December 27th, 2021
My main training has been in Cognitive Behavioural Therapy (CBT). An important part of CBT is identifying what we might call unhelpful thinking or beliefs, and how they impact upon our moods and behaviour. My recent learning from Internal Family Systems (IFS) therapy has thrown into question some of the approaches and assumptions associated with CBT and many other traditional talking therapies. It has challenged my CBT approach in three main ways by arguing that:
All of our minds are made up of multiple parts or sub-personalities.
Every single one of these parts has a loving protective intention towards ourselves (i.e. there are no bad parts!)
Different parts of us can become polarised.
Internal Family Systems (IFS) is an approach developed from Family Systems Therapy by Dick Schwarz and colleagues that believes we all have vulnerable wounded parts of ourselves called Exiles, and protector parts that work to stop our Exiles being exposed. We have protectors called Managers who plan, predict, control, and work proactively to keep us feeling safe. When vulnerabilities slip past the Managers, other protectors called Firefighters work reactively to numb, distract, or defend us. How exactly this system plays out is unique to each of us. This short video by Schwarz gives a fuller description of IFS.
In CBT, we often identify Core Beliefs. These are deep-seated usually unconscious beliefs we have about ourselves, other people in general, and the world around us. Some typical examples of Core Beliefs about ourselves could be ‘I am a bad person’ or ‘I am special’. As some of these beliefs can be very painful to be with, we usually develop many ways to avoid facing them. For example, the sadness and shame associated with thinking ‘I am a bad person’ can be alleviated by trying to please everyone and show how caring and considerate we are. This way the approval and praise we hope to get from others will soothe our worries about ourselves. From an IFS perspective I understand this as a vulnerable Exile being protected by a People Pleasing Manager part.
In the above example the strategy/part’s protective intention is pretty clear, even though it is easy to argue that despite the intention, people pleasing is likely to cause us more pain than relief in the long run: other people don’t always respond as we hope, and by putting others’ needs first we are likely to neglect our own. CBT can help us realise how unhelpful these strategies can be, but it is my experience that by acknowledging the protective role of that strategy/part, people actually become more open to re-examining it than when just presented with the evidence that it is not working.
Things are more complicated and controversial, however, when we look at coping mechanisms that are violent towards ourselves or others. How could suicide or child abuse, for example, have anything to do with being loving or protective? It can be really difficult to understand or empathise with parts like these. However, for me the key is in remembering we are talking about protective intentions, intentions that can be very misguided. Our parts, according to IFS, are exactly that, they are a part of us and the part does not take into account the full spectrum of our needs and other people’s. According to IFS, we all have a part of us that can do this, called The Self, a creative and compassionate part of ourselves that can communicate effectively with all other parts. This is why a key goal of IFS is developing our ability to ‘zoom out’ or ‘unblend’ from parts and connect to The Self. The Self recognises our parts as simply parts that we need to listen to but not be governed by. In the case of a suicidal part, usually this is a part that believes we cannot cope, and that in the face of continuous pain and failure, it is better to completely escape from life. With an IFS approach we can build our ability to face scary parts like this, respect them but reason with them, and learn we’re not beholden to them no matter how insistent they are.
Furthermore, a common dynamic that appears in IFS is the polarisation of parts. For example, a serious disciplined part of someone is likely to co-develop with a hedonistic spontaneous and potentially irresponsible part. The former works hard to keep the latter in the shade, and the latter tries to shackle off the constraints of the former. In a peculiar way these two parts can be seen to bring ‘balance’ to the system, in that if either were to suddenly disappear this person’s life would become either incredibly dull or out of control. In IFS we aim, connecting to The Self, to mediate between our parts and act in ways that simultaneously take into account multiple parts. This can lead to a more genuine sense of balance than the ‘balance’ of extreme polarisation described earlier.
Regarding polarisation, I am not aware of any framework for understanding this in CBT. A polarisation would likely be seen as two coping mechanisms that may need to be revised. For me, without the ‘all parts are welcome’ approach and an understanding of polarisation, there is a much higher risk of siding with one part or another. The therapist in the above example is likely to approve of the disciplined part as it is engaged and reliable in therapy, and to disapprove of the hedonistic part as sabotaging behaviour. One of the risks here, as with many delicate balances, is by favouring one side we inadvertently provoke the opposing side into rising up. The behaviour of the hedonistic part rising up is then likely to be further condemned and the cycle continues. Beyond merely propping up a part, IFS therapist Alessio Rizzo likens CBT treatment of OCD to the creation of a new part that has the job of managing the OCD, rather than working to understand and heal the trauma that fuels the OCD.
Having said all this, it is important to keep in mind the strength of evidence supporting the effectiveness of CBT for treating many difficulties, including OCD (as acknowledged by Rizzo in the cited article), and I myself find the language of CBT (coping mechanisms, unhelpful thinking, etc.) can be more accessible to some clients I work with compared with IFS, which involves trying to facilitate internal dialogue with/between parts of oneself. Some of the questions I am left with from these reflections are about how we measure success in therapy. Is it about people being able to cope? Or heal? The latter sounds more transformative and ambitious to me. If success is learning to cope and get by, then clearly creating parts of us that can help us cope is likely to be successful enough. With long-term therapy being sadly out of many people’s financial reach, it is understandable why the immediacy of coping rather than transformative healing is often the goal.
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