Psychotherapeutic landscapes, II

The first installment of this series of articles (“Psychotherapeutic landscapes”) established that IFS does fit into the third-wave of behavior therapies. This article goes a step further by mapping elements of the IFS process onto the criteria of what makes a third-wave therapy.

To review, the five key features of a third-wave therapy are: 1) a focus on context and function, 2) new models and methods should build on other strands of Cognitive Behavioral Therapy (CBT), 3) the capacity to apply processes to the clinician, not just the client, 4) a focus on broad and flexible repertoires versus a focus on signs and symptoms, and 5) the capacity to expand into more complex issues that are historically more humanistic, existential, analytic, or system-oriented.

Let’s address these one by one.

• A focus on context and function: Unlike CBT, which attempts to correct “faulty or erroneous cognitions,” third-wave therapies have little emphasis on changing the content of thoughts. Instead, the emphasis is placed on changing the “awareness of and relationship with” thoughts. In Acceptance and Commitment Therapy (ACT), this is achieved through “defusion” (the ability to put some distance between our observing self and our thoughts in Meta‐cognitive therapy (MCT), the thoughts are actively observed, regulated, and experienced in a novel way; and in Dialectical Behavior Therapy (DBT) a new relationship with thoughts is achieved through mindfulness and emotional regulation strategies.

Similarly, in IFS there are “no bad parts”—all parts are welcome. Therefore, whatever the protectors have to say is highly important and should not be contextualized or dismissed as a cognitive error, a negative thought, or something that needs to be challenged or replaced. What the Part says is valid and simply needs to be experienced and regulated in an adaptive way. IFS focuses on the process, context, and function of thoughts rather than on the content of thoughts.

• Building on other strands of CBT: Hayes and Hoffman (2021, p. 368) outline various characteristics associated with third-wave therapies, including “the flexible and functional attentional focus of MCT, the values work of ACT, the emotional regulation skills of DBT, and the present focus of MBCT.” They note that third-wave therapies “can apply to virtually any life situation, not just narrowly conceived clinical pathology.” These principles have been extrapolated from the foundation of CBT. IFS builds on this by focusing on the internal system, which allows the historical experiences of the individual’s Parts to be reviewed, adjusted, understood, and integrated into a new and more functional repertoire. This is very similar to what happens in cognitive therapy when thoughts are challenged and revised. It represents just one example of how IFS builds on the foundations of CBT.
• Applying processes to the clinician, not just the client: Hayes and Hoffman (2021) outline the various ways in which third-wave therapies emphasize the importance of applying these principles to the clinician as well as the client. In ACT, for example, “there is no fundamental distinction between the therapist and the client at the level of the processes that need to be learned” (p. 368-369). In DBT, the tasks of therapy are equally and actively applied to the client and the team of clinicians in order to prevent splitting. This provides containment in the presence of intense client reactions. In MBCT the clinician’s own practice of mindfulness is one of the primary guiding principles.

One of the fundamental objectives of IFS is to assist the client to access Self energy. Substantial time, energy, and clinical emphasis are placed on the clinician’s Self energy to achieve this. If the clinician is curious, compassionate, clear, and connected etc., then the client will attune to this and have greater access to similar qualities—including the other “C’s” associated with Self energy.

A clinician’s clear understanding of their own Parts and internal system will most likely assist them to do the “U-turn” (refocusing on oneself away from triggering stimuli). Un-blending in this manner further adds to Self energy and to the attunement potential for the client. A significant percentage of the (approximately) 90 hours of IFS-accredited trainings are dedicated to assisting student clinicians to understand and monitor their own internal systems. This helps them identify the overlap in processes between the clinician and the client.

• A focus on broad and flexible repertoires, versus an approach to signs and symptoms: Third-wave therapies are helpful for managing or reducing the signs and symptoms of presenting issues such as anxiety and depression. These therapies also have broader applications, such as assisting people to develop and implement their values (ACT); regulate their emotions in all sorts of circumstances, not just clinical situations (DBT); and be more present with loved ones and in their life (MBCT).

IFS can be helpful in clinical situations, of course, but it can also be applied more generally. IFS has been introduced into schools, athletic organizations, corporate environments, prisons, and the military. Sometimes there are “signs and symptoms” in these spaces, but application of IFS principles is often designed to address issues of resilience and positive growth, rather than to relieve suffering or “fix” a particular psychopathology.

• Expanding into more complex issues that are historically more characteristic of humanistic, existential, analytic, or system-oriented approaches: Many of the third-wave therapies address a wide variety of complex human issues. For example, ACT addresses issues of “meaning making” by its emphasis on values; Functional Analytical Psychotherapy (FAP) focuses on enriching peoples’ lives and emphasizes the core importance of the therapeutic relationship; and DBT places significant importance on interpersonal validation. These are all examples of how third-wave therapies deal with humanistic, existential, and system-oriented approaches.

In a similar vein, IFS has a spiritual dimension, partly addressed by the notion of Self energy. IFS also has progressive views on intergenerational trauma, legacy burdens, and cultural burdens, which are all examples of more complex, humanistic, and existential issues.

In the first two articles of this series, we have established that IFS is definitively a third-wave therapy. We have unpacked some ways in which IFS principles map onto the features of third-wave therapies and the psychotherapeutic landscape in general. In the third and final installment, we will pose one more question: What are the generally accepted processes of change in psychological therapy? How do the standard IFS principles facilitate them?