Addiction, Trauma and the Brain
Janina Fisher · Ph.D.
THIS PROGRAM HAS LIMITED APPROVAL FOR DISTANCE LEARNING CES. PLEASE CLICK ON THE SPECIFIC CE INFORMATION LINK BELOW FOR FULL PROFESSION/STATE DETAILS.
It is the participant’s responsibility to check if their state is approved for CEs. No refunds will be given on CE purchases for failure to check state approval. Please click on the Specific CE Information link below for more details.
Course Details
Janina Fisher, Ph.D. is a licensed Clinical Psychologist and Instructor at the Trauma Center, an outpatient clinic and research center founded by Bessel van der Kolk. Known for her expertise as both a therapist and consultant, she is also a past president of the New England Society for the Treatment of Trauma and Dissociation, an EMDR International Association Credit Provider, a faculty member of the Sensorimotor Psychotherapy Institute, and a former Instructor, Harvard Medical School. Dr. Fisher has been an invited speaker at the Cape Cod Institute, Harvard Medical School Conference Series, the EMDR International Association Annual Conference, University of Wisconsin, University of Westminster in London, the Psychotraumatology Institute of Europe, and the Esalen Institute. Dr. Fisher lectures and teaches nationally and internationally on topics related to the integration of research and treatment and how to introduce these newer trauma treatment paradigms in traditional therapeutic approaches.
Addiction, Trauma and the Brain
Childhood abuse and neglect leave a lasting imprint on the brain and nervous system. With a traumatized brain, the individual is left with little tolerance for emotion and limited ability to access good judgment. The result is heightened vulnerability to compulsive behavior and substance abuse as a desperate attempt to control emotional responses.
Research tells us that 40-70% of individuals in addiction recovery programs have histories of trauma. If we work with clients who have addictive disorders or with traumatized clients, it is imperative that we understand the effects of a traumatized brain on the ability to manage trauma responses and daily stress. Only integrative treatment approaches that address both the addiction and the trauma can adequately address these challenges.
Module 1: Neurobiological and emotional effects of early abuse in adulthoodModule 2: From Survival Strategy to Active Addiction
Module 3: Creating a path to sobriety or abstinence
Module 4: The challenges of sobriety
Module 5: Healing from addiction and trauma
Educational Goals
- Improved ability to treat traumatized clients with co-occurring addictive disorders
- Greater sophistication in trauma work
- Professional growth
with Janina Fisher, Ph.D.
Course Agenda
10 Hours = 10 CEs
Pre-recorded Zoom Session 1: Neurobiological and Emotional Effects of Early Abuse – 2 hours
Overview: Childhood abuse is not just a series of events. It occurs in a dangerous environment that threatens the child’s safety whether or not acts of abuse occur. The brain and nervous system respond instinctively to threat, and a threatening environment conditions the brain to perceive the world as unsafe. Survival responses are automatic and protective but continue to be stimulated long after the actual danger is over by traumatic reminders. Years afterward, the client’s nervous system responds to a safe environment just as it did to an unsafe world.
Session Content:
- Trauma and survival responses (15 minutes)
- Adaptation to an unsafe environment (20 minutes)
- Triggers and triggering: anticipating danger (15 minutes)
- Effects of a traumatized nervous system (15 minutes)
- The post-traumatic roller coaster (15 minutes)
- Addiction as a survival response (20 minutes)
- Question and Answer (20 minutes)
Overview: In the early stages, addictive behavior supports the ability to carry on with life and normal development. Unfortunately, the phenomenon of physical tolerance results in the need for increasing use of substances or addictive behavior to ward off intrusive memories or overwhelming emotions. Escalating risk to life and safety turn what was a survival strategy into a dangerous problem, but the fear of feeling overwhelmed is greater than the fear of the addiction.
Session Content:
- How compulsive behavior supports going on with life (15 minutes)
- The challenge of tolerance (15 minutes)
- Mutual escalation of trauma and addictive responses (15 minutes)
- Addiction and the prefrontal cortex (15 minutes)
- How different addictive behaviors regulate the nervous system (20 minutes)
- Trauma-related triggers (20 minutes)
- Question and Answer (20 minutes)
Overview: Initially, the addiction generates anxiety for the therapist and defensiveness in the client. The client may fail to retain information about the consequences of the addictive behavior or cannot access it at moments of desperation. It is a critical time for the therapeutic relationship. Therapists are tasked with managing their own anxiety so they can help clients become curious and interested in how addictive behaviors ‘treat’ or fail to treat their pain. We must help the client to see the connection between trauma triggers and addictive impulses, support them in being curious rather than defensive, tolerate their lack of anxiety, and increase their awareness rather than trying to change their behavior.
