Ego-state therapy for self-injurious behavior.

The authors describe the use of ego-state therapy for the treatment of self-injurious behavior (SIB). We propose that for some patients, SIB results from conflict among dissociated ego states. We review the historical and theoretical basis for this position and delineate a specific treatment technique. Our strategy consists of identifying an ego state in which SIB occurs, activating the patient's ego strengths using inner-adviser techniques and facilitating the integration of these resources within the ego state responsible for the behavior. We have used this strategy with favorable results for patients with dissociative symptoms, primarily those suffering from borderline personality disorder, posttraumatic stress disorder, or dissociative disorders.