Ego State Therapy
The Ego-State-Therapy (English: ego state therapy, Latin ego 'I', English state 'state') is a psychotherapeutic method from trauma therapy . It was developed by John Watkins and Helen Watkins .
People who have been severely mentally injured ( trauma ) develop defense mechanisms against the feelings of pain and fear associated with the injury to protect their personality . Some do this by “dividing” their personality into different parts of the ego (ego states). This almost always happens unconsciously at first . These I-parts can develop a life of their own like “own personalities”, with “own” will, “own” thoughts and feelings. Ego-State Therapy aims to help those affected to better reconnect these parts of the ego in the direction of a holistic personality.
history
The "Ego State Therapy" has been developed by the Americans John and Helen Watkins since around 1980 in the USA.
John Watkins (1913–2012), a pioneer of hypnotherapy , was Professor of Psychology and Director of Clinical Education at the University of Montana (USA) from 1964 to 1987 . He is a co-founder of the International Society for Clinical and Experimental Hypnosis (SCEH). His wife Helen Watkins , who died in 2002, was also a psychologist.
Ego state therapy model
Ego-state therapy is based on the theory that the personality consists of different parts of the ego (ego states). These parts are delimited and describable "sub-personalities". It takes into account psychoanalytic theories, hypnoanalytic techniques and recent findings from the treatment of dissociative disorders.
It is effective for post-traumatic stress disorder , borderline , anxiety or sexual disorders and dissociative identity disorders .
See also: hypnoanalysis .
Healthy parts of the ego
“I part” is understood to mean individual aspects of the personality, of one's own self (meaning and effect of the different I parts are described in the article Inner Team ). A healthy, non-traumatized person knows and uses about 5–15 such ego states. You are clearly aware and directed by the self . Most of such parts of the ego arise in childhood in the course of normal development.
Healthy parts of the ego are parts of the "everyday team", e.g. For example, the “competent specialist” who can give a technical lecture in front of colleagues, or the “good host” who can pour the coffee from the right, or the “cool guy” in the disco, or the enthusiastic “cyclist”. These are parts that humans have at their disposal and can switch between them as required.
See also: Eric Berne or there: Discovery of the ego states .
Unhealthy integrated proportions
In the transition area between the healthy and the split off parts there are unhealthy, integrated and consciously accessible parts that can be worked on therapeutically without hypnosis or trance .
A new part of the ego can also arise as a result of resistance in therapy. The patient is z. B. "suddenly so tired". This is to prevent the patient from becoming aware of an old structure that is badly adapted to current reality (or of frightening feelings behind it). The new ego part has the task of distracting from the fact that “there is something” or protecting another ego part that was entrusted with the design of the old (and now inappropriate) structure.
The therapist could now work with the current resistance; H. him z. B. “Ask on the inner stage” to get to know each other and let the patient visualize ( imagine ) him. ("What is the task of this tiredness, what is it supposed to protect against?") If this succeeds, it leads to the original ego state (ie the structure that is badly adapted today), which can then be used therapeutically.
Defense mechanisms , up to a certain degree, are to be regarded as completely normal protective mechanisms that everyone has and needs. The disease value is extreme in each case. For example, where the development of the internal structure is stuck in unresolved conflicts or the basic conflicts , such ego states perform their traditional tasks, which have an unhealthy effect for “people today”.
See also basic conflict here z. B. Basic Conflicts According to Operationalized Psychodynamic Diagnostics (OPD)
Psychoanalysis uses the term character types for a set of the prevailing defense mechanisms.
See also: character types .
Split-off parts of the ego
Feelings associated with traumatically hurtful situations can be so strong that people cannot stand them. Even conflict-laden situations can make demands on a person to which he has "no answer" and which can trigger a correspondingly deep fear. A defense mechanism is built up against this. One form is the separation of parts of the ego. Feelings and energies of unresolved trauma are stored in these . Special forms and tasks of such ego-parts can be distinguished: “persecutors”, radical helpers, perpetrator introjects (perpetrator- identified part), attackers, accomplices-introjects (perpetrator-loyal parts). Individual parts of the ego can also overlap and, if necessary, reinforce one another, e.g. B. Perpetrator-identified and perpetrator-loyal shares. In its ideal, pure form, a single part of the ego rarely comes to light.
As an example, consider a person who has been abused by a family member from childhood, has now lived in his own apartment as an adult, and is still visited by the perpetrator for acts of violence. His healthy part of the ego that can be contacted during therapy can learn the new information: “You don't have to let him in.” That will strengthen the person, but he still says, for example. B. “Yes, but I can't promise.” Because there is also the part identified with the perpetrator who believes, according to previous experience, to have to continue to (relatively) protect people by doing what the perpetrator demands. This can lead to the continuous decision to let the perpetrator into his own apartment again and again against his better judgment, according to the old motto: "You have to do what he wants, otherwise he'll kill you." This part is split off and is not subject the ego control.
Separated parts of the ego appear as if they had their “own personality”, with “their own” feelings and thoughts. They consider their existence to be helpful and essential for survival, and are potentially designed to last a lifetime. Some “know” each other and are in contact with each other. Others are completely split off (underground ego parts); the core personality is no longer in contact with them and they are often only accessible through hypnosis or trance.
See also: Dissociative Identity Disorder .
