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Advanced Skills and Interventions in Therapeutic Counseling

Gordon Emmerson, Ph.D.
Advanced Skills and Interventions in Therapeutic Counseling

By Gordon Emmerson, Ph.D.

Crown House Publishing Limited, Wales, UK, 2006

Reviewed by Judith E. Pearson, Ph.D.

As a sequel to Ego State Therapy (Crown House, 2003), Dr. Gordon Emmerson has recently published Advanced Skills and Interventions in Therapeutic Counseling to give readers additional guidance and training in working with personality "parts" in therapeutic settings.

What is an Ego State?

In his earlier book, Emmerson wrote:

Egos state therapy is based on the premise that personality is composed of separate parts…called ego states. The state that is conscious and overt at any time is referred to as the executive state. Some non-executive ego states will be consciously aware of what is happening, while others may be unconscious and unaware….An ego state is…distinguished by a particular role, mood and mental function, which when conscious, assumes first person identity. Ego states are a normal part of a healthy psyche…Ego states start as defense coping mechanisms and when repeated, develop into compartmentalized sections of the personality that become executive when activated. (p. 1-4)

Ego states begin in childhood as coping mechanisms, often in response to trauma or emotionally significant events. All ego states initially develop to protect or benefit the individual in some way. Ego states cannot and should not be eliminated, but they can evolve and mature. Ego states seem to have their own identity and feelings (although they should not be confused with the "alters" of multiple identity/dissociative personality disorder). The average person may routinely use 5 to 15 "surface" ego states that are "close to the surface of the personality and usually communicate well with one another." Other ego states, hidden below the surface, activate only in response to stimuli that trigger associations or memories of the past. Emmerson believes the unconscious mind is made up of underlying ego states (many of them holding repressed memories) that do not communicate with surface states. These "underlying" states are sometimes accessible only with hypnosis.

Ego states carry emotions and resources and can sometimes affect physiology, even expressing themselves as psychosomatic illnesses. Emmerson views an ego state as a "neural pathway of dendrite and axon connections [that are] trained by recurring synaptic firings." (p. 16). Ego states emerge with the development of the brain and are formed via repetition.

Ego states communicate with each other, like or dislike each other, and create conflicts among themselves. Some states are opposites of one another (weak and strong, for example). Memory lapses occur when an individual changes ego states and the new state has not been paying attention to what the previous state was doing. This phenomenon explains state-dependent learning. A "vaded" ego state results from past trauma and is evident in neurosis. Some ego states are pathological and harmful to self or others. An "introject" is an internal representation of a significant other who may be living or deceased. Introjects can parade as ego states, but they are not, and can be dismissed or asked to leave, if they prove troublesome.

Concerning the advantages of ego state therapeutic approaches, Emmerson writes:

The power of using an ego state orientation in counseling is that the counselor can focus work on the particular part of the personality with the problem. Gaining access to "where the problem is" is an excellent method of facilitating change where it needs to happen. Too often…an intellectual ego state discusses a problem that another, fragile ego state experiences…The fragile part is not attended to directly and the course of therapy is extended (p. 12)

Emmerson provides a brief history of ego state psychology and compares and contrasts it with mainstream therapeutic approaches: psychodynamic, cognitive-behavioral, phenomenological (humanistic). He presents a well-written chapter on basic counseling skills and ethics. His general advice for counselors working with ego states is to speak to each ego state with respect and allow ego states to surface by having the client sit in a different chair for each one. Give each state a name and keep notes of who's who. Speak directly to each ego state, and do not allow another surface state to serve as an intermediary. Proceed with a goal to help all ego states accept and support one another and function together harmoniously.

Emmerson states that psychological difficulties result from unresolved issues around negative experiences. He uses "bridging" to take an ego state to a memory of such an experience, to set the stage for new understandings and thus, resolution. Trauma resolution consists of having the vaded ego state express feelings and thoughts about the event, banish the introject, update learnings about safety, and feel freedom and relief.

Emmerson provides guidance for assessing client problems and choosing the course of therapy. His book contains chapters for working with a wide range of problems such as cognitive dissonance, situational difficulties, post traumatic stress, grief, anger, crisis, depression, addictions, obsessive compulsive disorder, sexual abuse, and suicidal ideation. The transcripts of therapy sessions assist readers in understanding how to elicit ego states, converse with ego states, and encourage ego states to talk with each other. It is also helpful that Emmerson numbers and summarizes the steps in each therapeutic intervention.

Throughout the book, Emmerson warns against counselor responses that are not therapeutic such as: · Analyzing the client's situation instead of letting the client relate what has occurred. · Taking what the client says at face value, without asking if other ego states have other opinions, information, or explanations. · Promising or reassuring the client of positive and lasting change. · Minimizing the client's emotions, instead of empathizing. · Using suggestions that could lead to false memories.

Emmerson teaches how to help ego states negotiate with one another, resolve conflicts, heal emotional wounds, reach agreement, and share information. He gives readers specific sentences and phrases to use to shape the dialog with the client, even in difficult circumstances, as when the client has difficulty accessing a particular state. He also speaks to the issue of "spontaneous hypnosis", a trance state that occurs spontaneously, without a formal hypnotic induction.

The Author

Dr Gordon Emmerson is a senior lecturer in the school of psychology at Victoria University in Melbourne Australia, where he coordinates the Masters Program in Counseling. He is a member and previous state president of the Australian Society of Clinical Hypnotherapy (ASCH), a member of the Australian Psychological Association (APS), and a Victoria state registered psychologist. He has published a number of articles on ego state therapy and has taught workshops on the subject throughout the world.

Conclusion

Advanced Skills and Interventions in Therapeutic Counseling is an excellent companion to Ego State Therapy. Ego state therapy has long been a mainstay in NLP and practitioners will no doubt welcome this book. Bandler and Grinder developed NLP methods for working with parts, and were influenced by Virginia Satir who spoke about people having parts of self, as well as by Fritz Perls who worked with "empty chair" conversations. While this book speaks very little about hypnosis, I think hypnotherapists will easily understand how to blend ego state therapy with their own trance induction methods (especially if they first read Ego State Therapy).

I caution practitioners to exercise care to ensure that clients understand that this method of working with "parts" is a useful model for understanding the complex nature of the human personality and that the work takes place in the "as if" frame. In this way, clients will not feel fragmented during the process.

While at first, the idea of speaking to different ego states may seem strange or off-putting to some, Emmerson demonstrates ways to weave the concepts into conversation in a very fluid and casual manner so that those concepts begin to make sense. Emmerson explains the methods so well that the reader's only difficulty might be squeezing a sufficient number of vacant chairs into the office to begin working with all those ego states!

To order Advanced Skills and Interventions in Therapeutic Counseling contact Crown House Publishing Ltd online at www.crownhouse.co.uk (for readers in Europe and the United Kingdom) or www.CHPUS.com (for readers in the U.S. and North America).