Finally, a book on DID and IFS (Internal Family Systems)

A book has been published that combines recent recommended treatments for DID with the treatment of IFS, or Internal Family System. The title is Trauma and Dissociation: Informed Internal Family System: How to Successfully Treat Complex PTSD and Dissociative Disorders by Joanne H. Twombly. (ISBN 9798887591353)

I've watched for over a decade on this board as various members express frustration, confusion or exhaustion as their therapist applies IFS terms and theory directly to us, the client, without making sufficient allowance for the dissociation or for alters/parts. IFS posits that the "mind is made up of relatively discrete subpersonalities, each with it's own unique viewpoint and qualities."

Sounds kind of like DID, right? It should. The theory owe a lot of its development to an awareness of DID. However, confusion, frustration or even damage to a client with DID can occur when a therapist assumes these subpersonalities exist for someone with DID in similar ways for someone who is not dissociative. The subpersonalities described by the theory are NOT identical to alters or dissociated parts. Trying to make the theory line up with parts/alters of an individual often doesn't work.

Assuming the existence of "the Self" in a DID system can be extremely confusing and misleading. When I met briefly with two therapists who were IFS practitioners I felt many of us getting upset. One therapist was making assumptions about us that were way oversimplifying, applying labels that didn't fit. Therapists may identify alters using categories that are key to internal family systems thinking -- exiles, firefighters and managers. These don't necessarily match up at all with the role, purpose or origin of DID parts and alters.

If you hear your therapist using the three terms or if you know they use IFS in their treatment, I suggest recommending they read this book to learn how best to treat you.

In my opinion, the danger of applying IFS too rigidly, as the danger of doing that with almost any one theoretical approach to DID, is oversimplification -- making assumptions that just don't fit the specific person, who experienced a unique array of traumas and/or neglect. So my opinion of IFS is admittedly cautious, sometimes negative. Not so for Twombly's book, which is more positive.

This book clarifies for both the therapist and client how to take advantage of some IFS principles and techniques without ignoring the difference between dissociative minds and non-dissociative minds. Twombly is a DID specialist with decades of experience and is one of the contributors to the Guidelines for Treating Dissociative Identity Disorder in Adults, Third Revision. She gives seminars on all of the above, as well as on using EMDR in the treatment of DID.

I sat in on a workshop she gave at a DID conference in Boston a few year ago and I liked her expressed mission of educating therapists who treat -- and, really, mis-treat -- DID. Like a handful of other long-term DID specialists, she's authored articles and book chapters on DID. I think she also consults with therapists who are fairly new to treating DID.

Thanks for sharing. I have been the target of quite some mansplaining about IFS as DID therapy last week and I am looking forward to reading this. our favorite T was originally trained in systemic and IFS therapy and it makes him an excellent DID T but he does use the proper framework... I hope that this will give more people access to DID-specific therapy. So many are turning towards IFS because its the only thing they can get...

Thank you for the recommendation.

Our T has mentioned some of the IFS stuff, which she is just learning, but rapidly moved from that when it became apparent that we have DID. We've started to help educate her on some of the more recent developments too, but she has talked about healing without necessarily fusing and learning to share.

If we get the opportunity, we can recommend it to her. Tomorrow, however, Lilith is penciled in for more therapy.

Take care,
Vi

This book is out in a second edition (ISBN-13 ‏: ‎ 979-8893161250) and it has won the Frank Putnam award, given by the ISST-D, or the International Society for the Study of Trauma and Dissociation. The ISST-D organization contains some very useful documents, both for persons with DID and psychotherapists treating it, including the critical Guidelines for Treating Dissociative Identity Disorder in Adults, Third Revision. If your psychotherapist isn't a DID expert, they should read this article. If they are a DID expert, they've certainly read it.

Frank Putnam was the first to author a book on treating dissociative identity disorder, then called multiple personality disorder. His Diagnosis and Treatment of Multiple Personality Disorder was published in 1989. So the Frank Putnam Award honors an author for "an outstanding book that significantly contributes to our knowledge and understanding in the field of trauma and dissociation."

If you're being treated by a therapist who uses IFS or Internal Family Systems with you and things feel off or forced to you, ask your therapist to read this book. Although IFS recognizes and works with parts of one's personality, it is not appropriate for one-to-one application to dissociative identity disorder without adjustment. I've read many posts here over the past decade plus from people who are frustrated by a therapist trying to interpret their DID alters and their system exclusively through a lens of IFS. It's like trying to force a square peg through a triangular hole.

It should be noted that the originators of IFS do appear to think that their therapeutic framework is directly applicable to DID. In my opinion, and in that of this author, that is wrong.

Hi,

Thanks for telling us about the book. IFS is really frustrating. It sounds like it should work... but it doesn't (for us). IFS is more dangerous because they think they understand DID but they don't. It's like IFS has this nice, simple, logical, and WRONG way to do it. Maybe this book will help that.

We had one T who kept talking about THE SELF . We finally told them if we could do the SELF thing we wouldn't have DID.

Oh look! We're a Firefighter!!! Do I get to drive a big red truck?

Iain

its kind of serious but the situations that result from it are so awkward...
I have listened to different people over the years and learned that there truly is IFS training that includes proper trauma therapy tools and training in DID specifically. nice guy from Australia got very upset with me for criticizing the way I saw it done in my country...
but without all that additional training its just weird
its a bit like EMDR. Without the advanced training for DID it becomes kind of dangerous or frustrating. People need to stop trying to use tools for DID that are not meant for DID and hope for the best. Once they get trained for DID things work out a lot better. why not just get trained for DID...

We'll definitely share this with our therapist! He's never applied IFS to us, but we enjoy talking about DID literature, so I think this'll be an interesting read for him!

Hi,

Yeah. Good therapists read about this stuff and learn what to do with us. I hate it when they think they know some cool new system and stop listening.

Good luck.

Iain

IFS states that everyone has parts and that there is a central "Self" that the parts are subordinate to. Conflating parts with alters would be inaccurate. This is why this book is so important, it teaches a therapist with knowledge of IFS how and how not to apply what they've learned to DID.

There is no "Self" alter in DID -- unless you happen to have an alter named "Self."

Treatment guidelines for DID states that all parts are alters -- including a host who may be present in therapy and perhaps skeptical about having DID. Treatment also recommends that a therapist treat all alters as equally important to the person.

To be considered an IFS Certified Practitioner, you only have to complete the IFS Institute's training program, which costs around $10K. The IFS Institute is part of a corporation that is valued in the billions of dollars. Not necessarily a negative but it certainly gives me pause.

$10K! You're sh*tting me. No wonder therapy is so expensive. Glad the book is helping them do better with DID. I like the 'all alters are important' piece. I got real tired of Ts thinking we were the problem. We're the f-ing solution.

Colin