When "internal family systems" therapy goes wrong...

[Sideways]

Several people who I know have had that therapy believe they have DID. They insist that they have it because they have parts.

To me, this outcome is predictable. And really tragic. Imagine using a therapy to get better, and it ends up convincing you you’re even sicker than you really are!

For a person with no mental health pathology, who has a solid concept of self, and the way their emotions form part of themself - sure. Naming emotions seems like a fairly harmless thing to do. Not altogether sure why “Anger” or “Shame” need new names, but for a healthy person, talking about Joe and Geoff rather than Anger and Shame could be helpful.

But IFS isn’t for people who are coming from a rock-solid concept of self. And if they have a problem with becoming overwhelmed by their anger, for example, it seems to me that the dialogue “Joe completely took over and smashed my friend in the mouth the other night”... it seems obvious to me that for a lot of people needing therapy, that’s going to create problems.

Because all of a sudden we’re thinking about “what Joe did the other night”, and how can we change “Joe’s behaviour”.

Wtf? There is NO Joe! Joe didn’t smash your friend in the mouth the other night, YOU smashed your friend in the mouth the other night. You did that!!!! Joe is actually a complex part of your whole, and Joe doesn’t have nice clear edges that distinguish him from the rest of ‘you’.

I can imagine that for a lot of people, that dialogue would be difficult to come back from. Because it offers a seperateness from themselves and their problems. If you’re already mentally fragile, asking a person to seperate, then reintegrate ‘Joe’ seems like a fairly obvious risk. And little wonder IFS seems to be linked to higher rates of DID.

 

[lostforgottensoul]

Unfortantly, there is not enough studies done on IFS and sadly, when a therapy is taken and ran with like this without a good amount of studies and evidence of a positive outcome a good amount of time and then make it the next best thing to do (and expensive at that. Castlewood, for all 3 levels, was $7,400 minus travel, lodging, and text books) you tend to get the majority of your patients way more messed up then when they came to you.

IFS is marketed to everyone. Saying everyone has parts. And I suppose i can see that to an extent (though can they prove these are "parts" that need reconciling?) but DID and even DDNOS is different. Much more seperated and disocciated. There will be a difference in my "parts" and how I interact with them, they interact with me, and how they interact with the word and speak then the average Job Blow. So, what's to say that Joe Blow's therapy works for me? Peer review studies on paper! You are messing with very large pieces of a human 's mind. You should at least be able to hack up your claims with studies!

Personally, wanting to distroy (or kill) a part says NO written all over it. The parts have a reason they are doing XYZ. I want to know why so that I can slowly learn new ways to change said behavior. Maybe I learn that if I do XYZ then fawning doen't happen. Practice that. Maybe it happens but less, try somethibg new. Trisl and error.

 

[Freida]

Im guessing my T must be taking a different path with the IFS because she really stays with the idea that I'm understanding my emotions by thinking of them as different aspects of my personality. Not different people -- different aspects. For me it's breaking down the feelings into manageable chunks that have a specific emotion or memory attached to it. The names are simply to keep them organized and try to help me connect by putting a "title" with it. Before we started with IFS it was all just a huge tangled ball of crap and I couldn't even make a dent in it. This way has helped me see cause and effect and the things I don't want to face.

And yes - I do want to kill a couple of them because they are attached to things I can't handle. But that's not allowed in her version of IFS. I have to come around to understanding these things happened to ME and I can't kill the messenger who is holding it aside for right now. So ya - so far so good. I've already had some good results that are encouraging.

 

[Friday]

@Justmehere ... I swear I’m working on a longer draft, although parts of it are in use below ;), but I really wanted to hit this piece.

@Freida ... my apologies up front, organizing my thoughts right now is like herding 3 legged cats, so this ain’t anywhere near as concise as I’d like it to be, and may skip around a bit. If it’s clear as mud? Give a holler. If I try and edit right now, I’ll never post it.

