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Comprehensive Treatment of Complex Trauma and
Dissociative Disorder: The Internal Family Systems
Therapy Approach
ISSTD Conference, November 19th, 2009
Mark F. Schwartz, Sc.D., Richard Schwartz, Ph.D., and Lori Galperin,
MSW, LCSW
Castlewood Treatment Center
for Eating Disorders
800 Holland Road
Ballwin, MO 63021
Phone: 636-386-6611
Website: castlewoodtc.com
1
INTRODUCTION
2
3
Violence – Part 1
The soul needs love as vitally and urgently as the lungs need oxygen. It may not be self-evident
to healthy people just how literally true this is, for healthy people have resources of love that are
sufficient to tide them over periods of severe and painful rejection or loss. Similarly, one does
not realize how dependent the body is on oxygen until one has nearly suffocated, or has had to
resuscitate someone who is gasping for breath. But when one has worked with deeply and
seriously ill human beings, the evidence of the need for both oxygen and love is overwhelming.
The kind of man I am describing protects himself from the emotional suffocation of living in a
loveless atmosphere by withdrawing the love he has begun to feel from everyone and
everything, in an attempt to reserve for himself whatever capacity for love he may have. But his
supply of self-love is also deficient. And it cannot grow to the dimensions that are necessary for
health when it is not fed by love from others. If it were not deficient, he could afford to love
others. But his withdrawal of love from everyone and everything around him not only protects
him from emotional pain, it also condemns him to the absence of emotional pleasure or joy; for
we cannot enjoy the people who make up our world, cannot enjoy being with them, except to
the degree that we love them. So the person who cannot love cannot have any feelings – pain or
joy.
But a joyless life is a synonym for hell. A man who does not love and cannot love, is, in effect,
condemned to hell. His entire environment from which – without love – he is cut off, is without
enjoyment for him, and thus the world he “lives” in is a source of emptiness and emotional
suffocation for him. Both the world and the self are experienced and perceived emotionally as
being dead, inanimate, without a soul – without feelings.
From: Gilligan, J. (1996). Violence: Our Deadly Epidemic and Its Causes. New York: G. P.
Putnam’s Sons, pp. 51-52.
4
Cybersex

As of January 1999, there were 19,542,710 total unique visitors/month on the top
five pay porn Websites, and there were 98,527,275 total unique visitors/month on
the top five free porn Websites.

In November 1999, Nielsen Net Ratings figures showed 12.5M surfers visited porn
sites in September from their homes, a 140% rise in traffic in just six months.

Nearly 17% of Internet users have problems with using sex on the Net.

Severe problems with sex on the Net exists for 1% of Internet users, and 40% of
these extreme cases are women.

Most e-porn traffic, about 70%, occurs weekdays between 9 a.m. and 5 p.m.

There are 100,000 Websites dedicated to selling sex in some way; this does not
include chat rooms, e-mail or other forms of sexual contact on the Web.

About 200 sex-related Websites are added each day.

Sex on the Internet constitutes the third largest economic sector on the Web
(software and computers rank first and second), generating $1 billion annually.

