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A community of mental health professionals passionate about Ego State Therapy (EST) with a mission of creating public awareness of this effective approach, furthering and expanding EST education, and providing a directory of trained EST clinicians. 

Psychologist Session

What is Ego State Therapy

Ego State Therapy is an effective approach that was founded by John and Helen Watkins.  Although it has a clear psychoanalytical foundation, results seem to be much more efficient than psychoanalysis.  It is an effective and very useful approach when working with internal conflicts, especially trauma and dissociative disorders.  However, it is also useful with many other clinical concerns.

Ego states are the parts of our personality that make up our entire self.  These parts give us the ability to adapt, think, act, and respond differently in different situations.  Sometimes conflict occurs internally among different ego states and an individual may not even be conscious of why the conflict is there.  Exploring and working with the different parts of our selves can produce efficient results and relief. 

Usually, Ego State Therapy is combined with hypnosis in order to effectively explore the covert ego states and any internal conflict(s).  This is especially useful if the conflict is not a conscious process, which is often the case.  However, it should be noted that ego state theory and therapy applications can and are utilized without hypnosis as well.  Many therapists assign journaling assignments such as writing to “the child within,” which certainly assumes the existence of a covert ego state. 


Statue holding ears closed
Normal Multiplicity and Internal Voices


We all have internal voices and different states of self to guide and regulate our thoughts, emotions, and behavior. These voices may help us at times and other times may cause us distress. These states are often not conscious to the self and may be influencing us in ways we are not consciously aware of.  Clinical hypnosis is often utilized with EST to give voices to these states of self and to access internal resources that you may not be consciously aware of.  This can assist us in exploring symptoms as well as solutions to a variety of psychological problems, conflicts, and/or improving psychological well-being. 

Image by Annie Spratt
The Unconscious & Clinical Hypnosis


Much of what we do involves implicit memory and thoughts, feelings, and/or emotions that are not in our conscious awareness. Freud liked it to an iceberg, where much of what is there isn't seen on the surface. When states are not conscious to the self, they can influence us in ways that we are not consciously aware of.  Clinical hypnosis is often utilized with EST to access and provide a platform to work with these states. Clinical hypnosis can provide an avenue to access unconscious internal resources, assisting to explore symptoms as well as solutions to a variety of psychological problems, as well as enhancing performance, and/or improving psychological well-being. 

Thinking Man on Couch
Complex Trauma and Dissociation


Ego State Therapy is a commonly used approach for trauma, especially dissociative disorders.  The Watkins believe ego states are separated by internal adaptive boundaries depending on need and environmental context.  For instance, if someone suffered repetitive trauma as a child, they may have developed more rigid boundaries between states of self through the defense of dissociation to protect themselves. It is likely these boundaries now cause problems in functioning and/or memory impairment. Those with dissociative disorders also have parts that are in great conflict with each other. EST provides an approach to safely manage these defenses and can assist in updating one's internal system to function adaptively in current environment and life circumstances, improving quality of life.  

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