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by Marie Tierney
A couple of years ago during my Internal Family Systems (IFS) Level One training, I remember the trainer sharing his experience of using IFS online with clients and how well it worked. He explained that because clients turn their focus inwards, often with their eyes closed, doing IFS online was very similar to the in-person experience. I distinctly remember feeling uncomfortable and sceptical about the idea of working online, instead of in-person, which jarred with my experience as a relational and body psychotherapist. I believed that physical presence was required to work at relational depth, and therapy had to be delivered in-person.
Since that time, I have become increasingly comfortable working online, developing my skills and confidence as an IFS therapist in online groups including a practice triad with fellow trainees, and a supervision group. IFS is now my main way of working therapeutically, and I have integrated it into online and in-person practice.
Unexpected changes
My intention here is to share my experience and tips for working online gained as a member of a training team that suddenly had to shift online during the very first days of the Covid-19 lockdown, for the third and final week of a Level One training in IFS.
The emerging pandemic meant I was unable to join the training in person, an early portent of things to come. Writing this article is a way of speaking for the sad parts of myself which missed the bonding with the IFS training team, and for the anxious and fearful parts triggered by the lockdown.
In retrospect I can see that the initial shock of finding ourselves online due to Covid-19 triggered a survival response in the training team as we stepped up to the challenge. We all held our anxious and fearful parts, while high functioning manager parts took over and did an extraordinary job. The efforts and good humour displayed by everyone facilitated a wonderful week under challenging circumstances. Individually and collectively the training team modelled the ‘5 Ps’ of Self-led therapists – presence, patience, persistence, perspective, and playfulness.
The training, capably delivered by lead trainer Osnat Arbel, was safely steered through choppy waters as the very first IFS Level One training delivered (partly) online at short notice during a time of crisis. It could not have happened without the dedication and support provided by IFS UK training partners Nicola Hollings and Olivia Lester, and every member of the training team, whose commitment enabled participants to complete their training without interruption.
Internal Family Systems Therapy
Internal Family Systems was developed by Dr. Richard Schwartz over the past 30 years and has grown into a powerfully transformative, evidence-based model of integrative psychotherapy. Trained as a systemic family therapist, Richard Schwartz developed IFS while working with self-harming eating disordered clients who talked about their inner world in terms of parts. IFS combines systems thinking with multiplicity of personality, believing that inner parts contain valuable qualities and that the core Self knows how to heal, leading to integration and wholeness. Internally, the individual parts of a person interact with each other like members of a family would. Having inner parts and Self work together allows us to better lead our behaviours, relationships and lives. The metaphor of an orchestra can be helpful in conceptualising IFS; Self is the conductor whose job it is to listen to and lead all the different parts in harmony.
As a non-pathologising model, all parts are welcomed as having good intention. The key aspect that sets IFS apart from other ego state therapy models is the idea that at the core of each human being is a Self, the seat of consciousness. The Pixar movie Inside Out is an excellent representation of parts, as a young girl’s five personified emotions of joy, anger, fear, sadness and disgust compete to lead her through life. In addition to therapy with individuals, couples and groups, IFS is being used in such diverse environments as education, coaching, sports, and peace negotiations.
Encountering IFS
My introduction to IFS was through Bessel van der Kolk’s The Body Keeps the Score. Although initially wary of the corporate sounding Self-Leadership, I was soon hooked and completed the three levels of IFS training in the UK over a period of 18 months. IFS is an add-on to my work as a relational and body psychotherapist, grounded and informed by core training as a humanistic and integrative therapist in the biodynamic tradition.
My first experience as a training assistant was on the Level One IFS training in Sheffield in November 2019. Level One is a 15-day training, delivered in three blocks of five days. It was a privilege to be selected as an assistant, facilitating small group practice. I enjoyed helping others to learn the model while deepening my understanding of IFS. The training is deeply experiential with a ratio of one assistant for every three participants to facilitate daily practice in triads. Our training had 30 participants, 10 training assistants and one lead trainer. I loved the experience of travelling to Sheffield, leaving home and work behind as I cocooned myself in an IFS world, working as an assistant during the day, and socialising and debriefing with other assistants and participants in the evening after our day’s work was done.
Online IFS therapy
As mentioned above, IFS is ideally suited to online work as the focus is inner, and clients usually work with their eyes closed, guided by the therapist. IFS therapy sessions often start with a check-in to identify a part, followed by the invitation to ‘go inside’ or ‘go within’ in a spirit of mindful enquiry. As a compassionate model of psychotherapy, IFS locates the source of healing within the client, incorporating aspects of mindfulness practice. Clients take attachment inside as parts get to know Self and be known by Self, helping parts to release extreme beliefs and emotions. The therapeutic relationship is still key to building safety and trust, creating the safe container to guide and facilitate deep inner work.
