Robin Shapiro - Easy Ego State Interventions: Strategies for Working With Parts

EASY
EGO STATE
INTERVENTIONS

Strategies for
Working With Parts

ROBIN SHAPIRO

W. W. NORTON & COMPANY

New York London

A Norton Professional Book

To David Calof, April Steele,

and all the teachers, clinicians, and clients

who have taught me about parts.

CONTENTS

Part I
GETTING STARTED WITH
EGO STATE WORK

Part II
PROBLEM-SPECIFIC INTERVENTIONS

ACRONYMS AND
ABBREVIATIONS

If you are new to ego state therapy, welcome to a powerful, flexible therapy. If you are an old hand, I hope you find some new interventions to add to your therapeutic toolbox.

Before we delve into the how-tos and whys of ego state therapy, let me give you an example of a general ego state intervention, helpful to a variety of people, especially therapists. If you want to experience it yourself, shut your eyes occasionally in order to access your own particular states.

Go inside. Notice, as you sit deeply into your chair, that you are an adult. As an adult, you have boundaries. You have professional and other skills. And you have a broad perspective. Think of yourself acting competently with clients, paying bills, voting, and behaving as an adult in your relationships... Now go deeper, and as that competent adult, find that small child inside of you. Notice how that child holds your curiosity, your need to elicit love and approval, and for many of you, because you chose this profession, the need to take care of those around you. When youve found that little one inside, look at it and feel its gaze coming back to you and let yourself know if this little one inside deserves to be taken care of: fed, protected, allowed normal sleep, loved, kept around loving people and everything else a human needs. Will you commit to taking care of this child in you?... And will you, as an adult, keep this child back from situations in which you need to be and act like an adult?... Good. Now I want you to imagine walking through a normal day attending to adult things, while taking care of and protecting this child. Make sure this child is fed, hydrated, well slept, and entertained. Make sure that your adult self keeps this child out of situations that call for adult behavior. Walk through letting your adult decide what your boundaries will be with your work, your families, and the needs of all others... When youre ready, hug that child inside, feel that young heart beating inside your heart and those little lungs breathing with you, and come back, fully to the room and this book.

What did we just do?

III We changed your state by closing your eyes and going inside.

III We accessed the adult functional part of you, including an adult role.

III We accessed a child state and normalized some of its functions.

III We connected the two states.

III We put the adult state in charge and got its agreement that the child state is its responsibility. Then we delineated those responsibilities.

III For some of you, we gave a new way to think about self-care and boundaries.

III And at the end, we integrated the younger part back inside the here-and-now adult.

I learned parts of this exercise in the early 1980s from Thom Negri (personal communication, 1981). At that time, I had a passing acquaintance with Sigmund Freuds id, ego, and superego (Freud, 1933, pp. 105106) and had read about Eric Bernes (1964) transactional analysis and its famous three circles (P for parent, A for adult, and C for child). Later I learned the gestalt two-chair technique and studied deeply with hypnotherapists, especially David Calof (go inside), who often called up ego states for therapeutic effect. In the mid-1980s, I started working with my first dissociative identity disorder (DID) client. As I quickly learned, anyone working effectively with DID must respond to ego states. In 1993, I learned eye movement desensitization and reprocessing (EMDR), the powerful trauma therapy, which at the time did not address dissociation. Because there is no faster way to awaken dissociative phenomena than to do EMDR without proper preparation, there are now at least eleven books and countless workshops (some of which I have taught) dealing directly with EMDR and dissociation, most of which discuss ego state work. Joanne Twombly and Richard Schwartzs The Integration of the Internal Family Systems Model (IFS) and EMDR (2008) introduced me to the comprehensive internal family systems model. Workshops and online forums at the International Society for Study of Trauma and Dissociation gave me many other tools for working with dissociative individuals.

In this book I want to share the interventions that have worked for my clients that you may not have seen elsewhere. I hope this book is helpful to therapists new to ego state work and to veterans of the modality wanting new interventions to add to their toolbox.

Ego state therapy works well with every other therapy that I know about: explore inappropriate cognitions with examinations of which ages hold them; enhance the safe, present-moment strong adult before exposure to the traumatized younger parts; expand on the built-in ego states in psychodynamic therapies; make it possible to do EMDR with the most traumatized and dissociated clients by having the functional parts hold and behold the traumatized ones; find the brainspot that fits with the age or dissociated part (Grand, 2013). And, if you have simple trauma, or a client who simply needs some new skills, you might not need ego state therapy at all.

Many of the interventions in Easy Ego State Interventions are as universal as the example I gave above, suitable for garden-variety clients with normal developmental issues, such as differentiation from families and peer groups, self-care, and grief. Many of the interventions will also work with clients across the dissociation spectrum, a condition particularly well suited to ego state work, including clients who suffer trauma and complex trauma. This book offers ego state approaches that work for both client populations, though a thorough discussion of dissociation is beyond the scope of this book.

Be aware that when clinicians talk about ego state therapy they are often talking about dissociative state therapy, not ego state work with garden-variety clients. Are they talking about here-and-now, associated, but sometimes younger-feeling parts of the self (garden variety ego state work), or reflexively triggered, dissociated, separate parts? I discuss both throughout this book.

, Easy Ego State Interventions will not teach you all you need to know about dissociation. For that, I suggest Ego States: Theory and Therapy (Watkins & Watkins, 1997), The Haunted Self (van der Hart, Nijenhuis, & Steele, 2006), and Coping With Trauma-Related Dissociation (Boon & Steele, 2011) For EMDR practitioners, Healing the Heart of Trauma and Dissociation (Forgash & Copely, 2007), EMDR Toolbox: Theory and Treatment of Complex PTSD and Dissociation (Knipe, 2014), and Neurobiology and Treatment of Traumatic Dissociation: Towards an Embodied Self (Lanius & Paulsen, 2014).

If you have never done ego state work with clients, it may feel odd to ask, how old does that feel? or, what part of you holds that thought? Most clients pause for a moment and answer the question. Some clients, after a session or two of going inside, start giving reports: My obnoxious teenager came out at a party this weekend. My geeky ten-year-old really loved the science museum. I really had to work hard to stay in my adult when I went to that job interview, but I nailed it.