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Manual Parts 14 Clinical Applications Ifs
Manual Parts 14 Clinical Applications Ifs
Manual Parts 14 Clinical Applications Ifs
2-Day Advanced
Workshop
Clinical Applications of Internal
Family Systems (IFS)
Frank Guastella Anderson, MD
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MATERIALS PROVIDED BY
Speaker Disclosure:
Financial: Frank Anderson maintains a private practice. He receives a consulting fee from the
Center for Self Leadership. Dr. Anderson receives a speaking honorarium from PESI, Inc.
Non-financial: Frank Anderson is the President of the Foundation for Self Leadership.
Materials that are included in this course may include interventions and modalities that are beyond the
authorized practice of mental health professionals. As a licensed professional, you are responsible for
reviewing the scope of practice, including activities that are defined in law as beyond the boundaries of
practice in accordance with and in compliance with your professions standards.
Two Day Clinical Applications
Workshop:
Internal Family Systems (IFS)
1 Therapy
Frank Anderson, MD
Website = FrankAndersonMD.com
@2019 Frank G. Anderson MD, all rights reserved
2
Meditation
1
3
Experiential Treatments
2
5
What’s Important for Healing
Mindful Separation
(Unblending)
Self vs. Building Resources
Permission vs. Stabilization
Therapeutic Relationship (TR)
Healing at the Core
@2019 Frank G. Anderson MD, all rights reserved
3
7 The Goals of IFS
Permanent healing of emotional wounds
Video
8
“All the little voices in our heads”
4
9 Vulnerability Turned Into Wounds
To be who we truly are, to feel our emotions and to be able to
share it with someone else.
Brene’Brown
“To feel is to be vulnerable.”
“Vulnerability is the core of all emotions and feelings.”
“Vulnerability is the birthplace of love, belonging, joy,
courage, empathy and creativity.”
“Uncertainty, risk and emotional exposure.”
When we are vulnerable with someone and they react from their
parts with criticism, attack, rage, violation, defensiveness or
neglect.
It can turn into a wound and then we need to protect ourselves.
@2019 Frank G. Anderson MD, all rights reserved
3 Kinds of Parts
Parts that carry wounds (exiles)
Parts that prevent wounds from getting triggered (manager)
Parts that stop the pain (firefighters)
10
5
11 Wounded or Burdened Parts
Often young & vulnerable
Carry wounds, burdens, hurt & trauma
Memories, sensations, emotions and beliefs
Shame, unmet needs, lack of connection, being
alone
Stuck in the past, implicit memory
“Parts are not their wounds”
11
12 Protective Parts
12
6
13 Prevent the Pain
13
14
7
Get to Know One of Your
15
Preventive Parts Exercise
The caretaker, the fixer, the one that understands, the one that
accommodates, the one that figures things out, the funny one?
15
16
8
Suicidal Part
Systems
17 Drinking Part
Thinking Part
17
18 Self
Different from parts
Healing capacity
Soul or core
18
9
19 Qualities of Self (8 C’s)
Curious Courage
Calm Creative
Confident Connected
Compassion Clarity
@2019 Frank G. Anderson MD, all rights reserved
19
20
10
21
Compassion- Empathy Exercise
21
22
11
The Steps of the Model:
23
Working with Protective Parts
23
24
12
“The goal of working with
protective parts is to help them
separate from the Self, to learn
their job and fear and to get their
25 permission to access the wound.”
25
26
13
27 The First 3 F’s
Identifying the Target Part and Unblending
1. Find the Part- Where is it located in or around your
body?
Identifying a neural network
2. Focus On It- Going inside
Getting the client used to internal focus
3. Flesh it Out- Get to know more about it
How do you know it? Hear it? See it? Feel It?
Does it have a color, shape
27
28
Identifying Parts Video (1)
28
14
Feel toward & Flesh out
29
Video (2)
29
30 The 4th F
Unblending and Identifying Self
4. Feel Toward It- Self Energy detector
The most important question here.
Parts are capable of stepping back.
Neuroscience talks about “state change”
When parts are willing to step back Self
emerges.
