It has been more than a century since Freud and his associates discovered unconscious mental processes. Other psychological pioneers, such as Janet, Binet and Prince, also made monumental contributions in this area, and a major psychological tradition called “Psychoanalysis” emerged. This approach stemmed from philosophical rationalism and was based on observations made of patients seeking help for mental conflicts, and on self observations through introspection.
Other seekers for human understanding, impressed by the contributions of the physical sciences, sought freedom from “subjectivism” by focusing on the “objective results” of mental processes, e.g., “behavior”. Behavior was tangible and more easily lent itself to laboratory experimentation.
From these pioneers (which included James, Dewey, Thorndike, Watson and others) the second major psychological system, “objective empiricism” developed. Psychology re-defined itself as “the science of behavior”.
This tradition dominated the psychology of the 20th Century. From it, brief, active systems of psychological treatment emerged, such as behavioral and cognitive therapy.
Each tradition had its own limitations. Psychoanalysts, relying primarily on free association, dream interpretation, and the analysis of transference reactions as their research “tools” developed a system of therapy, which, though often effective, required the expenditure of many hours of treatment.
Although psychoanalysis has continued, and has developed more sophisticated theories, (object relations, self theory, Lacanian psychology, etc.) there has been almost no change in the basic “tools” of its therapeutic technique. Accordingly, psychoanalysis has languished as a “practical” treatment modality.
The empirical-behavioral tradition, while showing immediate therapeutic results, has done so by ignoring conditions and behaviors which are mediated through sub-liminal, “unconscious” processes, thus severely limited the scope of its operational area. Also controversial, is the long-term permanence of symptomatic improvements achieved through cognitive-behavioral therapies.
Abandoned by psychoanalysts, and initially ignored by academicians (because of the ill-repute of stage demonstrations) clinical and experimental hypnosis has continued to occupy the focus of an active group of investigators and practitioners. Small in number, but sparked by such well-respected academicians as the Hilgards at Stanford University, and innovative therapists, like Milton Erickson and many others, this third tradition has continued and flourished. Their findings are publicized through several hypnosis journals and within national and international hypnosis societies.
In the past 30 years a small group of such hypnotherapists, seeking to develop a more rapid treatment methodology, which would combine the speed and efficacy of the cognitive-behavioral approach, plus the depth of the psychoanalytic tradition, have been developing a therapeutic system known as “Ego State Therapy”.
Based on the psychoanalytic theories of Paul Federn, John and Helen Watkins and their associates (including Frederick, Phillips, Hartman, McNeal, Morton and others) have published many papers and several books detailing Ego State Therapy techniques. Other investigators, (such as Kluft, Torem, Fraser and Hunter) have further advanced the use of Ego State Therapy in the treatment of dissociation.
Moreover, the “First World Congress of Ego State Therapy” was held March 20–23, 2003, in Bad Orb, Germany, sponsored by German and European hypnosis societies.
Ego State Therapy promises rapid, long-lasting results in much shorter time than psychoanalysis, and several empirical, efficacy studies have already been published demonstrating its validity (Watkins & Watkins, 1997, pp. 162–194; Emmerson, 1999; Emmerson & Farmer, 1996).
This present work, Ego State Therapy, by Gordon Emmerson is a major building block in the emerging body of literature which marks this developing approach. It is comprehensive in covering the field, and will be a basic reference on Ego State Therapy for years to come.
Newcomers to this approach sometimes have difficulty conceptualizing just what is meant by “an ego state”. A strength of this work is the way Emmerson, using metaphors and other explanatory methods, clarifies just what an “ego state” is, and how it functions in the psychic economy of the entire person.
He clearly delineates states that represent more conscious moods, which he terms “surface” ones, and states that are normally below the threshold of awareness, for which he uses the term “underlying”. These latter ones generally require hypnotic activation to make them accessible for therapeutic interventions.
While he does not severely criticize other systems of treatment he points out that the “cognitive therapies” must of necessity deal with “surface states”, and he opts for more depth in therapy noting that, “to paste a coping skill on the surface of an injured personality is to further remove that person emotionally from ‘Self’”.
Emmerson presents the therapist/client verbalizations in many different cases, which help the reader to understand just how he, and his colleagues, practice Ego State Therapy.
In these, he himself often employs the Socratic-questionings commonly used by cognitive therapists. However, he demonstrates how much deeper insights can be achieved when these are administered to a “hypnotized” client, and he advocates the learning of hypnotic skills by more therapists.
The message here is that Ego State Therapy is not simply a specific, coherent treatment approach, but that its techniques can be adopted and added to the armamentarium skills of the cognitive therapist, the psychoanalytic therapist and other practitioners.
His text differs from that of the Watkins and Watkins (1997)1 in that his broad experience has been apparently drawn from working with non-hospitalized private clients. His cases are more like those treated by Helen Watkins than the severe neuroses and dissociations which John Watkins encountered in military and Veterans Administration Hospitals. Thus, his cases and treatment techniques complement those found in the Watkins’ text. The goals of insight, integration, and personality reorganization, however, are similar in both volumes.
Therapists and counselors will find this work an excellent and well-written textbook for the learning of Ego State Therapy – especially when combined with study in clinical hypnosis.
John G. Watkins, PhD
Professor Emeritus
University of Montana
1 Watkins, J. & Watkins, H., 1997, Ego States: Theory and Therapy, Norton, New York.