Internal Family Systems Therapy for Addictions: Trauma-Informed, Compassion-Based Interventions for Substance Use, Eating, Gambling and More

“Now more than ever, we need widely available compassionate treatment approaches to addiction and substance use disorder, yet many generalist therapists avoid seeing clients who need help with addictions. Sometimes this is because they were taught this wasn’t within their scope of practice by supervisors. Or it may be because they’ve had intimidating experiences with unrelenting or overwhelming addictive behavior, they’ve experienced the wrath of an angry client, they fear the client will overdose, they can’t tolerate the sinkhole of the client’s ambivalence, or they’ve felt futile and useless after repetitive cycles of addictive recurrences and bearing witness to a client’s decline. If any of this rings a bell and you would prefer to feel empowered with clients who engage in addictive processes, read this book. It illustrates three master clinicians using the innovative internal family systems (IFS) approach to help clients deescalate inner conflicts and navigate addictive behaviors.” ―Zev Schuman-Olivier, MD, director of the Center for Mindfulness and Compassion and director of Addiction Research, Cambridge Health Alliance, and assistant professor in psychiatry, Harvard Medical School

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“Addiction experts usually come in three flavors: treatment providers who tout their explicit formula for recovery, sociopolitical thinkers who understand addiction as a complex societal ill, and students of child development who recognize the trauma-strewn pathways that result in addiction and self-harm. How refreshing, then, and how remarkably comprehensive and satisfying, to see an amalgamation of all three perspectives in Internal Family Systems Therapy for Addictions, which then goes on to teach us precisely how to intervene.

“As a onetime addict, addiction researcher, and clinical psychologist, I’m blown away by the impact of Sykes and colleagues’ IFS-guided approach to therapy. For nearly 10 years I have used this approach with my addicted clients, and there’s simply nothing out there with such precision and power to help. IFS in general, and the authors’ step-by-step formula for applying IFS impeccably with this difficult population, targets addiction where it lives―in the struggle between overcontrol and abandon. As these authors clarify through their singular insights and expertise, it’s a struggle that gets resolved through focused attention and self-compassion, not by taking sides.

“This book is for therapists, clients, educators, coaches, and clinical researchers who’ve been trying to make sense of the convoluted literature and practice guidelines intended to help those who suffer from addictive disorders. It brings clarity to the chaos, both intellectually and pragmatically, but its most impressive achievement is to map out a treatment approach that actually makes a difference.” ―Marc Lewis, PhD, C.Psych, professor emeritus (University of Toronto), clinical psychologist, and author of The Biology of Desire: Why Addiction Is Not a Disease and Memoirs of an Addicted Brain

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“Until recent years, our understanding of addiction has been based on outdated and flawed assumptions―mainly that it’s either a disease or a result of a lack of willpower. The IFS approach to therapy offers both a new paradigm for understanding addictive behavior through a compassionate lens and an effective framework for treating it to create lasting change. This wonderful book provides an accessible manual to therapists who are interested in tackling addictive processes at their core using IFS. Internal Family Systems Therapy for Addictions is a timely and important contribution that is likely to change the narrative around addiction treatment.” ―Niall McKeever, founder of The Weekend University

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“We all contain contradictions, yet when it comes to behaviors labeled as addictions, internal contradictions are often pathologized. Traditional treatment models confront the person seeking help and try to silence the ‘addict’ voice. Thankfully, Internal Family Systems Therapy for Addictions recognizes that the contradictions, including the seemingly destructive parts, must be recognized rather than suppressed.

“After more than 20 years of experience in the field, I have found very few books that escape the misguided belief that people dependent on drugs are diseased, are in denial, should be confronted, and must get specialized ‘addiction treatment.’ This excellent and practical book challenges and rejects that view, and even questions the term addiction itself.

“The authors use a logical and clear stepwise approach that does not require an expert understanding of IFS, and they include exercises for both clients and the therapist. These exercises challenge the therapist’s bias and stigmatizing ideas, replacing them with an understanding of the deep struggles that people with addictive habits desperately need to reconcile. For that reason alone, this book is essential reading for any clinician working with people who use drugs addictively.” ―Shaun Shelly, Department of Family Medicine, University of Pretoria, South Africa

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“In the midst of an overdose epidemic, we are past due for novel approaches to working with those with substance use disorders, and Internal Family Systems Therapy for Addictions does just that. This volume provides those who might not be familiar with IFS a thorough introduction. It also offers a unique lens for both conceptualizing substance use disorders and treating them, with numerous concrete tools and practical strategies that clinicians can employ. A must-read for anyone working in addictions.” ―J. Wesley Boyd, MD, PhD, professor of psychiatry and medical ethics, Baylor College of Medicine

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“I am deeply grateful for the arrival of Internal Family Systems Therapy for Addictions to the healthcare literature stage. It offers a real roadmap for working with the complicated, multilayered dynamics within the ‘addict’ and the people surrounding them, and it illuminates a methodology for reaching the core internal pain that has been avoided or managed until it can be contacted and healed.

“The overview on addictive processes lays out with elegant clarity a thorough exploration of the addiction dynamic, a healing map, and specific, heart-led skills training and experiential exercises. The attention to the therapist role and concrete directions for addressing therapist reactivity to addictive behaviors is especially notable, as client-clinician polarities are a central challenge in addiction treatment. This book is packed with relatable human examples, all accompanied by a comprehensive treatment plan and map. Organized so that anyone can grasp the essentials and relate to the information, there are concrete tools for understanding, growth, and healing for therapists, clients, family members, members of the 12-step community, and others.

“I cannot recommend this book highly enough for all who treat, relate to, or suffer from the burden of the addiction dynamic.” ―Sarah B. Stewart, PsyD, recognized expert in trauma, addiction, IFS, and EMDR

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Cece Sykes, LCSW, is a consultant and senior trainer with the Internal Family Systems Institute, where she specializes in trauma and addiction and educates therapists around the world on how to apply the IFS therapy model to addictive processes. Additionally, Sykes is now exploring how psychotherapy affects the therapist’s life. She lectures, consults, and leads workshops on these and related topics, and also maintains a private practice in Chicago. She has co-authored a number of articles on treating the impact of sexual trauma in families and authored the chapter “An IFS Lens on Addiction: Compassion for Extreme Parts” in the 2017 book, Innovations and Elaborations in Internal Family Systems Therapy.

Martha Sweezy, PhD, is a part-time assistant professor in psychiatry at Harvard Medical School, a research and training consultant at the Center for Mindfulness and Compassion at the Cambridge Health Alliance, and a psychotherapist at a private practice in Northampton, Massachusetts. She has published articles on IFS in peer reviewed journals, co-edited two books on various applications of IFS, and co-authored three treatment manuals on IFS (on trauma, couple therapy, and now addictions), as well as the second edition of Internal Family Systems Therapy with Richard Schwartz. Her next book, which explores shame and guilt in the context of psychic multiplicity, will be published by Guilford Press in 2023.

Richard C. Schwartz, PhD, is the creator of Internal Family Systems, a highly effective, evidence-based therapeutic model that depathologizes the multipart personality. His IFS Institute offers training for professionals and the general public. He is currently on the faculty of Harvard Medical School, and he has published five books, including No Bad Parts: Healing Trauma and Restoring Wholeness with the Internal Family Systems Model. Dick lives with his wife, Jeanne, near Chicago, close to his three daughters and his growing number of grandchildren.