I'm 81 now and I lived and went to university in San Francisco during the 60s. I'm retired now but I cut my clinical teeth on family therapy, systems therapy, network therapy, etc. and am more than familiar with it's history; I lived it during it's flowering. One thing that most people don't get (but that the early family therapists soon realized--especially Jay Haley) is that individual therapy and systems therapy are two different epistemologies with different assumptions about how to look at the world. It has to do in large part with your unit of focus. If the focus is an individual it is a language based on what's going on inside someone's head; the other is about the relationships between people. Haley is one of the best sources about this difference and how it informs how you make an intervention. Haley used to lecture at medical psychiatric institutes but discontinued doing so because the psychiatrists were so brainwashed/indoctrinated. I remember when I was at UC Irvine doing a post doc and one psychiatrist told me incredulously when (at a lecture Haley was giving) he asked Haley what he would do with a schizophrenic. Haley said he wouldn't let that be defined as the problem.
thank you so much for posting this comment. I love talking to people like you who actually live through a period of time I’ve only read about. I think you might find internal family systems theory really interesting, is the gap between individual and group or family. It’s becoming a more popular form of therapy and I’m hoping to have an influence, and raising the consciousness of people are working in realms of psychosis. Let’s keep talking!
I feel our entire family has been abandoned by the mental health system. Our daughter, diagnosed with a psychotic disorder was institutionalized for six, consecutive years and forcibly drugged, just long enough to be brainwashed into thinking that her only route to recovery was to accept that she is biologically inferior to 'normal' non psychotic individuals and that she must compensate by being on drugs for life. Now that she has been home for six years, things are gradually improving, no thanks to the publicly funded mental health system,, the one that most of us working folks use. The only times our family was helped as a unit, was was when we were lucky enough to receive support and encouragement from people with lived experience of psychosis. It is incredibly difficult to find clinicians who are informed by people with lived experience and it is even harder to find clinicians who have been on the sharp end of the needle. If one is lucky enough to have a few hours leftover each week, one is compelled to serve as an individual advocate to help keep OTHER people's children from being stuffed into the psychiatric meat grinder, and finally, a systems change advocate so future laws and public policies will protect the right of individuals and families to access humane, VOLUNTARY recovery-oriented services, including family therapy. A cursory look through any public mental health directory will turn up ample numbers of marriage and family counselors, even those trained in family systems therapy but very few of these are willing to wade in the water we live in every day. When a family member or caregiver makes an appointment with an average family therapist, one must waste precious time convincing the therapist that psych social approaches to psychosis are more effective than involuntary, biological approaches and that this is well documented. Exhausting, time consuming, and disheartening. It shouldn't be my job to remedy the second class higher education every family therapist receives! I'm just trying to hold things together on my end! We are one of the richest most powerful nations on earth. It shouldn't be this difficult to get effective help!
The Mental research Institute in Palo Alto was a center for family systems therapist while I was working at Satria house. This was the laye70’sThey were working with families who had a psychotic kid and doing just this work the family systems work. There may be more to dig up from the work. This institute was doing also known as MRI.
Yes and Clow Mendes and Salvador Minuchin and Monica McGoldrick and Mario Tonti. Family Therapy Network Magazine. It was so possibly hopeful and not not just for SMI!!!!!! Each of the names mentioned worthy of research and videotapes must be stored somewhere. Keep up the good work.
I appreciate your writing and it's thought-provoking, i'm leaving comments in the spirit of curiosity because this thing about IFS has come up a lot and I've never understood it (and I figure if you're a practitioner you must know and think a lot about how it works for people).
I definitely am in favor of a larger variety of frameworks being made available to people and am genuinely glad if they are even helpful to just a few people given the magnitude of psychic suffering people are surviving.
Just conceptually it's just puzzled me for a long time why IFS is presented as very different than these other explicitly behavior-based approaches when the differences between them look so negligible to me (reiterating, again, everyone's different and to others the differences clearly can be very meaningful).
