Ego state therapy is based on the idea that a person's psyche is the amalgamation of several distinct people or egos, such as the wounded child or controlling personality. It developed from psychodynamic psychotherapy, and uses techniques similar to those used in family and group settings. Ego state therapy was originally developed by John G. Watkins and Helen Watkins, psychotherapists who specialized in hypnosis, dissociation, and multiple personalities.

What Are Ego States?

Ego state therapists frequently refer to a “family of selves.” They don't literally mean that a person has multiple personalities. Instead, each of us must navigate several discrete identities and roles. For example, a woman might adopt the role of protector toward her children but feel like a fearful or neglected child around her mother. Ego state therapy aims to identify these different roles and then integrate them into a coherent self.

Ego states are an adaptation to various life circumstances, rather than innate states of being. Sometimes a person becomes stuck in an ego state, or finds that an ego state is no longer beneficial. A child abuse victim, for example, might get stuck in the role of frightened child. This could lead to anxiety, unhealthy relationships, and other behavioral patterns based on an ego state that's no longer functional.

Ego state therapists identify four distinct ego states:

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    A vaded ego state is an ego that has experienced a traumatic event it has not yet processed. Vaded ego states cause emotional reactivity and require resolution of trauma.
  • Conflicted ego states are those that are in conflict with one another. They lead to a sense of internal conflict, and ego state therapy aims to resolve the conflict.
  • Retro states are ego states that once worked but that are not harmful. Ego state therapy endeavors to help these states learn to come out only when they are useful.
  • Normal ego states are healthy states that are openly acknowledged, not in conflict, and not maladaptive. The goal of ego state therapy is to achieve normal ego states.

Effectiveness of Ego State Therapy

Ego state therapy is normally a brief approach to therapy instead of a long and protracted process that requires several years of work. Ego state therapists may practice other forms of therapy, such as cognitive-behavioral therapy, in an attempt to work with each ego state. Some therapists also use hypnosis, and ego state therapy remains a popular choice among therapists who rely on hypnosis. Although ego state therapy has only been around for about 25 years, several studies have shown that it can be effective at treating a variety of conditions, including posttraumatic stress.


  1. Hartman, D., MSW, & Zimberoff, D., MA. (n.d.). Ego states in heart-centered therapies. Journal of Heart-Centered Therapies, 6 (1), 47-92.
  2. Phillips, M. (1993). The use of ego state therapy in treatment of posttraumatic stress disorder. American Journal of Clinical Hypnosis, 35 (4), 241-249. doi: 10.1080/00029157.1993.10403015
  3. Watkins, H. H. (1993). Ego-state therapy: An overview. American Journal of Clinical Hypnosis, 35(4), 232-240. doi: 10.1080/00029157.1993.10403014