“I appreciate that de-pathologizing people’s emotional struggles and challenges is important,” she says, “but it’s not just about our parts; it can be about other things, like biochemical changes, too.”
Schwartz says he has heard this concern many times in the course of his career but maintains that IFS respects the place of biochemical issues and medication’s role in addressing them.
“If you’re talking about things like schizophrenia and intense depression and so on, my position is that we all have genetic predispositions for certain conditions,” he says. “I have one for asthma. I’ve just been getting over a bit of an asthma attack, and migraine headaches. Those are physiological, biomedical things. They’re real. But our parts get wind of those things, and begin to use them when they don’t feel like they can get through otherwise.”
In a workshop at last year’s IFS conference in Denver, Schwartz and bestselling author Dr. Lissa Rankin discussed the success many therapists have found in using IFS to alleviate physical symptoms by healing the parts that trigger them. From an IFS perspective, Schwartz says, Ross’s psychotic symptoms likely came about in much the same way that a part-induced asthma attack might come about: through a genetic proclivity for delusions that a part made use of to get Ross’s attention.
“That was, from my point of view, a biochemical reaction,” Schwartz says. “He had the gene to make him hear voices that way. Once the part realizes it doesn’t have to do that anymore, the biochemical thing stops.”
This is a radically unorthodox view of schizophrenia, but it appears to be working for Ross. Three years after his first IFS unburdening, with vastly diminished paranoia and no further hospitalizations, he points to that first session with Schwartz as the turning point in his recovery.
“Once I had that experience doing an unburdening,” he tells me, “feeling the major change that happened, it really opened things up for me. It changed everything. I can’t tell you it immediately cured me, that one session, but it was such a dramatic shift that it really opened up the path to the eventual work. It made me feel like my goal of getting better was really possible.”
Ross’s voice today is lively and articulate, a far cry from the halting monotone that stymied Medeiros. He says that while antipsychotic medication calmed him and made the voices in his head less terrifying, it didn’t actually help him heal.
“To be honest, I really was always hearing voices,” he says. “It was something I felt I had to deny when I saw psychiatrists because I very much didn’t want to have a higher dose of medication, and I was concerned about being hospitalized, too. But I think as I am now, where I hear so little of the voices that they just don’t even register, it’s kind of like — I don’t think that’s the medication suddenly kicking in. I think that’s all IFS.”
When I first spoke to Ross in August 2019, he had just been hired for his first job, an extraordinary step away from the downward spiral of dependency that our mental health system sends so many patients down. Though he told me that he had parts that still required attention — an inner critic, a numbing part which muted his feelings, an “unacceptable part” that carried childhood shame — they had calmed down significantly since he had built positive relationships with them using IFS and relieved them of some of their burdens. When one of them or his “voice-hearing part” got activated, he practiced what Schwartz calls “Self-leadership,” taking a step back from the part (“unblending” in IFS parlance) and hearing out its concerns. He told me he planned to taper off his antipsychotic medication in consultation with an IFS-trained psychiatrist as soon as he had proved to himself that he could live independently.
“There are certain conditions I want to meet,” he said then. “I want to work full time — I’m only working 20 hours per week, and that’s not quite enough to support myself. Then I want to move out of my mom’s house, take a little time, and then start the tapering process.”
By the time I checked in again a few months later, Ross was up to 40 hours per week, had begun driving himself to work each morning in his own car, and had moved into an apartment with a roommate. He was continuing to make progress on healing his parts, both in sessions with Medeiros and in work on his own.
The most powerful thing about IFS, Ross says, is the way it has restored his sense of agency.
“It wasn’t just like I needed to be fixed by some external force,” Ross says. “It was like, ‘Yeah, I can make these changes.’ That was huge.”
With passionate advocates like Ross and an expanding community of IFS therapists committed to affecting Schwartz’s paradigm shift, IFS is beginning more and more to feel like a movement, one which has already evolved the culture of psychotherapy toward de-pathologization and an acceptance of inner multiplicity. Patients can find IFS therapists in all 50 U.S. states through the IFS Institute’s online directory or on Psychology Today. Many have also done “parts work” on their own using psychologist Jay Earley’s popular guide Self-Therapy.
Schwartz likes to joke in talks that he is planning to rewrite the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), psychiatry’s bible, to explain the basis of each disorder in non-pathologizing terms of protectors and exiles, thereby challenging the dominant “chemical imbalance” view. But for all the humor, his real ambitions are even greater than that. Experts in conflict resolution, anti-racist education, high school guidance counseling, mediation, 12-step addiction recovery, and a growing list of other fields have begun adopting IFS techniques and developing pilot programs based around its principles. Just as important, Schwartz wants IFS to transform the way we connect to each other one-to-one.
“This is a radically different paradigm for understanding human beings than the ones that dominate our culture,” he says. “If it is true that these things we think of as our inner enemies are really heroes stuck in time, that by itself allows people to relate inside with a lot more compassion and love, which translates to how they see outside enemies and relate to them.”
In an era in which Congress, the internet, and the U.S. population at large can seem just as polarized into mutually attacking parts as the “internal families” of Schwartz’s most profoundly unwell patients, that’s a tantalizing message. Is it really possible that even those who most infuriate us have compassionate, relatable Selves at their core, hidden behind a screen of protectors who would gladly give up their hurtful behavior if the pain they were defending were seen and healed? As Schwartz himself often says when speaking to new crowds, it would certainly be wonderful if it were true.
Written by Ben Blum
Author of "Ranger Games: A True Story of Soldiers, Family, and an Inexplicable Crime" (Doubleday, 2017);
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