- Working with pain. When it feels safe, states that hold hurt are helped to release it.
When is it used?
Ego State Therapy is used for trauma, anxiety, inner conflict, and dissociative disorders. Most of what is known about it comes from clinicians’ case reports. In 2013, two small studies (of 36 and 30 people with PTSD) tested a single long session, five to six hours, of a version that uses hypnosis to relive the trauma, and compared it with a placebo. The researchers reported that it helped. The studies were small and were carried out by the method’s own developers, including John Watkins.
Ego State Therapy and DID
Ego State Therapy was one of the first therapies to take parts seriously, and it has been used with DID for decades. In DID, the theory says, the walls between states are much thicker, with amnesia and separate identities.
Because it can involve hypnosis and reaching hidden states, it is important to work with a therapist who is well trained and goes at a pace the whole system can handle.
Related terms
- IFS (Internal Family Systems)
- Theory of Structural Dissociation
- Ego-State (historical term)
- Alters / Parts
A note about theories
The therapies and theories about trauma and DID are ideas that researchers are still studying and arguing about. None of them are proven facts. What works for one person may not work for another. Please take the time to read about any therapy yourself, ask questions, and decide what feels right for you.
Sources
Watkins, J. G., & Watkins, H. H. (1997). Ego States: Theory and Therapy. W. W. Norton.
Federn, P. (1952). Ego Psychology and the Psychoses. Basic Books.
Barabasz, A., Barabasz, M., Christensen, C., French, B., & Watkins, J. G. (2013). Efficacy of single-session abreactive ego state therapy for combat stress injury, PTSD, and ASD. International Journal of Clinical and Experimental Hypnosis, 61(1), 1–19.
Christensen, C., Barabasz, A., & Barabasz, M. (2013). Efficacy of abreactive ego state therapy for PTSD: Trauma resolution, depression, and anxiety. International Journal of Clinical and Experimental Hypnosis, 61(1), 20–37.
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