The greatest technological innovations on the Web were developed by the sex
industry (video streaming is one example).
5
Trauma Bond
Why it must be addressed:
As long as the trauma bond remains strong, the
internal and external safety necessary for
healing/recovery work does not exist.
2. Overtly and covertly abusive relationships may
continue with the abusive family of origin.
3. Re-enactment: The patient may attempt to
solve the primary abusive relationship problems
through re-enacting these relationships in other
significant relationships. (e.g., abusive spouse)
1.
6
Trauma Bond II
Can be understood as lack of individuation or
differentiation.
a.
b.
Victim to victimizer model including: Re-enactment for
mastery.
Trauma bonded person is left with the feeling: “I am
just like him/her (abuser), I am one of them ( member
of abusive family), therefore unacceptable to the
outside world.”
7
Control of Symptom
vs…
Recovery
8
Why, for instance, does an ostensibly “honorable man” do
something that betrays? Why does an apparently “honest” man
do something deceitful? Why does a generally “kind” man do
something that wounds? Why does a reputably “caring” and
decent man commit an act so steeped in contempt that it is as if
someone else had done it, for he himself could not possibly?
Those of us raised to be men of must ask such questions of
ourselves. And all of us must ask such questions about the men
whom we know most intimately…why, I have wondered, are
“good” men sometimes so completely unreliably moral? Why do
we sometimes act as if we have lost our values mooring, lost sight
of our beacon, convictions, lost hold of our sense of self? What is
going on in us? Why do we evidence such wanton behavioral
swings – such unpredictable splits in who we are?
Stoltenberg, 1993
9
Aleksandr I. Solzhenitsyn
If only there were evil people somewhere
insidiously committing evil deeds, and it were
necessary only to separate them from the rest of
us and destroy them. But, the line dividing good
and evil cuts through the heart of every human
being, and who is willing to destroy a piece of his
own heart?
Gulag Archipelago
10
“SELF-EMPATHY” - The internalizing
(evoking) of the attentive, validating,
caring relationship to oneself. This
involves helping the client articulate her
experience and bring it into her own
internal relational context.
11
Shame
Let’s take a closer look at this process. Imagine a situation in which a child
awakens from a nightmare and cries out in fright. The child screams, “I’m
scared, I’m scared! There’s a monster!” Mother abruptly silences the child’s
screams with, “Now stop that. Don’t be silly. Big boys don’t get scared of silly
things like dreams.” The effect upon the lad is that he has been shamed for
being afraid. Perhaps this same boy, running away from a bully at school, is
told by his Dad, “Don’t be a coward! Read boys aren’t afraid to fight.” If this
boy has sufficient experiences in which his scared or frightened feelings are
met with shaming, he will learn that there is something wrong with him
whenever he feels afraid. Feeling afraid has become shameful, bad.
Situations which trigger fear will now also trigger shame. This indirect
activation of shame has now become autonomous, thereby causing the
expression of fear itself to become bound by shame. Thus, a particular affect
can come to spontaneously activate shame without shame itself being directly
induced.
Kaufman
12
Rupture in Attachment Impingement
(Greenburg & Mitchell)
The child’s psychological survival must not depend
upon meeting the mother’s needs. The major
consequence of prolonged impingement is
fragmentation of the infant’s experience. Out of
necessity, he/she becomes and requests of others.
The child’s “true self,” – the source of spontaneous
needs, images and gestures – goes into hiding,
becomes detached and atrophied. The “false self”
provides an illusion of personal existence whose
content is fashioned out of maternal expectation.
The child becomes the mother’s image of him.
13
Self-parenting: according to survivors, qualities
of ideal parent









