Dissociation and Dissociative Parts in Internal Family Systems (IFS) Therapy: Working with the System That Leaves

In Internal Family Systems (IFS) Therapy (and trauma therapy in general), dissociation is a protective strategy to understand, rather than one to try and eradicate, or get rid of. When a client zones out, becomes foggy, goes blank, loses track of the conversation, or suddenly feels disconnected from themselves, something very intelligent is happening in their internal system. The client is showing how they survived overwhelming circumstances, or their childhood as a whole.

Dissociative phenomenon is complex and varied, and can be very confusing both for clients and therapists. A practical delineation of how dissociation shows up in sessions and life that I found very helpful comes from IFS Expert, Chris Burris.

Dissociation can show up as:

1) a dissociative part that takes over the system to protect from something happening internally or externally

2) a barrier or energy (but not an actual "part") between parts inside the person; the function being to keep the client's system away from knowledge or feelings held somewhere else in the inside

3) a combination of 1 and 2, which a part (dissociative or otherwise) can send or create a barrier or energy to protect the system from knowledge or feelings that it perceives would overwhelm or destabilise the system.

The overriding thing to remember is about dissociation is that we all do it to some degree. There is a continuum to dissociation from everyday experiences like day-dreaming to the profound compartmentalisation seen in complex trauma and dissociative disorders. It's just that in internal systems with a lot of trauma, the ability to dissociate is a highly adaptive response to a chaotic or dangerous early environment. The overarching goal in IFS is to help clients develop access enough Self-energy that they start to introduce the idea of a choice about if/when to use the skill of dissociation, and how this occurs, rather than parts doing this automatically as a surival response, as they did in childhood.

Using IFS lingo, dissociative parts often function as firefighters, reactively and rapidly pulling clients away from intense emotions, traumatic memories, or vulnerable exiles. Others operate more like managers, proactively keeping painful memories, sensations, or feelings out of awareness so the person can function day to day.

These protectors may appear as:

• Blankness or mental fog

• Sudden sleepiness (experienced by client and therapist)

• Losing track of the conversation

• Feeling dizzy, detached, unreal, or "not here"

• Difficulty accessing emotions, body sensations, or memories

  
  

In trauma therapy literature, it's often noted that dissociation can occur across four domains: behaviour, affect, sensation, and knowledge. A client may remember an event but not feel it, experience physical pain without understanding its origins, or describe severe trauma with little emotional connection. These separations are unfortunately often framed by therapists who aren't trauma-informed as "resistance". I would argue that "resistance" doesn't exist, and using an IFS frame, we can look beyond easy explanations and see dissociation in all its manifestations as a protective adaptation.

So, what to do when dissociation emerges in life or in session? The first task is not insight or intellectualisation, but regulation. So, therapist and client need to slow down. If the client is disappearing, the system is telling you that something difficult is emerging, or the pace is too fast. Rather than pursuing content, it's essential to help the client access present moment by grounding with and through the senses, noticing the body in the chair, feeling feet on the floor, or orienting to the room can help restore dual awareness*.

Then become curious about the dissociative part itself:

"What happens inside when that fog comes in?"

"What does this part want us to understand about its job?"

Dissociative parts are often heroic protectors. They expect intrusion, pressure, or attempts to bypass them. Respect and relationship must come before any offer to take on another role inside, or invitation for change. You might not get traction the first time, or even the second (or the fifteenth). Like most relationships characterised by a lot of scepticism, connection is achieved by repetition, genuine interest, and care.

It's also important to notice and acknowledge parts that dislike the dissociation. Clients may come to therapy with gaps in their explicit memory, loss of time in their day-to-day life, or something more commonplace like "poor memory". Their systems may be frustrated by the impact that dissociation has had on their lives. Additionally, internal systems characterised by dissociation often believe therapy is being wasted when they dissociate, that they aren't doing the therapy "right", or that they should be doing better. This polarisation between dissociative parts and the ones inside that don't like them often increase pressure on the system, making dissociation more likely, rather than less.

The most important principles when working with dissociation are simple: encouraging patience and persistence, slower is faster, and repetition is key. The IFS principles of honouring the protector for how they helped the client survive, and helping the system distinguish between past and present are also essential. Over time, dissociative parts can learn that today's reality is different from the one they were originally protecting against, and/or the client's capacity to deal with challenges has expanded exponentially.

When that trust develops, the system no longer has to leave in order to survive.

About the Author

Sean Cuthbert is a Clinical Psychologist, Psychology Board of Australia (PBA) Approved Supervisor, Certified IFS Therapist, and IFS-I Approved Clinical Consultant in private practice in Melbourne, online throughout Australia, and internationally. He provides 1:1 therapy for clients, and supports professionals through individual and group supervision/consultation.

*If you're reading this and you've heard or read Richard Schwartz question grounding as a therapeutic strategy, or you've taken IFS Level 1 training and they've frowned upon using coping skills with clients, I would argue that Level 1 teaches foundational IFS and it is not a trauma training, and invite you to check out the work of Joanne Twombly, or join the ISSTD.