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This Clinical Q&A article responds to a question about what process to use to access and identify ego states when working with complex trauma. The procedure for implementing Fraser's Dissociative Table Technique is explained and detailed in 8 clearly defined steps. The author builds on Fraser's original instructions and adds several innovations for use by EMDR therapists. Tips on implementing this technique are given. The article then concludes with a session transcript to illustrate the use of this powerful tool.
Keywords: eye movement desensitization and reprocessing (EMDR); emotional part of the personality (EP); apparently normal part of the personality (ANP); dissociative table; meeting place
Question: I have read about the importance of working with ego states when working with complex trauma. Is there a process that is best used to identify ego states? If so, what is this process and how do I use it?
ANSWER:
Identifying and working with emotional parts (EPs; van der Hart, Nijenhuis, & Steele, 2006) of the personality is essential when working with complex trauma and dissociation. EPs of the personality are like isolated neural networks carrying the maladaptively stored information. These EPs live in "trauma time." When they are activated, they experience the affect, negative cognitions, behaviors, thought processes, action urges, and so forth, which are stored in the unhealed traumas and typically are not correctly time oriented early in treatment. These EPs contribute to the client's instability and repetition of the maladaptive behaviors and self-beliefs. Gaining access, identifying, communicating and working with these parts are necessary in preparation for effective trauma reprocessing.
An easy yet profound way to identify these parts of the personality is a process called Fraser's Dissociative Table Technique (Fraser 1991, 2003). This technique is a must-have tool for clinicians working with complex trauma. It is a tool that needs to be used within the larger framework of a phase-oriented approach to the treatment of complex trauma and dissociation. The use of this tool requires that the clinician is knowledgeable in the treatment of dissociative disorders (Fraser, 1991, 2003; Paulsen, 2009). If you are new to working with internal parts of the personality and dissociation, it is essential that you receive training and consultation from a clinician experienced with this technique as well...