Supporting Your Neurotype with Internal Family Systems℠
By Clarissa Harwell, LCSW and Clinician at the IFS Telehealth Collective
When we read and hear about different kinds of psychotherapy, what is said and written is often regarding a neurotypical experience from a neurotypical perspective. In fact, most research on evidence-based therapies includes neurotypical test subjects and is therefore not representative of neurodivergent experiences, and many therapists have little or no training in supporting neurodivergent clients. Therapies most often recommended for autism, for example, have been passionately disavowed by the Autistic community and pay no attention to what impact this has on our internal system and well-being. Neurodivergence, in and of itself, does not require treatment, and therapies have historically been focused on compliance - that is, attempts to make neurodivergent individuals appear more neurotypical. Not only is this oppressive, ableist, and harmful, but it can also create lasting trauma. One need only listen to the Autistic adults who were subjected, as children, to these therapies to begin to understand the damage caused. Therapy is meant to help, not hurt. Before we dive into this mind-expanding topic, let’s first understand the basics.
What is Neurodiversity?
Coined by Australian sociologist Judith Singer, neurodiversity simply acknowledges that variations of neurotypes are natural among humans. As Nick Walker, an Autistic scholar, artist, and author puts it, “it is the diversity of human minds, the infinite variation in neurocognitive functioning within our species. Humanity is neurodiverse, just as humanity is racially, ethnically, and culturally diverse. By definition, no human being falls outside of the spectrum of human neurodiversity.”
Under the umbrella of neurodiversity is neurodivergence, which Walker defines as “having a mind that functions in ways which diverge significantly from the dominant societal standards of ‘normal.’' There are multiple ways in which one can be neurodivergent, and our understanding is ever-evolving. A few examples of neurodivergence are autism, dyslexia, ADHD, traumatic brain injuries, and brain alterations due to heavy use of psychedelics.
Where Neurodivergence and IFS Meet
Now that we have a foundational understanding, we can begin to explore what I like to call the convergence of Internal Family SystemsSM (IFS) therapy, developed by Richard Schwartz, Ph.D., and Neurodivergence. Just as no cultural group, race, or gender is a monolith, neither are neurodivergent people. Walker asserts that the dominance in the Western world of the medical model, which is inherently pathologizing, creates a dynamic in which professionals focus on “fixing” traits and characteristics that fall outside of neurotypical. This comes at the expense of everyone - when we treat disorders rather than seek to understand; when we aim to “fix” instead of supporting people in living their own unique truth, we are not affirming, and we perpetuate the view that neurodivergence is a problem. They are not. Internal Family Systems is a therapeutic approach that shares Walker’s concerns regarding the tendency towards pathologizing the spectrum of human emotions, behaviors, and thought processes. IFS is a paradigm-shifting experience for many.
Alike, but Different
What will be true for the internal system of one neurodivergent client may not be true for another. That said, there are similarities among neurodivergent people that are less likely to present in neurotypicals. This can show up in therapy as auditory, visual, and sensory processing variations, differences in comfort level with eye contact, preference for concrete language or not using figures of speech, specialized and intense interests, stimming behaviors, and increased sensitivity to perceived rejection.
In my work with neurodivergent clients, I have the privilege and joy of adapting IFS for those with low interoception, alexithymia, aphantasia, and sensory sensitivities; for those who may be challenged by tasks of executive functioning such as time management, memory, impulse control, and prioritization. (*For further reading about some of these terms, see links at the end of this post). Some clients enter therapy with anxiety, depression, obsessive-compulsive thoughts and behaviors, sensory processing challenges, and trauma. Many carry burdens of shame, perhaps from years of feeling different from peers or as a result of well-meaning parents and partners having expectations that were not met. Still, others have internalized the ableism so present in our culture and may feel worthless or struggle with constant comparisons to neurotypical peers.
Unmasking and Unburdening
For many neurodivergent people, trauma can accumulate as a result of living in a world that seems designed for neurotypicals; where sounds, sights, and crowds are overwhelming, where sensory differences are invalidated or misunderstood, and where eye contact and long periods of sitting are expected and where much effort is put into making neurodivergent folks appear more neurotypical.