Unconditionally loving and accepting.
Affirming.
Takes responsibility.
Sets and teaches healthy boundaries.
Is protective.
Values play.
Is forgiving of mistakes.
Encourages growth.
Listens to child in open and receptive way.
These are the qualities of the ideal “self-parent”
14
Reflectivity
Accounts vary in the extent to which people are able to reflect on their
experiences, for example, to remember how they felt, why they felt like
this, how else they may have felt. Importantly, this also relates to their
abilities to form ideas about other’s internal states; for example, to be
able to consider what might have been going on in the mother’s or
father’s minds – feelings, intentions, needs and explanations which may
have guided their actions (Fonagy et al., 1991; West, 1997). This has
variously been termed psychological-mindedness, sociality (Kelly, 1955,
Proctor, 1981, 1984) and ‘theory of mind’ (Baron-Cohen, 1997).
According to Fonagy et al.:
The development of the reflexive self is, thus, intrinsically tied to the evolution of social
understanding. It is through the appreciation of the reasons behind the actions of his
caretakers and siblings that the child can come to acquire a representation of his own
actions as motivated by mental states, desires and wishes.
Fonagy et al., 1991, p. 203
15
Middle Adolescence
“What am I as a person? You’re probably not going to understand. I’m complicated! With my really close friends, I am
very tolerant. I mean I’m pretty understanding and caring. With a group of friends, I’m rowdier. I’m also usually friendly
and cheerful but I can get pretty obnoxious and intolerant if I don’t like how they are acting. I’d like to be cheerful and
tolerant all of the time, that’s the kind of person I want to be, and I’m disappointed in myself when I’m not. At school, I’m
serious, even studious every now and then, but on the other hand, I’m a goof-off too, because if you are too studious, you
won’t be popular. So I go back and forth, which means I don’t do well in terms of my grades. But that causes problems at
home, where I’m pretty anxious around my parents. They expect me to get all A’s and get pretty annoyed with me when
report cards come out. I care what they think about me, and so then I get down on myself, but it’s not fair! I mean I
worry about how I should get better grades, but I’d be mortified in the eyes of my friends if I did too well. So I’m usually
pretty stressed out at home, and can even get very sarcastic, especially when my parents get on my case. But I really don’t
understand how I can switch so fast from being cheerful with my friends, then coming home and feeling anxious, and then
getting frustrated and sarcastic with my parents. Which one is the real me? I have the same question when I am around
boys. Sometimes I feel phony. Say I think some guy might be interested in asking me out. I try to act different, like
Madonna. I’ll be a real extrovert, fun-loving and even flirtatious, and I think I am really good-looking. And then everybody
and I mean everybody else is looking at me like they think I am totally weird! They don’t act like they think that I’m
attractive so I end up thinking that I look terrible. I just hate myself when that happens! Because it gets worse! Then I get
self conscious and embarrassed and become radically introverted, and I don’t know who I really am. Am I just acting like
an extrovert, am I just trying to impress them, when I am really an introvert? But I don’t really care what they think,
anyway. I mean, I don’t want to care, that is. I just want to know what my close friends think. I can be my true self with
my close friends. I can’t be my real self with my parents. They don’t understand me. What do they know what its like to
be a teenager? They treat me like I’m still a kid. At least at school, people treat you more like you’re an adult. That gets
confusing, though. I mean, which am I? When you are 15, are you still a kid or an adult? I have a part-time job and the
people there treat me like an adult. I want them to approve of me, so I’m very responsible at work, which makes me feel
good about myself there. But then I go out with my friends and I get pretty crazy and irresponsible. So which am I,
responsible or irresponsible? How can the same person be both? If my parents knew how immature I act sometimes, they
would ground me forever, particularly my father. I’m real distant with him. I’m pretty close to my mother though. But it’s
being distant with one parent and close to the other, especially if we are together, like talking at dinner. Even though I’m
close to my mother, I’m still pretty secretive about some things, particularly the things about myself that confuse me. So I
think a lot about who is the real me, and sometimes I try to figure out when I write in my diary, but I can’t resolve it.
There are days when I wish I could just become immune to myself!
The Construction of Self
16
Attachment and Self Fantasy
Attachment becomes a highly structured
vehicle through which increasingly complex
information about the self becomes available.
Developmentally, attachment contributes to
acquired selfhood structures.
Children abstract their uniqueness from the
experience of being involved in a unique
relationship with and then transform that
relationship to identity.
17
Bowlby’s Hypothesis
(Bowlby, 1990)
Each person’s resilience or vulnerability to
stressful life events is determined, to a
very significant degree, by the pattern of
attachment during early years.
18
Secure Attachment I

Because their caretakers have been routinely available to
them, sensitive to their signals, and responded with some
degree of reliability (though by no means is perfect care
required,) these infants develop a confidence that supportive
care is available to them.

They expect that when a need arises, help will be available. If
they do become threatened or distressed, the caregiver will
help them regain equilibrium.

