Co-authored with Cece Sykes, LICSW
Cannabis, screens, drinking, drugs, gaming, food, hookups! We have so many ways to check out. And it’s not always easy to check back in. As a result, addiction is a universal concern these days.
When addiction is viewed as a disease juggernaut that overpowers and conquers regardless of negative consequences, providers and clients alike often conclude that treatment must focus on eradication. While there is no debating the high risks and extreme consequences of serious addictive practices, Internal Family Systems (IFS) therapy has a contrasting view of the origin and function of addiction. It’s survival work. Simply put, the well-intentioned protective subpersonalities (parts in the language of IFS) who engage in addictive practices aim to save the internal family by soothing underlying emotional pain that has the potential to cripple.
From this perspective, here’s how addiction develops. A vulnerable part gets hurt, and then the proactive manager parts, a team of strong, controlling, task-oriented agents named for their devotion to stability and improvement, try to hide or improve that part. As their tactics become too inhibitory and harsh, a distracting/soothing team (called firefighters in IFS because their job is to douse the flames of emotional pain and shame) employs some rapid-result self-medication like alcohol, drugs, food, or sex to distract from or soothe the now aggravated emotional pain of the wounded part.
While this attempted solution harks to the inner logic of feeling better in the moment, its toll on the body, mind, and spirit keeps growing. Addiction creates chaos, is full of risks, and promotes a cycle in which reactive firefighters keep using in response to proactive, shaming managers, and then the managers keep surging back. In the ideal world of a manager, duty, diligence, and shaming are just the right medicine. After a using spree, they will criticize mercilessly and demand perfection to get the internal system back on track, both socially and at work, which causes rebellious firefighters, who firmly believe only they can stop the pain, to fight back.
This destructive cycle can go on and on, and it feels shameful. Most clients who have suffered rigid food practices, chaotic drinking, or porn use have tried and failed to fix it for good for years before revealing their painful problem to a therapist. While they might vaguely reference old issues, it can take months to share the real extent of their use. When they do, it’s a breakthrough. It’s also the moment for everyone involved to be aware of the following irony. Most people will share painful secrets only when they have a solid connection and they trust their confession will be confidential. When that level of trust and willingness is achieved in therapy, we should celebrate. However—and here’s the irony—as things stand in the field of mental health today, that moment also puts the therapeutic relationship at risk.
Clients get this. Knowing what usually comes next, they’ve avoided the topic. When they do finally work up the courage to disclose, they need our curiosity and compassion. (That sounds really stressful! Say more.) But because high-risk behaviors activate anxious, critical managers, what they usually get is labeling, disapproval, and urgency. Manager parts will judge lifestyle choices, reproach clients for failing to disclose sooner, and default to taking action: Let’s get you into treatment, now! When an anxious manager insists on referring a client out for addiction treatment, the client loses the connection that made disclosure possible in the first place.
Of course, some people seek treatment knowing they’re in too deep with an addictive process, wanting to stop, and seeking help. In this case, a referral to addiction treatment and 12-step meetings is a straightforward, valuable intervention. They’re ready for a focused level of care. But many people who engage in an addictive practice need to talk about why before they talk about stopping.
This is a big dilemma. Clients who decline addictions-specific interventions are left with no real help. And ill-prepared therapists are left feeling responsible but anxious and stuck. Meanwhile, an important opportunity is lost. So, how can we make the most of this moment?
The Internal Family Systems (IFS) therapy model is a good option. Its systemic perspective normalizes the pattern in which risky behavior excites manager fears in both client and therapist. IFS teaches therapists to disengage (unblend from) stigmatizing, anxious reactivity and guide the client to do the same. We meet disclosure about a client’s addictive practices with deep appreciation for their trust. And if they’re reluctant to engage in addictions-specific treatment, we don’t assume they’re in denial, as the saying goes. We assume they’re experiencing the inner polarities that typify the addictive process.
Namely, manager parts come to therapy desperate to try new ways of coping with emotional pain, while firefighter parts remain fiercely invested in whatever addictive practices seem to work. The first team fears disaster if the client continues using, while the second is afraid of what would happen if the client were to stop. Both sides have a point.
We all need managers. They do the right thing and stay on track. We also need a team that ensures rest, relief, and pleasure. Both managers and firefighters make crucial contributions. The problem comes when they get trapped in extreme roles while trying to suppress emotional pain. IFS teaches therapists to engage them in respectful dialogue, gain their trust, and ask for permission to help wounded, tender parts. Protectors are more than happy to ease up when those parts feel better. It’s axiomatic in IFS that firefighters are not the problem and managers are not the solution. By witnessing and loving the wounded parts they protect, we get both teams off the hook.
