A Non-Pathologising Approach to Psychotherapy

by Elizabeth Keating

Introduction

It explains why people cut themselves. It explains why people experience violent bursts of rage. It explains why people sometimes have a deep sense of calm. It is an innovative approach to therapy that combines systems thinking and the acceptance that everybody is made up of a collection of personalities of different ages and beliefs that organize as a system. It is Internal Family Systems therapy.

Richard Schwartz, PhD, is an eminent family system’s therapist in Chicago. He wrote textbooks on the approach and is well known in the field. In the mid-1980’s, he started to pay attention to how his clients described the parts of themselves that pulled them in opposite directions. He listened with an open mind and was amazed at the rich world of full personalities that started to come through. These were not clients with Multiple Personality Disorder. His drive to find a more effective way to do therapy combined with his open curiosity about the various parts he might find began his journey towards a non-pathologising model that views clients as having within them the resources they need. To his version of multiplicity, a concept that emerged long before these conversations.

Freud explored unconscious aspects of personality. He “opened the door for his exploration of multiplicity with his descriptions of the id, ego, and superego”(Schwartz, 1995:12). Some post-Freudians expanded that concept to inner entities and so, object relations theory was born. Since the 1940s this theory has espoused that “our internal experience is affected by introjected “objects,” holograph-like representations of significant people in our lives (Klein, 1948; Gunthrip, 1971) (Schwartz, 1995). Jung considered them as more than introjects and used the term complex to describe a little personality.

Schwartz sees multiplicity as a way of seeing the human mind “as a system of interacting minds” (Schwartz, 1995:17). This can take a while to get used to as we have been led to believe that we have a unitary personality. But intuitively it makes sense. It explains why sometimes people feel ‘taken over’ by an impulse to do something that seems ‘out of character.’ We have all heard the words, ‘I don’t know what came over me’ or something similar in the telling of such confusing behaviour. Usually people feel guilt or shame for such an outburst, because they think it means they, as an entire person, are “bad” in some way. But if they could accept that this is just one subpersonality climbing into the driving seat for that instant, it would be much more freeing. It’s quite a leap for us to make when we are used to thinking as ourselves as having a unitary personality. When accepted, it allows for the exploration of this inner system of ‘parts.’ This is the term that most clients prefer to use doing IFS work, though aspect, piece, person are also used. This approach respects the right of the client to select their word, and most clients choose part.

Of course, in any organized system, there needs to be a leader. IFS espouses the existence of a core Self that is a compassionate inner leader. Schwartz gleaned that this was the ‘seat of consciousness’ from his work with clients.

 ‘From birth this Self has all the necessary qualities of good leadership, such as compassion, perspective, curiosity, acceptance, and confidence. As a result, the Self makes the best internal leader, and will engender inner balance and harmony if it is allowed by the parts to lead. A person’s parts are organized to protect the Self at all costs and will remove it from danger and from leadership in the face of trauma. Parts will then blend their extreme feelings or thoughts with the self, obscuring its leadership qualities, and causing it to be separated from the sensations of the person’s body’ (Schwartz ,1995:57).

This explains a person’s response to trauma. It explains why some people dissociate when extreme things happen to their physical body. It explains why others cannot even remember appalling events that happened to this body because the parts mobilized to take the Self so far away that they did not witness it. This conjures up such a hopeful scenario – that the Self cannot be hurt in any way by what a person experiences because the parts knew what to do in the face of danger. So no matter what atrocities a person experience, their Self is intact somewhere. There lies the hope for me, as a therapist. There lies the potential for the client, not me, to rebalance their inner system so that more and more the Self is leading.

I have experienced IFS first as a client, when living in Chicago, and then as a therapist. As a client, I was amazed by its long-term efficacy and at all the information that was waiting in my inner world via images, thoughts, memories, emotions and physical sensations. In the physical body, parts can be experienced as a pain in a small or large area, as a tingling sensation, as heaviness in a limb. When the therapist helped me to connect with my Self it produced a deep sense of calm that many people experience after meditation. If I had not experienced all of this myself, I would not have believed it possible. And this is a sentiment I have heard echoed by many clients and fellow trainees since stumbling serendipitously upon this approach. I found it just as I was returning to Ireland.

