IFS therapy is upending the thinking around schizophrenia, depression, OCD, and more

This is an article written by Ben Blum who has it listed on Medium for paid members only. In an effort to protect Mr. Blum’s copy right, I have only included the first few paragraphs of this article on psychotherapy. To read the full article or find more content on psychotherapy, click here. For more about trauma treatment at SkyeHelps, click here.

In May 2014, three days before graduating from college in Massachusetts, Ross Calvert (name changed for privacy), a quiet, artsy guy whose hopeful eyes and side-parted mop lend him some of the cherubic quirkiness of a Wes Anderson protagonist, had a bad acid trip from which his brain somehow failed to come back. His best friend’s face kept looking weird and sinister. Passing strangers seemed to be whispering about his appearance, his mannerisms, his thoughts. Ross managed to keep it more or less together when his family arrived for his graduation, but for the next several months, voices came in and out of his head in a constant swell. One evening, Ross locked himself in the bathroom of the house he shared with friends just outside Boston and refused to come out. After exhausting all other avenues, his friends finally called the police, who broke down the door, hauled Ross out to a squad car, and delivered him to the hospital, where he was stripped of his clothes and belongings, forcibly administered antipsychotic medication, and confined to the psych ward.

The conventional view of psychosis in modern Western medicine is that it is essentially biological in nature. The focus is on rapid diagnosis and medication. Involuntary hospitalization remains common, despite evidence that it can often be avoided through early intervention involving families and psychotherapy. In one small but suggestive study, involuntary hospitalization induced post-traumatic stress disorder in 31% of patients.

“When I first saw Ross, it was almost as if there were a pane of glass between us,” says David Medeiros, the therapist who Ross’s parents brought him to after he got out. “His speech was delayed. And then every time there was another hospitalization, it felt like another glass was put in place.”

In March 2016, two days after yet another hospital release, Ross spiraled into another crisis. Again the police delivered him to the hospital. Again he was confined to the psych ward and forcibly medicated. This time he received a diagnosis of schizophrenia.

It was a devastating blow for Ross, his family, and his therapist. Between 85% and 90% of schizophrenic patients are unemployed in the United States, one of the most difficult places on Earth to live with the diagnosis. In a 1992 World Health Organization study of schizophrenia that continues to spark controversy in the field, patients in developing countries healed and went into remission at significantly higher rates than their counterparts in developed countries like the United States.

The problem is much bigger than schizophrenia. All too often, patients in today’s U.S. mental health system fall into a downward spiral of increasing diagnoses and increasing medication. As journalist Robert Whitaker reported in his controversial classic Anatomy of an Epidemic, the number of people on government disability for mental illness has actually increased since the introduction of Xanax, Prozac, and other drugs that were once billed by pharmaceutical companies as a panacea for mental health. Though psychiatric medications have brought relief to millions of patients, the impact of long-term use of many drugs is only starting to become clear: chemical dependency, mounting side effects, and fundamental changes in the neurochemistry of the brain. For patients with a diagnosis of schizophrenia, the effect is particularly severe. Numerous studies have found that schizophrenics fare worse on long-term antipsychotics, though it remains the standard of care. Ross was teetering on the edge of a long, steep hill that ended in near-total dependency: on daily meds to manage symptoms, on hospitals to arrest full-blown psychotic episodes, and likely on disability checks to provide for a living. (He had already begun the process of applying.)

Medeiros, Ross’s therapist, didn’t want that to happen. He had known Ross since age 11, when his parents had first brought him in for germophobia, and couldn’t help believing that the warm, quirky kid he remembered lay somewhere inside the shell-shocked guy who now showed up each week in his office. But nothing Medeiros had tried seemed to be getting through. Ross kept ending up back in the hospital and coming out even more wary and cut off.

On the day after the 2016 presidential election, terrified by what it meant for the country, Ross slipped into psychosis yet again, wandering into the courthouse downtown and making a scene before the police finally hauled him off to the hospital. This was the fourth hospitalization in two years, and Medeiros was running out of options. At a loss for what else to do, he decided to try something radical: a novel therapeutic model called internal family systems therapy (IFS).

All too often, patients in today’s U.S. mental health system fall into a downward spiral of increasing diagnoses and increasing medication.

IFS had recently been the subject of a lot of chatter in the psychotherapy community. It was based on a novel theory of the mind so profoundly at odds with the biomedical model of mental illness that, if true, called decades of clinical orthodoxy into question. In IFS, mental health symptoms like anxiety, depression, paranoia, and even psychosis were regarded not as impassive biochemical phenomena but as emotional events under the control of unconscious “parts” of the patient — which they could learn to interact with directly.

Medeiros had only been undergoing IFS training for a year and didn’t feel ready to do more than some preliminary exploratory work with Ross. But he had some idea who could help: Richard C. Schwartz, PhD, the developer of the therapy, whom Medeiros had had the good fortune to meet in person back in June 2016. When Schwartz appeared on the lineup for a trauma conference in Chicago, Medeiros signed up with the hope of speaking to him again. Nearly holding his breath with anxiety, Medeiros found an opportune moment to seek Schwartz out and explain Ross’s case. Schwartz listened intently.

“Why don’t you bring him to Boston to see me?” Schwartz said.

Click here to read the rest of this article on how IFS is changing psychotherapy. Click here to set up a psychotherapy appointment with a SkyeHelps Trauma Counselor.