INTERVIEW: Marcella Cox
“The capacity for self-compassion is key to the healing process. With IFS, limitless compassion becomes available for you, your parts, and for those around you.”
Marcella Cox was inspired to create IFS Telehealth Collective after launching a virtual group practice in 2018 for eating disorders in her home state of California. As a therapist with a passion for helping others in recovery from disordered eating and body shame, Marcella found Internal Family Systems as well as her work with Mindful Self-Compassion to be a natural fit for her clients.
Marcella's vision to build a community for therapists who are on the front lines serving others is complemented by her experience developing and running a successful group practice that specializes in teletherapy.
Marcella serves on the IFS Telehealth Collective team as co-founder and executive director.
Get to know more of Marcella’s story, and how she came to join the Collective!
Was there a single, defining moment that drew you to the mental health field?
Marcella: Being a therapist is actually a third career for me. After I graduated from college, I worked in marketing and communications roles for several years with Silicon Valley technology companies. Once my second child was born, I decided to take a hiatus from corporate life to raise my kids. When it was time to return to work, the thought of promoting products felt soulless; it just wasn't where my heart was.
I had the privilege to ask myself, "What do I really want to do?" I decided that I really wanted to help others. Soon, I was in grad school and on my way to a third career as a marriage and family therapist (MFT).
What led you to want to study marriage and family therapy?
Marcella: To be honest, when I went to grad school, my kids were in elementary school, and the program I chose had to work for their needs as well. Luckily there was a program that was really close to my home that offered a MFT program.
There was no "A-ha!" moment where I realized that becoming a MFT as opposed to another type of mental health counselor was the right choice for me. In retrospect, I probably would have still studied to become a MFT, although I may have chosen a program that felt more in line with my interests.
What has influenced you the most when it comes to how you approach your work?
Marcella: I would say that when I went to my Internal Family Systems (IFS) Level 1 training several years ago, it completely changed my perspective. That's when I finally had my "Ah-ha!" moment. I could see how well this approach aligned with my lived experience, and to me, it really made so much sense. Truly, so many pieces fell into place when I learned IFS. All those other therapeutic approaches just suddenly seemed less relevant.
I was first introduced to the IFS Model in 2013. I had a supervisor who was trained in IFS at an eating disorder clinic where I worked. She gave me some books on IFS that helped me gain my initial understanding. As I built on that foundation, I started working from that framework. Completing the IFS Circle, an online program that teaches the basics of IFS, at the same time as my Level 1 training really solidified my understanding. It wasn’t until my Level 1 training that I felt confident enough to practice the full model.
What has also been influential has been my own work with an IFS therapist for the past several years. Once I began exploring my own inner system and doing some deeper healing work, I developed a greater appreciation for IFS. In order to provide effective IFS therapy, I truly believe you need to have done some internal parts work yourself.
What is it about IFS that speaks to you?
Marcella: There is so much to love about the IFS Model. IFS takes a holistic view and works with the client’s system instead of symptoms. What I’ve learned from my own work and the work of my clients is that if we only attend to the symptoms, underlying pain and burdens are left unhealed.
Another aspect of IFS that I have found so compelling is that EVERYTHING makes sense when you get to know the parts of yourself. You can better understand yourself and why parts of you do what they do.
I also love the way IFS gives access to compassion. Besides IFS, I'm a certified teacher of Mindful Self-Compassion, as developed by Chris Germer and Kristin Neff. With IFS therapy, when you have access to your Self, and your client has access to their Self, limitless compassion becomes available, which is essential for healing. Combining IFS and Mindful Self-Compassion in my work has been really beneficial for my clients who have strong critics and struggle with eating issues and body shame.
Can you speak to the difference between teaching someone about the IFS Model and helping them experience it?
Marcella: What we know is that information alone isn't healing. It keeps you in your head and caught up in your thoughts. What is healing is helping someone to access their own internal compassion and care. When clients connect with and develop a relationship with a part of themselves, it is powerful. You can't do that when you're only in your head because it is an embodied experience. To me IFS therapy is about bringing Self-energy into the room, so that my clients can be more present and attuned to themselves and more fully understand and develop a trusting relationship with their parts.
