Ego State Therapy (EST) is a form of psychodynamic therapy that derives from psychoanalysis, clinical hypnosis and constructs of dissociation. Ego States were first identified by Austrian-American psychologist Paul Federn, a contemporary of Freud. Federn was a lifelong collaborator with psychoanalyst Eduardo Weiss, who analyzed John Watkins. Watkins was an American psychologist who formally founded Ego State Therapy as we practice it today. (My trainer and supervisor, Dr Wendy Lemke, was a mentee of Jack Watkins). Due to the nature of EST interventions and the absence of incentives for financial backing, research on this modality is limited. Although the evidence-base does not seem so robust, academic publications are available on the historic development of EST and its current applications. EST remains a respected treatment approach in accordance with official ISSTD trauma and dissociation guidelines.

EST assumes that we all possess different states of self, that is, those aspects of our personality that show up reliably in certain roles or settings. States of self can also show up when past trauma is triggered. A state pf self is simply a collection of perceptions, behaviors and affect in one neural or memory network. EST uses hypnotic language and approaches to access your internal experience. You may be asked to be respectful of thoughts and feelings that are coming up, to be open to learning why you are reacting the way you do or to empathize with the purpose behind the way you have developed. The overall purpose of EST is to feel more connected to yourself and live your most authentic life. In an EST session I will help you become less judgmental about your inner experience, and help you create a calm and cooperative inner life. EST does not promote either the fragmentation or fusion of the self. I practice EST in strict accordance with trauma best practice guidelines.

Clinical hypnosis is the use of hypnotic phenomena in mental health treatment. Hypnosis is the process of facilitating focused attention, and almost all psychotherapy do this. I use hypnotic phenomena in my practice all the time: shifting your awareness, harnessing attention, noticing internal processes, experiencing your five senses, accessing memory and evoking motor function. In an EST session, you may be asked to be open to storytelling, visualization, positive reframing, questioning and curiosity. Hypnosis is NOT actually “stage hypnosis”: those performances are aimed at deception for entertainment purposes. In my work, I never override your agency or will. I don’t know how to put you to sleep or make you surrender control. You only enter into the therapy session as lightly or deeply as it feels safe and manageable to you.

You are a good fit for EST if you feel comfortable exploring parts of yourself, in other words, aspects of yourself that feel inconsistent with who you think you are. EST is a good fit if you enjoy depth work, exploring defenses or origins that lie outside your conscious awareness. If you are highly imaginative and creative, this kind of work may appeal to your right-brain affinity. This work is also indicated for people who already know that they have different states of self, or for those already received a diagnosis of Dissociative Identity Disorder.

Not quite. Ego State Therapy has a very different approach (and origin) from IFS (Internal Family Systems.) They share the common feature of “parts work” but the models operate on different very premises. EST do not categorize parts, nor use the concept of a spiritual “Self”. EST has no manualized protocols or sequential treatments. EST is not a spiritual program. EST does not reject assessment and pathology and comfortably exist alongside clinical and professional standards for mental health treatment.