“What’s healing is the self to part relationship. And that relationship gets built based on the part being able to tell its story without repercussions.”
In this episode of the Numinus podcast, Dr. Joe speaks with Dr. Robert Grant. Dr. Grant is an Internal Family Systems (IFS) therapist, a ketamine-assisted psychotherapist, a pulmonary physician, a professor of medicine at UCSF, a former researcher in HIV prevention and treatment, and a cofounder of the Healing Realms Center. The Healing Realms Center is a clinic specializing in ketamine-assisted psychotherapy.
Dr. Grant is especially well known for his work as an IFS therapist specializing in ketamine treatments. IFS was developed by Dr. Richard C. Schwartz. It is a therapy based on the notion that the human mind is made up of inner parts. And healing involves the cultivation of harmony among these parts. It is commonly used in the treatment of post-traumatic stress.
In this interview Dr. Joe and Dr. Grant explored:
- How his research into preventing HIV led him to studying IFS
- What “parts” mean in the IFS model
- The three most common types of parts: Managers, Exiles, and Firefighters
- What “self” mean in the context of IFS
- How parts become burdened by trauma
- The role of “self” in healing
- The 6 F’s: Find, Focus, Flesh it out, Feel, beFriend, and Fear
- What ‘unblending’ is
- Why IFS fits so well with psychedelics
Here is more information on subjects mentioned in this episode:
- Dr. Grant mentions a documentary in the beginning of the interview. He doesn’t remember exactly which one, but he believes this could be it
- Internal Family Systems Therapy, Second Edition by Richard Schwartz and Marta Sweezy
- The 6 F’s
- Greater Than the Sum of Our Parts by Richard Schwartz
- Annie and Michael Mithoefer, IFS therapists who helped conduct and design the MDMA-assisted psychotherapy for PTSD phase 2 trials by MAPS
More quotes from Dr. Grant from the interview:
“It was the human connection that was curative. And the mescaline was helpful maybe because it facilitated that connection.”
“Other people may trigger different parts of us that give us an opportunity to learn about our inner processes.”
“‘Self’ is the part of us that can see our own trauma without being re-traumatized.”
“Healing is a process of hearing out that inner dialogue. So we can really develop a relationship with our parts.”
“Sometimes spaciousness actually fosters connection because it allows us to see each other more clearly.”
“Parts are still there after the healing process. You’re not trying to get rid of them. You’re just trying to allow them to be seen and to play healthy roles that are playful, pleasant, and productive to a certain extent.”
Here are some highlights from their conversation:
Let’s talk about healing. That’s where I wanted to go next. You said things like, ‘this part needs to tell their story.’ And you gave the example earlier about, maybe someone coming to therapy because they feel confused about whether to stay in or leave a relationship. And that the purpose of the therapy is not to arrive at a conclusion, but to create space for these stories to be heard. Can you tell me what’s healing about having these parts express themselves?
It’s the beginning of the healing process. So I think that what’s healing is the self to part relationship. And so that relationship gets built based on the part being able to tell its story without causing a reaction or without having repercussions. So creating a connection between the self and the part by listening to their story is an essential step in the process of building those relationships.
We have a number of heuristics which are actually helpful. And if I can digress a bit, the founder, Rick Schwartz, in his most recent iteration of his book with Marta Sweezy, said that IFS could be conceived of as a psychodynamic theory. And so it is in this lineage of psychodynamic process. And because it does embrace the multiplicity of the mind, it allows for conflicting, psychodynamic relationships within the person.
What I like about IFS is that it goes one step in the direction of giving us tools for uncovering exiled or subconscious material. And so a classically trained psychoanalyst might expect to spend hours or days or years listening to the client on the couch, and eventually the subconscious material will bubble up, either in terms of dream interpretation or day time fantasies or behaviors that create ambivalence within them. I mean, they’ll just wait for it. And I love that idea of just waiting, witnessing. And so I have great respect for thoroughly trained psychoanalysts.
And IFS does give us some tools that allow us to move pretty quickly toward uncovering subconscious or exiled material. And so it has a toolbox that allows us to be expeditious. But I don’t think the process is very different from what a psychoanalyst would do. It’s just a little more guided and a little more intentional.
So one of the heuristics that IFS has is called the 6 F’s, and so I can walk us through those. You want to find parts. So whatever part we want to find, we want to see what’s up for the person. It might be that a single part has very strong feelings that need to be heard out. Or there may be a pair of parts that want to stay in or want to get out, a polarized pair of parts. So you want to find the one or two or three that you’re going to work with on that day. And then you want to focus on them, let them know that you’re here to listen to them. And when I say you, it’s actually the client ‘self; is there to listen to them. Now, the therapist’s ‘self’ energy is also very important in this process, so that the therapist ‘self’ and the client ‘self’ are there to listen to the parts. So, you know, it’s intuitive that that’s reassuring. I mean, if you’re wanting to make friends with someone, what do you do? You focus on them. You look them in the eye and you focus and then you flesh out.