Im guessing my T must be taking a different path with the IFS because she really stays with the idea that I'm understanding my emotions by thinking of them as different aspects of my personality.

It seems to be really effective in certain vet-circles because it plays out the opposite as it does in (a lot of) the general population... instead of distancing, and fragmenting, and disavowing responsibility... it’s introducing, and bringing closer, and conceptualizing.

There was a vet group I was a part of for awhile that called PTSD TheBeast. It was a concept I was able to really relate to -all teeth & claws & temper & I predicitble nature; learning short leashes & new SOPs/new partnerships/new balance whilst relearning discipline- that unlike IFS was/is super useful to me... because it was bringing things closer, rather than breaking them off and shoving them away.

The closest parallel I can draw (the difference -for me- between TheBeast kind of conceptualizing and IFS as practiced ‘round these parts) is the difference between 2 people hitting things when they’re mad, and the vastly different/ durn near opposite results.

• Jill & Joe Average (no background fighting) being told to “go hit a pillow”? Is just training them to hit things when they’re mad. No surprise, when they get mad? They start lashing out, hitting things fairly at random, just like they’ve trained themselves to do.
• A trained fighter blowing off steam on a heavy bag, meanwhile, isn’t training themselves to hit things when they’re mad. It’s training them to focus and direct their rage in a controlled environment of their choosing. It’s more control, and conscious decision making, not less.

Same action, but the difference is where they’re starting from, and therefore what they’re learning or reinforcing. The trained fighter is reasserting control, reconnecting with years of training discipline. The untrained pillow hitter isn’t reconnecting with anything, because there’s nothing to connect with, they’re learning a brand new skill; hit things when mad. <<< That’s not to say that untrained fighters “shouldn’t” have the same sorts of physical needs/outlets. It’s saying the new skill that they learn? Needs to be discipline, not blind flailing. IE back up a step and get. trained. Learn the discipline, so that’s what you’re reinforcing as you’re blowing off steam. Bottom line is same action = different results based on where they’re starting from.

For me? I already broke, and broke badly. It took me a long ass time to duct tape all my broken pieces back together in quasi-working fashion ... and re-fragmenting myself? Into even more broken pieces, along new fault lines, in addition to the old ones? Is just a reeeeeeally bad idea. FUBAR bad. Hence IFS is really not useful to me.

I know a helluva lot of people who didn’t break. More like they origami’d... folding the parts of themselves that they can’t deal with, right now, away. Until they almost become 2 dimensional representations of themselves. These are the people I see IFS work great for IF...

• A good therapist? Is able to help unfold those pieces. Reintroducing the shape and structure of those pieces to the whole, giving them their proper place, (not folded away, sometimes under layers and layers of folds until they’re invisible and not just out of the way but completely obscured or forgotten). And voila! (Long process made short ;)) A 3 dimsenional self starts emerging.
• A shit therapist? (IMO) hands over the scissors and has their client start cutting along the folds :banghead:creating broken pieces, fragmented selves, artificial separation. (For a few different reasons, ranging from laziness, to wanting a sexy client, to well intentioned idiot; assessing the problem wrongly and creating far more problems).

So, FWIW, how I see it

- Is a person Fragmented or Folded (where are they starting from?)
- What do they need to learn? (What brings them together instead of distancing?)
- How good is their therapist?

 

[MyWillow]

What my psydoc T emphasises is acceptance - of fear, anger, joy, laughter. If I struggle to identify one or the other she simply reflects my words back to me or takes the responsibility of anger, for example, because I can’t. Yet. We talk about outdated coping mechanisms rather than maladaptive behaviours. What it feels like to set boundaries with SAFE people. What safety feels like. Talking about boundaries with my family is very triggering so we’ve agreed that I’m doing the best I can. For now. I know I’m a bit split but it’s framed in a positive way. Protective. Adult-ing. High achiever. Learning new coping mechanisms. Healing. Learning where the responsibility for my experiences lie. Having hope that I can lift myself out of them. Welcome the tears. For they are also healing.