I don't take issue with people talking to themselves or making up roles or something, in fact it's easy for me to understand how a creative act like that could be very necessary and helpful to some people. But to me it just seems clear also that anything that is based in "emotional regulation" as the goal is all ultimately driving towards behavior modification (and yes that can be life-saving and empowering to some people certainly), whether through self-knowledge narrative or ritual or nonconsensual drugs, to me it looks like it's all going the same place. Also with all of these modes the emphasis on the 'self' seems like it can only be useful if you're able to believe the self is like 'real' in some way.
I am aware how awful it is for people to feel out of control of themselves and out of depth with understanding others, and i functionally really support whatever people need to do to mitigate that and know I don't have to understand everybody's processes of surviving. But when I think about mental illness I'm just more inspired by thinking about making a world that accepts people's failures to be coherent, even terminal failures, rather than teaches them (whether gently or violently) how to live differently.
I think it’s worth pointing out an error in the way It looks like you’re thinking about IFS. The goal is not “emotional regulation”, it’s literally to unburden the system from trauma and allow the parts to recenter and take on new roles. it’s a really different worldview. It’s about being led by the part of oneself that is curious and compassionate, and not by the parts that are scared and angry, etc. The theory is that when trauma happens in our lives, we have specific parts in our consciousness that take on that trauma, and it is exiled away, so we don’t have to feel it. but there are actually parts of ourselves that continue to feel it, and they are like younger parts of our self, that we ignore. and IFS, we filled a relationship with our unconscious minds, and we go back and find these parts and help them let go of their pain .Then we have other parts that protect us from getting close to the trauma, and quite often those parts end up, clashing with each other, and being polarized, like the part that wants to focus on some hard work and the part that just wants to get high. all of these parts are related to each other and can seem invisible when they’re all blended but when you start blending the relationships become more clear.
The thing with CBT and DBT is that they can teach you all kinds of emotional regulation skills, but they don’t actually touch the trauma. There is a belief in IFS that everyone, fundamentally, has a self that is curious, and compassionate and creative and courageous. But from most of us, that self is buried under layers of complex internal dynamics. But we assume it exists, and we engage with it. In the end, it’s a spiritual practice. Like you say, it’s not for everyone, but I sure wish more people could find that part of themselves.
My kids are napping in the back of the car, thanks for giving me an excuse to think and talk about something I love.
Thanks for the clear explanation. I get that it's definitely not explicitly about 'emotional regulation' the way that CBT is. It also just seems like maybe what I don't get about IFS just boils down to the entire model of 'healing a traumatized self who is really good inside'. Without necessarily embracing the paradigm of 'trauma', i would probably agree that layered brutal experiences are most likely the main thing causing people to have psychosis and similar difficulties. That's probably the end of what I would be able to agree with in how you describe the fundamental beliefs of IFS. Anyway now I do understand better... Glad it was enjoyable to write it out
i am just deeply skeptical at this point of the biological-versus-social dichotomy for explaining these situations, including the bad cop/good cop dichotomy of, say, forced drugging versus talk therapy... again, everyone's different and in life everyone's survival solutions will be different, but just conceptually these supposedly distinct approaches don't seem meaningfully different to me.
it sounds like we have common ground here. The thing about internal family systems that really works for me is that it’s grounded and systems thinking that’s what I was trying to get across in this blog post. There’s such an interesting history of people doing work with families that just got buriedand IFS is one of the ways that it’s coming back.
it's very easy for me to understand why the 'biological' paradigm of understanding psychosis is nearly useless on a practical level and systemically harmful.... but almost impossible for me to understand why people love internal family systems theory so much... (to be clear, as with anything related to mental health, i ultumately don't begrudge anybody doing things that may help them, whether it's pharmaceutical drugs or therapy or alcoholism or al-anon or religion... everyone's different) ... just on a conceptual level i find the positivism and rationality of it baffling and alienating. i've known a lot of people who seem to love it and i'm happy for them but being honest it makes no sense to me to impose some sort of narrative of archetypes on your 'self' in order to have... harmony or something? i've read some other things you've written on this topic but to me it still never comes off as distinct from any other 'make a happy/validating narrative' type approach... and i would think that has as many limitations, if not more, than CBT, DBT, ACT, what have you...
