Approaching Addiction Treatment with an Internal Family Systems Lens

By Timothy Bambara, MA Addiction and Recovery, MAC, Resident in Counseling

About a year ago I was working with an extremely fascinating client who had “a lot” going on. The client had multiple addictions, a litany of traumatic events and conditions that occurred in their life, and the emotional regulation issues that come along with surviving all of this as an addict. I conceptualized this client’s case as a Jackson Pollock piece. When looking at the painting up close, it was extremely chaotic and violent.  But when I was able to step back and see the whole painting (and some of Pollock’s paintings are 160 square feet) I could see all the chaos, and that it existed in a frame that did, in fact, contain the chaos. I thought this was illuminating and would often talk to my supervisor and my executive director about this case and how I was working with this individual. The client ended up transferring to another facility, however my leadership team saw this experience as an opportunity to introduce me to addiction treatment via Internal Family Systems (IFS).

Internal Family Systems is a recent theoretical approach to therapy that was first introduced by Dr. Dick Shwartz in the 1980s. Dr. Schwartz was working with children who were suffering from eating disorders and through his work, he noticed that the children would often talk about ‘parts’ inside of themselves that were having conversations with each other. You may have recently seen Pixar’s box office triumph this summer, Inside Out 2. My entire clinical team went opening night, and we had a blast analyzing the movie. The idea of the different emotions all playing roles inside of us is essentially “parts” therapy and Schwartz began to organize this approach into systematic interventions and a transformative new psychotherapy, which today is known as Internal Family Systems. After working with my “Jackson Pollock” client, the leadership team at Bridging the Gaps recommended I start to investigate IFS. 

Before I became an addiction counselor, I wanted to be a professional actor. I have a few degrees in the performing arts and spent some time as a younger man in Chicago, pursuing this dream.  I still am very active in my local community theater. I love the performing arts and I am thrilled whenever I have a chance to audition, and even more pumped when I am cast to play a part. I do not think my leadership team was aware how well IFS would translate to me as an actor. I was recommended a free series of trainings, and I participated in several online seminars over the next few weeks. Shwartz’s work has been continued by professionals such as Dr. Frank Miller who has conducted most of my training sessions. 

Throughout my career as an addiction counselor, I have primarily leaned on a Cognitive Behavioral Therapy (CBT) approach. To me, it is very practical, it’s simple, it makes sense, and it also seems to come naturally to me when I am using CBT interventions with a client. It seems to work well in the initial few months of treatment for addiction. However, I came to realize last year, that if I wanted to go deeper into the core psychological issues with a client, I needed a better way to map it all out and not get lost in the chaos of the painting. In fact, what I really needed was a new pair of lenses to see the 3-D picture (yes, remember those from your visits to the mall in the 90s? I never could quite see the elephant…). The IFS training that I embarked on over the last year and continue to pursue has allowed me to do just that and to discover something extremely important: the authentic self.

So, let’s start from the beginning. Tim is born into this world as his authentic self with self-energy. Shwartz identifies eight qualities of our self-energy, 8 Cs: confidence, calm, compassion, courage, creativity, clarity, curiosity, and connectedness. My nephew Leo is about to turn 1 and I see all these qualities in him every Saturday when we FaceTime. So wee Tim is born in this world with all these qualities. What happens?  Life happens, and life can be full of painful lessons. For instance, Tim is in preschool and another kid bites him because he wants Tim’s blocks. Wee Tim is harmed or wounded, he does not feel safe, and he freezes. Two things happen at this point. A part of Tim’s authentic self has now been wounded. It’s not ok to be vulnerable anymore and a part of his authentic self goes into hiding because it does not want to get harmed again. We call this part an “exile”. A potential new part emerges (let’s call it wee Tim’s rage).  Wee Tim takes one of the blocks and whacks the kid. This part is an “extreme” part or as Shwartz calls them “firefighters.” They come in to protect us from the pain through extreme actions (in wee Tim’s case, a violent act). Now, unbeknownst to wee Tim this is a socially unacceptable reaction. This extreme part has now made the other kid cry and wee Tim gets taken into an office with adults where he is properly shamed for his actions. This causes more of Tim’s authentic self to be harmed and retreat into exile. But all is not lost. Tim is about to develop some new parts, parts that he will use everyday of his life going forward. They are “managers”. 

Flashing forward, wee Tim is now a young man, a college graduate, who is navigating the city of Chicago. He’s 25, and he’s pursuing his dream of becoming an actor. His managers have helped him get training, get his headshots together, help him to prepare for auditions, and help him to walk into situations with confidence. He will do this with academics, with work, with relationships. The managers are allowing Tim’s authentic self to enjoy safety and to hide in the background. The managers have all learned how to play different parts for different situations, the people pleaser at work, the white knight in relationships, the loyal friend…etc. However, there’s many parts of Tim that have been wounded along the way and have never healed. One of these parts, you met him when Tim was in preschool, is the part that can’t handle rejection and thinks life is unfair. When Tim is rejected or thinks life is unfair, he has learned to counter the rejection with an “extreme” part. This manifested as aggressive acts throughout most of his childhood and adolescence. It occasionally served him on the football field in high school, but that was the only place it was acceptable to be aggressive. As he continued to get rejected for aggressive acts and burdened with criticism and guilt, he began to… SUPPRESS HIS EMOTIONS…particularly anger. 

Tracking? When Tim is 17 years old, he discovers alcohol. As Homer Simpson once infamously quoted, “Ah beer, the reason for, and solution to, all of life’s problems.” Tim begins to drink.  And as time progresses, he drinks more. And every time he gets rejected or finds life to be unfair, his new favorite firefighter comes to the rescue, with beer, liquor, and other illicit substances and behaviors. If you know any professional actors they will tell you, they get rejected A LOT.  Irrational beliefs start to develop. Feelings of low self-worth arise. The authentic self becomes lost in a sea of bourbon. Needless to say, Tim does not achieve his dream of being a professional actor.

But don’t cry for me, Argentina…because now, with an understanding of IFS and parts therapy, I am able to help other alcoholics and addicts address their own parts, their managers, firefighters, and exiles, as they strive to connect with their authentic selves. My first few rounds of training I learned the basics of IFS, as well as how applicable these interventions are across the board. The main goal of IFS is to heal parts of us that have been wounded and it can be used is several circumstances, for healing trauma, issues pertaining to race or sexual orientation, the parts of us that want to use drugs and alcohol, or even the parts of us that want to end it all through suicide.

One of the basic tenets of IFS work is that we want to get to know these parts, not judge them, and that we have the assumption that each part has good intentions. This is extremely important when working in the addictions field because the last thing we want to do is judge a client and/or perpetuate stigmas. We get to know the part, or, more specifically, the clinician guides the client through a series of sessions where they get to know their parts. They get their parts to talk with each other. They locate exiles and they heal them. They can know their authentic selves again.  They talk with the extreme parts that want to drink and do harm, they ask them what they really need, and they can make better choices. 

I am new at IFS; however, I can tell you that I have watched it work in real time with several of my outpatient clients over the last few months. As a grown man and recovering alcohol I still have trouble with rejection or when life is unfair. However, I have gotten to know that part that wants to drink when that happens, and I have been able to give him much more productive alternatives and healthier options that help to get his needs met. As I continue to learn more about IFS and practice this addiction treatment with my clients I will continue to expand on these fascinating interventions.