Internal Family Systems and Chronic Pain

An Overview of IFS

IFS stands for Internal Family Systems, and it’s a model of therapy developed by Dr Richard Schwartz.  IFS is concerned with the “family” of different parts of yourself that live inside you, not with the people who form your external family. 

The main premises of the IFS model are:

  • Everyone has lots of different parts
  • Everyone also has a core Self (also known as Self energy)
  • All our parts have good intentions
  • Some parts get pushed into extreme roles as a response to stress or trauma
  • The more trauma we’ve experienced, the more extreme some of our parts will be
  • Our parts interact on the inside much like a family, with alliances, polarizations, and conflict

Your core Self is shown at the centre of the image. Self is not a part. It’s the YOU that isn’t a part.

The protective parts (managers and firefighters) protect the exiles who carry burdens and trauma.

The goals of IFS therapy are:

  • To liberate parts from extreme roles
  • To help unburden parts that carry trauma/pain
  • To restore trust in Self leadership
  • To achieve more balance in the system

All of these things will help to calm your nervous system, and can ultimately help to reduce or eliminate chronic symptoms and illness. 

The concept of ‘Self’

Self is extremely important in the IFS model, and a big goal of IFS therapy is to increase access and connection to ‘Self energy’ within the system.

  • Self is not a part.
  • Self is the YOU that isn’t a part.
  • We’re all born with a Self and it can never be destroyed.
  • Self is the main healing agent in the system.

The eight C qualities of Self
Self has the capacity for: compassion, curiosity, care, calm, clarity, courage, confidence and creativity.

 In a healthy system Self is like the conductor of the orchestra, and can be a kind caring leader for your parts. But if our protectors are very active they can block Self, like clouds blocking the sun. Then we can get caught in patterns of being driven by dominant and powerful protectors, who sometimes fight with one another for control (see polarizations), which then only increases our stress.

 One of the goals of IFS is to help all our parts to have a positive relationship with Self. The C qualities of Self mean that Self can appreciate and have compassion for even our most extreme and challenging protective parts.

Just noticing and naming parts when they show up can help us to access more Self energy. Other things that can help are things like meditation, mindfulness, breathwork, yoga… anything that helps calm your system can open more space inside.

Protectors #1: Managers

Managers are one of the two types of protectors in our system. They work tirelessly in a proactive way to keep us safe and functioning.

Their goals are:

  • To protect our exiles from being wounded again
  • To keep our exiles shut away to protect us from their overwhelming emotions, which the managers view as dangerous.

Their strategies often involve controlling us and keeping us in line or ‘on track’. Typical manager parts are: taskmasters, critics, parts that make us exercise, caretakers, parts that control what we eat, planners, organisers, judgemental parts, hypervigilance, pessimism, parts that use substances or behaviours to soothe, etc.

Many of these parts are actually very young and have been stuck in these roles since we were children

Our managers are a really important part of our system, and we definitely need them around. However, sometimes our managers take on extreme roles and this can be detrimental to our wellbeing. When this happens, they are often unappreciated for the work they do and they may be in conflict (polarized with) other parts in the system.

A goal of IFS therapy is for managers to recognise Self as the leader of the system so that they don’t have to carry on working as hard as they have in the past. In order for this to happen, the exiles that the managers protect might need to be unburdened. But we need the permission of the managers to do that.

Working with managers and gaining their trust is a very important part of IFS.

Many people with chronic pain have a lot of very active managers. Pain and symptoms themselves can be caused by manager parts. Hypervigilant parts can create muscle tension, and then the hypervigilance directed towards the body can cause this to be perceived as pain. Some managers might use pain or other symptoms, such as fatigue, as a proactive strategy to keep us from doing things that they think are dangerous.

Protectors #2: Firefighters

Firefighters are one of the two types of protectors in our system.

Where managers are proactive and work on prevention, firefighter are reactive. Think of them as the emergency responders who swoop in to save you when your system is at risk of overwhelm. When the proactive managers’ strategies aren’t enough, the firefighters rush in to try and save the day. Their only goal Is to protect you from overwhelming emotion or painful memories as quickly as possible, and at any cost! Firefighters act fast and are fiercely protective, and they can override managers’ attempts to control things.

Where managers are mostly about control, firefighter strategies often involve something that looks like a loss of control. For example: Extreme rage, substance abuse, bingeing, gambling, dissociation, self-harm, suicidal thoughts or actions.

Firefighters may sometimes use pain or symptoms as a reactive strategy to get us out of trouble – e.g. a sudden migraine or other extreme symptom that comes on suddenly and distracts us from emotional pain.

 Firefighter parts are often unpopular or feared in our systems because of the collateral damage they cause in their attempts to help us. They are also often unpopular in the wider system of our friends/family too.

 Firefighters are often in conflict with manager parts that use very different strategies to protect us.

 Just as with manager parts, our firefighters have our best interests at heart even if it doesn’t seem like it.



