Getting To Know “Parts” Involved With Medical Conditions, Part 1

When I first wrote Mind Over Medicine in 2012, I wasn’t aware of Internal Family Systems (IFS).

But for 6 years, I had been writing daily love letters from my “Inner Pilot Light” to my hurt parts, first to myself and then to my online community as The Daily Flame, (which later became a book.) I didn’t realize at the time that I was practicing part of the IFS model, all the way back then, reuniting hurt, traumatized, lost parts of myself with the wise, mature, loving divine Self inside, and extending love, compassion, reassurance, and connection between Self and parts.

In the original 2013 version of Mind Over Medicine, the Six Steps To Healing Yourself included a rigorous diagnostic assessment of the root causes that might underlie medical illness, which included childhood traumas and other ongoing traumas in adulthood that might be dysregulating the nervous system and disabling the body’s natural self-repair mechanisms. But I didn’t have the sophisticated understanding of the “HOW” of healing trauma that the IFS model offers.

I discovered IFS after the book’s publication in 2013, while out and about on my Mind Over Medicine book tour. My trauma therapist cousin Rebecca Ching was the one who turned me onto it and insisted it would be a total game-changer for me and my patients. She was spot on. (Thank you Rebecca!)

After that, I started marrying the Six Steps To Healing Yourself with IFS, and a whole new way of practicing medicine was born. I’ve been teaching that way of practicing medicine to physicians in the Whole Health Medicine Institute for over a decade, and the model we teach has morphed over time as I’ve learned more, as the field of traumatology has advanced, and as my students have challenged me and educated me. The revised edition of Mind Over Medicine that came out in 2020 includes this more sophisticated understanding of IFS as part of its foundation.

Twice, IFS founder Dick Schwartz and I have taught a class about healing parts that are involved in medical conditions, along with the Six Steps of Healing Yourself. We taught together, once in person at the IFS conference before the pandemic, and once on Zoom mid-pandemic.

Now, on June 8-9, Harvard-trained psychiatrist, author of 3 books about IFS, and rock star IFS master trainer Frank Anderson, MD and I are partnering up to activate our Wonder Twin powers to add to that discussion. Frank is so generative and creative, and we had a wonderful experience creating new material for our IFS & memoir writing class WRITE TO HEAL. So we’re pairing up again to teach a weekend Zoom workshop IFS AS MEDICAL TREATMENT.

Learn more and register here.

What do I mean when I say “marrying the Six Steps To Healing Yourself with IFS?” First, let me say what we DON’T mean. We’re not suggesting that IFS is a miracle cure, that trauma is the only cause of medical illness, or that you shouldn’t seek conventional medical treatment if you’re sick. We’re also not saying your parts are causing your illness, per se. While it’s true that trauma causes chronic nervous system dysregulation and chronic inflammation- and those physiological changes can cause a variety of medical symptoms- it’s not as if your traumatized parts and their protectors are intentionally making you sick.

Sure, some people have hypochondriac parts or malingering parts or parts seeking out secondary gain. But most people who struggle with medical issues have no idea that their medical problems might be related to their parts- or to trauma at all.

In IFS As Medical Treatment, we’ll be teaching therapists, doctors, patients, health practitioners of all sorts, and anybody interested in IFS as preventive medicine how to use IFS on yourself or with clients and patients who suffer from medical conditions as a result of parts that might use the body to get core needs met- or wounded parts that lead to the chronic nervous system dysregulation and chronic inflammation caused by psychological trauma.

For example, let’s examine The Six Steps To Healing Yourself:

Step 1: Believe that healing is possible.

Step 2: Connect to and surrender to Self

Step 3: Let Self choose your healing support

Step 4: Diagnose the root cause of your illness

Step 5: Write The Prescription for yourself

Step 6: Treat your fears and resistance.

Now let’s break those down from an IFS-perspective. We’ll cover Steps 1-3 today, then we’ll cover Steps 4-6 in Part 2 of this series.

Step 1: Believe that healing is possible. 

If you believe you’re “incurable,” “terminal,” “chronically ill,” or “permanently damaged,” you’re probably right. If, however, you’re willing to question your beliefs and open up the possibility that healing could happen and cure might be in the cards for you, you open a portal of possibility. Once you’ve removed the anchored belief that cure is not possible, you make yourself vulnerable (in a good way) to the health benefits of realistic positive thinking (without magical thinking.) We know from the placebo and nocebo research that whether you believe you will get better, or whether you believe you’re cursed, can actually impact your health outcome. By believing healing is possible, even if it’s statistically unlikely, your parts can relax a little bit and feel a little less acutely afraid, and then your nervous system can begin to settle down.

If you don’t believe that it’s possible that healing might be in the cards for you, you may need to be proactive about shifting your beliefs with the practices you will learn to help you let go of limiting beliefs and replace them with health-inducing ones. It’s fine to acknowledge the uncertainty that accompanies any healing journey and allow yourself to feel the feelings that might come with uncertainty- fear, grief, disappointment, frustration, despair. But also remember that when you don’t know what the future holds, anything is possible, even an unexpected cure.

You can educate yourself about the statistics of your prognosis if it calms the part that wants to know and helps you manage your expectations and assess your situation with a realistic lens, but keep in mind that you are not a statistic. Remember- you are a unique individual who has an unknown and unknowable future. This is not about entering a state of false hope or denial. It’s about removing blocks to the doorway of healing and then walking all the way through that doorway into grounded hope.

