Combining Medicine with Therapy
I have found that using medicines alone for the purpose of relieving symptoms can be quite helpful, but often yields limited and temporary results. Intentionally integrating medicine into the overall transformation that a client is wanting for themselves, however, can be life changing. As such, I choose to maximize my efforts by doing the latter, and prescribe only in close conjunction with therapy.
The Role of Medicine in Internal Family Systems Therapy: Reliable Access to Self
In IFS therapy, medicines are used not simply to suppress or relieve symptoms, but more importantly to help a client to get access to Self more reliably.
The therapy and self inquiry approaches that I use are intended to help clients to discover and gain deep respect for themselves and all aspects of who they are as living beings, so that self-transformation becomes natural. In the Internal Family Systems approach, one technique we train is called “unblending” or temporarily separating from our conditioned habits of thought and behavior and gaining new perspective on them, as well as ourselves and who we are apart from them.
As we become more unblended, we typically discover a state of being called “Self,” with positive qualities such as calmness, curiosity, compassion toward self and others, and creativity to name a few, which some clients had never even recognized in themselves up until this point. Accessing Self is fundamental in IFS, as Self is the state of mind from which healing and transformation takes place. It is also a wonderful place to function from in one’s day to day life.
Accessing Self is dependent on one’s ability to unblend from parts, yet some of parts, particularly parts that are deeply conditioned by trauma and/or partially mediated by one’s biology (severe depression, anxiety, bipolar mania, psychosis) can be very difficult to unblend from in order to gain perspective. In such cases, medicines, when used wisely, will help people to unblended from these parts and access Self, while also allowing some access to these parts in therapy so that longer term healing and integration of those parts can occur. This can allow for significant dose reductions. The usual goal would be optimal sense of wholeness and alignment in one’s life on as little medication as can be achieved at any given point.
Shared Decision Making
Since pharmacotherapy requires both the participation of the physician and the patient to be effective, we will make medication decisions together as a team. No medication is prescribed until we are both completely on-board. Medications will not be continued while we are not both completely on board. I will not press you into taking medication while you are still ambivalent, as I myself do not prescribe medication without careful consideration of risks and potential benefits. I am quite comfortable working with patients to help resolve their ambivalence and arrive at a decision that feels safe and comfortable to them. I believe in the patient's right and responsibility to educate themselves with regard to any substance they are ingesting, in addition to the physician's responsibility to provide education to the best of his/her ability.