Unlike the protector parts, the exiles don’t have a job or a role in our system. The exiles are vulnerable parts that carry burdens and that need healing. They are often young ‘inner child’ parts, and are often stuck in a scene or memory from the past.

Typical burdens that our exiles hold are:
Feelings of shame, terror, guilt, hopelessness, powerlessness, isolation, or worthlessness.
Beliefs that we are unloveable or worthless.

The exiles are shut away in our system and guarded by the protectors. Managers work proactively to prevent the exiles from entering consciousness. Firefighters work reactively to shut the exiles away again if they break through.

The protectors work hard to keep the exiles out of consciousness for two reasons:

  • They’re trying to protect them from being hurt again.
  • They’re trying to protect our system from being overwhelmed by the burdens the exiles carry.

Exiles are desperate to be heard and cared for, but are cut off and shut away in the system so they are continually experiencing abandonment. When they’re triggered they can sometimes break through the managers and flood us with their strong emotions. The firefighters then swoop in with their more drastic strategies to shut the exiles out again.

Exiles may use pain or other symptoms as a way of communicating distress, like a cry for help.

Internal Conflict: Polarizations

Just as with external families, there may be conflict in our system within our internal family of parts.

A polarization is the term used in the IFS model to describe the situation when two parts (or clusters of parts) are working in very different ways to keep you safe, and are fighting over what’s best for you. Imagine two well-meaning parents fighting over a child… but that’s happening inside of you, and that conflict ultimately doesn’t help the child (or exile) that they’re trying to protect.

Some examples of common polarizations:

  • A part that wants you to go to the gym vs a part that says you don’t have time because you need to work.
  • A part that uses alcohol to numb anxiety vs a part that shames and berates you for drinking too much.
  • A vulnerable part that is desperate for love vs a manager that fears intimacy and keeps people away.
  • A part that creates pain or symptoms to force you to rest in response to parts that push you to do too much.

This type of internal conflict can cause a lot of stress in the system, and can be a contributing factor to chronic pain and other stress-related illness. It is common for parts that use or create pain to be polarized with other parts

When two warring parts realise they have a common goal (protection), they might be able to agree to collaborate instead of fighting. And typically once the exiles they protect have been helped and the wounds of the past have been healed, the protectors will be released from their extreme roles.

How can IFS help explain chronic pain and other symptoms?

 In IFS terms the typical TMS personality traits (as identified by Dr John Sarno) such as self-criticism, perfectionism, people pleasing etc, can be understood as powerful protective parts that have taken on these roles as a form of self-protection.

IFS is a beautiful, gentle way of exploring these protectors and finding out more about why they believe they have to do what they do.

In addition, many parts manifest in the body as physical sensation or symptoms. Parts can be involved in creating and perpetuating chronic pain and other chronic symptoms such as fatigue, dizziness, skin conditions etc.

Parts can create symptoms as a strategy. 
For example:

  • Pain or fatigue may protect us by keeping us out of situations they view as a threat.
  • A bad back may force us to rest if we push ourselves too hard.
  • A migraine might keep us away from people if we have social anxiety.

Some parts create pain as a by-product of their role.
For example: pain due to muscle tension from a hypervigilant manager.

Parts may also use pain to communicate distress.
So, an exiled part that’s desperate for redemption, love or attention may create pain as a cry for help. 

Parts that create pain are often involved in fierce polarizations.
Some common polarizations around pain and symptoms are:

  • Parts that cause symptoms as a response to people-pleasing or workaholic managers that push the person to neglect their own needs.
  • Parts that seek to numb, dissociate, or sleep in response to parts that create pain.
  • Parts that are desperate to fix the symptoms that react with extreme anxiety or frustration to symptom-producing parts.

As you pay attention to your parts, befriend them, listen to them, and help them, you promote healing in your system. As this happens, parts can be released from these extreme roles, and symptoms will reduce and/or go away completely.

What can you do to help yourself?

If working with an IFS practitioner isn’t possible for you, you can use the concepts explained here to support your own self-healing journey. You can explore and befriend your own parts through journalling or meditation (see links below).

Focus on a part you want to explore, ask them questions and allow the answers to come without thinking too hard. You can do this through meditation or by writing the answers down.

  • How long have you been doing this?
  • How are you trying to help me?
  • What are your intentions for me?
  • What’s it like for you to have this role?
  • Do you enjoy doing this?
  • What would you like to do instead?
  • What are you afraid would happen if you stopped doing what you do?

As you do this – notice how you feel towards the part. Try and engage with it from a place of curiosity and compassion. If you feel scared or it, or angry with it that will be coming from another part, so notice that and see whether that part will give you space so you can stay with the original one. If it won’t – take some time to explore the one that’s interrupted instead.

As we connect to these parts from our core Self, we can approach them with compassion and gratitude for their tireless work. When they feel appreciated, they will usually begin to soften.

Check out my resources for chronic pain