So that’s the third F. ‘Tell me more about that. Tell me what that was like for you. Tell me what was the worst part of that or the best part of that? What did you do with that?’ And then there’s this phrase that we use is, ‘how do you feel toward the part?’ And that’s actually a key step because, you know, if you asked me, Bob, ;how do you feel toward that part that’s carrying shame?; And if I say something like, ‘well, I actually dislike that part, it’s annoying. It bothered me my whole life. Why would I be ashamed of it?’ Those are not self qualities. So what that tells you when I answer that way is that it’s not a self to part relationship with being developed. You’re hearing from another part of me that is trying to exile that part carrying the shame. And so you would at that point having asked me how I feel toward the part, but having not heard from self, you would say, ‘okay, can you give attention to the part that wants to get rid of that shame and let’s find out about it. What is it trying to do? What is afraid will happen if we heard about the shame? What would it rather do if we didn’t have to suppress that part that had all the shame all the time?’
And, you know, and so we change the focus to the part that came up in reaction to the other part, and we continue to do that. And then we’ll ask, ‘how do you feel toward that part that wants to get rid of the shame?’ And, you know, at some point I’ll say, ‘well, I’m curious about what is it trying to do? And I want to know more. And that’s self energy. And so then that’s our green light to start doing the real work of developing self to part relationships. So the feel toward is one of 6 F’s.
And then and then you want to unblend as much as possible. You want the part to be able to see the self, and the self to see the part and and parts don’t like doing that. They like being connected to self. They like being connected to self so much that they stick to self, like a glove. And so one thing that I like to say is, ‘can we ask the part to give us some distance and spaciousness so that you can see it better and so it can see you better?’ So one of the beautiful things about connection is whether it’s between people or within our parts, within ourselves. Sometimes the spaciousness actually fosters connection because it allows us to see each other more clearly. And then, you know, that can be healthy and relationships as well. Sometimes that relationship I mentioned earlier, ‘do I stay and do I go out?’ Maybe there is a middle ground. It’s, you know, let’s just take some space and, you know, we don’t spend every day of our lives together. But we think we can walk and have some spaciousness. And that may be all the relationship wants or needs.
And it’s the same way within parts within ourselves, but sometimes asking them to unblend, they’ll say, ‘no, no, I cannot unblend.’ They’re desperate for more attention. But they said, ‘Well, no, it’s if you just give us some space, then I can see you better. You can see me better.’
So there’s unblending and then there’s befriending, just continuing to say, ‘it’s so great that I’ve been trying to protect Bob from feeling shame. You’ve done such a great job. And look how well he’s done in school and that has led to a career. And that’s so great.’ But do you really want to keep doing that all the time? And often they’ll say, ‘No, I’m exhausted.’ I’d rather that Bob, if there were a way for Bob to deal with his shame without me having to work all the time, I would like that, but I don’t think there is a way to do that. That’s why I’ve constructed this job. So the part may say that. You could say, ‘well, you know, I think there is a way to help Bob with the shame without you having to work all the time.’ Sometimes the part would say, ‘I’m not sure that’s possible, but I would want that. So, you know, let’s give that a try.’ And then you can ask, you know, that protective part to rest and it can stay close and watch if it wants, just in case something comes up that makes it afraid. It can step back in if it needs to. But that then gives you an opportunity to go back to that exile, which initially caused the protected part to come up. But that part now is befriended and it’s willing to rest. And so you can work with the exile material.
And then ultimately you would want to get to a point where whatever caused the burden of shame to come to that exile part, then that part can have a chance to leave that situation and unburden that shame. And then the whole system can appreciate that , ‘Yeah, there was a way to deal with the shame that didn’t involve having to compulsively work all the time.’
So the healing process is really one of befriending the parts and airing them out and ultimately giving the exiled parts a chance to be retrieved from the hard situation and then to unburden the beliefs that were important to survive that hard situation. And then to have the rest of the parts come back into the situation, and ask them, ‘did you see what happened there?’ And some of them will come back in and say, ‘oh, yeah, wow, I’m impressed. I didn’t think there was a way to solve that problem. But yeah, there was.’ So great.
And some of them may come back and be a little frightened. Like the example I gave might say, ‘you know, I spent my whole life working obsessively to do well in school. And now what do I do? I don’t know what my job is.’ ‘It’s okay. You know, I’ll work with you. There’s lots of jobs that you could do. Maybe you can work on writing a book or something other than school.’ Maybe oftentimes the job that the protectors want to do has nothing to do with what they were doing. The part of me that wanted to do well in school might want to take up finger painting or, you know, writing poetry like I was doing in college. Maybe they want to go back and do that or, you know, like, hey, who knows? But letting them do what they want, it’s an important part of being a good self for them, a good self leader for them.
I mean the parts are there, they’re still there after the healing process. You’re not trying to get rid of any part. You’re just trying to allow them to be seen and to play their healthy roles, which are roles that are playful and pleasant and productive to a certain extent.
Connect with Dr. Robert Grant on the Healing Realms Center website.