Xuanxuan's Polarized Life | Internal Family Systems Therapy (3)

中文在文章后半部分

文章由作者秦小杰（心理咨询师，心理治疗师）用中文写作，后经deepseek翻译成英文，秉持：写作初心和来访咨询故事写作原则。本文中所涉及的个案分享，先发送给来访者，经其阅读后获取书面知情同意后发表。为最大限度保护来访者隐私，所有个人识别信息再进行深度匿名化处理，并已对部分非核心情节进行虚构改编。本文旨在分享心理学知识，任何案例均不具备唯一对应性，请勿对号入座。

本文为内在家庭系统治疗（IFS）文章系列的第三篇，您可点击下方阅读前两篇：

• 内在家庭系统治疗 (IFS) 简介

• 来访蕊芬：从黑暗到光明的意向转变

(Full article is available in Chinese in the latter part of this document)

This article was originally written in Chinese by Qin Xiaojie (Counselor and Psychotherapist), and later translated into English with DeepSeek, adhering to the author’s original intent and principles of writing about client stories. The case study presented in this article was shared with the client beforehand and published only after obtaining their written informed consent following their review. To maximize the protection of the client's privacy, all personally identifiable information has been thoroughly anonymized, and certain non-essential details have been fictitiously adapted. This article aims to share knowledge of psychology; no case is uniquely correspondent to any specific individual, and readers are advised not to identify with the content personally.

This article is the third installment in our series on Internal Family Systems Therapy. You can read the previous articles by clicking the titles below:

• The Gentle Intro | Internal Family System Therapy (1)

• Rose's Breakthrough | Internal Family Systems Therapy (2)

Author:  Qin Xiaojie

Time: 2025 Beijing

The Beginning: A Stiff Smile, A Shattered Inner World

On a summer day in 2020s, Xuanxuan walked into the counselling room in Beijing and sat down across from me.

Despite the severity of her depression, the corners of her mouth were still pulled upwards into a polite, yet heavy, smile—as if to spare me the full weight of her burden. But her body told a different story: her movements were stiff, like a marionettes, and her fingers trembled slightly between words, especially when she held a pen.

She was in the worst phase of her life. Depression had eroded her ability to function—she struggled with responsibilities at work and found it difficult to return after a holiday. By all external measures, she had an enviable career, and a lovely family. Yet, she was also a client experiencing mild to moderate suicidal ideation at that time.

Fortunately, she was already under the care of a psychiatrist and receiving regular psychotherapy from the Chinese hospitals. This medical support was the essential foundation that allowed our work together to begin. As her therapist, I understood the ethical necessity of this safety net; I could not ethically support a high-risk client without it.

The Aware Yet Wounded: A "Veteran" in Psychological Distress

Xuanxuan was no novice to psychological work. Before coming to me, she had two years of psychiatric treatment, had been on medication, and had participated in both individual and group therapy. These interventions had been vital.

She was fluent in the language of therapy, using terms like "regression" to describe her state and displaying clear insight into how her family of origin affected her. From her accounts, I gathered that previous therapists had likely employed psychodynamic approaches, focusing heavily on cognitive adjustment.

Around our one-year mark, she received a preliminary diagnosis from her doctor: Bipolar Disorder.

When she was functioning well, Xuanxuan was exceptional—meticulous and responsible at work, a devoted mother and wife who silently shouldered family financial pressures without complaint when needed, and a supportive figure for friends and even strangers. But during one session, using a visualization exercise, she described her inner world: "I feel like I'm carrying so much on my back that I'm already hunched over, yet I keep adding more." Her sense of responsibility, kindness, and drive came at the cost of profound self-depletion.

She was intellectually aware of how her perfectionism consumed her. Anxiety manifested in compulsive behaviors—repetitive cleaning and uncontrollable shopping sprees, especially during low moods, where she would buy things she didn't need, losing all sense of the monetary reality, completely disconnecting from the financial reality of her actions. She knew this compulsive spending was a maladaptive strategy to cope with emotional tsunamis, one that was eating away at the family's finances and threatening its stability. Yet the pattern remained stubbornly entrenched.

During depressive episodes, she became paralyzed. "I did nothing all weekend, just lay in bed, sleeping or scrolling on my phone," she'd say. "I don't want to see my children. I have no energy for them; their presence irritates me." Her world seemed muted, wrapped in a concerning "sense of separation." "When I walk on the street, I don't notice cars until they are very close," she described—a clear sign of derealization dissociation, the mind's way of insulating itself from unbearable pain.

This dissociative quality was palpable in our sessions. Even when recounting childhood domestic violence, her tone remained flat, as if narrating someone else's story. It reminded me of a client from my therapy group for survivors of domestic violence I had facilitated years ago (memories documented in A Snapshot of Project A’s Group Therapy | The Therapist’s View). That client had little memory of her childhood—a form of dissociative amnesia—until one session when she suddenly recalled being sexually abused as a child, recounting it with the same eerie calm.