I appreciate your critical voice. The best I can do is tell you why it works for me and then maybe that will be helpful.
for starters, as a young person who got diagnosed with a psychotic disorder, I had so much negative shit put all over me bye doctors and family and even friends, but the worst part about it was my own internal thoughts, and how fucking negative they were. It was incredibly liberating when I found a model that could explain to me that not only were negative thoughts just a part of me, but the critical voice that was putting me down for the negative thoughts was also just a part of me.
There is this Language, that people and IFS use of “unblending” and it’s the idea that we can feel a strong emotion, and it feels like we are the one thinking it, and then we can take a step back from it, and notice that the emotion has a quality to it, and maybe even it’s familiar, and we realize that it’s just a part. And that part has other parts that are connected to it.
it sounds like you are objecting to this idea that people are coming up with all of these imaginary archetypes in their heads and talking to themselves, but it’s actually a lot more practical than that. It’s basically just a way to get to know yourself and then understand the behavior of other people .
As far as I understand it, when you talk about CBT and DBT, those are behavioral strategies, they are ways of changing behavior. And they can be very helpful. I have a client who’s diagnosed with borderline personality disorder. (She uses the diagnosis herself and find it helpful) and from her perspective, the DBT training she’s done has saved her life. And because she is so much more emotionally regulated, she’s in a place to be able to do some deeper trauma work, so that’s what we do with IFS.
I'm 81 now and I lived and went to university in San Francisco during the 60s. I'm retired now but I cut my clinical teeth on family therapy, systems therapy, network therapy, etc. and am more than familiar with it's history; I lived it during it's flowering. One thing that most people don't get (but that the early family therapists soon realized--especially Jay Haley) is that individual therapy and systems therapy are two different epistemologies with different assumptions about how to look at the world. It has to do in large part with your unit of focus. If the focus is an individual it is a language based on what's going on inside someone's head; the other is about the relationships between people. Haley is one of the best sources about this difference and how it informs how you make an intervention. Haley used to lecture at medical psychiatric institutes but discontinued doing so because the psychiatrists were so brainwashed/indoctrinated. I remember when I was at UC Irvine doing a post doc and one psychiatrist told me incredulously when (at a lecture Haley was giving) he asked Haley what he would do with a schizophrenic. Haley said he wouldn't let that be defined as the problem.
thank you so much for posting this comment. I love talking to people like you who actually live through a period of time I’ve only read about. I think you might find internal family systems theory really interesting, is the gap between individual and group or family. It’s becoming a more popular form of therapy and I’m hoping to have an influence, and raising the consciousness of people are working in realms of psychosis. Let’s keep talking!
I feel our entire family has been abandoned by the mental health system. Our daughter, diagnosed with a psychotic disorder was institutionalized for six, consecutive years and forcibly drugged, just long enough to be brainwashed into thinking that her only route to recovery was to accept that she is biologically inferior to 'normal' non psychotic individuals and that she must compensate by being on drugs for life. Now that she has been home for six years, things are gradually improving, no thanks to the publicly funded mental health system,, the one that most of us working folks use. The only times our family was helped as a unit, was was when we were lucky enough to receive support and encouragement from people with lived experience of psychosis. It is incredibly difficult to find clinicians who are informed by people with lived experience and it is even harder to find clinicians who have been on the sharp end of the needle. If one is lucky enough to have a few hours leftover each week, one is compelled to serve as an individual advocate to help keep OTHER people's children from being stuffed into the psychiatric meat grinder, and finally, a systems change advocate so future laws and public policies will protect the right of individuals and families to access humane, VOLUNTARY recovery-oriented services, including family therapy. A cursory look through any public mental health directory will turn up ample numbers of marriage and family counselors, even those trained in family systems therapy but very few of these are willing to wade in the water we live in every day. When a family member or caregiver makes an appointment with an average family therapist, one must waste precious time convincing the therapist that psych social approaches to psychosis are more effective than involuntary, biological approaches and that this is well documented. Exhausting, time consuming, and disheartening. It shouldn't be my job to remedy the second class higher education every family therapist receives! I'm just trying to hold things together on my end! We are one of the richest most powerful nations on earth. It shouldn't be this difficult to get effective help!
