Redressing addiction — with Internal Family Systems therapy

On January 28 I started a series of posts reviewing promising psychotherapeutic approaches to addiction. I managed to cover a few, though with stops and starts — mostly due to Covid hassles and anxieties. So today I’m continuing the series with a post on Internal Family Systems (IFS). I wanted to understand it better before trying to explain it, and I think I finally do.

For years my online therapy with people in addiction has relied on my early training in psychodynamic therapy, dobs of mindfulness-meditation, what I’ve picked up from emotion-focused psychotherapy, ACT, Gestalt and other gems, plus my own personal experience of addiction. Add to that 30 years studying developmental psychology with a focus on emotion regulation, and what I’ve learned about the brain processes that underlie addiction and drug use. All of this came together in my own hybrid style of therapy. And it usually helped. Yet there were people I couldn’t help at all. There were brick walls and false leads and levels of trauma, chaos and heartbreak that left me gaping, and left my clients no further ahead. I knew I needed more training.

Internal Family Systems has been around since the 80s, and more and more people are becoming aware of it. It’s not easy, primarily because its premises go against the grain of mainstream psychology. Instead of trying to fuse the parts of the person into one coherent whole, IFS allows the parts to remain parts, it sort of honours them, so that you can get to know them, listen to them, understand them, and eventually take care of them. With respect to addiction, you never hear “you must stop.”

What are these parts? Maybe you’ve thought of them as voices, or selves, or subpersonalities — it doesn’t matter. They appear as habitual perceptions or expectations with distinct emotional loadings (e.g., anxiety, anger, longing) — and they can be intrusive in the background or they can seem to take over.

In working with addiction, the parts are not hard to find. Addicts often identify at least two. One is the “addict self” who just wants to get high (or to binge or have sex). That part is powerful, it overtakes the system, it has no regard for tomorrow, and it’s very difficult to resist. In AA, it’s said to be doing push-ups in the parking lot. In psychology jargon, it’s called compulsion. NIDA calls it a diseased brain. But I don’t find any of these concepts at all helpful. From a neuroscience perspective, I can point to the part of the brain that “does” compulsion — the dorsolateral striatum — but all that’s really doing is putting a habit into play. And as we know, addictive urges are all about habit. So what happens if we consider this to be a part of a person that is young, energetic, one-track minded, and determined to overcome negative emotion in the only way it knows how? When you think about it that way, it’s hard to negate it or to hate it.

The other part addicts often identify is the voice that gives you royal shit for doing it, thinking about it, planning it, having done it (drinking, drugs, gambling, whatever) last night or every night for the last week or the last month. We often call this the internal critic, and its specialty is self-blame and self-contempt. So what happens if we see this part as a younger version of ourselves, who learned to be our caretaker or disciplinarian? You better be good! Don’t you dare goof up again! You’re going to be in real trouble if you do that!! Once we see this part as trying to help keep us out of trouble, it’s hard to feel alienated from it or even victimized by it. Instead, IFS asks us to open a dialogue with this part. For example: You come out whenever I’m likely to do something “bad” (like call my dealer), don’t you — I guess that’s been a full-time job lately. But then you get so upset with me that I get seriously depressed, and then I just want to get high all the more. Let’s try reducing the pressure a bit.

And there lies the problem for most addicts. (I use that word for convenience, as you know.) The critical voice and the “let’s get high” voice activate and augment each other. Endlessly. In IFS, both these parts are called “protectors” because their job is to take care of you. Neither one is evil. They just have radically different styles. The critical voice or “manager” thinks only of the future. The “getting high” distractor voice thinks only of the present. These two parts branched off and solidified, earlier in development, because you needed them. Or so it seemed. How many times a day do you suppose the average 6-year-old thinks about NOT getting in trouble? How many times did you do bad shit anyway? The trouble now is that those two parts are so busy trying to shut each other down that you can’t get anywhere. Neither part will stop doing what it’s doing. It all seems so hopeless.