So, when I had moved back, I travelled to Sweden three times to take part in the first Level 1 training offered there. This involved 15 days of training with Schwartz and other IFS experts. While IFS is well established in the U.S., it is now making headway in Europe, with trainings completed in Germany, Sweden and France. Currently, I am the only IFS therapist in Ireland, but I am starting to plan trainings here. I am keen to be joined by many others as I think this non-pathologising approach could help thousands of clients free themselves from living with addictions, pain, depression, anxiety, eating disorders, PTSD, grief, and any number of other conditions that take the joy from their life and even endanger it.

This approach has been used successfully with many populations and its most recent study, with patients with chronic rheumatoid arthritis in a Harvard study is being written up. It was most successful at dropping the psychological and physiological symptoms of the clients who received it.

So how does it work? After training, an IFS therapist has a good sense of how to safely introduce the system so that the client agrees to use this approach. For the clients who give the green light, the techniques are designed to get the therapist to communicate with and show respect for every single part, no matter how ‘destructive’ or extreme it seems to the outside world. This is because all parts are doing their very best on behalf of the person. They take on extreme beliefs and feelings as life events happen to the person. Taken to the nth degree and after extreme trauma, this leads to all the parts being polarized into isolation so that they are not even aware of the others – Multiple Personalities Disorder. But for the vast majority of people this is not the end result.

Brief Outline of Internal Family System

The techniques help build rapport and learn how the parts relate to each other. The parts can be categorized as protectors or exiles. By blending with the Self/seat of consciousness, protectors try to prevent the person from experiencing the exiles. The exiles are parts that have taken on very intense and often painful emotions and beliefs, usually experienced at a young age. Examples are shame, rage, fear and dependency. Many people’s systems live in fear that exiles will take over the Self and person will not survive this. These parts work hard to keep the exiles literally exiled, as if they lived in a cave somewhere.

The parts that protect fall into two types – managers and firefighters. Managers try to keep a person in control of every situation and relationship so that they don’t feel hurt or rejected. Self-critical, striving, controlling and judging behaviour are just some of the ways these parts work. Firefighters get busy after an exile has left the cave and been triggered. They try to protect the system by either soothing it or distracting it. Binge eating, addictions and suicidality are all firefighters.

The IFS therapist, using theconnection to his/her own Self, helps the client to connect more and more with his/her own Self. Mostly, especially as the work progresses, it is the client’s Self that is doing the work. The IFS therapist just guides it and keeps it safe and steps back so that the client’s parts can learn to trust the client’s Self more and more.

Here the system thinking comes in quite actively as the therapist and client get to gather information on which parts relate to each other and in what way. They can be polarized or have alliances with each other or they can be blended with each other and/or the Self. Working slowly to get the permission of each part, the IFS therapist and client eventually reach the exiles and help them to literally unburden the extreme beliefs and feelings after first witnessing them. Again it is the client’s Self who does this, and it is a remarkable process. There is not enough space here to outline exactly how but this is also a good thing. Reading the book referenced below and watching the educational materials available via Schwartz’s website are a necessary next step for those wanting to learn more

Finally, this is not a panacea to everything. When used with very fragmented clients it must be used safely and after much training. Such clients are all too aware of the existence of many parts of them and they need safe help in depolarizing their parts so that their systems can experience greater harmony. Usually they are fragmented further when the managers are not respected and the exiles become active too quickly. All parts must give permission for the work to happen. Hence, there is no resistance from the client as the psychotherapist cannot work without every part’s compliance. Gaining this can take a while but is vital to successful work and saves time in the long run.

So this is how IFS came to Ireland in 2009. I am grateful to introduce it here because it works for so many clients and because it empowers them to heal and rebalance their inner families or systems whether they are in the therapist’s office or on their own. I warm to its utter respect for all our parts And I am moved by its proof that there is an unharmed Self in everyone. IFS therapists have the privilege of guiding that Self back into the driving seat so that the client can be Self-led.

Elizabeth Keating, of Strong Tree Psychotherapy, is an IFS therapist based in The Novara Centre, in Bray. Tel: 087-657 6965. Strongtree@ireland.com  Richard Schwartz is interested in offering an introduction to IFS in Ireland in September 2010. For information or to register interest, please contact Elizabeth.

References

Schwartz, R.C. (1995) ‘Internal Family Systems Therapy.’  London:Guildford Press.

Further information: (www.selfleadership.org).