After completion of Level One IFS training, I gained experience and confidence in working online from participation in two online groups, a practice triad with fellow trainees and a consultation group with a lead trainer, to support my development and growth as an IFS therapist. An IAHIP workshop I attended about working online was informative and reassuring. A listing in the IFS UK directory led to enquiries for online work and I started working online with clients in Summer 2019. I have now worked with clients from several different countries. Before the lockdown, 25% of my practice was online. At the time of writing, I see all my clients online.
Lockdown
On 10th March 2020, I packed my bag as usual the evening before my planned journey to Sheffield, looking forward with anticipation to being an assistant on the third week of training. Later that night, as I caught up with news about the rapidly evolving situation with the virus, I realised that there was a risk I might not be able to get back home if travel restrictions were implemented. Our lead trainer had already made the decision to deliver the training online from Tel-Aviv, due to Israeli restrictions. I made the difficult decision to stay at home and was immensely relieved to discover I could still join the training as an online training assistant as some participants were joining remotely. The online group grew each day as people gradually left Sheffield to return home.
Tips for providing training online
It’s truly amazing how fast things have changed since 10th March as Covid-19 restrictions have forced many therapists to work and train online. Here are some of the key insights that have helped me:
1. Connect
It’s vitally important to pay attention to enable the best possible connection. Online is different and it’s not ideal, but it is the best possible solution in current circumstances. Set the intention to be fully present with each other. Online is ideally suited to small groups and it worked great in practice groups of three and home groups of seven. It also worked well in other small group practices such as a demo and a question and answer session. In some ways small group experience can be even more intimate than in person.
There is less intimacy in large group experiences online and it can feel frustrating not to see everybody and to miss being able to ‘feel’ people in the large group. It can feel especially disconnecting to not hear what people are saying. More than anything, there is the missed opportunity to interact and bond with others in the in-between moments possible during in-person training, to connect with the felt sense of another’s presence and spirit. There is a loss of social time to hang out with others, to sit together and drink a cup of tea during breaks or eat lunch together. In this time of social distancing, it is important to focus on emotional connection and to look for meaningful moments to connect on screen.
I value the experiential nature and community of IFS trainings and it is possible to create this online in small groups but less so in the large group. My experience was echoed by a participant who e-mailed me to say “It was lovely to see you in Sheffield, yet frustrating, as I did not feel in contact.” I attempted to make contact with others by inviting people to approach the large screen to chat although I struggled to establish connection without the intimacy and privacy of physical presence.
2. Be flexible
Due to circumstances I was operating without a map to guide me as an online assistant. I had personal experience using Zoom with individual online clients, and as a participant in online practice and supervision groups, but had never hosted a group. I anxiously installed Zoom Pro the evening before the training started to allow me to host practice groups.
The advantage of being a pioneer is the opportunity to experiment with different tools to discover what works and what doesn’t. Because I wasn’t physically sitting beside the trainee therapist in practice group, it was more difficult to gently prompt the trainee until I discovered I could privately message the person using the chat facility on Zoom. Similar to in-person, it’s important to agree in advance how the trainee wants to be coached. One participant liked the chat facility, and one preferred not to use it.
Although phone use is not allowed in the room, as a training team we quickly discovered the value of using WhatsApp to communicate with each other. I did sometimes wonder how it appeared to participants to see me looking down at my phone.
3. Use technology well
Invest time and effort into getting your set-up right. It does make a difference. Use good lighting. Natural is best, but if necessary, use a light source in front of you. Don’t sit in front of a window or light source. Pay attention to your position on screen to ensure you are well framed at a good height, looking square at the camera, not down or up at it. Get the sound right, invest in a headset and webcam if necessary. Experiment and watch a webinar about how to work online if necessary.
Become familiar with Zoom by watching a tutorial. Take responsibility for hosting the meeting to ensure it starts on time. Expect inevitable delays as people come online to join the meeting room. Be aware that participants can see you and are observing you. If you need a break, step out, turn off your camera and sound. Be aware of boundaries and that you can be overheard by other participants even when they have their camera and sound off. Chat facility can allow private conversations and it may be important to turn off the chat facility when access is not necessary.
4. Control the controllables
The benefit of working from home is being able to spend time with family, to have one foot in the training ‘bubble’ and one foot at home. It’s important to create a buffer zone between home and work. It can be challenging to create and maintain boundaries e.g. I had a family member who needed support with panicky feelings due to Covid-19 which I had to attend to before returning to a team meeting at the end of a long day. It may help to create a formal ending ritual to mark the end of your workday, to shift your energy. This could be standing up to consciously stretch or shake your body in any way you like, or it could be changing your clothes or washing your hands and face.