IFS recognizes a third class of parts called “exiles”. These are (usually) the really young parts that have experienced trauma or abuse of one kind or another. They are terrified. They’ve been hurt or shamed beyond their capacity to heal. We normally can’t or don’t want to re-experience that hurt, so we keep it buried. Hence the term “exile” (what psychoanalysts call the unconscious). But we don’t bury all of that pain…the hurt rises up inside us when we feel desperate, alone, misunderstood, or threatened. Addiction itself can trigger these feelings! And that’s exactly when the distractor — the “I need to get high” voice — gets activated. I can take care of this awful feeling, it says. Right now! Which of course triggers the manager part: Don’t you dare! You promised. Then the savage back-and-forth between these parts pushes the exiles further down, hides them even more, and douses them with more shame and fear…in case there wasn’t enough already.

Having practiced IFS as a therapist now for several months, I am sold on its efficiency and its power. (I’ve even begun as a client, myself, with an IFS therapist. What better way to learn the ropes…not to mention some timely self-improvement.) My clients “get it” almost at once. I don’t have to sell them on the rather esoteric imagery and jargon. They just take a look inside and say, Um yeah, that’s pretty much what’s happening. And then they start to change.

This is just a bare-bones intro. Let me end by saying that the goal of IFS is to let your Self (they spell it with a capital S) start to take care of your parts — appreciate them, comfort them, ask them to turn down the volume, to step back a bit. And reassure them that you — the present whole you, the Self, the calm centre that you may find in meditation — are going to take care of things, and take care of them — so they can begin to relax.

It’s pretty remarkable to feel that start to happen. You don’t feel so desperate. And all those layers of hopelessness begin to lighten and float away.

 

 

15 thoughts on “Redressing addiction — with Internal Family Systems therapy

  1. Joanna NicciTina Free June 10, 2020 at 6:49 pm #

    Thanks for this post, Marc, and for saying a bit about your own process, too. (I love that you do that.)

    When I learned it, both as a therapist and in rehab myself, we called it parts work – getting all of the voices and urges communicating with one another, with a loving presence – eventually Self – to bring the parts to the table for all of the voices to be heard, witnessed, and worked with.

    It’s easy for me to forget this as an option, in part because some of it comes so naturally now, and also because I’ve learned so many different paradigms and tools over the years that it’s a conversation, or an article like this one, to remind me to open the other drawers of the tool chest and dig in!

    So, after I respond to you, I’ll be playing with this today, as I notice how the desire to do internet searches and read other people’s content is bumping into the desire to edit my own!

    Time to gather the team for a huddle;)

    Here’s to you and yours as well.

    Oh, and…
    Marshall Rosenberg’s work in Nonviolent Communication is a wonderful partner to parts work. NVC teaches us that everyone’s voice can be heard and that no compromise is necessary, as long as we communicate at the level of needs instead of strategies. That’s a simple summary of a more involved process. I think you’d appreciate it, too.

  2. Terry McGrath June 11, 2020 at 12:22 am #

    we surely have to question the whole notion of treatment – for what other conditions are people subjected to the dismantling that occurs with drug users and alcoholics in treatment, those with irrational thinking and dysfunctional emotions, who else gets to be grilled and exposed and have their core intruded upon, so they stop doing something most everyone else is doing in some form or another – dealing with their inner anxieties, their core fears. The business of treatment creates, like the business of medicine more and more theories and treatments each of which requires some specif approach and of course training or the buying of books etc. Let.s accept addicts for who they are, lets do what you say and acknowledged the parts not as wrong bits but as pieces of the individual all working together to enable that person to survive this cruel and often unyielding world – but lets also keep them safe from themselves for those voices can be so destructive – most of recovery is simply an individual staying alive long enough to get themselves to accept their bits and feel good enough about themselves that they can then care for themselves in ways that are positive and good for all.

  3. Russell June 11, 2020 at 12:24 am #

    Excellent article, thank you
    Do you plan any updates on your You Tube channel?

  4. Peter Sheath June 11, 2020 at 11:44 am #

    Hey Marc
    Again such a good blog and right on the money. Like yourself I’m pretty convinced that there is a very natural way of getting alongside someone, building a therapeutic relationship and creating a safe environment where learning can occur. Things like Internal Family Systems Theory, ACT, person centered counselling and etc. offer adjuncts and an evidence base but essentially, for me, it comes down to one human being connecting with an other in synchronicity, harmony, beauty and love. Only last Friday night a sat with a guy, throughout the night, holding him whilst he experienced some very extreme emotional states. Doing this takes a level of skill, resiliency and emotional intelligence that comes from years of lived experience, training, wisdom and confidence. Reading your blog helped me to reflect on that whole Friday night experience and realize that, what I did that night, wasn’t a million miles away from what you describe here. Thanks so much for the way how you articulate these things, you do it so well.

