Internal Family Systems Therapy for Eating Disorders
Internal Family Systems Therapy can be a uniquely beneficial modality for individuals in recovery from eating disorders. It’s no coincidence that Internal Family Systems Theory was originally developed by Richard Schwartz out of his observations and experiences working with clients with severe eating disorders who had not had much success recovering in other forms of treatment.
What he found when working with these clients is that they often talked of conflicting parts of themselves – the part that wanted to recover and knew that their eating disorder was harming them, the part that was afraid of letting go of their eating disorder and what that would mean about their identity, the part that was angry about being in treatment for their eating disorder and wished to be left alone, and the part that drove them to engage in eating disorder behaviors. These clients reported that more traditional eating disorder treatment models of the time, which emphasized eradicating the eating disorder entirely, felt threatening to not only their eating disorder, but their holistic sense of self, as the eating disorder part had been so integrated into their identity.
Rather than continue down the path of trying to convince these clients to let go of their eating disorder, and all the parts of themselves associated with it, Schwartz began asking clients about these conflicting parts, what roles they were serving in their lives, what they were afraid of and trying to protect them from, and what role they might prefer to serve if they no longer had to be afraid. In approaching these parts of his clients with curiosity and compassion rather than trying to control or get rid of them, Schwartz found promising evidence that this allowed these clients to differentiate between their core self and these parts, address underlying fears and trauma, and ultimately feel less pull toward engaging in eating disorder behaviors.
Given that eating disorders are often perpetuated by a cycle of self-shaming, self-judgment, and self-isolation, it makes a great deal of sense that a modality like Internal Family Systems Therapy, which centers compassion, client autonomy, and curiosity would be an excellent way to break the eating disorder cycle. It is important to note that the peer-reviewed research base for the use of Internal Family Systems Therapy in the treatment of eating disorders is currently limited, though this is in part due to how difficult it is to standardize and study the modality, given its highly adaptable and client-specific nature. Nevertheless, clients and clinicians alike share anecdotal evidence that Internal Family Systems Therapy has been a beneficial addition to their eating disorder recovery. Below are more specific ways that Internal Family Systems Therapy can be particularly suited to addressing common challenges of eating disorder treatment and recovery.
Enhancing Interest in and Commitment to Recovery
For many people who pursue treatment and recovery from their eating disorder, the decision to begin recovery and keep recovering is often one they have to make over and over again, multiple times a day, with their eating disorder parts kicking and screaming along the way. Internal Family Systems Therapy provides an alternative to this constant tug-of-war in which clients are taught to work with the fears and anxieties of their eating disorder parts, rather than against them. By making contact and extending care to their eating disorder parts, rather than trying to white-knuckle through those parts’ protests, clients can find ways to integrate their eating disorder parts into their recovery, whether that’s through offering them alternative roles to serve, demonstrating that those parts no longer have to protect them, or simply extending care to those parts when they feel threatened or scared.
Cultivating Self-Compassion and Self-Care
Internal Family Systems Therapy holds that there are no bad parts, and that the goal of therapy is never to get rid of any parts, but rather to integrate our more extreme parts into adaptive and functional roles within our system. For clients who have engaged in more traditional eating disorder treatment which often emphasizes completely getting rid of the eating disorder and its associated behaviors, this paradigm shift can be a welcome relief from feeling like a part of them is bad or has to be eliminated. Instead of feeling like they have to exile their eating disorder parts, in Internal Family Systems Therapy clients are encouraged to make contact with those parts, find out how those parts have been protecting them or otherwise trying to help them, acknowledge and extend gratitude to those parts, and get curious with those parts about what other roles they might like to serve as the client moves further into recovery. In this way, eating disorder treatment and recovery can become more centered on client autonomy, values, and change that stems from self-compassion and understanding rather than self-judgment.
Getting Unstuck from the Messy Middle of Recovery
Internal Family System Therapy’s emphasis on cultivating self-energy can be particularly helpful for clients who find themselves feeling burnt out or lost as they move further along in their recovery process. Maybe you’ve changed your behaviors and worked hard to process your emotions, but you’re starting to wonder who you are or what you’d like to take up more space in your life now that the eating disorder has taken a backseat. This can be a great moment in your recovery to focus on activities, interests, and relationships that help you tap into the facets of self-energy. As a reminder, when we notice self-energy, it’s a sign we’re connecting to the core of ourselves. We know we’re tapping into self-energy when we feel engaged with curiosity, compassion, calmness, clarity, courage, confidence, creativity, and connectedness, as well as with presence, perspective, patience, persistence, and playfulness. Finding ways to cultivate these facets of self-energy can be a beneficial way to discover new passions, values, and interests in recovery and beyond.
It is important to note that while Internal Family Systems Therapy can be a great addition to an individual’s recovery process, it should be one part of the puzzle in addressing eating disorder behaviors, thoughts, and urges. Eating disorder recovery often takes a village of both therapeutic modalities and skills, nutritional support from a dietitian, and for some, medication support from a psychiatric provider.
Internal Family Systems-Informed Therapists at Austin Counseling and Nutrition
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