Ego State Therapy

Ego State Therapy sees you as a team of parts rather than one fixed self. Learn how it works, who it helps, and how it differs from IFS.

  • Written by a board certified therapist
Portrait of Lacey Cottingham

Lacey Cottingham

MSW, LCSW

What is Ego State Therapy?

Ego State Therapy is a therapy method created by John and Helen Watkins. It began as an effective treatment for Dissociative Identity Disorder, but it has evolved with growing evidence to support its use in treating PTSD, Complex PTSD, or even simply being overly self-critical.

Ego State Therapy assumes that a person is not one solid identity, but rather parts of a whole. The tines of a fork individually are not the fork, but rather together they are a fork. One petal of a rose is not itself a rose, only all the petals together are.

An example I give my clients is that I have a therapist-self who is generally composed, nurturing, non-judgemental, and geeks out about psychology but I also have a crafter-self who wants nothing more than to curl up under a crocheted blanket and make socks while listening to audiobooks. These are two wildly different humans, but they both exist in the same body, and they are both Lacey.

In Ego State Therapy we are meant to flow between our professional self, to our creative/playful self, and perhaps to our nurturing self (for our furbabies, children, or domestic partners). We generally see a healthy human as one who can transition through their different roles smoothly. A parent wakes up in parent mode, gets their kids on the bus, then transitions to their worker role. At lunch time they drop the worker role and either their playful self emerges to send memes to friends or play a mobile game. For some people, their work self will not allow them to be hungry, but a different version of them might.

In general the creators of Ego State Therapy see being just one version of ourself as an unhealthy state. Consider a common problem in first time parents: While there are some that transition from the before to the after just fine, the defining line is that they do in fact transition. I have often heard new parents come into therapy and feel like they have “lost” themselves in being a care taker. Their playful, professional, or creative self has disappeared behind the need to keep a new human safe and fed. )

When is Ego State Therapy used in therapy?

Have you ever felt conflicted about the right course of action? Do you think and rethink plans or decisions, making sure it’s the right one? It can be because the different aspects of ourselves are fighting over what’s the safest thing to do at the moment. Untying that knot is where Ego State Therapy comes in.

Ego State therapy takes the stance that most sources of emotional suffering are parts of self coming into conflict about how to protect the whole. This can be your child self wanting to please your parents, but becoming very distraught that your professional self needs to delay responding to your parents’ text message until after work. The child- self might become worried the parents will scream at you for ignoring them, while your professional self logically knows they would call if it was an emergency.

I have found that breaking our emotions and desires down into parts of self allows for an easier exploration of the core issue. It turns the emotions into a conversation, rather than a wordless dread living in one’s chest. On a secondary note, I also appreciate that it gives a more compassionate view of “laziness”, “treatment resistance”, “opposition”, or “stubbornness”. Ego State Therapy views these situations as a part being scared, and trying to protect the system from a threat. This allows for greater compassion, and not taking the emotions or self-protective actions personally.

How is Ego State Therapy different from Internal Family System(IFS)?

Really there are only 2 major differences between IFS and EST.

First, IFS assumes that there is a core self, or a higher self. The compassion, nurturing, and wisdom flow exclusively from this part down to the others. My question is, who is your core self?

It’s not really fair to say that the you at home gets to have the final say or the 51% voting power.

I have observed that not everyone has a part that it would be fair to label as the “core”. That is the first reason IFS does not work for me.

Second is the naming convention. In IFS you have a rigid designation of “Core Self”, “Firefighter”, “Exile”, and “Manager”. Parts are like people, and people generally do not like being referred to by their job once you have gotten to know them. To feel respected, people and parts generally like being referred to as something a little more descriptive. Additionally, conversations flow more smoothly in therapy when I do not have to clarify which trauma memory or wounded self (exile) I am referring to. Giving every part a dedicated name (“the 15 year old”, “the professional self”, “mom”.) leaves every one respected, and does not distract from the emotions each part is feeling.

If my explanation resonated with you, or you think this method would be helpful for you, feel free to schedule a 15 minute consultation with me!

Learn more about Ego State Therapy.

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Common Questions

What is Ego State Therapy?

A method created by John and Helen Watkins that treats a person as parts of a whole rather than one solid identity. It began as a treatment for Dissociative Identity Disorder and has evolved to help with PTSD, complex PTSD or even being overly self-critical.

When is Ego State Therapy used?

When different parts of yourself are in conflict about how to protect the whole, such as feeling torn about the right course of action. Breaking emotions into parts turns a wordless dread into a conversation.

How is it different from Internal Family Systems (IFS)?

The author names two major differences: IFS assumes there is a core or higher self that leads the other parts, while Ego State Therapy does not, and IFS uses fixed labels like Firefighter, Exile and Manager, while Ego State Therapy lets parts go by names they like to be called.

How do I know if it might help me?

If the explanation resonates or you think this method could help, the author suggests scheduling a 15-minute consultation to talk it through.

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Portrait of Lacey Cottingham

About the author

Lacey Cottingham

MSW, LCSW

Lacey Cottingham, MSW, LCSW, is a trauma and neurodivergent-affirming therapist in Durham, NC, specializing in complex trauma, autism, ADHD, dissociation, DID, overwhelm, and chronic patterns that can make everyday life and relationships harder to navigate. She also provides adult ADHD and autism assessments.

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