5. Expect the unexpected
A participant got up and left the room three times during practice group. When I enquired what was happening, he told me a builder was calling to the front door. Another day, an oil delivery truck arrived at my house, and I had to close the blinds to avoid disturbance. It can be easy to become distracted, especially on the final day when you’re already home. If you’re moving around don’t forget to turn off the audio. I could be heard moving around the house putting out the rubbish while participants completed evaluation forms. I returned to several messages asking me to mute my sound!
6. Working online is hard on the body
It can be exhausting and intense, just like in-person training and even more so, staring at a screen and sitting in one position for extended periods without adequate breaks. It’s essential to schedule time for exercise and movement. I missed my morning and evening walks to the training venue, fresh air, and lunchtime movement space.
It’s important to take screen and stretch breaks every 30 to 60 minutes, to get up and walk around, to move, shake, take some deep breaths, or practice a little eye yoga by keeping your head still while looking at the 12 points of a clock with your eyes. Take advantage of any nature views inside or outside your office to help you regulate. I used the soothing green of the trees outside my window as a frequent re-set for my nervous system.
This is an excellent time to practice some of the tools that we often recommend to clients for rest and self-care. Connecting with another person or a pet or nature can be wonderfully restorative after a long day of sitting, helping to reduce stress and restore well-being.
7. Model Self presence and work with parts
Have access to support. It’s a good idea to consider pairing up with an online buddy and scheduling regular check-ins with each other. Be creative in how you respond to conflict online and how you might virtually look into another person’s eyes.
Consider scheduling a session with your therapist or supervisor to support and enable you to name and release your struggles and restore Self Leadership. Meeting my supervisor online and chatting with another assistant helped me to notice and name triggered parts that needed my attention. We are all digging a bit deeper in response to the present need and in so doing we are drawing out the best in ourselves and each other.
The ‘5 Ps’ of online training
Presence: Hold Self Energy for yourself, the group and the training team, same as in person. Pay attention to ‘staging’ your presence online. It’s important. Parts will come up. Pay attention to them. Speak for them. Ask for help and support even though it can be more challenging with physical distance. It is possible to connect online in community.
Patience: Things will go wrong. Expect it! Be kind with yourself and with others.
Perspective: Participants will trigger you. You will trigger them. Same with other assistants and trainers. It’s no different online and may be even more challenging as these dynamics can be more difficult to recognise and address. There is a sense of common purpose on a training which sustains differences and challenges.
Persistence: Every challenge is an opportunity for growth, every ‘tor-mentor’ a teacher. Stay open to moment by moment experience. Be open to things going differently than in-person. Be graceful under pressure.
Playfulness: Have fun. Laugh, move, sing. Be joyful. Even more important during an online training.
Conclusion
Working online is different to in-person training, with unique opportunities and challenges. Above all, it requires flexibility and the ability to adapt to changing circumstances as technology doesn’t always work as expected. Despite the physical distance there is a feeling of togetherness, of being focused on a common goal. It is possible to connect online in a training community.
Working as an assistant is a wonderful experience and opportunity to work with experienced trainers. It is truly awe-inspiring to accompany participants on a life changing journey as they encounter their own parts and learn how to support others in healing their protectors and vulnerable parts. It can be challenging to hold space for participants, and for yourself, noticing parts that get triggered. It’s important as an assistant, and especially when working remotely, to be able to access support and to have someone to check in with and debrief as needed.
Given a choice, I would opt for in-person therapy and training. I was looking forward to being a part of the training team for the first IFS training in Belfast scheduled for June 2020, unfortunately now postponed. While there are aspects to the lockdown which I am enjoying, such as slowing down and spending more time at home, I look forward to a time when we can once again gather together to connect in person.
Marie Tierney is an IAHIP accredited psychotherapist and Internal Family Systems therapist with a special interest in anxiety, stress, trauma and addiction. She can be found at www.marietierney.ie. |
References:
Dana, D. (2020, April 14). How to help our nervous system during a pandemic. Psychotherapy Networker.
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Dana, D. (2018). The Polyvagal Theory in Therapy. New York: Norton.
Docter, P. (Director). (2015). Inside Out [Film]. Pixar Animation Studios.
Ewens, H. (2020, April 2). Here’s everything I’ve learned about starting therapy at home. Vice. Retrieved from https://www.vice.com/en_au/article/jge9mb/online-video-phone-therapy-at-home-guide on 12/05/2020
Schwartz, R. (2009). Internal Family Systems Therapy. New York: Guilford Press.
van der Kolk, B. (2014). The Body Keeps the Score. New York: Viking.