Such confident expectations are precisely what is meant by
attachment security.
L. Alan Stroufe, 2000
19
Stroufe
Securely attached individuals who have
internalized the capacity for self regulation
are compared to those who either down
regulate (avoidant) or up regulate (resistant)
affect. Felt security is no longer restricted to
caregiver behavior. Appraisals of availability
of security figure including threats of suicide,
of leaving or sending the child away, or
marital separation anticipated, all influence
security.
20
Multiple Internal Working Models
Reciprocally incompatible and segregated or
dissociated models of self and of the attachment
figure are constructed and, thereby, interfere with
integrative functions of memory, consciousness
and identity. This suggests that dissociative is more
than a defense against trauma. The results are
sequential simultaneous or trance-like
contradictory behavioral systems. Disorganized
infants are unable to synthesis their overall
experiences of their interaction with the caretaker
into cohesive mirroring structure.
21
Main
Her interest was in the narrative coherence. Rather than
focusing on the individual’s story, she looks at the
structure of the story. What the person allows
themselves to know, feel and remember in telling the
story. Breaks in the story, disruptions, inconsistencies,
contradictions, lapses, irrelevancies, and shifts are
linguistic efforts to manage that which is not integrated
or regulated in experience or memory. Fonagy calls this
“mentalizing” affective experience to reflect upon the
diversity and compliant of internal mental states.
Specific memories used as evidence supporting general
descriptions of primary relationships are important.
22
Dismissing of attachment
1.
Idealization.
2.
Dismissing derogation.
3.
Lack of memory.
4.
Response appears abstract and remote from memories or feeling.
5.
Regard self as strong, independent, normal.
6.
Little articulation of hurt, distress or needing.
7.
Endorsement of negative aspects of parents behavior.
8.
Minimizing or downplaying negative experiences.
9.
Positive wrap-up.
10.
No negative effects.
11.
Made me more independent.
23
24
I.
II.
III.
IV.
V.
Loving – there for child emotionally
(cherish)
Rejection – turning away attachment
(rebuff/minimize)
Involving/Preoccupying – guilt
induction (spousification)
Neglect – inaccessible when physically
present (workaholic, narcissistic
parents)
Pressure to Achieve – perform or risk
love
25
Metacognitional
Metacognition means treatment of one’s
mental contents as “objects” on which to
reflect, or in other words “thinking about
one’s thinking.” Distinct skills contribute
to its characterization, such as the ability
to reflect on one’s mental states,
elaborating a theory of the other’s mind,
decentralizing, and the sense of mastery
and personal efficacy.
26
TABLE I.I
Facilitating “Earned Secure Attachment”
1.
Facilitating a coherent, cohesive, collaborative and reflective “fresh” narrative with clarity and perspective.
2.
Examining exaggerated, polarized, internally conflicting loyalties to family system or family system “rules.”
3.
Facilitating metacognition, particulary redefining reactivity, proportion and understanding origins of core beliefs.
4.
Facilitating self-compassion and internal connections to disowned parts of self.
5.
Utilizing an attuned “connected” relationship with therapist as a home base for exploring development.
6.
Learning to solicit and draw on internal and external resources for support, soothing and stress reduction.
7.
Re-examine detailed beliefs about self and others.
8.
Relinquishing defense of dissociation and re-associating affect, sensation, and knowledge such that there can be choice about behavior.
9.
Not inhibit or minimize internal experiences and learn to tolerate distressing emotions and express affection.
10.
Resolution of internal relational exchanges between parts of self.
11.
Internalize self-parenting that is non-punitive, non-punishing and comes to rely on internal voice of wisdom.
12.
Sets and teaches healthy boundaries.
13.
Resolution of significant losses in one’s life.
14.
Deconstruct the attachment patterns and core relational conflicts and revise expectations, and be capable of holding contradictory feeling in
consciousness simultaneously without negation or dissociation.
15.
Integrate traumatic attachments, losses and re-enactments with reduction of shame, recognition or attributions and re-examining traumarelated behaviors.
16.
Establishing appropriate entitlements related to having needs, expressing needs, and meeting needs.
27
SELF HEALING
28
Self Healing
Therapist is no longer “healer” but more
“mid-wife,” facilitating the birth of that
which already exists inside the client,
waiting to be born.
29
Schema of Self
He emphasized the value of the
alternative, psychological approach, which
explains posttraumatic symptomatology as
a consequence of the shattering of
schemata concerning the self and the
world. Trauma disrupts the meaningful
organization of life experience, thereby
exerting a debilitating effect on selfperception and ability to face the future.
Shay, 1995
30
False Self
(from Winnicott)
Parents who are intensively over-involved
with their infant cause the child to develop a
false self based upon compliance. Care-giver
doesn’t validate the child’s developing self,
thus leading to alienation from the core self.
Parenting practices that constitute lack of
attunement to the child’s needs, empathetic
failure, lack of validation, threats of harm or
coercion and enforced compliance, all cause
the true self to go underground.
31
REENACTMENT
32
The Protagonist does not know that the
performance is designed to master
“events” that were once too exciting, to
frightening, too mortifying to master in
childhood. Unable to remember the
events, his life is given up to reliving
them in a disguised form.
(Stoller, 1986)
33
Intra-Psychic Conflict
Extension of intra-psychic conflict onto the stage
of the outer world often manifests itself in
interactions with others that cannot strictly be
called interpersonal, because they are essentially
extensions of the individual’s problems from the
past. These problems are played out using
another, not for his or her real self, but as an
involuntary actor cast in a role from a scenario
the patient repeats in the present in order to
avoid past memories and feelings.
From Masterson, J & Orcutt, C. (1989). Marital Co-Therapy of a Narcissistic
Couple. In J. Masterson & R. Klein (Eds.), Psychotherapy of the Disorders of
the Self. New York: Brunner/Mazel
34
DISSOCIATION
35
Putnam
“Developmental Model”
Multilevel developmental disturbances are
produced by the segregation or
compartmentalization of information, skills,
and behavior into discrete dissociative states,
such that this knowledge is only erratically (as
opposed to reliably) available to the individual.
Difficulties with the integration of
dissociatively compartmentalized information
impair metacognitive executive functions and
iteratively disrupt the developmental
consolidation of sense of self over the life
course.
36
Dissociation
Early dyadic processes lead to a “primary
breakdown” or lack of integration of a
coherent sense of self, i.e. Unintegrated
internal working models.
 Disorganized attachment is the initial step in
the developmental trajectory that leaves an
individual vulnerable to developing
dissociation in response to trauma.