Session Content:
- What the therapist sees and the client does not (15 minutes)
- Making the connection between the trauma and addiction (20 minutes)
- Increasing client curiosity (15 minutes)
- “Boring the client into health” (20 minutes)
- Increasing the client’s awareness of risk (15 minutes)
- Being on the client’s side without enabling (15 minutes)
- Questions and Discussion (20 minutes)
Overview: Sobriety or abstinence bring a host of new challenges for traumatized individuals. The years of addiction have left their nervous systems with no tolerance for emotion and stress, leaving them unprepared for the increased activation of trauma responses and implicit memories. In sobriety, most clients notice an increase in anxiety, irritability, reactivity, and sometimes flashbacks and nightmares. Desperate for relief, they may begin having addictive impulses. Relapses are commonplace, but their consequences usually result in motivating another try at sobriety.
Session Content:
- Preparing the client for the challenges of sobriety (15 minutes)
- Developing a Window of Tolerance (15 minutes)
- Using The Abstinence-Relapse Cycle to Predict Crisis (20 minutes)
- Identifying signs of traumatic activation or implicit memory (20 minutes)
- Identifying signs of addictive impulse (15 minutes)
- Dealing with relapse and pre-relapse behavior (15 minutes)
- Questions and discussion (20 minutes)
Overview: Healing of both addiction and trauma requires self-compassion and self-forgiveness. Understanding the addictive behavior as a protector part trying to regulate emotion and the intense vulnerability as a communication from younger traumatized parts naturally elicits empathy. Being able to feel for and with all trauma-related parts, most clients naturally have an instinct to reach out, comfort or express gratitude. That process of relating with compassion and care to their traumatized parts is inherently healing.
Session Content:
- Trauma and dissociation: parts offer survival strategies, not just memories (20 minutes)
- How each part defends against threat (15 mins)
- Understanding addiction-related parts (15 minutes)
- Teaching clients to develop inner dialogues (15 minutes)
- Appreciating how each part helped the client survive (15 minutes)
- Negotiating new solutions for a safe world (20 minutes)
- Questions and discussion (20 minutes)
Addiction, Trauma and the Brain
with Janina Fisher, Ph.D.
Learning Objectives
Live Session 1:1. Summarize the brain’s responses to threat and danger
2. Describe symptoms indicative of sympathetic nervous system over-activation
3. Provide psychoeducation on trauma-related triggers and triggering
4. Articulate the role of compulsive and addictive behavior in managing nervous
system dysregulation Live Session 2:
1. Identify the effects of traumatic triggering on the functioning of the prefrontal cortex
2. Explicate the role of tolerance in the development of active addiction
3. Describe the different effects of anorexia, bulimia, self-harm, and substance
abuse on the nervous system
4. Identify signs of prefrontal inhibition Live Session 3:
1. Provide psychoeducation on the relationship between trauma and addiction
2. Facilitate increased curiosity and self-awareness in addicted clients
3. Implement 3 mindfulness-based techniques
4. Increase the client’s ability to observe the consequences of addiction Live Session 4:
1. Identify three challenges of sobriety or abstinence
2. Describe the Abstinence-Relapse Cycle
3. Identify 2 signs of increased PTSD symptoms
4. Identify 2 signs of increased addictive impulses Live Session 5:
1. Summarize the structural dissociation model
2. Describe manifestations of survival responses by parts
3. Increase the client’s ability for internal communication and dialogue
4. Evoke client compassion for trauma-related parts
For intermediate mental health professionals including Psychologists, Social Workers, LPCs, and LMFTs.
Continuing Education
This program offers limited Distance Learning CEs.
To receive Distance Learning/Home Study continuing education credit, applicants must complete all course materials, purchase the CEs, submit an evaluation form, and pass a post-test with a score of 80% or greater. It is the responsibility of the attendee to determine if the CE credit offered by Academy of Therapy Wisdom meets the regulations of their state licensing/certification board.
CostThere is a CE Processing Fee of $40 for the Distance Learning CEs, which will be available for purchase after the entire course has been completed. CONTINUING EDUCATION CREDITS OFFERED:
Psychology: Not offered for this training.
Counseling:
Academy of Therapy Wisdom has been approved by NBCC as an ApprovedContinuing Education Provider, ACEP No. 7370. Programs that do not qualify for NBCC credit are clearly identified. Academy of Therapy Wisdom is solely responsible for all aspects of the programs. This program is approved for 10 CE Credit hours.
Social Work: This program has been approved for 10 Distance Learning Social Work Continuing Education hours for relicensure, in accordance with 258 CMR. NASW-MA Chapter CE Approving Program, Authorization Number D92427-2.
Marriage/Family Therapy: See below for CAMFT information.
California Professionals:Academy of Therapy Wisdom, Provider #1032323, is approved by the California Association of Marriage and Family Therapists to sponsor continuing education for LMFTs, LCSWs, and LPCCs. Academy of Therapy Wisdom maintains responsibility for this program/course and its content. This course meets the qualifications for 10 hours of continuing education for LMFTs, LCSWs, LPCCs, as required by the California Board of Behavioral Sciences.
This course is $197. You can purchase it here.
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Cancellation Policy
We offer a 14-day money-back guarantee on all of our live & on-demand courses. If you find that the training is not right for you, please email us at support@therapywisdom.com within 14 days of your purchase. You can request a full refund or exchange, whichever you would prefer.
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CE Expiration Date
The Live CEs will be available until 60 days after the last live call (through January 30th, 2024).