 

[theshadowoftheliving]

A bit tangental, but it feels absolutely related to this discussion: I see a lot of "systems" on social media when I search for DID. It seems to have become a bit of a fad for younger people to "have DID." Maybe some of them do. But for some it seems almost more like a game, a way of deferring responsibility. I can definitely see the allure. No one wants to own mistakes that they have made, or bad things that they have done. Blaming it on someone else (or their perceived someone else) defers responsibility.

I think for these people, treatments like the IFS described here are alluring, because the treatment modality doesn't challenge the status quo.

Unfortunately this all makes it harder for those of us who actually have DID to get the right treatment we need.

 

[Freida]

@Friday that was a fabulous explanation! And you are right - it really does show the difference in how something like IFS can be used to both help and create more problems.

Until they almost become 2 dimensional representations of themselves.

Holy crap this makes so much sense. Because yep -- even though I did break I broke into the me on this side of the wall and the unwanted me on the other side. The origami idea is brilliant --- unfolding what is already there to make a whole rather than trying to cut out a new shape.

Nicely said!

 

[DharmaGirl]

To me, everyone's thoughts make a lot of sense, and explain it better than I can.

 

[hithere]

IFS helped me the fastest and it was way more gentle than emdr. I think reading Dick Schwartz's books helped and there is one by Jay Early caled Self Therapy. So reading those books helped (also watched a few you tube vids) my therapist helped the most though as he led the way or started the process. I will say that first time it was really hard as I had serious trust issues, but the most important part was for the therapist to keep an "OPEN heart" position toward me and all the parts. I will also say that the first time I did it it felt really silly to come up with names--but interestingly it wasn't hard to name them when I allowed myself too and stopped laughing at the process and judging it as silly. Although the names chosen were to describe what that part did (or does) -not names like Bob or Sue or Sally. I also gave some names based on how I "saw" them in my imagination, such as "dark man" or "white fairy" etc.

The motto of IFS is "All Parts are Welcome" This is really important because some of the parts that do a really good job at protecting me can easily be seen in a negative light, but allowing them "room" to reveal themselves and the role they play in protecting was the most helpful. On my own I discovered some very entrenched parts that used ways to protect me that were just plain exhausting. It was nice to let them they no longer needed to do that and that they can have another job or do something different like go play and enjoy life.

I felt a "release" and a "relief" that thankfully has remained in many important areas.

Where IFS can go wrong and one may say it went wrong with me (but I handled it) is the main "me" the main "self" can get completely merged with the part and that is so painful. It happened to me a lot and I didn't really learn how to quickly separate. If my therapy had not been interupted I would have liked to work on that for a few sessions and then practice getting "un-merged" with parts. As long as I don't talk about trauma or get triggered I don't merge; but we're dealing with trauma -- so-- comes with the territory.

I believe that I got more done in 3 sessions with IFS than a year of CBT & trying to do exposure work. Everyone is so different. It's just one way to get straight at the emotions and automatic thoughts and tease them out of a chaotic mess.

 

[Freida]

The motto of IFS is "All Parts are Welcome"

This is a big part of why I do emdr --- my parts are NOT welcome. I want them all to go away - or just die. The goal of emdr is to get me to view them in a different light -- as a help instead of a hindrance. Then they can get integrated into the whole me, and i'll hopefully hate them less.

That's one of the things I love about this site -- finding all the different ways people heal and scooping up all the ideas I can! :)

 

[Runninginrain]

This ^^^ is my understanding.

The issues around IFS and people suffering increasingly fragmented sense of self, without associated relief from their underlying mental health issues, continues to be an issue impacting the way that treatment is approached in my part of the world (Australia), where IFS is particularly unpopular among the mental health profession.