(Liotta, 2000)
37
Pathological Dissociation
Four characteristics distinguish pathological
from normative dissocation: Only in
pathological dissocation do we encounter loss
of executive control, change in selfrepresentation, amnesic barriers, and loss of
ownership over behavior.
Kluft, 1993
38
The Self is a Conglomeration of Selves, Multiple
Mental Systems





Each with the capacity to produce behavior
Each with its’ own impulses for action
One system can be cut off from other
(unconscious)
Verbal self gives meaning and consistency;
language becomes linked with identity and
meaning making
Defense systems service the self to preserve
sense of consistency
39
Pathological intensification
The natural healing trajectory of the organism is
impeded. The adaptation, that was originally
self preserving, becomes entrenched rather than
giving way naturalistically to the next phase of
healing, as though it has become “snagged” on
something. The “something” is prior unresolved,
related “burdens.”
40
Multiplicity
Internal Family Systems presumes an innate
multiplicity, i.e. the unfolding of parts is natural,
whether under normative, optimal or abysmal
life circumstances. The degree of access and
smooth interplay of parts vs. the
compartmentalization and degree of
polarization of parts, relates back to the kind
and degree of burdening, i.e. how much has to
be “exiled” and the amount of “protection” it
takes to keep it so.
41
OUT OF CONTROL
BEHAVIOR AS A TRAILHEAD
42
What becomes of this forbidden and
therefore unexpressed anger?
Unfortunately, it does not disappear, but is
transformed with time into a more or less
conscious hatred directed against either
the self or discharge itself in various ways
permissible and suitable for an adult.
43
Every deep desire, every powerful emotion, gives
a trail into the unconscious. Usually there is only
one-way traffic: outbound, toward the world of
sensation and action. But we can follow the trail
to its source by going against the current. With
this desire to go against desire, to buck the
demands of biological conditioning, the journey
of self-realization begins in earnest.
Meditation in Action
Eknath Easwaran
44
Celebrating the Symptom
Sincere letter of gratitude to
Protective Parts for their efforts on
behalf of survival or safety (relatively
speaking).
45
Repetition
Nevertheless, the need to repeat also has a positive
side. Repetition is the language used by a child who
has remained dumb, his only means of expressing
himself. A dumb child needs a particularly empathic
partner if he is to be understood at all. Speech, on
the other hand, is often used less to express genuine
feelings and thoughts that to hide, veil or deny them
and, thus, to express the false self. And so, there
often are long periods in our work with our patients
during which we are dependent on their compulsion
to repeat - for this repetition is then the only
manifestation of their true self.
- Alice Miller
46
Affect and Cognition I
Janet believed that traumatized individuals
became phobic about memory because
they have failed to develop narratives
about their traumata, instead experiencing
posttraumatic amnesias and
hyperamnesias
van der Kolk, Brown & van der Hart, 1989
47
Fear of Overwhelming Affect
Avoidance
Stop!
Before it
intensifies
Preach
“Forgiveness”
Circumvent
Decide the
client is not yet
ready to deal
with their
trauma
Project
Keep the
therapy purely
Cognitive
Behavioral
“Fix it” –
whenever the
client begins to
feel
Cite statistics to bolster
your sense of rightness
Rescue
48
Change subject –
stop abreaction or
witnessing in midstream
Affect and Cognition III
His treatment approach involved bringing
compartmentalized memories and
feelings into consciousness where they
could be processed therapeutically. He
anticipated contemporary treatment
strategies with his three-phase therapy
model.
van der Kolk, Brown, & van der Hart, 1989
49
Abreaction With Sexual Abuse Survivors
(Hunter, 1991)
Abreaction is revivification of past memory with
release of bound emotion and recovery of
repressed or dissociated aspects of a
remembered event.
Abreaction provides a psychic reworking of the
trauma that identifies, releases and assimilates
unresolved aspects of the abuse, allowing
resolution and integration on both psychological
and physiological levels.
50
Abreaction With Sexual Abuse Survivors
(Hunter, 1991)
Planned abreactions can provide a step-by-step
framework in which memory work can be done
safely, giving the client mastery over what he/she
could not control as a child.
Abreactive work must be adequately timed,
managed and processed, or it may re-traumatize
the client, promote further repression and
dissociation, produce negative transference
reactions, trigger non-therapeutic regressions and
may even precipitate psychotic decompensation,
self-mutilation or suicide attempts.
