ego state therapy
What is ego state therapy?
Ego State Therapy is a collaborative, paced approach that works with parts-of-self to understand internal dynamics and reduce internal opposition—especially when there is “stuckness” shaped by inner conflict, self-sabotage, avoidance, or a strong inner critic. It is also commonly used to address anxiety, depression, anger, shame, trust and attachment difficulties, and trauma-related patterns (including reenactments and dissociative coping).
In sessions, the work involves identifying which parts-of-self are active, understanding their protective purpose, and validating their concerns. Rather than forcing parts to change, the approach supports them—when appropriate—to develop more up-to-date “job descriptions” so they can respond to present-day reality rather than past threat. Parts are not eliminated; they are respected, negotiated with, and integrated as the work progresses.
A common way of organising the work is structured imagery (an “inner conference room,” sometimes called the Dissociative Table) to access inner dynamics clearly and efficiently.
Common outcomes include increased containment and stabilisation, greater internal cooperation, and improved capacity to relate to difficult emotion without becoming overwhelmed.
How it pairs well with EMDR therapy
Ego State Therapy is often integrated with EMDR Therapy to support readiness, consent, and pacing. In more complex presentations, protective parts may interrupt or block reprocessing through looping, loss of dual attention, or overwhelm that exceeds ego strength—or because parts are not on board or have not consented
Parts may also experience trauma processing as a reenactment, which can feel confusing or re-traumatising. Ego State Therapy addresses these obstacles by increasing internal cooperation and stabilization, allowing EMDR to proceed more safely and effectively.
For dissociative and non-dissociative clients
Ego State Therapy is useful across the spectrum—from clients who notice different “sides of self,” to those whose coping includes more pronounced dissociation. In this framework, disowning or distancing from a state can be a natural protective function, and when distancing becomes a primary coping style it may contribute to dissociative disorders.
This approach relies on consistent containment and closure. Sessions end by containing disturbing material until the time is right, supporting affect regulation as a learned skill, and—when indicated—“tucking in” parts-of-self so the system can return to present-time orientation. The aim is continuity of functioning between sessions while integration and reprocessing continue over time.