Difficult to achieve in Trauma
@2019 Frank G. Anderson MD, all rights reserved
30
15
31
Real Self Energy Video
31
32
Practice First 4 Steps
32
16
33 The 5th F- Be-Friending
Learn Its Job and Positive Intention
Internal Attachment work
Fostering the relationship between the Self and
the protective part
A two way street
Have the part share what it is holding
What is its job
Learn about its positive intention.
@2019 Frank G. Anderson MD, all rights reserved
33
34 The 6th F
Find Out Its Fear
34
17
35 Common Protector Fears
35
36
18
37
Practice/Demo all 6 Steps
37
38
19
The Science Behind the 6 F’s
39
39
40
Mind-Brain Relationship (Siegel)
40
20
41 Neurons to Networks
41
42
21
Horizontal (right-left) Network
43
Left Right
Hemisphere Hemisphere
Linguistic, Physical,
Logical, Emotional
Factual, Unconscious
Conscious
Connects to
Connects to
Hippocampus
Limbic,
Brainstem &
Body
43
Vertical Network
44
Medial Prefrontal
Cortex,
Top-Down Anterior
Cingulate
& Insula
Right
Hemisphere
Limbic
(amygdala,
hippocampus,
hypothalamus)
Brainstem &
Thalamus
Body
Bottom-Up
@2019 Frank G. Anderson MD, all rights reserved
44
22
45 Networks of Emotions (Panksepp)
Networks of seven basic emotional systems
Seeking- explore, desire, aspirations of the heart
Mesolimbic dopamine system
Fear/Anxiety-including fight & flight
Fight= high dopamine Flight= low dopamine
Rage/Anger
Closely parallels fear system, different paths in amygdala and beyond
Lust/sexual
Female- (oxytocin), Male- (vasopressin)
Care/Nurturance
Oxytocin & prolactin
Panic/Grief-Separation & loss can lead to panic attacks and depression
Opioids, oxytocin, prolactin
Play-most underutilized emotion in therapy
@2019 Frank G. Anderson MD, all rights reserved
45
46
Symptoms = Mind & Brain = Parts
46
23
47 How We Pay Attention: Going Inside
Exteroceptive attention
Externally focused, relies on prefrontal cortex
Interoceptive attention
Internally focused, relies on insula and posterior cingulate
which are linked to limbic system & brainstem
(emotions and physical sensations)
47
48
24
49 Self Energy
Speculation- Self Energy is a “state of being”
that lives in the mind and utilizes integrated
neural networks in the brain. It is both internally
and externally connected to the flow of energy
and is a maximally integrated state.
Speculation- Actually the lack of neural network
firing?
The dimensions of Self.
49
50
25
The Vertical Network and Fear (extinction)
51
(Ledoux)
OMPFC
AC
(LA)
NE, 5HT, DA
(CE)
Thalamus Amygdala
Hypothalamus
Hippocampus
Brainstem
Sensory ANS,
@2019 Frank G. Anderson MD, all rights reserved endocrine
51
52
Beyond the 6 F’s
Direct Access
When separation is not possible
Updating the Part
Introducing the part back then to the Self of
today
Deal with Overwhelm
IFS not phase oriented treatment
The Invitation
What if you didn’t have to do this job anymore
What if we could heal the wound
@2019 Frank G. Anderson MD, all rights reserved
52
26
53 When Separation is Not Possible
Talk Directly to the Part-Direct Access
Direct access- When the part won’t unblend
Can I talk to the part directly.
Are you there?
So you are the part of …. Who……?
What are you afraid would happen if you separate?
What other concerns do you hold?
After addressing all the fears, Can I talk to ……Now?
Did you hear all of what that part just said?, if not make
sure you share it.
Goal of Direct Access is…
53
54
27
55 Dealing with the Overwhelm
55
56
28
Video- Putting it all together
57 Direct Access, Learning It’s Job
and Fear and Getting Permission
57
58
29
Practice Direct Access and
59
Addressing Protector Fears
59
60
Polarizations and Alliances
60
30
61 Polarizations or Conflicts
A common protector fear is another protector
If he stops drinking he will get depressed
Parts in conflict block access to wounds
Often protecting the same wound
But not always
Helpful for parts to see they have a common goal
Commonly confuse the therapist and block progress
That’s the point!