Much of the mental health profession here are particularly cautious about fragmenting personality as a method of treatment. In many practices, patients are often encouraged not to name or interact with distinct ‘parts’, even with a DID diagnosis. I’ve certainly come across that, together with the arguments in favour of treatments that promote an integrated concept of self to avoid the documented risks associated with fragmentation.

It actually surprises me that the Schwartz guys are still practicing, let alone that IFS seems to have survived that period.

Certainly you don’t need to look far for people who have genuinely benefited from IFS, so credit where it’s due, it IS helping a lot of people. But (as with any therapy) that certainly isn’t a uniform outcome, and if the press is to be believed, a ‘bad IFS outcome’ tends to do a lot more damage than, say, a ‘bad CBT outcome’. So if it isn’t working for you? Perhaps steer towards the more evidence-based approaches for ptsd.

ETA I have a bias though. I’m naturally cynical of therapy approaches that make a shittone of money for a few particular people. To me, that’s Scientology in a nutshell! But I digress...!!!

Could you send/link me some of the stuff they use in your country? The IFS fad is strong where I live and it doesn't work for me.

So please stop projecting.
You’re putting in this Freudian psychoanalysis as to names (my names) and such.....this isn’t that kind of therapy. That’s not what I’m doing.

You haven’t read any of my posts about my struggles with problematic parts or even my diary entries to know that I have made a lot of progress in this realm. When I first met Fawn, it took me a MONTH to get her to stand down and let Self take over. Now when fawning behavior pops up, I can get it to stand down pretty fast. This is progress (and naming her “Bambi” is just something cutesy I did, nothing less, nothing more.)

You are still reading FAR too much into what I said. Fawn is a behavior, nothing but a behavior. My fawning behavior made me VERY sick last year. Did you ever get to the point of talking to your parts? Did you ask them what they need? Did you ask them why they do what they do? Did you ask them who they interact with? Have you ever asked them to stand down? Do you understand the concept of self? Do you know about protectors? Do you know what blending is? THESE are the keys to this kind of therapy, not worrying about the naming issue. You’re seriously getting sidetracked here and you can’t understand the bigger picture as to why this kind of therapy works for many.

As said before, I think you just had bad therapists. IFS is an effective way for many to manage their feelings and behaviors because you ultimately end up with an interconnected family tree that cues you in to why you do what you do. (My family tree explains a lot!)

Uh. IFS would say that "Bambi" is only trying to protect you and that you need to accept and comfort her in order for her to "trust" you to lead.

I understand how naming and externalising 'bad parts' helps. But IFS takes it way further then that.

 

[Sideways]

Could you send/link me some of the stuff they use in your country?

Consider Ts that use CBT, at reasonably advanced levels, and to a lesser extent DBT. They've both been incredibly helpful for me, and there are 'trauma informed' approaches that can be used for people with complex trauma (particularly with CBT).

More recently ACT has been gaining a lot of ground here, and I've done courses in that a few times because it really clicked with me.

Although, CBT has the benefit of longevity and is "the" evidence-based approach that many psychologists round here start with (for depression, anxiety and ptsd), and it forms the basis of much of the way I now understand and think about thoughts/feelings/behaviours as distinct things.

Treatment between the different professions here is very clearly divided in that respect. I've had psychotherapy and psychodynamic therapy from 2 different psychiatrists, which most psychologists here are fundamentally not trained in or qualified/licensed to do. Both have been beneficial, although the gentler plain old 'talk therapy' with a trauma-specialist has been the most helpful, supplemented by the skills-based approaches above (so yeah, talk therapy and cbt/dbt/act, with different therapists doing each, at the same time, alongside medication).

ETA The BlueKnot Foundation produced Practice Guidelines for CSA trauma therapy in Australia, which is looked on fairly favourably by the majority of mental health practitioners, and I think is widely accepted as the 'best practice' approach here (although, not everyone will agree with them in their entirety). That's available on their website in short and long forms I think.

Sorry JMH for going off-topic - it's an older thread, so I hope you don't mind.