I've learned over the years as I've taught Mindful Self-Compassion, to find my own voice when teaching. With IFS, even though you are following the model, everyone has their own way of interacting—their own presence that they bring to the session. The Model allows for the flexibility and creativity of the clinician to show up authentically as themselves to meet their client just as they are, which can be healing in and of itself.
What is a passion of yours in this field?
Marcella: I started my first business, Kindful Body, because I saw a need in the San Francisco Bay Area for more skilled eating disorder professionals. I was getting lots of calls from clients looking for support in their recovery from eating disorders. However, like myself, my network of clinicians who treated eating disorders were all booked up. It was discouraging to know that my only options were to refer them to someone who already has a full caseload, or to someone that doesn't treat eating disorders. Neither option was great, but the second could cause actual harm to the client. I decided to create a collective of experienced clinicians who provide quality online therapy specifically for those struggling with disordered eating. So I began hiring clinicians from other parts of California with experience treating eating disorders and availability.
Since then, we've been building towards that vision to fill that need. I found that our practice was well-suited for a particular kind of client: high functioning that did not need a higher level of care, who had pretty good internal motivation. With the terrible traffic here in the San Francisco Bay Area and in many other areas in California and people generally really over-scheduled, online therapy was a great fit.
How have you found that IFS influences your work with Eating Disorders?
Marcella: IFS is great for any mental health challenge, but it is especially powerful with eating disorders. Even though I might integrate some other approaches, IFS is the framework and the way I see what's happening within a client. I have such deep respect for their protectors and how they're trying to fulfill their role to protect the client.
Clients with eating disorders often share there is an "eating disorder voice" inside, which drives much of the disordered eating behavior. IFS recognizes this as a "part" or sometimes there are a cluster of parts, but there is so much more to that client. The traditional approach has been to get the eating disorder symptom(s) to stop, which is rarely successful. With IFS I can help my clients access curiosity and compassion to befriend even the most challenging parts of themselves to more fully understand and appreciate how their eating disorder is trying to help them and the hidden wounds beneath.
How have you found the transition to telehealth to be for yourself/ your clients?
Marcella: When the pandemic hit, I was the only one on my staff who was actually meeting clients in-person. In early 2020, Kindful Body had two employees plus myself. We have steadily grown since and now have nine eating disorder clinicians including myself. But COVID certainly changed everything.
At the start of the pandemic, a couple of my clients were hesitant to transition to telehealth and put their therapy on pause, but they eventually came back. Today, most of my clients now prefer online sessions. What I've seen is that many of them are actually making more progress with telehealth. And I think it's because of the disinhibition effect of doing therapy from the comfort of their own home. In sessions from their home, they're able to go deeper. They don't have to get in a car and drive somewhere after, which tends to transition them away from the healing work of the last hour. Seeing the benefits of telehealth for my clients, I plan to continue to see my clients online for the foreseeable future.
Any challenges you faced with telehealth?
Marcella: The biggest challenge to online therapy is technology issues. For example, when our power went down during the California fires, we had to do therapy over the phone. But with IFS, this was not as much of a challenge as with other approaches. IFS is such an internal process that you really can do it over the phone.
What led you to decide to create IFS Telehealth Collective?
Marcella: The idea of starting IFS Telehealth Collective came out of separate conversations I had with both Paul Ginter and Mariel Pastor. As co-founders, we were passionate about creating a top-notch IFS clinical team similar to what I did with Kindful Body. Our ideas for IFS Telehealth Collective have only grown since then. We're excited to be the bridge connecting people with well trained IFS clinicians. More than that, we are also eager to leverage the experience that Paul and Mariel have as lead trainers to continue to invest in the growth of the clinicians on our team
What part of your career are you especially proud of, that brings you the most joy when you look back at it?