Common in DID
@2019 Frank G. Anderson MD, all rights reserved
61
62
31
63 Alliances Between Parts
63
Wounds
64
(Exiles)
64
32
65 Wounded parts
65
66
33
67
Unburdening
67
68
34
69 The Post Unburdening Process
69
70
35
71 Legacy Burdens
We all carry Legacy burdens
Culture, gender, ethnic, race
The gifts and the burdens of legacy
They often block healing in trauma
Can be unloaded without witnessing
Sometimes they hold messages they want to share
Check the % that belongs to the client and the % that is not theirs
and can be released
Bring in all ancestors that have carried the burden
Release and transform for all involved
Address loyalty issues
We each have our own paths
Call in the Self of the parent
71
72
36
73
Sit in Silence Exercise
73
74
74
37
75 Memory Reconsolidation
75
76
Memory Reconsolidation (Ecker)
Accessing phase- Identification of specific symptom &
retrieval of implicit awareness
(Find, Focus, Feel)
76
38
77
Demo
77
78
IFS Applications
78
39
79
Psychology vs. Biology
(Part vs. Symptom)
79
Anxiety
Part that worries. What are you afraid of?
Differentiate anxiety from panic
Different neural networks
Or are the serotonin levels low?
Who is the exile?
@2019 Frank G. Anderson MD, all rights reserved
80
40
MAPS: Multidisciplinary Association for Psychedelics
81
Studies
MDMA- next slide
LSD- decrease anxiety, discovery of serotonin
neurotransmitter
Psilocybin- mushrooms, serotonin hallucinogen
Ibogaine- People with problem substance use have
found ibogaine can significantly reduce withdrawal from
opiates and temporarily eliminate substance-related
cravings.
Ayahuasca- for drug addiction and PTSD
Medical Marijuana- PTSD in veterans
@2019 Frank Anderson MD. All rights reserved.
81
MDMA
5-HT, NE, DA, oxytocin & vasopressin, Left
amygdala activity, PFC activity
allowed patients to re-experience traumatic
experiences in the absence of fear (enhance
extinction)
82
41
83 OCD and ADHD
83
84
42
85 Autism Spectrum Disorders
Rigid-concrete thinking
Anxiety
Avoidance
Fantasy
Stimming
OCD symptoms
Inertia
85
86
43
87 Often more that one Addictive Part
The part that drinks to feel comfortably numb
Keeping things at bay
The part that says “I’m out of here.” and drinks shots
The part that drinks to feel socially comfortable
That part that smokes pot to get away from feeling bad about not being
able to focus and concentrate in school
That part that smokes pot to be cool
The part that smoke pot to forget about being bullied
@2019 Frank G. Anderson MD, all rights reserved
87
88
44
89 Substance use and Addictions
Similar approach with Eating issues
Often restriction and binging parts in conflict
Most of the day can be spent thinking about food
Food as control
Accessing the wound is challenging
Sexual addiction
Parts draw to them self the very thing they are trying to
protect from
Avoidance and attention
Gambling
Technology overuse
@2019 Frank G. Anderson MD, all rights reserved
89
90
45
91 Shame
Critical or Neglect
Shame
Parts that shame
Critical-shaming protectors
Feel guilt for what they do
Parts that have been shamed
Exiles- I’m no good
Parts that run away from and
perpetuate the shame
Parts that feel shame as a result of
neglect (no one cares, I’m no good)
@2019 Frank G. Anderson MD, all rights reserved
91
92 External Critic
"Shamer”
Internal Critic
"Shamer"
Exiled Part
(Unlovable)
“Shamed”
@2019 Frank G. Anderson MD, all rights reserved Arrow demonstrates how
parts feel bad about their
own behavior
92
46
External Neglect
93 "Shamer”
Internalized Neglect
(Disconnects to protect)
Intellectual Parts
Perfectionistic, “Out Of Here Parts”
(Tries to fill the void)
Angry Parts (What’s the point?)