Common Step 1 Parts

• Parts that hold burdened beliefs, like hopeless parts that don’t believe healing is possible or exiles that feel unworthy of getting better
• Pessimistic parts that protect parts that are scared of disappointment if they hope
• Parts that give power over to authority figures and believe anything they say
• Parts that hold childhood beliefs about health and sickness, like “I’m a sickly person” or “cancer runs in my family”
• Protectors that might be getting core needs met as a result of the illness and might not want to let go of that strategy to get core needs met

Examples of common burdened beliefs include:

I have nothing to live for.

I want to get much, much worse.

It’s not safe to be healed.

I don’t deserve to be healed.

I don’t want to be healed.

I don’t want to live in my body.

I must always be sick.

I cannot live without illness.

It’s impossible for me to be healed.

I will never be healed.

I won’t do what I need to do to be healed.

I want to die.

Step 2: Connect to and surrender to Self

Step Two is about connecting to your wise, mature, adult, divine Self inside, to develop the internal support and guidance you’ll need to navigate your journey to healing. Once you allow yourself to believe that healing might be possible, it helps to prepare to be paradoxically proactive but also surrendering attachment to outcomes. You can be too passive on a healing journey, but you can also white knuckle your healing journey with such desperate clinging to control that you strangle the whole process and stay in a chronic, repetitive stress response.

Letting go of attachment to outcomes is no small feat when you’re suffering, desperate for relief,  and clinging to some measure of certainty in the midst of the kind of uncertainty that can be very threatening for some of our fearful parts. How do you let go of clinging to cure when your very life may be at stake?

While some people may choose to surrender to a higher power outside yourself- God, Buddha, Allah, Jesus, an archangel, a guide, or a guru, in the IFS world, you might consider surrendering to the divine Self inside. Self is your wise inner healer, your intuitive guide, your higher power within. Whether you access this spiritual connection through an inner or outer higher power, solidifying your connection to this higher power and accessing it inside your own being is the key to Step 2. Of course you want to be healed! But the heaviness of that longing can keep you desperately grasping, which keeps you in a stress response.

Don’t try to suppress your desire for healing. Let yourself be on fire with your desire for healing, then cast the burden of this intense desire over to whatever spiritual Source you trust and ask for help and clear guidance while navigating your healing journey. Trust that if right action is required, you will be guided and shown what to do, that your body and your intuition will be your compass. This conscious act of offering your problems to the Source of love that created you, which also exists inside of you, alleviates some of the heavy feelings that can accompany a healing journey.

Without bypassing any painful emotions you feel, you can simultaneously allow yourself to be bathed in the gratitude for all the help that will come to support you, emotionally, physically, and spiritually, as you reconnect to the jnterconnected web of life by connecting to your Self energy. Make the humble action of admitting that you can’t do this alone, that you will need guidance from the healing energy that courses through this web. Once you let go of thinking you can control this process, intuition, signs and synchronicities, body wisdom, and whatever else you need to navigate this path will come. A process is activated, and guidance will flow through. Once you are connected to this web of life with your act of surrender, you can no longer remain separate from it and it can rise to support your journey. Fill yourself with the knowing that help is here.

This step is a call to action, an opening to the guidance that can be received, interpreted, discerned, and followed via your Self. The rational mind can be helpful to analyze treatment options and other choices you’ll need to make, but nothing beats your wise inner Self for shining the clarity of your inner knowing on the aligned path.

Common Step 2 Parts:

• Controlling managers that try to micromanage and control health outcomes (often polarized with firefighters that engage in unhealthy behaviors)
• Religiously or spiritually traumatized parts that don’t trust the Mystery or believe there’s a Self
• Scared parts that think you’ll stay sick if you don’t strong arm your attempt to get well
• Dissociated parts that have lost almost all connection to Self
• Parts that struggle to trust

Step 3: Let Self choose your healing support

While connecting to your wise divine Self inside gives you the internal support you’ll need, you’ll also need external support in the form of a healing team. As much as self-help books like to suggest that healing can be a solitary journey, optimal healing does not usually arise from the consciousness of the rugged individualist. Paradoxically, your body is beautifully equipped to heal itself. AND… you cannot do it alone. You’ll need to make yourself vulnerable to the support of others, especially if you’ve been a lifelong caregiver, over-giving without receiving as much from others as you need.

If you believe you have to do everything yourself and you can’t dare to rely on anyone else’s love and support, that’s a recipe for illness, since human beings need one another to achieve optimal mental and physical health. Even if you’re an introvert or a monk, you’ll need the right kind of support. Keep in mind that great support might come from a group of lay people who gather together with the intention of healing. You might also need experts, whether they are doctors, therapists, CAM providers, or bodyworkers. Discerning carefully who has a seat at your “Healing Round Table” could save your life. Let your wise, mature Self be the one who chooses who supports you.

Common Step 3 Parts:

• Rugged individualist parts
• Codependent parts that prefer caring for others over receiving care
• Parts that feel unworthy of good support
• Parts that feel helpless to find good care
• Parts afraid of taking up space or being the center of attention
• Parts that have a hard time being assertive
• Parts that settle for good enough
• Parts that struggle to challenge authority
• FInancially struggling parts

In our class, we’ll be supporting our students with working with parts through each step. If you’d like to bring more of this way of practicing medicine, psychiatry, or therapy to your clients, we welcome you! And if you’re more interested in learning this material for your personal healing journey, you’re also welcome.

Learn more and register here.