IFS for Addictions: Creating a Context for Collaboration and Hope
Develop and enhance the therapeutic experience with these FREE worksheets
Cece Sykes, LCSW, Martha Sweezy, PhD, Richard Schwartz, Ph.D.
Hospitals, clinics, and addiction treatment programs have standard assessment forms that clients fill out in the context of a larger process called an intake evaluation. A staff member or trainee walks the client through the assessment questions to get as much factual information about them and their history as possible. The interviewer is a stranger and an evaluative authority figure who the client may never see again.
We have a bone to pick with this approach. A fact-finding interview with a narrow line of questioning (which coaxes tell-tale information about self-destructive behavior in excruciating detail) summons a fragile, shamed person to the punitive court of self-judgment. It’s intrusive and it establishes a hierarchical relationship that can easily evoke fear and defensiveness. It also fails to explore the ways in which the client is productive and tells us little about how they are navigating inner conflict, which is a crucial feature of addictive processes. The standard assessment approach puts the interviewer in a one-up manager position with authority over the one-down, troubled client and is a disservice to both parties. In these ways, it is antithetical to the IFS approach.
In our first therapy session with a client, we are careful not to start by urging them to expose their most shame-inducing secrets. Just like the client and the interviewer in a standard assessment, the client and the therapist are initially strangers to each other. Therefore, in IFS therapy, our first aim is to create a safe, collaborative context. We view assessment as a process that occurs over time. Instead of launching into an investigation, we get curious, avoid assumptions, and ask a lot of open-ended questions— and we continue in this vein in every session thereafter. We learn the client’s history and assess their functioning over time. We understand that larger institutions create standard criteria for evaluation in order to maintain a certain level of care and to ensure that clients get what they need, so we don’t mean to minimize the challenges of changing the standard approach. But we do have strong views about what works best for clients.
The importance of a first session is that it leads to a second session. We can’t help people if they don’t show up. In IFS, we take a nonjudgmental stance and offer compassion from the beginning, recognizing that the client’s willingness to disclose their struggles is hard-won and courageous. As therapists, we aim to embody what we call the 5 P’s: Our patience, perseverance, and perspective are reassuring and calming—while our presence and playfulness are engaging. We notice the client’s parts as they operate in the three categories of manager, firefighter, and exile. We offer a reframe to their struggles by eliciting and validating the positive intentions of polarized protective teams. And, above all, we offer hope: You can feel better, and I can be your guide.
In our new book, , we’ve created therapist exercises to help you empathize with the fear and reluctance clients often feel when working through addictive or problematic firefighter behaviors.
Download these , and truly put yourself into your clients’ shoes to develop and enhance that therapeutic relationship.
This was an excerpt from Internal Family Systems Therapy for Addictions.
We have a bone to pick with this approach. A fact-finding interview with a narrow line of questioning (which coaxes tell-tale information about self-destructive behavior in excruciating detail) summons a fragile, shamed person to the punitive court of self-judgment. It’s intrusive and it establishes a hierarchical relationship that can easily evoke fear and defensiveness. It also fails to explore the ways in which the client is productive and tells us little about how they are navigating inner conflict, which is a crucial feature of addictive processes. The standard assessment approach puts the interviewer in a one-up manager position with authority over the one-down, troubled client and is a disservice to both parties. In these ways, it is antithetical to the IFS approach.
In our first therapy session with a client, we are careful not to start by urging them to expose their most shame-inducing secrets. Just like the client and the interviewer in a standard assessment, the client and the therapist are initially strangers to each other. Therefore, in IFS therapy, our first aim is to create a safe, collaborative context. We view assessment as a process that occurs over time. Instead of launching into an investigation, we get curious, avoid assumptions, and ask a lot of open-ended questions— and we continue in this vein in every session thereafter. We learn the client’s history and assess their functioning over time. We understand that larger institutions create standard criteria for evaluation in order to maintain a certain level of care and to ensure that clients get what they need, so we don’t mean to minimize the challenges of changing the standard approach. But we do have strong views about what works best for clients.
The importance of a first session is that it leads to a second session. We can’t help people if they don’t show up. In IFS, we take a nonjudgmental stance and offer compassion from the beginning, recognizing that the client’s willingness to disclose their struggles is hard-won and courageous. As therapists, we aim to embody what we call the 5 P’s: Our patience, perseverance, and perspective are reassuring and calming—while our presence and playfulness are engaging. We notice the client’s parts as they operate in the three categories of manager, firefighter, and exile. We offer a reframe to their struggles by eliciting and validating the positive intentions of polarized protective teams. And, above all, we offer hope: You can feel better, and I can be your guide.
In our new book, , we’ve created therapist exercises to help you empathize with the fear and reluctance clients often feel when working through addictive or problematic firefighter behaviors.
Download these , and truly put yourself into your clients’ shoes to develop and enhance that therapeutic relationship.
