Internal Family Systems (IFS) Therapy for Adults with ADHD or Autism

Adults with ADHD or autism often arrive in therapy with a surprisingly complicated relationship with themselves. After years of being told they are too much, too sensitive, too disorganised, too intense, too rigid, too emotional, or simply not trying hard enough, it is not unusual for them to have developed a fairly harsh internal commentary about who they are and how they function.

This is one of the reasons I find Internal Family Systems (IFS) particularly helpful when working with neurodivergent adults. IFS doesn't require us to assume that the person's neurodevelopmental differences are the problem that needs fixing. Instead, it gives us a way of becoming curious about the different parts of a person that have developed around those differences and around the experiences they've had as a result of them.

ADHD and autism aren't schemas or "parts"

It's important to be clear about this from the outset. IFS isn't a treatment for ADHD or autism, and neither ADHD nor autism should be conceptualised as something that needs to be cured. They are neurodevelopmental differences, and good therapy shouldn't inadvertently become another place where a person is encouraged to become more acceptable to a world that has often struggled to understand them.

At the same time, being neurodivergent doesn't protect someone from psychological difficulties. In fact, repeatedly being misunderstood, criticised, excluded or compared with people whose brains work differently can leave quite a mark. An ADHD child who repeatedly forgets things, loses homework and struggles to organise themselves may eventually receive the message that they're lazy or irresponsible. An autistic child who finds social interaction exhausting or communicates differently may repeatedly be told that they're difficult, rude, strange or simply not trying hard enough.

Those experiences can become part of the person's psychological world, even though the underlying neurodevelopmental difference isn't itself a psychological problem.

This is where IFS becomes useful.

The parts that develop around the experience of being different

One of the central ideas in IFS is that we all have different "parts" of ourselves. These parts of self are essentially different aspects of our internal experience that can have their own emotions, beliefs, intentions and protective roles.

For an adult with ADHD, there might be a part that genuinely wants to be organised and on top of things, another that becomes overwhelmed when there are too many competing demands, and another that reaches for distraction whenever something feels difficult or boring. There may also be a very critical part that has become extremely good at pointing out every mistake: You did it again. You always do this. Why can't you just get your shit together?

The temptation in conventional psychological thinking can be to identify the procrastinating or avoidant behaviour as the problem and try to get rid of it. IFS encourages us to become curious about what that part is actually doing for the person. What is it protecting them from? What does it believe would happen if it didn't step in?

Sometimes the answer is surprisingly compassionate.

A part that appears to be "sabotaging" someone's productivity may actually be trying to protect them from the anxiety and shame associated with failing. A highly critical part may have learned that if it keeps pushing hard enough, perhaps the person can avoid disappointing other people. The behaviour may not be particularly helpful anymore, but it often makes considerably more sense once we understand where it came from and getting to know our parts is a powerful way to achieve this.

The inner critic can be particularly loud

Many adults with ADHD or autism have developed a remarkably sophisticated inner critic. It can sound like a stern schoolteacher, an exasperated parent, a disappointed partner or, occasionally, a particularly unpleasant amalgamation of all three.

"You're being lazy."

"You should be able to do this."

"Everyone else manages."

"Why can't you just act normally?"

If you've heard variations of those messages often enough, it's not surprising that some of them eventually become internalised.

One of the things I appreciate about IFS is that it doesn't require us to try to get rid of the critical part(s). Instead, we can become curious about them. Often, a critical part is actually trying to protect the person in the only way it has learned how: by pushing, criticising, anticipating failure or trying to prevent further rejection. That doesn't mean we have to agree with the critic. Understanding its intentions to try to help up and where it came from is different from surrendering to it.

IFS and masking

This becomes particularly interesting when working with autistic adults who have spent significant portions of their lives masking.

Masking can involve consciously or unconsciously adapting behaviour to fit social expectations. An autistic person may learn to carefully monitor their facial expressions, eye contact, tone of voice, conversational timing and body language because they've discovered, often through painful experience, that behaving "naturally" doesn't always lead to particularly pleasant consequences.

It would be easy to approach this by simply telling someone that masking is bad and that they should stop doing it. I'm not sure that's particularly helpful. Masking can be exhausting and can certainly contribute to distress, but it can also serve a protective function and, in some circumstances, may be a deliberate and perfectly reasonable social strategy.

IFS gives us another option. We can become curious about the part that masks and ask what it is trying to accomplish. Is it protecting the person from rejection? Is it trying to prevent conflict? Does it believe that other people will only accept the person if they perform a particular version of themselves?

The goal isn't to eliminate the masking part(s). It may be helping the person develop more choice about when they use it, rather than feeling that they have no alternative.

What sits underneath the protective parts?

