Internal Family Systems And Healing (2024)

Internal Family Systems

Welcome to my blog on Internal Family Systems and how it may be helpful for numerous medical health conditions.

You may like to also read my blog Can Psychedelics Heal Autoimmune Disease.

What Is Internal Family Systems?

The Internal Family Systems (IFS) model, pioneered by Schwartz, is swiftly gaining recognition as a form of individual psychotherapy. It instructs individuals on how to mindfully engage with their internal experiences, fostering self-awareness and interaction. This approach encourages cultivating self-compassion towards various facets of oneself, which are seen as distinct sub-personalities, often characterised by intense emotions, judgments, or physical sensations.

Encouraging an internal dialogue that addresses polarized thinking, Internal Family Systems (IFS) works to alleviate emotional intensity and dysregulation, factors known to heighten pain perception and disease activity in RA. Additionally, IFS incorporates nonjudgmental observation and active mindfulness, techniques that have proven beneficial in managing various painful conditions, including RA. Currently, over 2200 therapists globally have received training in the Internal Family Systems approach. (source)

Despite its name, Internal Family Systems is primarily an individual psychotherapeutic modality and not a family systems technique. It teaches the skills of attending to an individual’s internal experience, but it is different from cognitive behaviour therapies, which primarily focus on restructuring distorted thinking or unrealistic cognitive appraisals to achieve changes in behaviour or emotion. Internal Family Systems combines elements of other psychotherapies to help individuals learn about and change the beliefs and emotions that surround their symptoms. First, similar to mindfulness-based meditation practices and psychotherapies, individuals are helped to separate from their thoughts and emotions, and access a mindful state called “Self” in Internal Family Systems. (source)

When you are in this state called ‘self’ you feel the 8 C’s – listed in the image at the top of this blog

Instead of solely observing their internal processes with mindfulness, individuals are urged to embark on a journey of inner inquiry, probing into their thoughts and emotions. This practice often leads individuals to uncover memories of attachment injuries or traumas, which they then witness while in this empowered state of Self. (source)

Internal Family Systems And Rheumatoid Arthritis

To conduct a proof-of-concept randomised trial of an Internal Family Systems (IFS) psychotherapeutic intervention on rheumatoid arthritis (RA) disease activity and psychological status. (source)

The Method

Patients with rheumatoid arthritis were randomised to either an Internal Family Systems group for 9 months or an education (control) group that received mailed materials on rheumatoid arthritis symptoms and management. The groups were evaluated every 3 months until intervention end and 1 year later.

Self-assessed joint pain (RA Disease Activity Index joint score), Short Form-12 physical function score, visual analog scale for overall pain and mental health status (Beck Depression Inventory, and State Trait Anxiety Inventory) were assessed. The 28-joint Disease Activity Score-C-reactive Protein 4 was determined by rheumatologists blinded to group assignment. Treatment effects were estimated by between-group differences, and mixed model repeated measures compared trends between study arms at 9 months and 1 year after intervention end.

What Was The IFS Intervention?

Participants participated in group sessions comprising 8 to 10 patients led by a single trained Internal Family Systems therapist who facilitated all groups during the study period. These groups convened every 2 weeks for the initial 3 months and then monthly until the study concluded. Additionally, individuals receiving the IFS intervention engaged in 15 biweekly individual meetings lasting 50 minutes each, spanning over 36 weeks, with one of the therapists trained in IFS.

The Internal Family Systems protocol provided conceptual training and coaching in use of the Internal Family Systems model. Participants were taught how to accept and understand their own feelings, such as fear, hopelessness, or anger in a compassionate way, as if they were members of their own internal family. They were led through exercises and participated in discussions designed to assist them in the identification of their individual emotional reactions to the pain and disability of rheumatoid arthritis, for example.

All meetings were focused on rheumatoid arthritis symptoms and emotional states related to and exacerbating these symptoms. Once the patients learned the internal dialogue skills, they were encouraged to practice on their own at home.

For instance, by acknowledging pain in a joint, recognizing the emotions and thoughts it triggers, and addressing these internal states with curiosity and empathy, a patient can gain insight into the necessity of finding a balance between succumbing to pain and stubbornly disregarding it. This awareness can lead to adjustments in plans to engage in activities in a more balanced and moderate manner. Moreover, the IFS intervention encouraged an examination of the roots of these emotional responses and negative beliefs, facilitating adjustments and moderation in these intense emotions or thoughts.


Of 79 participants randomised, 68 completed the study assessments and 82% of the IFS group completed the protocol. Post-treatment improvements favouring the IFS group occurred in overall pain, and physical function. Post-treatment improvements were sustained 1 year later in self-assessed joint pain, self-compassion, and depressive symptoms. There were no sustained improvements in anxiety, self-efficacy, or disease activity.

The improvement in overall pain and function that occurred at the end of the intervention was not sustained 1 year later and there was no significant improvement in anxiety throughout the study.

Conclusion From The Study

An IFS-based intervention is feasible and acceptable to patients with rheumatoid arthritis and may complement medical management of the disease.

Can Internal Family Systems Help With Other Medical Conditions?

This technique is increasingly being used as adjunctive therapy for certain medical conditions, with anecdotal benefits reported in migraines, back pain, and multiple sclerosis. (source)

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