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Presented by Rebecca Brumm, Chief Clinical Officer at Within Health
Eating disorder recovery is often complex, but it is possible with comprehensive and integrated treatment that addresses a patient’s unique needs. Because people with eating disorders tend to have fraught relationships with food, their bodies, and movement, most treatment or recovery plans include intuitive eating. Internal Family Systems (IFS) is a psychotherapeutic approach that can be used to deepen intuitive eating practice and enhance the recovery process.
Intuitive eating is a non-diet approach to food intake that involves listening to your body’s hunger and satiety cues and eating accordingly. Unlike diets, intuitive eating isn’t bound by rules—you can eat what you want and when you want, as long as you are tuning into your body’s signals. You are born with the ability to listen to your body’s needs, but the external rules that are forced upon us disrupt that connection.
With intuitive eating, you learn to trust that your body is wise and can effectively communicate its needs to you. It’s all about re-establishing that connection to yourself and your internal wisdom.
There are ten guiding principles of intuitive eating, including:
There is a large body of research revealing the benefits of intuitive eating. Higher scores on the Intuitive Eating Scale (IES-2) are associated with:1,2
Interoception refers to the ability to perceive physical sensations that arise from within your body. Intuitive eating relies on interoception since you must be attuned to your hunger and fullness in order to give your body the fuel it needs.
Interoception is associated with stronger mental health and facilitates a deeper connection to your body through awareness of the body’s needs, being able to accurately interpret those needs, and being responsive when sensing those needs.3
Internal Family Systems (IFS) is a model for psychotherapy that assumes people have many parts to them, with these parts consisting of the healthy self, exiles (wounded parts), and protectors, which aim to decrease vulnerability and protect us from pain. The various parts of a person are frequently in conflict with one another, and the person’s actualized self. The focus of IFS is to identify, address, and heal the painful and vulnerable parts of an individual and restore psychological balance.
The principles of IFS include:
Everyone has a healthy self, although, for some, it can be harder to tap into the self than for others. There are many layers, and sometimes it takes peeling through them to find the core self.
The healthy self doesn’t judge the other parts of the system but rather, seeks to understand them. According to IFS, all parts need to form a healthy, trusting, and nurturing relationship with the self—this is what’s known as being self-led.
Exiles are another part of the system. These are the young, painful, and shameful parts that can leave an individual feeling fragile and vulnerable as they carry unwanted emotions. These parts are referred to as “exiles” because they can feel like the oppressed or isolated parts of the system; however, they want to tell their story and be heard.
Protectors attempt to decrease vulnerability and contain exiles. There are two types of protectors: managers and firefighters. Managers run the day-to-day and attempt to reduce pain and protect vulnerable parts by controlling situations and relationships. Meanwhile, firefighters react to situations instead of attempting to prevent or control them. Firefighters react when exiles are activated in an effort to control or extinguish feelings. These parts are often responsible for impulsive behaviors and maladaptive coping mechanisms, such as disordered eating.
On the road to eating disorder recovery, intuitive eating and IFS complement each other immensely. Interoception is an incredibly important asset for both of these models so that you can get your biological, psychological, and emotional needs met. It also facilitates a deep trust in the mind and body as you learn to rely on yourself, encouraging you to become an expert on yourself.
In turn, IFS can also help understand and contextualize resistance to intuitive eating principles and assist in growth and healing. During the early stages of eating disorder recovery, if a patient experiences a big reaction to intuitive eating, it’s likely that a part has been activated. IFS seeks to understand that part and how it functions. Understanding how protector parts become activated by principles of intuitive eating can help increase compassion for the part, improve the process of reconnecting with the healthy self, facilitate growth and understanding, and provide reassurance to the activated part.
Taking an IFS approach to intuitive eating and activated parts can look like:
Protector parts are often activated through not wanting to get rid of the diet mentality. These protector parts hold various thoughts, feelings, and beliefs related to food, movement, the body, self-worth, and self-esteem that can make it difficult to heal your relationship with eating. Some examples of beliefs perpetuated by protector parts include:
Many people in eating disorder recovery experience grief when they let go of all the time, money, energy, and resources they’ve invested in dieting and disordered eating. That grief may look like an unhealthy mindset, such as “I can’t accept myself like this” or “I am not going to be the person I thought I’d be through dieting.”
It’s also important to consider the exile when thinking about intuitive eating. The exile parts may consist of shame, vulnerability, rejection, and unworthiness, and all of those feelings are what the protector parts seek to avoid and cope with.
There are various protector parts and coping thoughts, feelings, and beliefs associated with each of the ten intuitive eating principles.
For example, protector parts that might prevent you from honoring your hunger include:
It may be difficult to make peace with food because of the protector parts perpetuating old beliefs about what type of people and what types of food (e.g., “I am ‘good’ if I avoid carbs,” or “I can make up for ‘bad’ choices by exercising.’”)
Challenging the food police can be particularly hard for some people because protector parts may be saying:
Protector parts may also cause someone to react to the food police by swinging in the opposite direction and binging because they want to feel good for a change or because they want to numb the guilt they feel from managers.
Respecting your fullness can be challenging if your manager parts tell you it’s not safe to feel hungry or full or it’s not safe to feel connected to your body. Meanwhile, your firefighters may react by binging, restricting, disordered eating behaviors, and other means of distracting from inner sensations.
People in eating disorder recovery may struggle with discovering the satisfaction factor because protector parts may hold beliefs, such as:
The manager part may take pride or safety in being “needless,” which can make it difficult to connect with the satisfaction factor. Meanwhile, the firefighters may use eating as a justification to take a break or may cause someone to eat in secret.
Approaching emotions with kindness can be a particularly complicated principle to adopt because protector parts may encourage people to avoid emotions at all costs because they aren’t safe or because emotions are a sign of weakness.
Learning to respect your body in the context of intuitive eating may take time since your protector parts may perpetuate unhealthy beliefs like “I’m not worthy now, but if I change, I will be worthy.” Managers may tell you that only thin bodies are desirable or that life will be wonderful once you lose weight.
Disentangling from certain preconceived notions about exercise and movement can be challenging because manager parts might encourage exercise to undo “bad” behavior or insist that exercise will help control size and shape. They may also determine that only certain types of exercise “count” as exercise, as opposed to all movement being healthy and joyful.
The last principle of intuitive eating is honoring your health, and this can prove complicated when the protector parts swoop in and tell you that there isn’t time to honor your health, that you can’t be selfish, and that health only pertains to physical health.
Ultimately, Internal Family Systems can help patients not only identify and understand their many parts along with their functions but also learn to sit with the psychological dissonance that arises when several parts are in conflict. Awareness of these many parts is the first step toward challenging maladaptive beliefs and thought patterns, healing from trauma, and re-establishing a healthy relationship with eating and food.