  5. Eric Nada June 11, 2020 at 11:57 am #

    Marc, Great post and I am so intrigued. I have long believed that the idea of a coherent self is an impediment to change, generally, and that embracing the seeming inconsistency/fluidity of who I “am” is important. There are parts of me that I want to be a part of me and there are parts of me I wish weren’t a part of me. And even if I work on these undesirable parts so that I’m not as negatively affected by them, they are still a part of me. Regarding addiction, as a person who had terrible addiction problems but no longer practices traditional abstinence, this is most evident. The “addict” is still a part of me (and even it is made up of many parts!). I have developed many other parts of myself since recovering from my addiction problems, and even the “addict” part of me has matured over the years, but it’s still there. I’m intrigued and look forward to hearing more about IFS from your experience and perspective.

  6. Shelley Monych June 11, 2020 at 3:00 pm #

    I see very strong parallels in IFS and a form of Western Buddhism. I think I have asked you this in the past but did not receive a response- In addition to your use of mindfulness practice have you looked at any of the characteristics of this form of Buddhist practice such as no self, non attachment and impermanence? They so closely mirror so much that you as well as others I listen to talk about. I was an addict from 15-50 ( long periods of sobriety) when I stumbled upon a talk by Stephen Batchelor. I started practicing 6 years ago and it has quite simply transformed my universe. Anyhoo just curious if you had ever dabbled… NAMASTE Shelley

    • Marc June 11, 2020 at 7:51 pm #

      Hi Shelley. This is a fascinating question for me as well: how to reconcile the experience, not just of self but of many selves, with the crashing reality that there is no self…just a story we create and live by (which is one way of rephrasing the Buddhist perspective. As you can see, I’m working on it 😉

      I shared some thoughts about that seeming paradox a few posts ago: https://www.memoirsofanaddictedbrain.com/connect/post-addiction-buddhist-blues-and-how-to-cure-them-in-the-era-of-covid-19/ I still hadn’t experienced the power of the IFS model when I wrote that post…I was totally grabbing at straws. So now, with my increased familiarity with IFS, have I learned anything that can help make things clearer ? Besides how to help people (and my”self”) more effectively?

      I’m not sure, but I think it’s something like this: IFS highlights The Self with a capital S as the inner space of being whole, and compassionate, and wise…and having this kind of almost infinite perspective. This Self is therefore able to connect with and care for the parts, which are younger and isolated and helpless….and definitely in need of care. When I go to this place, it seem I could either call it my Self, in IFS terms, or my nonself, so to speak, in Buddhist/Sam Harris/mindfulness terms. And it’s the same place! — just named and defined differently.

      IFS derived from “family systems theory” (hence the name), which arose in the 60s or so. So…not only the parts but “the whole” seems to take on some degree of personification. I know this doesn’t solve the problem — maybe it’s just a short-cut or a play on words….but it seems to take us to the right territory…and opens up all kinds of fascinating new questions. Like why does impermanence, when you really get it, even for just a few moments, feel like the one thing that’s permanent? A permanent glowing capital-S Self? Or the complete absence of (a greedy, materialistic, selfish) self???

      The IFS credo has it that the Capital-S Self can see out but can’t be seen. It sees the parts, and cares for them and comforts them and forgives them. Thus the parts CAN be seen..that’s how you know they’re parts. And that’s the whole exercise: seeing the parts (e.g., the critical, judgmental part, the addict/let’s get loaded part, the I just need love part). IFS views this as a two-step process: first the parts “unblend” — which means you (mostly The Self?) can see them AS parts, (differentiated from “me”). Second, you forgive them, honour them, love them, etc. Which allows them to relax. So, for example, the addict part doesn’t go away, but it’s not so needy and desperate and trigger-happy. It’s more…I guess “content”.

      But here’s another little mind-warp: there’s a third step, in which the part “sees” the Self. Well, I thought we were saying that the Self can see out but can’t be seen. So what does it mean to say that a part, say a young part that’s needy and scared, can look back and, maybe for the first time ever, “see” The Self and thereby finally feel loved and taken care of?! I guess that part isn’t really “seeing” The Self so much as just feeling this closeness/intimacy/love from someone who is solid, present, and, well, loving. Sounds a lot like the Buddhist “nonself”, doesn’t it!

