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Betsy Thurston

Dietitian and Eating Disorder Clinician, USA

Title: The triangle of shame-dieting-overeating in internal family systems (IFS) therapy: Teaching patients

Biography

Biography: Betsy Thurston

Abstract

IFS therapy originated by Richard Schwartz, PhD, provides a framework for patients to learn how to change their eating behaviors by recognizing and working with thought patterns. In the course of nutritional counseling sessions, typical behavior habits that can easily derail health goals are identified and categorized in terms of thought forms called "parts" that have specific helpful functions in the psyche. This model groups the pails into three primary categories that form the points in the triangle: Exiles that hold painful emotions, managers that prevent emotions from surfacing and firefighters that suppress the experience of feeling these painful emotions in the event that they flare up. The goal of this treatment modality is to help the patient identify puzzling and sabotaging behaviors, to recognize that the behaviors always function with the goal of protecting the psyche and to learn how to develop a healing and productive relationship between the patient and the parts. The exile thought forms generally manifests as a feeling of not being enough, either in terms of physical appearance or general feelings of unworthiness or unlovability. Because the psyche needs to avoid connecting with exiles it creates managing parts to take over and distract instead. These protective or managing pails might take any number of forms, including the dieter, the critic, the perfectionist the good girl or even anger or denial. When these protective parts get too invasive in the mind they often create enormous stress, which in turn will activate separate thought forms to combat the stress. This third category, the firefighter, is like an extreme protector to the psyche, acting impulsively and recklessly. When a patient is fully merged with a firefighter part they might eat compulsively or mindlessly. The deep emotional drive to numb stressful emotions will almost always trump the logical goal of restricting calories or of weight loss, as these goals do not mitigate the brain's immediate need to suppress danger. In the triangle, the exiled parts, the protective parts and the firefighting parts all feed into one other, creating a trap which is hard to exit. As neurons that fire together wire together, behaviors tend to lock into habits that are difficult to understand or to break. The goal of IFS therapy in my nutritional counseling sessions is to help patients identify and constructively work with the thoughts/parts that come into play when they are not able to successfully follow meal plans or practical nutrition guidelines. By recognizing that there is space between thought and action, patients can begin to work with their parts for healing and for improved results when given weight loss guidelines.