How IFS Therapy Promotes Healing from Trauma
Internal Family Systems is an evidence-based therapy that helps people with ADHD heal from trauma. Here’s how it works.
Internal Family Systems: Article Contents
What Is Internal Family Systems?
Children with ADHD are more likely to experience abuse, neglect and other adverse childhood experiences (ACEs), research shows.1 The more ACEs a child endures, the more intense their ADHD symptoms tend to be and the less effectively they will cope with life’s challenging moments.
People with ADHD are also more vulnerable to traumatic experiences like bullying, humiliation, shaming, and chronic criticism – all of which can have a big impact, especially for the undiagnosed and untreated.
Traumatic experiences leave deep marks that shape behavior and beliefs about self-worth over a lifetime. Some people with ADHD develop extreme coping mechanisms – including procrastination, self-criticism, and explosive anger – to protect themselves from further harm.
Getting to know and caring for these protective and wounded parts of ourselves is the focus of Internal Family Systems (IFS), a form of therapy that helps individuals heal from wounds created by trauma. For people with ADHD, these can include:
- Frequent criticism: Negative statements such as, “Why can’t you sit still?” or “What were you thinking?” that lead the child to believe there is something wrong with them.
- Shame and blame: Comments that suggest a child’s academic or other struggles result from laziness, rather than lagging executive function skills or learning differences.
- Overcontrol: Rigid or authoritarian approaches used by parents in response to behaviors they felt powerless to change, resulting in threats or conduct that felt humiliating to a child.
Understanding IFS: Glossary of Terms
| IFS Term | Description |
|---|---|
Parts |
Internal subpersonalities that take on distinct roles in our daily lives. Experiences, especially in childhood, influence the roles that our parts adopt. |
Exiles |
Parts that carry burdens in the form of extreme thoughts, such as “I can’t get anything right,” and extreme feelings, including pain, anger, humiliation, and shame. |
Managers |
Parts that run the show and strive to proactively maintain control. They take on responsibility for seeing that the exiles will not be subject to further hurt. Managers may deploy procrastination, avoidance, people-pleasing, self-deprecation, and masking in situations that could lead to pain or instability. |
Firefighters |
Parts that play a protective and reactive role. When exiles threaten to destabilize the system with their extreme thoughts and feelings, firefighters douse the flames. Behaviors can include self-harm, substance use, and explosive rage. Regulation challenges in ADHD can exacerbate firefighter behaviors. |
Burdens |
Extreme ideas or feelings sparked by adverse experiences and carried by parts. |
Legacy Burdens |
Extreme ideas or feelings that pass down through families and cultures. |
The Self |
The core essence of a person that embodies positive, healing qualities. Accessing The Self is a major goal of IFS. |
Self-Energy |
The qualities a person possesses when connected to The Self: compassion, creativity, curiosity, confidence, courage, patience, and more. |
IFS in Action
A goal of IFS therapy is to help individuals access compassion, curiosity, and patience. These qualities help us grow and heal. But sometimes, trauma and extreme protective parts block access to them. An IFS session might include the following exchange:
| PATIENT | I’m so mad at myself. I missed a deadline at work, and all I can hear is that critical inner voice: “You always screw things up.” |
| THERAPIST | So, when you missed the deadline, your critic part got mad and started in on you. Is that right? |
| PATIENT | Yes. It’s relentless. |
| THERAPIST | I wonder what that part thinks would happen if it let up on the criticism? Just ask it. |
| PATIENT | It fears that I’d fail. Criticism is the only way I get things done. |
| THERAPIST | So, if it stopped criticizing you, you wouldn’t get anything done and you would fail? |
| PATIENT | Yes. |
| THERAPIST | Does that make sense? |
| PATIENT | Yes. I always forget stuff and I need constant reminders. |
| THERAPIST | And this part helps to keep you motivated? |
| PATIENT | I never thought of it that way, but, yes, it does. |
| THERAPIST | How are you feeling toward this part that helps you by never letting up on the criticism? |
| PATIENT | I don’t love the criticism, but I wouldn’t get anything done without it. |
| THERAPIST | Can you extend that feeling of gratitude toward the part? Maybe thank it for working so hard on your behalf? |
| PATIENT | It likes being acknowledged. |
| THERAPIST | That’s right. Now, ask the part how old it thinks you are? |
| PATIENT | It thinks I’m in middle school! |
| THERAPIST | Give the part an update. Let it know what’s different about you now – the skills you have that you didn’t have then, the circumstances you are in, etc. Also let it know that you are working with an executive function coach to learn effective ways to keep track of tasks. |
| PATIENT | The part is shocked. |
| THERAPIST | Ask what it would be like if you could take more responsibility for the reminders. |
| PATIENT | It would like that. It’s tired but doesn’t trust me. |
| THERAPIST | That makes sense too, doesn’t it? Your track record in middle school wasn’t stellar, right? |
| PATIENT | (laughs) You can say that again! |
| THERAPIST | And there were some vulnerable parts that got hurt then, right? |
| PATIENT | Yes. And this one doesn’t want that to happen ever again. |
| THERAPIST | Right. That’s what protective parts do. But they get stuck in time and don’t realize that you can help the vulnerable ones now. Ask the part what it would like if you could do that? |
| PATIENT | Again, it would love that, but it still doesn’t trust me. |
| THERAPIST | That’s right. You will need to earn its trust. |
| PATIENT | Yes. |
| THERAPIST | Let’s start with a manageable first step. See if the part is willing to observe what you can do now before it takes over with the criticism… What do you think? |
| PATIENT | We can try. |
| THERAPIST | Great! Thank the part for being willing to consider that. |
Unlike some therapies, IFS recognizes that even extreme coping behaviors serve a purpose and are trying to help. When protective parts feel appreciated, safe, and understood, they grant access to the parts that carry the most pain – and that opens up space for healing.
Internal Family Systems: Next Steps
- Read: ACEs and the ADHD-Depression Link
- Watch: How to Heal from Trauma Using Internal Family Systems
- Read: Does Trauma Cause ADHD? And Vice Versa?
Susan Bauerfeld, Ph.D., recently retired as an Internal Family Systems therapist.
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