This was an excerpt from Internal Family Systems Therapy for Addictions.
Internal Family Systems Therapy for Addictions: Trauma-Informed, Compassion-Based Interventions for Substance Use, Eating, Gambling and More
So often, addiction is viewed as a disease or an uncontrollable habit that signals a lack of willpower. In Internal Family Systems (IFS) Therapy for Addictions, IFS educator Cece Sykes, IFS author Martha Sweezy, and IFS founder, Richard Schwartz, suggest a paradigm shift. Rather than viewing addiction as a pathology, they propose that it reflects the behavior of polarized, protective parts struggling to manage underlying emotional pain.
In this manual, therapists will learn how to access their core, compassionate Self and collaborate with clients in befriending protective parts who engage in addictive processes; healing the vulnerable, wounded parts they protect; and restoring balance in their system.
In this manual, therapists will learn how to access their core, compassionate Self and collaborate with clients in befriending protective parts who engage in addictive processes; healing the vulnerable, wounded parts they protect; and restoring balance in their system.
Meet the Experts:
Cece Sykes, LCSW, is a senior trainer with the Center for Self Leadership, teaching IFS training programs across the US and internationally. She has been in clinical practice for over 30 years treating individuals, couples and families. Trained initially as a structural-strategic family therapist, Cece worked for decades with trauma survivors and families affected by abuse, chronic trauma and addictions. Cece expanded her clinical focus to include the Internal Family Systems (IFS) model of psychotherapy in the late 1990’s. She was drawn to its elegant and compassionate approach to treating trauma, addictive processes and other hard-to-treat clinical issues. She has led workshops and training seminars for many years including at The Institute for Juvenile Research, The Department of Children and Family Services, The Family Institute at Northwestern University and many other mental health agencies. She was adjunct faculty at Governors State University and at the Jane Addams School of Social Work at the University of Illinois in Chicago. She co-authored two journal articles on treatment of sexual abuse in the late 1980’s, contributed to the development of the IFS core training texts and recently contributed a chapter on compassionate treatment of addictive process in IFS Elaborations and Innovations (Routledge, 2016).
Learn more about her educational products, including upcoming live seminars, by clicking here.
Martha Sweezy, PhD, is a part-time assistant professor in psychiatry at Harvard Medical School, a research and training consultant at the Center for Mindfulness and Compassion at the Cambridge Health Alliance, and a psychotherapist at a private practice in Northampton, Massachusetts. She has published articles on IFS in peer-reviewed journals, co-edited two books on various applications of IFS, and co-authored three treatment manuals on IFS (on trauma, couple therapy, and now addictions), as well as the second edition of Internal Family Systems Therapy with Richard Schwartz. Her next book, which explores shame and guilt in the context of psychic multiplicity, will be published by Guilford Press in 2023.
Learn more about her educational products, including upcoming live seminars, by clicking here.
Richard Schwartz began his career as a family therapist and an academic at the University of Illinois at Chicago. There he discovered that family therapy alone did not achieve full symptom relief and in asking patients why, he learned that they were plagued by what they called "parts." These patients became his teachers as they described how their parts formed networks of inner relationship that resembled the families he had been working with. He also found that as they focused on and, thereby, separated from their parts, they would shift into a state characterized by qualities like curiosity, calm, confidence and compassion. He called that inner essence the Self and was amazed to find it even in severely diagnosed and traumatized patients. From these explorations, the Internal Family Systems (IFS) model was born in the early 1980s.
Learn more about his educational products, including upcoming live seminars, by clicking here.
Learn more about her educational products, including upcoming live seminars, by clicking here.
Martha Sweezy, PhD, is a part-time assistant professor in psychiatry at Harvard Medical School, a research and training consultant at the Center for Mindfulness and Compassion at the Cambridge Health Alliance, and a psychotherapist at a private practice in Northampton, Massachusetts. She has published articles on IFS in peer-reviewed journals, co-edited two books on various applications of IFS, and co-authored three treatment manuals on IFS (on trauma, couple therapy, and now addictions), as well as the second edition of Internal Family Systems Therapy with Richard Schwartz. Her next book, which explores shame and guilt in the context of psychic multiplicity, will be published by Guilford Press in 2023.
Learn more about her educational products, including upcoming live seminars, by clicking here.
Richard Schwartz began his career as a family therapist and an academic at the University of Illinois at Chicago. There he discovered that family therapy alone did not achieve full symptom relief and in asking patients why, he learned that they were plagued by what they called "parts." These patients became his teachers as they described how their parts formed networks of inner relationship that resembled the families he had been working with. He also found that as they focused on and, thereby, separated from their parts, they would shift into a state characterized by qualities like curiosity, calm, confidence and compassion. He called that inner essence the Self and was amazed to find it even in severely diagnosed and traumatized patients. From these explorations, the Internal Family Systems (IFS) model was born in the early 1980s.
Learn more about his educational products, including upcoming live seminars, by clicking here.
