EGO STATE THERAPY is an approach to treating complex posttraumatic stress disorder (complex PTSD) and is sometimes referred to as ‘parts work.’
In particular, this therapy is designed to help treat symptoms of complex PTSD which come under the headings of :
- avoidance symptoms
- intrusive symptoms
- depressive symptoms
Let’s briefly look at each of these three types of symptoms :
AVOIDANCE SYMPTOMS :
These include avoiding places, people, events, and situations that remind one of one’s past trauma. However, individuals often employ psychological defenses (usually unconsciously) as a way of avoiding accepting the reality of their childhood traumatic experiences; these psychological defenses include :
- idealization of parents
- minimization of adverse effects upon the self of one’s childhood
Finally, people who have suffered traumatic childhoods may use dysfunctional coping strategies to avoid their emotional pain which, in turn, can lead to addictions such as :
- addiction to alcohol
- addiction to drugs (both illegal and prescribed such as sleeping tablets and tranquilizers)
- addiction to gambling
- sex addiction
- comfort food/carbohydrate addiction
- excessive exercise
- addiction to self-cutting / self-harm with the short-term effect of relieving unbearable stress/anxiety
INTRUSIVE SYMPTOMS :
These include nightmares, flashbacks, hypervigilance, anxiety, feelings of aggression, and irritability; such symptoms can also be categorized as high-arousal symptoms.
DEPRESSIVE SYMPTOMS :
These include despair, shame, inadequacy, unworthiness, hopelessness, helplessness, and a sense of being trapped in a tormenting frame of mind, with no escape route (this is sometimes referred to as ‘learned helplessness’).
Feeling one has no hope is a particularly invidious symptom as it is known that feelings of hope, even when highly distressed over long periods, lowers the probability of suicide attempts; logically, therefore, the opposite holds true.
Depressive symptoms can also be categorized as low-arousal symptoms.
‘PARTS’ WORK :
Ego states theory involves a technique known as parts work.
Parts work is based upon the theory that as a psychological defense we unconsciously ‘compartmentalize’ different aspects of our personalities to enable us to ‘mentally partition off the ‘parts of ourselves that we find unacceptable, and/or that contain intolerable memories, from the more acceptable ‘parts of ourselves that allow (at least a semblance of) day-to-day functioning.
These ‘parts’, or ego states, that hold we find unacceptable and/or hold distressing memories frequently reflect earlier developmental phases in our lives that occurred during our traumatic childhood and that are therefore related to traumatic memories.
How Can These Parts That Reflect Earlier Developmental Phases Manifest Themselves Now We Are Adults?
These parts may manifest themselves when we are under stress in the form of regressive behaviors.
For example, under extreme stress, we may display child-like tantrums or behave in an aggressive, rebellious manner like that of a young teenager. Or, when upset, we may curl up on our beds clutching a soft toy.
Internalized Parts :
We may, too, possess ‘parts of ourselves that we have internalized from emotionally significant others (usually parents or primary carers) during our childhood.
For example, if we had a parent who was highly critical of us when we were children, we may find we are prone to judging ourselves with a very unforgiving and self-lacerating attitude, constantly feeling that we failed to meet the exacting standards that we’ve set ourselves.
Or, if we had a parent / primary carer who was highly religious and regarded us as fundamentally flawed and sinful, we may, as adults, find ourselves tormented by fears of ‘eternal damnation.
INTERNAL FAMILY SYSTEMS (IFS) THERAPY:
IFS therapy is perhaps the most well-known therapy to incorporate ‘parts work.’ It is based on the idea that the individual has three types of parts; these are as follows :
- Exile parts
- Manager parts
- Firefighter parts
Let’s briefly look at each of these in turn :
EXILE PARTS :
As the name suggests, these are the parts of ourselves that developed as a result of the damage done to our personalities by our childhood trauma and which we largely keep banished and cut off from conscious awareness / repressed / suppressed.
The exile parts are kept closed off from conscious awareness as a means of psychological self-protection as these parts contain distressing memories and painful emotions such as neediness/dependency, intense anger, grief, fear, shame, loneliness, and vulnerability.
MANAGER PARTS :
These are the parts of ourselves that try to keep us in control and allow us to function on a day-to-day basis and keep extreme/distressing/counterproductive emotions at bay. Frequently, too, these parts are extremely self-critical.
FIREFIGHTER PARTS :
These parts attempt to protect us from the emotional pain the comes upon us when our exile parts start to break through and impinge upon our consciousness and behavior (as may happen, for instance, during periods of intense stress and/or when we are reminded – either consciously or unconsciously – of our childhood trauma).
However, they do this by causing us to behave in impulsive, and, in the long-term, self-destructive ways such as excessive drinking, abuse of narcotics, workaholism, risky, promiscuous sex, gambling, and overeating.
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David Hosier BSc Hons; MSc; PGDE(FAHE).