IFS distinguishes between parts that are carrying vulnerable emotions and memories and the parts that have developed protective roles around them. For neurodivergent adults, this can provide an interesting way of understanding the relationship between their current difficulties and experiences from earlier in life.

An adult with ADHD who has spent years being criticised for being unreliable might have a part carrying a deep sense of shame: I'm a disappointment. Someone who experienced repeated social rejection might carry a part that believes, People don't really like me when they see who I actually am.

These beliefs can be remarkably persistent. A person can understand perfectly well, intellectually, that they are competent, loved and valued, while another part of them continues to expect rejection, hurt or failure.

IFS doesn't try to argue that part out of existence. Instead, it encourages the person to develop a different relationship with it. Rather than telling the vulnerable part that it's being irrational, we can become curious about what it experienced and what it still needs, ultimately helping the vulnerable part to heal and unburden the emotional wound it is carrying. For people who have spent much of their lives criticising themselves for struggling, that can be a fairly radical change.

Neurodivergence and trauma can overlap

This is also where I think some nuance is particularly important. Not every difficulty experienced by an autistic or ADHD person is a trauma response, and neurodivergence shouldn't automatically be interpreted through a trauma lens. At the same time, neurodivergent people can experience repeated bullying, exclusion, criticism, family conflict, relationship difficulties and chronic pressure to behave in ways that don't fit their natural way of functioning.

Sometimes there is significant developmental trauma as well. In those circumstances, it can become difficult to disentangle the person's underlying neurodevelopmental characteristics from the adaptations they've developed in response to their environment.

Someone may genuinely find social situations exhausting because they're autistic, for example, while also having developed a fear of social rejection because of years of being bullied. An adult with ADHD may genuinely struggle with executive functioning while simultaneously carrying considerable shame about what those difficulties have meant in their relationships and work.

It doesn't have to be one or the other.

ADHD is real. Autism is real. The protective adaptations (parts) are real, and so is the emotional pain that may have developed around them.

The importance of Self

At the centre of the IFS model is the concept of Self, which is associated with qualities such as curiosity, compassion, calmness, clarity and connection. For someone who has spent years relating to themselves primarily through criticism, masking and correction, developing access to this different internal presence can be enormously important.

Instead of immediately asking, How do I stop doing this?, we might ask, What's happening inside me right now? Instead of treating procrastination, emotional intensity or social withdrawal as evidence that something is wrong with the person, we can become curious about the different parts involved and what each one is trying to accomplish.

That doesn't mean abandoning the desire for change. In fact, IFS can sometimes make change easier because the person is no longer fighting themselves quite so hard. There is a significant difference between saying, I need to stop being like this because there's something wrong with me, and saying, I understand why this part of me developed, and I'd like to help it find a better way of doing its job.

Therapy shouldn't become another form of masking

Perhaps the most important consideration when working with neurodivergent adults is that therapy itself shouldn't become another environment in which the person feels required to perform.

The goal isn't to make someone "less autistic" or to make ADHD disappear. Nor should every difficulty be explained away as neurodivergence when there may be anxiety, depression, trauma, relationship difficulties or other psychological factors that deserve attention in their own right.

Instead, therapy can help a person disentangle several different questions: Who am I? How does my brain naturally work? What have I learned to do to survive? What am I actually struggling with? And what do I genuinely want to change?

Those questions can be surprisingly difficult to separate when you've spent a lifetime being told that your natural way of being is the problem.

Moving from self-judgement to curiosity

Perhaps the most useful thing IFS offers neurodivergent adults is a different way of understanding themselves.

Rather than Why am I like this?, the question becomes What's happening inside me right now? Rather than What's wrong with me?, it becomes What is this part trying to protect me from? And rather than Why can't I just be normal?, it becomes something closer to What would it be like to understand myself on my own terms?

That shift might sound subtle, but clinically it can be quite significant.

The aim of IFS isn't to get rid of the parts of ourselves that are inconvenient, emotional, anxious, avoidant or highly critical. It's to understand them well enough that they don't have to run the entire show and to help them unburden the protective roles they've learned.

For some neurodivergent adults, that can mean moving from a lifetime of trying to fix themselves towards something considerably more useful: developing a relationship with themselves that is curious, compassionate and, importantly, much less exhausting.

A note about the evidence

It is worth being careful about what we claim here. IFS has an emerging research base and is increasingly being investigated and used clinically, but research specifically examining IFS as an intervention for ADHD or autism remains limited. IFS should therefore not be presented as a treatment for ADHD or autism themselves.

Rather, IFS may provide a useful therapeutic framework for exploring some of the psychological experiences that can accompany neurodivergence, including shame, self-criticism, masking, relational difficulties, trauma and the protective strategies people develop over time.

As with any psychological therapy, the approach needs to be individualised. The person sitting in front of us is always more complicated—and considerably more interesting—than a diagnosis.