Psychotherapeutic landscapes

IFS was introduced to the world of psychotherapy in the 1980’s and has steadily increased in popularity and accessibility over the last four decades. But what is the psychotherapeutic landscape in which IFS has evolved and taken shape? From where has it drawn its influences? Where is IFS placed in the taxonomy of psychotherapeutic interventions? Ultimately, where does IFS fit into the brief history of modern psychotherapy relative to other models?

Much like how history is defined by a range of factors including (but not limited to) cultural bias and philosophical framework, the history of psychotherapy can be interpreted from different perspectives. My training and interest is in clinical psychology. As such, my theoretical and historical biases favor that profession. This “Special Open Collection” invites you to contact us with your own version of how psychotherapy has evolved. Please articulate from your perspective where IFS might fit into this space and submit your ideas and/or feedback. We’d love to hear from you!

I think of modern psychotherapy as having four broad “ages”: the psychodynamic, the behavioral, the cognitive behavioral, and a range of what are currently referred to as “third-wave behavior therapies.”

Psychodynamic psychotherapy: The mid 1800’s was a dynamic time in the development of psychotherapy. Intellectual giants who featured heavily in this era include Pierre Janet, famous for his work in the fields of trauma and dissociation; Wilhem Wundt, who established the distinction between philosophy and psychology and was the first person to call himself a “psychologist;” and William James, the first educator to offer a psychology course in the USA. There are a host of other important figures in this age, of course, most prominently Sigmund Freud and Carl Jung, active from the 1880’s to the 1920’s. These men were arguably responsible for initiating the psychodynamic age, though their work stands on the shoulders of scholars who went before them. With its emphasis on intrapsychic processes, the unconscious mind, and the importance of developmental history and trauma, psychodynamic psychotherapy employs techniques such as free association, dream interpretation, and working with defenses.

The first wave, Behaviorism: In the early 20^th century, psychology entered a range of applied settings, like military training in the First World War (WWI) and World War Two (WWII). It also established itself in the North American educational system, which proved to be a turning point. The discipline of psychology became very popular in the 1920s, with many perceiving that it played a role in the Allied success of the WWI. This era was also synonymous with the rise of behaviorism, a field of psychology that emphasizes the importance of external measurements over the more introspective and less-empirical foundations of psychodynamic psychotherapy.

Behaviorism is a branch of psychology that notes the importance of reflex, reinforcement, and punishment in explaining behavior. It’s been highly influential and has helped form the theoretical and practical foundation for much of the profession of psychology over the last 100 years. (Many of the interventions I have used with my clients over the last two decades—including exposure therapy, behavioral activation, and applied behavior analysis—have their foundations in the work of behavioral psychologists from this era.)

The second wave, Cognitive behaviorism: Because of the emphasis that behaviorism places on external punishments and rewards, it has often been considered the “black box” theory of psychology. It emphasizes the inputs into the black box—or the individual’s mind—in the form of set parameters, punishments, or rewards; and emphasizes the outputs from the black box, in terms of behavior. Theoretical understanding of what happens inside the black box of the mind is not the emphasis. Cognitive behavioral therapy (CBT) debuted in the 1960’s and 1970’s and incorporates a useful range of behavioral techniques that attempt to shine light into the black box of the individual’s mind.

CBT highlights the importance of helping the client to shift their beliefs, assumptions, and predictions from being “negative, erroneous, or unhelpful” to being more positive, accurate, and helpful. (CBT was the predominant training method and school of psychotherapy to which I was exposed in my clinical training more than 20 years ago.) Hundreds of randomised clinical trials and meta-analyses have proven CBT to benefit many thousands of clients over the years. However, it is also subject to a number of criticisms. Some claim it fails to recognize the impact of developmental trauma or the client’s current environment. Additionally, CBT often pathologizes so-called “irrational beliefs,” even though these can be rooted in truth. The limitations of CBT impelled a third wave of behavior therapies in the late 1990’s.

“Third-wave” behavior therapies: In my first job as a clinical psychologist registrar in 2002, I was eager to read the early literature associated with this third wave of behavior therapy, specifically Acceptance and Commitment Therapy (ACT). But there was hardly any ACT literature available at the time and precious few journal articles. (I ended up writing to Steve Hayes in the USA to ask him for a copy of a ten-session ACT transcript he had completed with one of his clients, which he generously shared.) Since then, ACT has been joined by various other third-wave behavior therapies, including Dialectical Behavior Therapy (DBT), Mindfulness‐based Cognitive Therapy (MBCT), Functional Analytic psychotherapy (FAP), Meta‐cognitive therapy (MCT), and several others.

These therapies emphasise the importance of mindfulness, the role of emotions, acceptance of said emotions, various elements of therapeutic and interpersonal relationships, the role of meta‐cognition, and the importance of values and goals. I was asked recently to write a chapter for a textbook and was challenged to answer how to define third-wave therapies and whether or not IFS fits into this category. Thankfully, I was able to draw on Steve Hayes and Stefan Hoffman (2021), who have outlined the five features of a third-wave behavior therapy as follows:

• A focus on context and function
• The view that new models and methods should build on other strands of CBT
• The capacity to apply processes to the clinician—not just the client
• A focus on broad and flexible repertoires vs an approach to signs and symptoms
• The capacity to expand into more complex issues that are historically more characteristic of humanistic, existential, analytic, or system-oriented approaches

When viewed from this perspective, IFS sits firmly inside the realm of third-wave therapies. But it’s instructive to remain curious about how and why. In Part 2 of this series of articles, I will map the elements of IFS onto each of the five features above, in order to find, focus on, and flesh out where IFS fits into the current psychotherapeutic landscape.