(Blocks feelings)
Exiled Part
Feelings are (Unlovable) Arrow demonstrates how
difficult to access “Shamed” parts feel bad about their
own behavior
@2019 Frank G. Anderson MD, all rights reserved
93
94
Grief
94
47
95 Working with Couples
Toni Herbine Blank
She is hysterical. He is on the spectrum
Blame and Shame are common
Attraction and Redemption
We are drawn to people with similar emotional development and similar
wounds.
We silently contract to heal each other’s
Tracking the Sequence
The offer is healing the wound, so his or her behavior no longer
bothers you
Relational Unburdening
Empathy and Compassion from both the Self of the client and
their partner.
@2019 Frank G. Anderson MD, all rights reserved
95
96
48
97
Tracking the Sequence Demo
97
98
Kids and Attachment
98
49
99 Attachment Theory
The quality of parental care within the first two years of life
promotes an attachment style for a child and sets a
template for future relationships in adulthood.
These early bonding experiences are later remembered
not as visual or verbal narratives but in the form of
“implicit” or “emotional memories.”
This sets the stage for affect tolerance, self soothing and
an integrated sense of self later in life.
Healthy regulation by primary caregiver leads to healthy
self- regulation and secure attachment.
99
100
Attachment Theory
Attachment Styles
Secure (62%)
Healthy regulation by primary caregiver leads to healthy self- regulation
and secure attachment.
Avoidant (15%)
One response to an unresponsive or rejecting caregiver
Anxious-(Ambivalent) (9%)
The other response to unresponsive or rejecting caregiver
Disorganized (15%)
When caregivers are frightening (hostile/intrusive or helpless/fearful)
Seek connection & avoid the caregiver. Fright without solution!
100
50
101 Attachment Trauma
Different parts of children attach to different parts of the care-
giver
This can create attachment wounds
Attachment wounds make most of our relational
decisions
Healing involves Internal Attachment with Self
External vs. internal relationship as therapeutic?
Therapist as an adjunct- The Self as the primary
What are we offering in IFS?
Self as the corrective experience not the therapeutic
relationship
@2019 Frank G. Anderson MD, all rights reserved
101
Lisa Spiegel
Parts are an easy sell to kids, not so much for
teenagers
Play therapy is externalizing parts (unblending)
Can prevent exile development when bringing forth
Self into an acute trauma
The parents, the therapists and child's
Modeling is the most effective way to incorporate
parts language into the family
102
51
103 Parenting and IFS
Parent Coaching
Working with triggers within parents
Help them heal their wounds
Kids behavior is primitive and normal can mimic abusive
behavior for parents
Parents stop kids behavior to not get triggered internally, this
creates exiles in our kids
The triggering agreement (Co-parenting),
The Parent Self is different from Self Energy
Love, Limits and Teaching
103
104
52
105 Groups & Inpatients
Rheumatoid Arthritis Study
Limited time, limited amount of work to be done
Primary focus on protectors
Extreme parts typically bring people into hospital
Learn about their positive intention
Managers who run day to day life are overtaken
Deal with their shame about failing
Help restore the balance within the system
Long term groups can progress to healing
Create environment for healing & witnessing to happen in a safe manner
105
106 Spirituality
Guides
Angels
Departed Loved ones
God, Buddha, Jesus
Be open to what shows up in your clients, have
your parts step back
106
53
107 The Various Types of Trauma
107
108
54
Therapist’s Parts
109
What get’s activated in you?
Experiential exercise
109
110
55
111 Fear-PTSD- Hyper-Aroused (Ledoux)
OMPFC
AC
(PAG)-freeze
(LA)
(BLC) High NE, DA
Low 5HT
Thalamus
Amygdala High Glutamate
Hypothalamus
Hippocampus
Brainstem
Sensory ANS,
@2019 Frank G. Anderson MD, all rights reserved endocrine
111
112
56
113 Extreme Parts- Hyper or Hypo-Aroused
(Lanius) imaging studies, chronic child abuse
Hyper-aroused, Hypo-aroused,
reactive, withdrawal,
sympathetic dissociate
113
Video
114
Suicidal Part
114
57
115
Thank you
Frank Anderson
www.FrankAndersonMD.com
115
58
NOTES
NOTES