The strengths and abilities that come with neurodivergence are often undervalued and maligned. Years of masking - camouflaging neurodivergent traits in order to fit in, be accepted, remain employed, etc. - take a toll, and parts in the internal system can carry these burdens. In a culture that often overlooks the strengths and humanity of neurodivergent people, people can feel invalidated simply for being who they are.
How Can IFS Be Adapted?
Internal Family Systems assume positive intent from parts - even those that may be involved in the thoughts, feelings, and behaviors that we find difficult to accept. This makes IFS an inherently affirming model of therapy. Given that many neurodivergent people have frequent experiences of invalidation due to ableism, others’ lack of understanding of different neurotypes, and biases, it is crucial that therapy be a safe and affirming space. There are myriad ways that trained IFS therapists to create this. While no two clients are alike, and needs vary from session to session, here are some of the ways we are mindful and supportive of our clients’ neuro-traits:
Reducing or avoiding the use of ambiguous language
Inviting fidgeting and movement
Taking breaks as needed
Providing text and email reminders of appointments
Not expecting eye contact
Offering phone sessions
Accommodating all speeds of processing
Adjusting pacing of speech and sessions
Externalizing parts using art supplies, puppets, figurines, objects
Creating systems to track Parts
Using visual aids and cues
Adjusting lighting for telehealth
Providing concrete examples
Let’s take a closer look at a couple of these adaptations. For clients with aphantasia, the common practice of “going inside” in IFS is quite different. There are no mental images, or they are blunted or blurry, which makes it rather difficult, if not impossible, for a client to experience a Part in their “mind’s eye.” Close your eyes for a moment and think of the word “apple.” What happens when you do this? Do you picture an apple? What color is it, and what is its size? How do you experience the apple? If you’re able to call to mind an apple, it’s unlikely you are aphantasic. You may begin to imagine how the inner work of IFS will be a bit different for those who don’t experience mental images.
Externalization in therapy typically refers to the process of shifting something from our inner world to the outer world, perhaps even making it tangible. IFS clients might be guided to externalize their parts in a variety of ways, which can give dimension to them in ways that don’t occur internally. For example, someone could choose different rocks or stones to symbolize their internal system. Stones of varying shapes, colors, textures, and sizes become our managers, firefighters, and exiles. Small figurines of people, animals, and other objects work well, as do puppets. This act of externalizing parts serves to build the relationship not among parts but between the Self of the client and the parts. Though different from “going inside,” it is no less effective.
Alexithymic clients - those who find it difficult or impossible to recognize their internal emotional state or communicate their emotional state with others, and/or differentiate between feelings - frequently will not associate their physical sensations with emotion or parts. Giving descriptions of their internal experiences may not come easily or may not happen at all. Working with parts and building a connection between a person’s core Self and parts does not require this, and the gentle inquiry of IFS is expansive, allowing for the client and therapist to work together regardless of whether a client can identify or describe their emotional state.
Building more awareness is possible. Some clients may work most effectively with those externalized parts previously mentioned, and with guidance from their therapist, they begin paying mindful attention to any physical sensations they may experience. Over time, clients often make connections between their somatic experience and a particular part of themselves, which informs the therapeutic process. Most clients who experience alexithymia have faced criticism, judgment, and even ridicule. IFS can help people recognize the impact this has had on their system, and to heal the burdens formed by these experiences.
Though neurodiversity encompasses the full and vast spectrum of cognitive traits and experiences, it is those with neurodivergence who are more likely to be marginalized. As we increase the acceptance and understanding of human diversity in general and advocate for more affirming care for all, so too can we offer adaptations of IFS to meet the needs of all clients.
Have you wondered if your neurotype impacts how you interact with others and the world around you? Do you struggle with sensory input or find it difficult to determine how you’re feeling? Let a trained IFS therapist support the exploration of your internal system. If you live in California,, Massachusetts, Michigan, New York, or Oregon, please contact our Client Care Coordinator or call 503-447-3244.
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Glossary of terms with links to further information:
Alexithymia: difficulty or inability to describe emotions https://neuroclastic.com/the-alexithymia-autism-guide/
Interoception: the body’s sense of what is happening internally
https://neuroclastic.com/the-other-3-senses-you-never-knew-existed-but-you-should/
https://www.youtube.com/watch?v=A0zbCiakjaA
Aphantasia: the inability to visualize or think in images