Marcella: I'm proud of the team that I've built at Kindful Body. I had an idea, and I put it out there. I had no idea how it would grow and build. Now, having the privilege of working alongside skilled clinicians who have years and years of experience is really rewarding. The swell of awe hits me often during our weekly peer consultation. Witnessing the interaction between these talented eating disorder professionals, hearing about the excellent clinical work that's happening, and watching the support they're providing to each other, is really inspiring to me. It is so wonderful to see how it all came together and how we can serve more clients while supporting each other. This is my hope for IFS Telehealth Collective. Although my role is behind the scenes, my dream for the IFS Telehealth Collective is the same: cultivating that same sense of community and support for clinicians, while helping more clients heal with this transformative approach.
What behavior or personality trait do you most attribute your success to, and why?
Marcella: I have a diligent part of me that works REALLY hard. I believe success depends on having the vision, putting in the work to make it a reality and luck of being in the right place at the right time. It's also the people you're working with, and I guess I kind of have a knack for attracting people who have similar passions as me. As I envisioned Kindful Body, and as I'm envisioning the IFS Telehealth Collective with Paul and Mariel, I aspire to create places where I would want to work. That spans from the support given to our clinicians, to the compensation, to our policies and procedures, and the way we run the company. My goal is to create a place where clinicians can do the monumental work that they do and feel supported and recognized along the way. As a therapist, you can do the most incredible job, but no one sees it except you and the client. It's nice to have a team to celebrate your successes with.
At the IFS Telehealth Collective, you're not just getting a clinician; you're getting a team of clinicians plus the support of two lead trainers who are outstanding seasoned IFS clinicians in their own right and who know the Model better than anyone else. When you're in solo practice, you don't have the same variety of perspectives and experience to pull from. That's the other important piece of what we're doing here. Again, as a client, you're not just getting a therapist; you're getting a whole community of IFS therapists to support you in your healing.
What advice would you give to a younger version of yourself?
Marcella: To have more confidence and trust in myself. Starting a business is a really public venture, which can feel scary at times. I would tell that person that it's okay for me to take risks. Even though the people-pleaser in me still looks for external validation, I now can be more true to myself and what I need and want. Despite all the ways I’ve tried, and believe me I’ve tried many, there is no way to protect yourself fully from the inevitable emotional pain we all experience as humans. I would also tell myself that at the end of the day, life is really about being vulnerable in order to authentically connect with others and loving ourselves and others through all of its highs and lows.
What other challenges have you faced along the way that stand out when you think back on your life and career?
Marcella: I think it always has always been a challenge for me to find a balance between my personal life and career. I don't know if I will ever find the balance that parts of me fantasize about because I have a part of me that works hard and strives for excellence in whatever I do. However, despite that, I have learned to find more internal harmony among my parts even when my personal life and career are not balanced. Now that our pandemic project, the IFS Telehealth Collective, has launched, inside it feels right to give myself permission to not have to do ALL the things and work so hard. It feels good to show up more for family and friends without feeling so much pressure to get everything done.
What do you wish was public knowledge, or more people were aware of regarding the work that you do?
Marcella: I studied political science as an undergraduate in college and believe that activism is the key to bring about the social change we want to see in our communities, country, and world. During the past few years I have reconnected with my activist parts to focus on changing the inequalities and injustices that affect marginalized bodies in the field of eating disorders.
I love this quote by Desmond Tutu: “There comes a point where we need to stop just pulling people out of the river. We need to go upstream and find out why they’re falling in.” And that is what many in the eating disorder and mental health communities are doing now.
We need to understand that eating disorders are really a social justice issue in terms of who is marginalized and who has access to care. People of color and people in larger bodies are not only discriminated against, but they don’t have access to care in the same way that thin or average-sized white people do. That is wrong.
Fellow therapist and body justice activist Carmen Cool says, “The goal of therapy should never be to help people adjust to oppression.” I bring this perspective to all my work.
And I’d like to end by saying that if you are struggling with any mental health challenge, please reach out to get help. IFS Therapy has been such a gift in my life, as it has been for countless others.
If you’re interested in IFS therapy, and live in California, New York, Florida, Massachusetts, Oregon, or Michigan schedule a free consultation on our website to get connected with a clinician in your location.
