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Ego State Therapy by Gordon Emmerson PhD


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The book discusses the goals and benefits of Ego State Therapy and the nature, development and permanence of ego states. It includes the steps that are give in numbered point form (although not to be followed verbatim), offering a full explanation of each step and demonstrates with client / therapist dialogue.  It covers the definition of, the uses of and the methods of using ego state therapy, it then goes into the application and more detailed outline of a ego state therapy session, going through 3 sessions, each step is fully explained.  The book is finished of by discussing the implications of ego state therapy.

The Introduction (Turning the lights on: Ego State Therapy) starts with a brief explanation on what an ego state is and how, when and why they are formed – how, when and why we interchange between them.  It is very easy to understand and easy to read, this starts the book off in a way that makes the reader interested and confident they will understand whether this topic is just an interest or study / profession.  The introduction carries on with the goals of ego state therapy –

  • To locate ego states that harbour pain, trauma, anger or frustration and facilitate expression, release, comfort and empowerment.
  • To facilitate functional communication.
  • To help clients learn their ego states so that the states may be better used to the clients benefits.

It then goes on to outline the benefits of ego state therapy i.e. the increased understanding of personality, and an avenue for affective rapid and lasting change.

Chapter 1 defines ego states and ego state theory.  It describes the basis of ego state therapy being the premise that personality is composed of separate parts (ego states), explaining that although there may be many parts present, there is only one conscious and overt at any one time (the executive state), other states (non-executive) may or may not be consciously aware of what is happening.  An example of this is the change in mood we may have from the time something occurs to later on when we have settled down and may have a slightly different view on a situation – the executive state at the time of the occurrence, is replaced by another and our mood changes.  This chapter then goes on to give a more detailed explanation of what an ego state is and what their purpose and reason are, how they are created and the communications between ego states.  One important clarification in the book is a section on how the ego states differ from multiple personalities. The book states that we all have ego state but multiple personalities develop as an unconscious coping mechanism so that traumatic events can be forgotten from one day to the next.  The chapter continues with definitions and the nature of introjects and inner strength which have some definite differences to ego states, followed by a detailed history of the development of ego states an it effectiveness – giving some brief examples of research done.  The chapter finishes of with some examples of related therapies including psychoanalysis, gestalt therapy and transactional analysis.

Chapter 2 describes a number of ways that ego states can be accessed – either hypnotically or non-hypnotically.  It identifies and describes the techniques used to access ego states, both hypnotically and non-hypnotically and gives general guidelines for talking to them.  It gives short examples on the accessing and working with ego states and introjects, with guidelines and explanations for those examples.  It also explains who to promote internal dialogue between the state to get stronger states to help weaker ones by either being there to help or changing roles to take on more responsibilities.  The chapter goes on to explain the resistance deepening technique, the resistance bridge technique (a hypnotic technique that assists the client in moving directly towards the origin of the presenting issue), then moves onto how to access states that are reluctant to speak or co-operate.

Chapter 3 describes the methods of using ego state therapy and how a therapist can apply them.  Examples of the areas of usefulness are given.  Ego state trauma and how to deal with this are explained.  This deals with abreactions, neurotic reactions, finding the trauma and gives tools for working with the trauma.  Examples of this are given as a client / therapist dialogue followed by a break down of the process including improving ego state communication, internal and external ego state negotiation. Ego state mapping is described. This is useful for both the client and the therapist.  The client can gain a lot of insight into their own personality and learn who, what and why they are.  The therapist gains a lot of knowledge about a client and it is useful to have it mapped out, as there may be too many ego states and ego state relationships to remember.

Chapter 4 goes into some specific applications for ego state therapy.  It gives descriptions of the applications of ego state therapy, the most common being the goals of finding and resolving trauma.  These traumas may manifest in many ways including

  • Pain (this section also goes into the problems that may arise from using a pain relief that doesn't actually block the pain messages from going to the brain – it might be blocking the pain from the ego state in the executive but causing a non-executive state to feel it instead causing unknown and unresolved trauma).
  • Depression
  • Anger
  • Panic attacks

Couples counselling, treatment of addictions (a case study is given for a drug addict who had lost all confidence and desire to socialise and withdrawn from family and friends), smoking cessation, diet control, multiple personality disorder (dissociative identity disorder) and post traumatic stress disorder.

Chapter 5 gives a more detailed outline of the typical order of an ego state therapy session.  This chapter explains the components of an ego state therapy session and gives a rundown of 3 example sessions (a session to 'resolve trauma', a session to 'enhance internal communication' and a session to 'promote self awareness and knowledge of strengths'), these are not lists to be strictly adhered to but rather a guide as to the direction to take in similar situations.  A detailed explanation is given of each step taken which is easily followed and understood.

Chapter 6 describes the theoretical implications of ego state therapy.  This chapter asks 'why ego state therapy' rather than cognitive behavioural therapy suggesting that there is a place for all therapies but just as CBT provided a quicker and more up to date method of therapy than psychoanalysis and humanists therapies, ego state therapy provides the quick solution compared to CBT, and is a solution to the cause rather than the symptom.  It goes on to explain some theoretical implications of ego state therapy, with some brief study of the implications of blocked and false memories and nature / nurture.

This book is a very detailed and easy to follow text book which I found gave me a very in depth knowledge of the subject and has inspired me into wanting to learn more and eventually use ego state therapy in my own practice and although it went into in depth explanations it never seemed to bore me.  I know that I will be referring back to this book for a long time to come.  The only thing I would like to have seen would be more example dialogue between client and therapist in different and common situations, with examples from past real therapy sessions and outcomes.  But that said, the book has given me the inspiration to do more research on the subject and has given me a great deal of confidence to move forward with my hypnotherapy career, although I'm not sure that one therapeutic modal should take up over 90% of cases as the author suggests that he does (but that is another thing that I will find out with experience)

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