Trauma-Informed Stabilization Treatment (TIST Level 1): Healing the Fragmented Selves of Trauma Survivors

Janina Fisher, Ph.D. is a clinical psychologist, former instructor at Harvard Medical School, board member of the Trauma Research Institute, and a patron of the John Bowlby Centre, as well as an international expert on the treatment of trauma and dissociation. She is the author of Healing the Fragmented Selves of Trauma Survivors: Overcoming Self-Alienation (2017), Transforming the Living Legacy of Trauma: A Workbook for Survivors and Therapists (2021), and the Living Legacy Instructional Flip Chart (2022). Best known for her work on integrating newer neurobiologically-informed interventions into traditional psychotherapy approaches, she is the co-author with Pat Ogden of Sensorimotor Psychotherapy: Interventions for Attachment and Trauma (2015).

Childhood trauma, neglect, and failed attachment leave individuals with a legacy of overwhelming memories and emotions but also with a fragmented sense of self and a compromised nervous system that impairs the capacity to tolerate emotion or stress. Unaware that their intense feelings and reactions represent non-verbal implicit memories held by fragmented parts of the personality, these clients resort to desperate measures: addictive behavior and self-harm to numb the body or increase hyper-vigilance, suicidal ideation to restore a sense of control over painful emotions, dissociative and borderline responses of fight or flight when hurt, threatened, or rejected. Rather than offering a context for healing the effects of childhood trauma, therapy often becomes a crisis center whose goal it is simply to ensure the client’s safety.

The therapist is left with a quandary: how do we treat the underlying trauma when the client is unstable or unsafe, living from crisis to crisis, or caught in a revolving door of hospitals or treatment approaches? How do we acknowledge what has happened without opening up too much? The Trauma-Informed Stabilization Treatment (TIST) model was developed to provide some hopeful answers to these puzzling and frustrating challenges. Based on theoretical principles drawn from the neuroscience research on trauma, TIST offers a treatment approach that combines mindfulness-based cognitive therapy, Sensorimotor Psychotherapy, ego state techniques, and Internal Family Systems to address the challenges of treating clients with a wide range of diagnoses, including complex PTSD, borderline personality, bipolar disorder, addictive and eating disorders, and dissociative disorders.

Using a combination of didactic and experiential learning (demonstration, videotapes), participants will learn a new and promising model for treating trauma survivors that does justice to the traumatic past while stabilizing the ability to live a normal life here and now. When trauma symptoms are understood and treated neurobiologically as communications from young traumatized selves, even the most self-destructive, therapy-destructive, and de-stabilized clients become understandable and manageable.

Trauma-Informed Stabilization Treatment (TIST) Level 1
Pre-recorded Content
Agenda

The main points of the workshop are:

•  Understand the relationship between trauma and structural dissociation
•  Decoding crises and problems as internal struggles between parts
•  Learning various methods for increasing a client’s mindfulness of parts
•  Re-framing self-destructive behavior as a parts issue
•  Using the social engagement system
•  Developing the capacity for internal dialogue
•  Teaching internal communication skills

Module 1 Agenda:

• Trauma-Informed Stabilization Treatment (TIST): Healing The Fragmented Selves (9 min)
• A Neurobiologically-Informed Understanding Of Trauma (20 min)
• How Trauma Results in Self-Alienation (15 min)
• Trauma and Structural Dissociation (28 min)
• Learning to Notice Signs of the Parts (28 min)

Module 2 Agenda:

• Recruiting the Client (23 min)
• Differentiating Parts and Speaking “Their” Language (22 min)
• Increasing the Clients’ Mindfulness of Parts (28 min)
• Blending & Unblending (26 min)

Zoom Session 2 Recording – Foundational Skills for Trauma-Informed Stabilization – 2 Hours – 2 CEs

Module 3 Agenda:

• Decoding Crises and Problems as Internal Struggles (39 min)
• Positive Re-framing of Unsafe Behavior (23 min)
• Strengthening the Normal Life Part (21 min)
• Resourcing the Going On with Normal Life Part (31 min)

Module 4 Agenda:

• Disorganized Attachment (29 min)
• Disorganized Attachment and the Traumatic Transference (37 min)
• Right Brain to Right Brain Communication (22 min)
• Using the Social Engagement System (15 min)
• Fostering Client Attachment Parts (10 min)

Zoom Session 4 Recording – The Challenge of Traumatic Attachment – 2 Hours – 2 CEs

Module 5 Agenda:

• Teaching Internal Communication Skills (39 min)
• Internal Compassion and Soothing (19 min)
• Providing Reparative Experiences to Parts (29 min)
• Rupture and Repair of Internal Attachment (24 min)

Zoom Session 5 Recording – Developing Internal Communication and Collaboration – 2 Hours – 2 CEs

• Complications in Treatment (32 min)
• The Therapist’s Role (26 min)
• From Internal Conflict to Integration (24 min)
• A Healing Ending to the Story (6 min)

Zoom Session 6 Recording – Healing the Fragmented Selves of Our Clients – 2 Hours – 2 CEs

TIST Level 1 – Healing the Fragmented Selves of Trauma Survivors
Learning Objectives

• Identify two indicators of client fragmentation and internal conflict.
• Describe how to psychoeducate clients on the relationship between trauma and their internal experiences.
• Explain two methods to foster client curiosity and interest in their inner world.
• Recognize the three ways fragmented parts of the self can manifest in clients.
• Demonstrate the application of mindfulness skills to observe and describe internal parts.
• Utilize the language of parts to facilitate clients’ mindful awareness of their self-states.
• Identify two client defensive responses that contribute to unsafe behaviors.
• Explain the impact of trauma on addictive and self-destructive behaviors.
• Apply three mindfulness-based techniques to support clients in observing impulses without acting on them.
• Employ two internal dialogue techniques to aid in stabilizing clients engaging in unsafe behaviors.
• Define and differentiate one characteristic of disorganized attachment.
• Describe two distinct intervention strategies for addressing symptoms associated with disorganized attachment.
• Identify two intervention strategies aimed at fostering internal secure attachment in clients.
• Articulate the principles of interpersonal neurobiology and social engagement techniques relevant to trauma treatment.
• Describe one method for eliciting client empathy towards their wounded child parts.
• Educate clients on the application of internal dialogue techniques for self-understanding and regulation.
• Summarize two key elements of somatic, visualization, and ego state techniques in resolving traumatic memories.
• Explain the concept of a “disconfirming experience” in the context of trauma recovery.
• Identify two distinct intervention strategies that promote self-compassion in clients.
• Identify three or more signs of disorganized attachment and traumatic transference.
• Describe how to assist clients in validating their trauma-related parts and experiences.
• Articulate the meaning of ‘integration’ as it relates to the treatment of splitting and fragmentation.
• Identify (three) psychoeducational techniques for supporting clients to recognize and cultivate understanding of their own neurobiological responses to potentially traumatic events, including natural tendencies to attach for survival, to flee, to fight, to freeze and to submit.
• Differentiate between left brain-dominant and right brain-dominant responses to trauma and identify how structural dissociation manifests in individuals with varying levels of trauma.
• Name two defensive strategies employed by different parts of the personality in response to trauma and analyze how these strategies interact and trigger one another.
• Recognize three signs and symptoms of internal struggles in clients.
• Apply a two-step technique for unblending and fostering empathy for different parts of the self in clients, enabling them to differentiate between their own feelings and those of their parts, as well as fostering a compassionate understanding of internal struggles.
• Identify two reasons why unblending is so important when supporting your client.
• List three techniques for empowering clients to regulate their autonomic arousal in order to cultivate a nervous system state that is calm enough to support curiosity about their distressing experiences.
• Explain how the use of parts language may help trauma survivors to view distressing experiences in the present as communications from parts that have naturally evolved to sequester or to protect the client from becoming flooded by memories of those overwhelming experiences.
• Employ three coping techniques to use when clients get “hijacked” by an unsafe part.
• Integrate three components of “Dyadic Dancing” with clients so that they do not feel a loss of empathy when working with their parts.
• Explain the key difference between “attachment repair” versus “memory processing” as it pertains to IFS and Trauma-Informed Stabilization Treatment (TIST).
• Apply three diagnosing techniques to discover the causes difficulty with clients who are stuck and not progressing.
• Identify two personal biases in therapy sessions, fostering a client-centered approach focused on meeting the client’s needs rather than imposing therapeutic goals.
• Apply two strategies for de-coding treatment blocks when working with highly protective parts.

Intermediate mental health care practitioners.

To receive the 22.5 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.

Continuing Education credits offered:

Psychology: Not offered with this training.

Distance Learning:

NY State Mental Health Counselors: Academy of Therapy Wisdom is recognized by the New York State Education Department’s State Board for Mental Health Practitioners as an approved provider of continuing education for licensed mental health counselors. #MHC-0285.

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