There are many therapeutic approaches that use a theory of multiplicity to support healing. I find that in actual practice many of these approaches look about the same, and so I tend to think in terms of “parts work” and use whatever language feels most comfortable for the person I’m addressing at any given time. Keep in mind, two different therapists can use the same theoretical approach and work in completely different ways. As with any counseling theory, I find that it’s much more the person and the relationship that determines impact rather than the theory guiding the work.
So what’s so special about parts work? It can be a beautiful way to access and strengthen internal resources, a very safe and manageable way to bring unconscious material to the surface to be worked through and resolved, and a helpful resource for self-care outside of therapy. Because parts work does such a good job of bringing up material that isn’t already fully conscious, it can also be quite delicate work.
In my practice, parts work sometimes looks very different from one client to the next, and very different for the same client over the course of several sessions. A lot of this has to do with what things look like inside of the individual. A person who’s had good enough life experiences may be able to flow between self-states fairly gently and easily. The part of self that brings them to therapy is close enough to the part of them that goes to work and the part that communes with friends or family, so that they can come into therapy and relax into curiosity about their internal dynamics and different self-states. A person who’s experienced significant trauma, including attachment wounds, with insufficient repair is less likely to be able to “go inside” of themselves with relaxed curiosity. People with conditions like Dissociative Identity Disorder (DID) often have thick internal barriers between different parts of self and may find it jarring or destabilizing, initially, to become aware of ego states that are distinctly different from each other. Parts work looks different with different people and at different stages of recovery.
As a trauma therapist, I have great appreciation for the role of psychoeducation, cognitive behavioral, and interpersonal approaches to therapy. Psychoeducation refers to sharing information and exploring how that information applies to a person’s unique experience. Psychoeducation can include information about the nervous system, coping skills, relationship skills, etc. Cognitive behavioral therapy involves identifying thoughts or beliefs, noticing the impact of those beliefs, and working to change the beliefs that contribute to distress. Interpersonal therapy is about relationship. In any relationship, including a relationship with a therapist, just being together and interacting with compassionate and authentic attention has the potential to provide profound healing. At the same time, when past experiences are trapped inside causing distress in the present, that distress will continue until it can be processed and released. Parts work provides a means to access and heal distress from the inside out.
One thing that can be very distinct in doing therapeutic work from a parts perspective versus other forms of therapy is the invitation to disowned, dissociated, or exiled parts of self to participate in the therapeutic process. For example, I may have an intelligent, logical, highly verbal part that has no trouble talking about and making intellectual sense of a situation. This part of me may show up and work extensively with a therapist to figure things out and learn new skills, but this was never the part of me that actually drove my behaviors and responses. With parts work, I can appreciate the insights and contributions of this logical part, and also become curious about parts of me that experience intense emotions or impulses. Over time, by inviting every part of me to participate in the therapeutic process, I become able to experience the potential benefits that every part of me has to offer without the internal conflict or imbalance that’s likely to occur when parts are excluded or pushed away.
What does parts work look like in therapy? I have formal training in Internal Family Systems (IFS), Ego State Therapy (EST), and Psychodrama, and I’ve done some reading and discussion on Jungian and Gestalt therapies. I imagine there are countless additional approaches to parts work that I’m not thinking of right now or know nothing about, but I’ll say a little bit more about the three approaches that I know best.
Dr. Richard Schwartz has done a great job normalizing human multiplicity for the general public with Internal Family Systems, which he advocates as a standalone therapy. I think a lot of people need a lot more than pure IFS to safely heal, but I absolutely appreciate what IFS has to offer. Many therapists now offer “IFS informed” EMDR. IFS suggests that humans are born with a complete system of internal parts that stays with us throughout life, and these parts tend to take on one of three roles: manager, firefighter, or exile. Manager parts are the parts that show up to attend to normal daily life. Firefighters tend to be more extreme and reactive, showing up when things get hot. Exiles are typically hurt child parts that get trapped, excluded, and avoided. IFS work involves building trust with managers and firefighters so that they become willing to make space to help the exiles. The entire process is based on increasing access to “self-energy” or “Self,” the healing power we all have within us.
Ego State Therapy was developed by Jack and Helen Watkins with roots in the clinical hypnosis tradition and the psychoanalytic work of Paul Federn and Edoardo Weiss. EST suggests that the internal system develops over time and additional self-states form as we reach new developmental milestones and/or have new life experiences. EST recognizes some common roles in internal systems. Many people have wounded child states and “introjects” of primary caretakers from childhood, for example. EST also allows for great variation from one person to the next, so any ego state may be quite complex and unique to the individual. EST is often offered in conjunction with clinical hypnosis, EMDR, or both. From my perspective, EST has a broader range and is more helpful in treating complex trauma than IFS. But again, the clinician and their unique approach has a bigger impact than the theory they work from.
Psychodrama was developed by Jacob Moreno as a group intervention, although it can be adapted for individual work. Psychodrama isn’t strictly a theory of multiplicity, but psychodrama’s role theory can be used “intrapsychically” to work with different parts of self. What I love about psychodrama is that it incorporates internal systems work with broader systems work (i.e., family, community), and uses human interaction to support both objectivity and containment for work with the internal system.
If you’re interested in learning more about any of the approaches covered in this article, you may find it helpful to look up the following organizations: Ego State Therapy International, Ego State Therapy North America, the IFS Institute, the American Society of Group Therapy and Psychodrama, and The Michigan Psychodrama Center. Schwartz has published several IFS books for the general public. Most of the resources I’m aware of for EST and Psychodrama are geared more toward practitioners than the general public. Joann Twombly does a beautiful job speaking and writing about incorporating IFS into broader trauma recovery work. Dr. Sandra Paulsen has some beautifully illustrated books written for both therapists and the general public that demonstrate how EMDR and EST can come together. Dr. Scott Giacomucci has some wonderful videos on the Phoenix Trauma Center YouTube channel about trauma informed psychodrama. And of course, I’ll have more snippets about parts work in future blog articles.
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