Such parts of the ego are not to be confused with introjects recorded in the course of psychosocial development, i.e. inner images of people who were important to us and whose values, norms and behavioral patterns we have absorbed. Introjects do not start as defense mechanisms and are also accessible without hypnosis or trance in a therapeutic conversation for the inclusion of new, real information (allow an “update” of oneself). For example, if a law (introject) passed on to an important caregiver from childhood reads “You must not cry”, the inner part that represents this can gradually re-learn in therapy until the new, own law finally reads “You may cry as much as you want ”. Introjects don't insist on staying (like ego states); you can change it or ask to leave.
aims
The primary goal of Ego-State Therapy is to reduce the stress in the inner system and to direct the energy back to the creation of a fulfilled life. The patient should learn to better coordinate the different parts of the personality (the related needs and viewpoints) and to decide on the essential ones and to act accordingly. Depending on the severity of the disorder, the ego-parts can be fully integrated (inner team), or, now guided by one's own self, symbolically continue to be viewed as “one's own personalities”, but are now used constructively and integratively.
Methods
The split off parts of the self are a part of the self. That is why it is important to embrace it as a valuable resource. For many years they have faithfully and reliably done exactly what they were once commissioned to do. Even if today they can no longer adequately take care of the patient's self.
The therapy takes place in four phases:
- create internal security
- Find trauma, clear resources
- stabilize, work through trauma experience
- Integrate experiences, consolidate personality and identity
In therapy, the therapist can address a part of the ego directly. He is activated symbolically and imaginatively and can be asked directly about his story, his experiences, his task, his goals, thoughts, wishes, hopes and fears. In the "conversation" of the therapist or the patient with the ego part and the ego parts with one another, these can change and develop. The patient can supply the "I parts" with new data on current reality and learn to control and integrate the experiences and ideas contained in these I parts and to use the often hidden resources.
Fixed parts of the ego often “fear” that they should dissolve or disappear when they are “discovered” in therapeutic work. It is therefore important to appreciate their previous achievements, as paradoxical as it may seem, and to give them support or to assign them new important tasks that they feel equal to, so to reintegrate them.
See also the methods in: Psychodynamic Imaginative Trauma Therapy .
Classification of the therapeutic approach
Based on the knowledge that people can develop different inner parts, different therapeutic approaches emerged. For example, the parts of id - ego - super-ego named by Sigmund Freud flowed into the psychoanalytically / depth psychologically oriented therapeutic approaches. The work with the Inner Child came up and found expression in the Psychodynamic Imaginative Trauma Therapy by Reddemann . Therapists working with severely traumatized people found that these concepts did not go far enough. New approaches were developed that start from many inner parts (ego-state model) within a person, which can be described and classified and can be found in a similar form in other people. The various therapeutic approaches are often combined with one another, as has become common practice in psychotherapy today.
For integration work in the therapy of dissociative identity disorder (work with dissociated people), z. B. Application: the goal-oriented integration model ( The Tactical Integration Model by Fine 1991, 1993, 1996, 1999), the strategic integration model (Kluft 1988) and the model of Ego States by Watkins & Watkins. The first two models aim at complete integration into a whole of the person. The personality-oriented model of the Ego States aims at a functioning and satisfactory cooperation of the various partial personalities and / or ego states.
literature
- John G. Watkins, Helen H. Watkins: Ego States. Theory and Therapy . 1st ed., WW Norton & Company , New York (NY / USA) et al. 1997 (= A Norton professional book), ISBN 0-393-70259-6 . (engl.)
- John G. Watkins, Helen H. Watkins: Ego States. Theory and Therapy . 1st ed., Reprint, WW Norton & Company, New York (NY / USA) et al. 2007 (= A Norton professional book), ISBN 0-393-70259-6 . (engl.)
- John G. Watkins, Helen H. Watkins: Ego-States. Theory and therapy . 1st edition, Carl-Auer-Systeme-Verlag, Heidelberg 2003, ISBN 3-89670-414-1 . (German translation; English original title: Ego states. Theory and Therapy )
- Luise Reddemann, Arne Hofmann u. Ursula Gast (Ed.): Psychotherapy of dissociative disorders. Disease models and therapy practice - disorder-specific and across schools; 9 tables . Georg Thieme Verlag, Stuttgart et al. 2004 (= Lindau Psychotherapy Module), ISBN 3-13-130511-8 . (P. 101ff: goal-oriented integration model )
- Jochen Peichl: The inner dream landscapes. Borderline, ego state, perpetrator introject; with 21 tables . Schattauer Verlag, Stuttgart et al. 2007, ISBN 3-7945-2521-3 . ( Table of contents as PDF file )
- Jochen Peichl: Inner children, perpetrators, helpers & Co. Ego-state therapy of the traumatized self . 1st edition, Verlag Klett-Cotta, Stuttgart 2007 (= series: Learning to Live, No. 202), ISBN 3-608-89047-5 . ( Brief description of the content )
- Kai Fritzsche, Woltemade Hartman: Introduction to Ego-State Therapy . 2nd edition, Carl-Auer-Systeme-Verlag, Heidelberg 2014, ISBN 978-3-89670-745-1 . ( Table of contents )
Web links
- Dr. Jochen Peichl, Nuremberg, advanced training seminar 2006: Ego-State-Therapy (slides) (PDF file; 102 kB)
- Ph. D. Woltemade Hartman: What is Ego-State Therapy (Youtube, 4 posts in total)