I hear you loud and clear. I’m so curious how you found my blog.
The Mental research Institute in Palo Alto was a center for family systems therapist while I was working at Satria house. This was the laye70’sThey were working with families who had a psychotic kid and doing just this work the family systems work. There may be more to dig up from the work. This institute was doing also known as MRI.
I wish there was more stuff online about this important history!
https://en.wikipedia.org/wiki/Soteria_(psychiatric_treatment)
Yes and Clow Mendes and Salvador Minuchin and Monica McGoldrick and Mario Tonti. Family Therapy Network Magazine. It was so possibly hopeful and not not just for SMI!!!!!! Each of the names mentioned worthy of research and videotapes must be stored somewhere. Keep up the good work.
Thanks so much for speaking out and naming these important names!
I've found the first series of videos here an excellent introduction to Bowen's thinking:
https://www.thebowencenter.org/bowen-theory-vids
I'm watching them right now and they are wonderful! Thank you!
Glad to share!
I appreciate your writing and it's thought-provoking, i'm leaving comments in the spirit of curiosity because this thing about IFS has come up a lot and I've never understood it (and I figure if you're a practitioner you must know and think a lot about how it works for people).
I definitely am in favor of a larger variety of frameworks being made available to people and am genuinely glad if they are even helpful to just a few people given the magnitude of psychic suffering people are surviving.
Just conceptually it's just puzzled me for a long time why IFS is presented as very different than these other explicitly behavior-based approaches when the differences between them look so negligible to me (reiterating, again, everyone's different and to others the differences clearly can be very meaningful).
I don't take issue with people talking to themselves or making up roles or something, in fact it's easy for me to understand how a creative act like that could be very necessary and helpful to some people. But to me it just seems clear also that anything that is based in "emotional regulation" as the goal is all ultimately driving towards behavior modification (and yes that can be life-saving and empowering to some people certainly), whether through self-knowledge narrative or ritual or nonconsensual drugs, to me it looks like it's all going the same place. Also with all of these modes the emphasis on the 'self' seems like it can only be useful if you're able to believe the self is like 'real' in some way.
I am aware how awful it is for people to feel out of control of themselves and out of depth with understanding others, and i functionally really support whatever people need to do to mitigate that and know I don't have to understand everybody's processes of surviving. But when I think about mental illness I'm just more inspired by thinking about making a world that accepts people's failures to be coherent, even terminal failures, rather than teaches them (whether gently or violently) how to live differently.
I think it’s worth pointing out an error in the way It looks like you’re thinking about IFS. The goal is not “emotional regulation”, it’s literally to unburden the system from trauma and allow the parts to recenter and take on new roles. it’s a really different worldview. It’s about being led by the part of oneself that is curious and compassionate, and not by the parts that are scared and angry, etc. The theory is that when trauma happens in our lives, we have specific parts in our consciousness that take on that trauma, and it is exiled away, so we don’t have to feel it. but there are actually parts of ourselves that continue to feel it, and they are like younger parts of our self, that we ignore. and IFS, we filled a relationship with our unconscious minds, and we go back and find these parts and help them let go of their pain .Then we have other parts that protect us from getting close to the trauma, and quite often those parts end up, clashing with each other, and being polarized, like the part that wants to focus on some hard work and the part that just wants to get high. all of these parts are related to each other and can seem invisible when they’re all blended but when you start blending the relationships become more clear.