      Does this sound like total gobbledygook? I wouldn’t be surprised. It IS 1:30 AM and I’m stressed (gotta move house, back to Canada) and tired. But more to the point, I am just trying to figure this stuff out, and I don’t have the concepts or any kind of overarching model to use as tools.

      Do you have any hints to make this easier? What’s your take on it?!

      Thanks for raising this fascinating issue, and….sorry I didn’t reply last time. So here’s this long, complicated, philosophical treatise to make up for it.

  7. Sue Taylor June 11, 2020 at 3:37 pm #

    I am a mother of a son with an addiction now that has spanned many years. I read with hope of new insights and ways of supporting addicts that support them to live their lives more peacefully and safely.

    • Marc June 11, 2020 at 8:23 pm #

      Wonderful that you do that. I think IFS is an example or manifestation of a new wave…of viewing addiction with compassion and clarity, rather than calling it a disease and dumping it in the DSM wastebasket or calling it “evil” and waging war on those so defined. Like ACT, IFS stresses flexibility as the key to growth. But IFS sees flexibility as a bunch of parts being granted freedom, so to speak, to exist and even express themselves — even if some of those parts get you in trouble.

      The gist is that the addictive urge isn’t evil or sick or even lazy and indulgent. Rather, it’s a natural need to feel better…connected to a “strategy” or impulse to act without reflection. Yes, seeing addiction this way allows us to stop hating and fearing it…which is going to create a space of kindness and safety — a more peaceful space where people with addictions can live and grow.

      • Sue Taylor June 11, 2020 at 8:47 pm #

        Thanks Marc.
        I hear you…and understand you, but have to be honest and say it is hard to watch and wait in hope that the person seeks help they need.
        My flexibility is certainly expanding with this understanding, but it seems that creating a space of kindness and safety is not enough in some cases.

        I accept that addiction is driven by the need to feel better, and defaults to impulsive strategy to do the known behaviour.

        I am curious as to how you view the role of “responsibility” in the space of addiction?

        • Marc June 11, 2020 at 9:07 pm #

          That’s a tough one, Sue. I may seem to be glorifying addictive behaviour, or giving it a free pass, no matter what. But the IFS perspective is really just about internal dynamics, which must be an essential starting point for real change and growth. From a wider, social (or “interpersonal”) perspective, I think the analysis has to shift. When it comes to hurting other people, there should not be a free ride. And if the hurting doesn’t stop, then it makes sense for other people to protect themselves, either by distancing or by applying consequences.

          Obviously this is a complex issue, and I certainly don’t think I have all the answers. When focusing on personal growth, I think IFS and other forms of therapy can be wonderful tools. When focusing on people hurting other people, then yes, responsibility has to enter the picture.

          There’s some very cool work on this by a psychologist named Hanna Pickard. She wrote a commentary (entitled “Responsibility Without Blame for Addiction”) on an article of mine published in a journal called Neuroethics. It’s open-access, and you can find it here: https://link.springer.com/article/10.1007/s12152-016-9295-2
          I don’t agree with every word, but I respect and value her perspective.

  8. Sue Taylor June 12, 2020 at 3:36 am #

    Interesting when you talk about not giving the addictive behaviour a “free pass”, that is the battle I have…to speak or not to speak……free pass or seeming judgemental/punitive. …Stuck between a rock and a hard place.
    I am learning that unconditional love does not come automatically, and I have to say this is my learning from this experience.

    I think Hannah Pickhard’s article is very interesting and does cover some very valid issues. I embrace her “responsibility without blame” concept/framework. Seems so common sense, compassionate, and gentle, yet a challenge to find and achieve.

    • Annette June 16, 2020 at 5:04 am #

      Sue, I feel for you. My younger brother was addicted to drugs most of his life (14 onwards) My son also aped our heavy drinking (17 onwards.) I could only see, hear and feel the trauma when I quit drinking 5 years ago, to come to some kind of peace with it all.