What truly gripped me during those early days with Xuanxuan was one simple mindfulness exercise. I asked her to look out the window and tell me what she saw. Gazing outside, she said softly, "I see many people jumping from the building across the street." In that moment, I felt as if I were standing at the edge of a deep well, having accidentally dropped a stone and waiting an eternity for the faint echo from the depths. The well was deep—so deep it stole my breath. Beneath her calm surface a world shattered into pieces.

This is where we began. Our work would not be to dismiss the fragments, but to understand each one. The next article explores how IFS helped us listen to the voices within the shatters.

---

作者：秦小杰

时间：2025年北京

起点：僵硬的微笑，破碎的世界

北京几年前的一个夏日，旋旋第一次推开咨询室的门，坐在我面前。

尽管她抑郁已经非常严重，嘴角依然努力向上扬起，形成一个礼貌却沉重的微笑——似乎是不想让她的沉重压到我。可她的身体，却在无声地诉说着真实的内心：步伐僵硬，如同提线木偶；指尖在交谈间隙微微颤抖，尤其在握笔书写的时刻，格外明显。

那时的她，正处在生命中最糟糕的阶段。抑郁几乎吞噬了她全部的功能，部分工作职责无法承担，甚至在假期结束后难以返岗。她拥有一份旁人羡慕的工作，一段稳定的婚姻，可爱的孩子——可同时，她也是一个有着轻中度自杀意念的来访者。

值得庆幸的是，她已经在医院精神科接受药物治疗和定期的心理治疗。这是我们能够开始工作的安全基石。作为她的心理咨询师，我深知伦理边界：我无法独自承接高风险来访，医疗系统的治疗是我们工作的前提。

资深觉察者与沉默的伤痛

旋旋并非心理世界的初学者。在来到我这里之前，她已有两年的精神科就诊史，服用多种精神科药物，同时接受个体和团体心理治疗。这些早期干预成为了她生命的重要保障。

她对心理学术语如数家珍，言语间带着“退行”等心理专业词汇描述自己的状态，对原生家庭的影响也有清晰认知。听她的讲述，我推测之前的心理治疗师可能运用了精神分析等方法进行了大量的认知调整。

在我们工作满一年时，医院给出了初步诊断：“双相情感障碍”。

当她功能良好时，她是一名出色的职场人——细致、负责、有担当；也是一位无微不至的母亲和妻子，甚至在家庭经济困难时默默扛起生计重担、而毫无怨言；在朋友、甚至是陌生人需要帮助和支持时，她都会托举起他们。但我们在咨询中，用视觉化方式探索自我体验时，她这样描述：“我觉得自己背了很多东西，都已经驼背了，我还不停地往上放。”

这，是一种以过度消耗为代价的责任感、善良和努力。

她清楚自己的“完美主义”如何消耗着自己。无论是在工作还是育儿中，她都承受着的焦虑，并发展出一些强迫倾向的行为：反复拖地、无法自控的购物——尤其在情绪糟糕时，会购买大量不需要的东西，对金钱失去真实感知。她深知自己的疯狂购物行为是一种应对情绪海啸的无效策略，已经啃食家庭重要经济支柱，而可能最后摧毁这个家庭，但这个模式异常顽固，难以改变。

在抑郁发作期，她会陷入全面瘫痪。“这个周末我什么都没干，一直在床上躺着，睡觉，或者刷手机。”“我不想看到孩子，我没有一点力气为他们做事情，看到他们我感到烦躁。”同时，她的世界仿佛被静了音，存在一种令人担忧的“隔膜感”。“走在路上，汽车开到很近了我才感觉到。”—这是一种现实解体的解离体验，心灵在过度痛苦时为自己装上一层保护膜，让我们得以存活。

这种解离的状态，在我们的咨询中时有体现。即便讲述童年遭受的家庭暴力，她的语气也平静得像在诉说别人的故事，情绪仿佛被一层无形的薄膜隔绝。多年前，我带领家暴女性康复团体（咨询回忆收藏在了我当年写的这篇文章中：A Snapshot of Project A’s Group Therapy | The Therapist’s View）时的一位来访者——她对童年几乎毫无记忆（一种遗忘型解离)，直到某次咨询中突然回忆起年幼时遭受的性侵经历，而她叙述时，脸上也是这般不起波澜的平静。

跟璇璇一起的初期，让我心头一紧的，是一次简单的正念练习。我请她看看窗外，告诉我看到了什么。她凝视窗外，轻声说：”我看到很多人从对面楼上跳下来“。那一刻，我仿佛站在一口深井边缘，无意间投下一块石子，隔了许久才听见从极深处传来那一声微弱的回响——井很深，深得让我不由地屏住了呼吸。她平静的表面下，是一片从未被踏足过的支离破碎的废墟。

我们的工作就是从这里开始的。我们要做的不是选择放弃一些碎片，而是去深刻的理解每一片。下一篇文章，我会讲述我是如何开始逐渐使用“内在家庭系统治疗”，以及它如何在‘由上至下’的咨询流派边际效应递减为零时，显现出它超强的治愈优势的。