The thing with CBT and DBT is that they can teach you all kinds of emotional regulation skills, but they don’t actually touch the trauma. There is a belief in IFS that everyone, fundamentally, has a self that is curious, and compassionate and creative and courageous. But from most of us, that self is buried under layers of complex internal dynamics. But we assume it exists, and we engage with it. In the end, it’s a spiritual practice. Like you say, it’s not for everyone, but I sure wish more people could find that part of themselves.
My kids are napping in the back of the car, thanks for giving me an excuse to think and talk about something I love.
Thanks for the clear explanation. I get that it's definitely not explicitly about 'emotional regulation' the way that CBT is. It also just seems like maybe what I don't get about IFS just boils down to the entire model of 'healing a traumatized self who is really good inside'. Without necessarily embracing the paradigm of 'trauma', i would probably agree that layered brutal experiences are most likely the main thing causing people to have psychosis and similar difficulties. That's probably the end of what I would be able to agree with in how you describe the fundamental beliefs of IFS. Anyway now I do understand better... Glad it was enjoyable to write it out
i am just deeply skeptical at this point of the biological-versus-social dichotomy for explaining these situations, including the bad cop/good cop dichotomy of, say, forced drugging versus talk therapy... again, everyone's different and in life everyone's survival solutions will be different, but just conceptually these supposedly distinct approaches don't seem meaningfully different to me.
it sounds like we have common ground here. The thing about internal family systems that really works for me is that it’s grounded and systems thinking that’s what I was trying to get across in this blog post. There’s such an interesting history of people doing work with families that just got buriedand IFS is one of the ways that it’s coming back.
it's very easy for me to understand why the 'biological' paradigm of understanding psychosis is nearly useless on a practical level and systemically harmful.... but almost impossible for me to understand why people love internal family systems theory so much... (to be clear, as with anything related to mental health, i ultumately don't begrudge anybody doing things that may help them, whether it's pharmaceutical drugs or therapy or alcoholism or al-anon or religion... everyone's different) ... just on a conceptual level i find the positivism and rationality of it baffling and alienating. i've known a lot of people who seem to love it and i'm happy for them but being honest it makes no sense to me to impose some sort of narrative of archetypes on your 'self' in order to have... harmony or something? i've read some other things you've written on this topic but to me it still never comes off as distinct from any other 'make a happy/validating narrative' type approach... and i would think that has as many limitations, if not more, than CBT, DBT, ACT, what have you...
I appreciate your critical voice. The best I can do is tell you why it works for me and then maybe that will be helpful.
for starters, as a young person who got diagnosed with a psychotic disorder, I had so much negative shit put all over me bye doctors and family and even friends, but the worst part about it was my own internal thoughts, and how fucking negative they were. It was incredibly liberating when I found a model that could explain to me that not only were negative thoughts just a part of me, but the critical voice that was putting me down for the negative thoughts was also just a part of me.
There is this Language, that people and IFS use of “unblending” and it’s the idea that we can feel a strong emotion, and it feels like we are the one thinking it, and then we can take a step back from it, and notice that the emotion has a quality to it, and maybe even it’s familiar, and we realize that it’s just a part. And that part has other parts that are connected to it.
it sounds like you are objecting to this idea that people are coming up with all of these imaginary archetypes in their heads and talking to themselves, but it’s actually a lot more practical than that. It’s basically just a way to get to know yourself and then understand the behavior of other people .
As far as I understand it, when you talk about CBT and DBT, those are behavioral strategies, they are ways of changing behavior. And they can be very helpful. I have a client who’s diagnosed with borderline personality disorder. (She uses the diagnosis herself and find it helpful) and from her perspective, the DBT training she’s done has saved her life. And because she is so much more emotionally regulated, she’s in a place to be able to do some deeper trauma work, so that’s what we do with IFS.