51
Resistance Group
How am I avoiding remembering?
2.
How am I avoiding feeling?
3.
How am I avoiding talking about it?
4.
How am I minimizing it?
5.
How am I avoiding focusing on enjoying parts of life?
6.
How am I avoiding noticing triggers that cause me to hurt
self?
7.
How am I avoiding dealing with current life stresses?
8.
How am I still protecting my family?
9.
How am I avoiding being close to others?
10. What secrets have I not yet discussed?
11. How am I fighting my therapist and working my program?
1.
52
COMPASSIONATE
WITNESSING
53
Compassionate Witnessing
This occurs when the Self of the client is able to
witness the stories of parts from a compassionate
position. Ask the client to identify an activated
part (usually associated with extreme behaviors,
thoughts or feelings). Ask the client where in the
body the part (position of Self) indicates that
another part is blended with the Self. Ask the
blended part to please step aside and let the Self
work with the activated part. (This may include
asking more than one part to step aside).
54
UNBURDENING
55
Burdens
The concept of “burdens” is brilliant in its
widespread application. It sidesteps the need to
compare, contrast, count symptoms to diagnose,
and postulates instead more of a “no one escapes
unscathed” framework. Thus, “burdens” can
encompass beliefs, feelings, and energetic residue
of events and experiences that overwhelmed the
internal and/or external accessible resources of
the organism and its attachment environment at
the time, thereby creating constraint.
56
Unburdening
Burdens are thoughts, feelings or energies that
constrain parts and keep them from assuming
their natural healthy roles. After compassionate
witnessing has taken place, ask the part whether
it might like to get rid of the (burdensome)
thoughts and feelings it took on, related to the
scenes just witnessed. Ask where in the body the
burden is located, and what they would like to
give it up to.
57
Come to your senses!
SELF
UNBURDENING
Much of culture, religion and certainly the
milieu of dysfunction within a given family, work
to separate a person from what is natural and
instinctual (within & without) and seek to
substitute a false authority – to create
compliance, conformity and the guilt that fuels
unending obligation and penance, in its
masquerade as reverence.
58
In I.F.S., the more unburdening
of these “legacy” and personal
burdens, the more space for Self
to re-enter. Decreasing
compartmentalization leads to an
increase in metacognitive
capacities and establishment of a
coherent, cohesive narrative.
59
When you act on your countertransference (or let your firefighters
lead), the client’s worst fears come true.
The past has repeated itself and once
again culminated in the same damaging
outcome.
60
Positive Resolution
Trauma must always be resolved in order to be put in proper
perspective. Resolution may be positive, negative or functional. A
positive resolution occurs when the adult is able to process the
trauma in a realistic way, experiencing whatever levels of pain,
anger or loss are elicited by a clear memory of the event.
The person perceives the event accurately, and does not feel
irrationally responsible for having caused it. The person is able to
understand that the experience occurred in the past, and no longer
feels devastated by the memory of the event, as if it were a clear
and recurring danger in the present
Above all, the person does not feel compelled to repeat the event,
either consciously or unconsciously. Adults who have experienced
a positive resolution generally feel that they are in control.
61
Internal Family Systems Innovations
1.
2.
3.
4.
5.
Delegates capacity for healing within the
client: “self-healing”
Defenses accessed first. Get to know them
and celebrate their genesis.
Get permission to access the parts they
protect.
Get fear, shame and punitive internal voices
to step back, allowing a more vulnerable core
affect – and more accurate self-reflection.
Deep structure, access to sensorimotor,
visceral, image-dominated, right brain –
previously unavailable material.
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Unlock the unconscious
7. Integrate disowned parts of selfconsolidation.
8. Release of potential residing within
9. Establish a cohesive coherent
autobiographical narrative.
10. Establish an “earned secure” attachment
with self and parts as well as affect
regulation.
11. Integrated affect and cognition.
6.
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Internal Family Systems Innovations
12.
Therapist being “in self” allows what
Kohut called empathy – mirroring
“without judgment, without sympathy,
without excessive analysis.”
It mirrors the subjective experience of
the self providing self-cohesive.
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