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A Typical Client - Therapist Exchange in an Internal Family Systems Session

Client: I'd like to work on my bingeing.
Therapist: OK, can you find the part of you that gets you to binge?

C: I don't know. I can sense an agitation.
T: Where do you feel this agitation in your body?

C: In my solar plexus.
T: Can you tell me more about the feeling?

C: It's kind of jumpy and pushing.
T: Can you relate to this feeling as a part that gets you to binge?

C: I guess so.
T: How do you feel toward this part? [If the therapist is talking to Self, the answer will be something along the lines of compassion, curiosity, and/or acceptance.]

C: I need to get rid of this part; I gained 20 pounds in the last two years.
T: So there are parts of you that hate the bingeing part and want to get rid of it?

C: Yeah, I guess.
T: And it makes sense that they would feel this way, right?

C: Yeah.
T: See if you can let them know that, and then see if they would be OK if they went into the waiting room so we could talk to the bingeing part. [The parts can only be helped by Self, and the presence of polarized parts will impede the process.]

C: OK, they said they would do that.
T: Great. So check again—how do you feel toward the bingeing part?

C: I'm kind of scared of it; it has so much control!
T: So there are parts of you that feel like they have less power than this part?

C: Yes.
T: See if they can wait in the waiting room as well.

C: OK.
T: And how do you feel toward the bingeing part now?

C: Kind of sad.
T: Sad because of what it does to you, or sad for it, like compassion? [If the former, we have another part; the latter indicates the presence of Self.]

C: Yeah, compassion because it feels like it has to do that.
T: And you feel somewhat accepting toward this part now and perhaps curious to know more about it?

C: Yes.
T: Great. Ask the part, "What are you afraid would happen if you didn't get me to eat at those times?"

C: It says I can't handle it.
T: Can this part show you more about what it thinks you can't handle?

C: It's like a big endless pit.
T: See if the bingeing part would be willing to step aside for a little bit so that we could find out more about that pit. We'll be careful so that you don't fall in.

C: It's not sure about that, but it says it will try.
T: That's fine. It can watch us and come back if it feels it's necessary. [We want to respect the needs of managers and firefighters to prevent the emergence of exiles.] So can you tell me more about that endless pit?

C: I'm sure it has to do with my parents not being there when I was little.
T: OK, is it possible that there is a part here that is good at figuring things out and knowing the answer?

C: Yeah, I have that.
T: See if you can appreciate that part for how it helps you, but see if it will wait in the waiting room while we get to know the "pit" feeling. [The therapist serves as a "parts detector."]

C: OK.
T: So, just take some breaths and become aware again of the pit feeling.

C: Yeah, it's like a black hole in my belly.
T: Could we relate to this black hole feeling as a part?

C: Yeah, that makes sense.
T: And how do you feel toward this part?

C: I feel sorry for him. He's so alone!
T: Yes. Can he show you a scene where he is stuck in the past? [If the client assigns a gender, then the therapist goes along with it.]

C: He's in his room, and mom is home, but she is sick, or maybe drinking.
T: Would you be willing to go back into that scene and be there for him, however he needs you to be?

C: That seems like a bad idea.
T: Why?

C: I don't think I would ever get back.
T: So there is a part of you that is afraid the little boy will take over if you get close?

C: Yes, that's what happens sometimes.
T: Tell this part, if it would step aside, that we'll make sure the little boy doesn't take over.

C: OK, it's not sure if it can trust that, but it will give it a try.
T: OK, thank that part for being so willing to help us with this. Ask the little boy if he would like you to come into the room with him.

C: Yes.
T: Tell him that you would like to come, but he has to promise not to blend with you. If he tries to blend and take over, you will have to leave. [Addressing the concerns of the part that just stepped aside.]

C: He says OK.
T: So, go back there and be with him. What does he need?

C: Mom treats him like he's worthless.
T: Would he like you to help with that?

C: Yes, but he doesn't know what to do.
T: Ask him if he wants you to talk to mom.

C: He says "No." [Self can intervene directly, or just provide nurturing and reassurance for the exile.]
T: What does he need from you then?

C: Just to tell him that he is not worthless.
T: OK, just be with him in this room, and tell him what he needs to hear.

C: You are fine. Mom has problems, but that isn't about you. I wouldn't leave you alone if I was your mom. [This can continue as needed.]
T: How is he doing?

C: He feels better.
T: Ask him if there are other scenes he wants help with, or would he like to leave the past behind and be with you in the present?

C: He wants to leave. [Often, addressing one or two scenes will remove what Stan calls the "key log" and clear the COEX.]
T: OK, where could he stay, if he's with you in the present?

C: I guess on my shoulder.
T: Does that work for him?

C: Yeah... He'd rather be in my heart.
T: Is that OK with you?

C: Yes.
T: OK, invite him there... How is he doing now?

C: Much better.
T: Do any of the other parts want to hang out there with him?

C: No. He's fine just with me.
T: Can he feel the burden of this worthless feeling that he has been carrying?

C: Yeah. It's kind of like that black hole feeling.
T: Would he like to release that burden?

C: Yes.
T: Ask him where he carries that burden of worthlessness in or around his body.

C: It's like a big weight pushing down on his shoulders.
T: Would he like to release that into fire, wind, light, water, or something else?

C: Light.
T: Help him by visualizing that burden being released from his shoulders into the light, and let me know when it is all gone.

C: OK. [A cognitive therapist might converse forever with a client's logical parts about this irrational belief in the client's worthlessness, while providing no relief at all for the part that carries the burden. If you want to debug the software, you need to specifically address the subroutine that contains the bug.]
T: Ask him if there are parts of him that got split off and lost in the past, that he would like to reclaim moving forward.

C: He can't find anything like that.
T: Anything else he wants to do right now?

C: No, he's fine.
T: Want to go back to the bingeing part?

C: OK.
We would next appreciate the bingeing part for how it took care of the little boy in the past when no one else was. We'd ask if it saw how the little boy was now being cared for by Self, and invite it to release the burden it carried of having to always keep the distressing feelings out of consciousness.
Then, that part could find a new role, possibly one of getting Self's attention when the little boy was feeling insecure, but instead of blending and causing the person to eat, it would just be sending a message to Self.

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