      As long as you’re not enabling, that’s key. No money for booze, no shirking of consequences which he has to deal with. I listened hard to my brother: he was usually in two states: the wanting, needing the fix state, or the utter hatred for himself state. The rest of my family (2 sisters, my twin brother) found him difficult and so avoided him: I stuck with him, he was still my brother.

      I’ve seen and heard that from my son too, which feels devastating, to see the repeat. But through patience, listening and many walks together, I hear hope emerging, and it’s those words I repeat back to my son.

      Ny younger brother took his life in 2009 – I dream of him still, and he’s totally at peace now and has accepted himself, which is what i hoped he could do. I doubt my son will repeat it: he saw how devastated I was by it all and he has more time sober than drunk, which I’m grateful for.

      I think Buddhism is a great way of understanding Life and ourselves: an opening to the third eye, if you like. I’m trying to persuade my son to try it, but at least he’s worked for a while, and is looking at further studies to help that wonderful mind he has beneath the urge to obliterate a lot of the pain he had in his late teens and early 20s.

      The Void/Space/Third eye is my constant friend now, all wise and all seeing. I’m lucky to have survived my heavy (but functional) drinking and to find the peace I’d often sought in booze and other addictions. Re. your journey, remember that our society doesn’t teach/encourage us to be gentle, so connect with communities who do that. My online sober community helps in that – and I reflect that back.

      If you’ve thought of considering mental health therapy, I wholeheartedly recommend Open Dialogue (available in some places in the US), as it’s based on family systemic therapy, and listening to the polyphony of voices in our loved ones, and with our loved ones. Peace to you and your son,

      • Sue Taylor June 16, 2020 at 7:34 pm #

        Thankyou for sharing your story and journey with me Annette.

        I have come to understand the only person i can change is myself, and so I am working on it.
        I don’t think I am enabling as i do not provide money directly, but will provide meals in my home, clean bed, shower, washing machine and warmth of a heater.
        The pain of watching someone you love suffer so greatly is at times unbearable and evokes so many emotions – even I am surprised by them and keep “battling” them.
        It sounds as though you are talking about noticing them and letting them be, while the Void/space/third eye holds us in a space of being able to be “okay”…even with this pain.

        This blog has helped me see my son differently. The other day I saw the different parts of him. One part wanted to help me in the garden, the other to escape to his own space, one part to be forgiven (as he had returned home 5.00am in a terrible state, another part annoyed/angry at us for being upset with him as he had no memory of what he had done.

        I saw all the parts in a space of one day, and this increased my compassion for him.
        I am trying honest communication, but he does not want to hear what I or others may have to say, so i am working on acceptance of this.

        So I watch, and wait…not so much on the edge of my seat anymore…. and try to remain focused on sending love rather than fear.

        Thanks again Annette.
        All vibrant energies of love and peace accepted, for both my son and myself. And in turn i send you my gratitude.

  9. Alejandro Navarro June 16, 2020 at 1:16 am #

    Hi Marc,

    Great post and introduction into another way to look at and treat the mind and the self.

    I love this…

    “For years my online therapy with people in addiction has relied on my early training in psychodynamic therapy, dobs of mindfulness-meditation, what I’ve picked up from emotion-focused psychotherapy, ACT, Gestalt and other gems, plus my own personal experience of addiction. Add to that 30 years studying developmental psychology with a focus on emotion regulation, and what I’ve learned about the brain processes that underlie addiction and drug use.”

    I know from my previous experience overcoming addiction that it seemed almost “hidden” from my view no matter how hard I looked and consulted with health practitioners that it was either AA, 90 day detox program or CBT as the only options in getting hold of what was at that time something that I had spent 1/3rd of my life doing.

    With more knowledge, studying, reading, researching and taking in the “best parts” of different treatment interventions I feel at least in Australia, addiction treatment is still treated like a person with a headache – well this worked for this many people so it must mean it will work for everyone. So after the big 3 AA, Detox clinic, or CBT/ACT has been tried, many are still left fighting even harder against a brick wall.

    With 1 year to go before I have my Bachelors degree, there are many more years ahead to study and learn and listen to one day enter the neuroscience/psychology field and be able to contribute like people such as yourself who can change for the better, how addiction is viewed AND how people are treated and what policies could be put in place to help individuals get access to the “right” type of treatment that can work for them.

    Cheers.

    Alejandro

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