Internal Family Systems (IFS) Therapy: Chronic pain

This article describes how most chronic pain has a significant psychological component that can be successfully treated with Internal Family Systems (IFS) or Parts Therapy.

“It turns out that most chronic pain, and an astonishing variety of other medical maladies, have little to do with damaged tissues or untreated infections. They’re maintained by complex mind–body interactions, in which our brain’s natural proclivity to avoid pain traps us.”

“We’ve begun to learn, for example, that histories of childhood sexual or physical abuse are significant risk factors for chronic back pain, and that job dissatisfaction is a much stronger predictor of it than having a job that requires heavy lifting, lots of sitting, or other physical strains.”

“When we’re anxious, states of chronic fight-or-flight arousal can disturb the normal function of our organs. We see this when anxiety causes our stomachs to produce too much acid and gives us heartburn, or our intestines to dysregulate and bring on irritable bowel syndrome, or our muscles to seize and result in chronic back pain. Sometimes, even when our physical systems are functioning normally, our brains actually produce or amplify pain and other troubling sensations either out of fear or to fulfill psychological needs.”

“Effective treatment of chronic pain involves understanding the roles that psychological factors play and finding ways to address them. One particularly useful way to do this is through Internal Family Systems therapy (IFS), a psychotherapy that’s rooted in a clear understanding of the interplay of psychology and the body. IFS is based on the observation that each of us comprise many psychological ‘parts,’ seen as valuable members of an inner family, which exist to help us thrive and to protect us from pain.”

“Trauma and attachment injuries, however, force many of our parts into serving functions that can be problematic. One such group of parts, called exiles, are young and vulnerable, and carry early emotional injuries (what IFS calls burdens), such as a sense of worthlessness, terror, or emotional hurt. Before the trauma, they were the lively, creative “inner children,” but after they began to carry the burdens of trauma, we locked them away to keep them from overwhelming us with their raw emotions and vulnerability.”

“Once we develop exiles, the world feels more dangerous, and we feel more fragile being in it. As a result, another group of parts tries to protect our exiles from getting triggered. To do that, these protector parts take on roles like the harsh internal critic, the overachieving perfectionist, or the frightened avoider. In IFS terminology, these protectors function as managers, dictating our day-to-day activities to make sure our exiles don’t get emotionally injured.”

“During times of increased stress, when these managers can’t adequately manage our emotional pain, another set of protectors, termed firefighters, jump into action at an even higher level of defense. Firefighters are emergency responders, and their activities include acute depression and suicidal thoughts, cutting, binging, alcohol or drug use, and panic attacks. Both protector-managers and firefighters may use physical pain to protect our exiles.”

I offer IFS therapy and integrate it with Brainspotting therapy to help clients heal from trauma, anxiety, depression, stress, and other conditions. If you would like to learn more, book your free consultation below.