Sometimes, when psychotherapies become mainstream, they start to attract a lot of criticism. This, in some ways, makes sense; because the risks are high when it comes to mental healthcare, the emergence of any new treatment is bound to raise concerns. Unless they have been extensively validated by many studies and have achieved “evidence-based” status, then skepticism might be a reasonable reaction.
Recently, internal family systems therapy has been attracting that kind of attention. Founded by Richard C. Schwartz in the 90s, IFS was practiced relatively infrequently for decades until it gained popularity on TikTok and other social media platforms.
What is Internal Family Systems Therapy?
IFS therapy distinguishes itself from others via a combination of fundamental psychological theories like multiplicity of the mind—the idea that each individual contains multitudes—and family systems dynamics. First working as a family therapist, Schwartz theorized that each individual also had an inner life that was full of diverse personalities and conflicting needs and desires.
In family systems therapy, it’s thought that one member of the family may have an extreme condition that creates a disorderly dynamic within the nuclear setting. A child might have to take on another role—for example, being forced out of their natural child identity to care for the parent. Or perhaps the child’s illness is so severe that the parent has to play multiple roles to manage the present.
In internal family systems, it is theorized that within each client are “parts” that have been wounded and traumatized. They are managed by other “parts” that have been created to run day-to-day living and to navigate personal relationships.
The same “parts” are thought to exist in everyone who would benefit from the therapy, which usually involves patients exhibiting psychopathology symptoms. These parts are called “exiles,” “firefighters,” and “managers.” (Schwartz suggests that these parts exist in everyone, even outside of IFS therapy, but this theory hasn’t been confirmed through widespread scientific study, in part because the therapy is still relatively understudied and has only recently been popularized by mainstream culture.)
It’s believed that patients typically seek therapy because of the part called “the exile,” which was traumatized by an incident or assault during childhood. To help manage the emotions of that part when it’s triggered, then, another part will emerge to protect the traumatized part, this one called “the firefighter.” The protective tools employed by the firefighter might not always be the most helpful, however, and could result in, for example, angry outbursts and aggression.
A person obviously cannot operate effectively in either state, so IFS theorizes that a part called “the manager” emerges to help the system function day-to-day. IFS works to heal that complex and often disjointed dynamic within the individual so that the “exile” can feel heard and cared for, thereby transforming the roles of the “firefighter” and “manager” so they eventually better serve the individual’s dreams and goals instead of managing their trauma.
According to an article published in The Nation, criticism has not only risen from the public but also from within the field itself. In an analysis published by the Society for the Advancement of Psychotherapy, authors Lisa Brownstone and Madeline Hunsicker express concern that IFS is increasingly being used for patients with psychotic disorders. But I’d like to share my experience as a patient with schizoaffective disorder since I first began doing parts work about 15 years ago.
My Experience with IFS and Psychosis
I first stumbled upon IFS by accident when I was seeking help in high school. A local therapist told me that she used this therapy modality and gently eased into the concept by saying she did “part work.” I didn’t think anything of it at the time; simply getting help was enough for me.
My psychotic symptoms began in high school, right before I saw her. After battling a few years of depression, my first romantic break-up sent me into a fit of delusions of grandeur, paranoia, and hallucinations that led me to isolate myself.
Since this was the very beginning of my disorder, I did not yet have a name for what was happening. I did not know that what I was experiencing was psychosis. In fact, I wanted to avoid having psychosis or the label of “schizophrenia” attached to me in fear of being discriminated against by society at large. But I ended up being treated for it almost by accident, by both my psychiatrist (who put me on antipsychotics as an off-label mood stabilizer) and my IFS therapist.
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While working with parts, I learned that I could manage my voices and visions in a way where I was able to talk directly to them. It gave me a space to communicate with my inner world. By being able to draw out my parts and have conversations with them, all while a therapist was providing a safe and comforting environment, I was able to organize my voices into their own personalities and get to know them.
Eventually, I concluded that my voices did stem from “exiles” (traumatized parts), and the voices were an extension of who I was as a person. This realization did not get rid of the voices—some still arise when I’m stressed—but it did help me integrate the voices more fluidly. I’m not sure I would’ve been able to do this if I had never come across the ideas that IFS taught me.
The voices have been very easy to manage in my adult life, even though it can be difficult to make sense of reality when my psychotic symptoms happen all at once. I feel that the experience of doing IFS early on in life helped me become unafraid and welcoming towards the voices of my inner world.
I think we all have parts to some extent, though I recognize that dissociated and psychotic people might have more voices than others and that IFS might affect people differently. But, based on my own experience, it’s possible that it could also help.
