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

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.

Module One: Trauma and Self-Alienation – 1.5 hours

Live Session One – 2 hours

Module Two: Foundational Skills for Trauma-Informed Stabilization – 2hours

Live Session Two – 2 hours

Module Three: Suicidality, Self-Harm, Addictions, and Eating Disorders – 1.5 hours

Live Session Three – 2 hours

Module Four: The Challenge of Traumatic Attachment – 1.5 hours

Live Session Four – 2 hours

Module Five: Developing Internal Communication and Collaboration – 1.5 hours

Live Session Five – 2 hours

Module Six: Healing the Fragmented Selves of Our Clients – 2 hours

Live Session Six – 2 hours 

Module One: Trauma and Self-Alienation

Surviving trauma, especially when young, requires that we disown the abused, humiliated child and try to be a child who is too ‘good’ to be abused. The effects of disowning and rejecting ourselves to survive have lifelong consequences, resulting in personality or dissociative disorders, unsafe behavior, and tumultuous relationships, including the therapeutic one. In this module, we will look at a trauma model that addresses this important issue and how to help clients understand themselves with compassion rather than shame and self-judgment.

Module Two: Foundational Skills for Trauma-Informed Stabilization

Overcoming internal fragmentation and self-alienation require the ability to focus mindfully rather than ‘going with’ the flood of emotions and impulses survivors experience daily. Step-by-step instructions will help the therapist guide clients from impulsive actions and reactions to mindful awareness and increasing their ability to be “with” themselves.  Learning to relate to their intense distress as a communication from young traumatized parts changes their relationship to the strong emotions and tendencies to act out.

Module Three: Suicidality, Self-Harm, Addictions, and Eating Disorders

Research demonstrates the strong relationship between a history of trauma and the development of unsafe behavior, addictions, and eating disorders. This module focuses on how to help clients learn to relate to unsafe impulses as trauma responses driven by protector parts. Trauma-related cues in daily life stimulate fear and shame, driving fight and flight parts to desperate measures that bring short-term relief but recreate the unsafe environment of childhood. Understanding their intentions as protective often calms the system and allows clients to build the resources and skills they need to manage emotional overwhelm.

Module Four: The Challenge of Traumatic Attachment

Physical, emotional, and/or sexual trauma in childhood has a profound effect on attachment development, causing what researchers call ‘disorganized attachment.’ The child (and later adult) respond to the threatening environment with a heightened yearning for closeness and fear of abandonment alternating with fears of closeness and heightened mistrust. Separation anxiety alternates with pushing others away or fleeing from them. The intensity of these opposing drives is confusing and frightening for the client and often strains the therapeutic relationship. In this module, we will address how to deal with traumatic attachment as it complicates the treatment.

Module Five: Developing Internal Communication and Collaboration

The next challenge in the treatment is the development of internal collaboration between parts driven by conflicting survival responses. Self-destructive behavior is usually addressed behaviorally, but high relapse rates confirm the need to also treat the trauma and traumatized parts. Learning how to help clients change their relationship to unsafe thoughts and impulsive actions is a first step. Next, treatment requires an ability for internal dialogue and negotiation that results in increasing empathy for the parts and a willingness to deal with them creatively and compassionately. Safety becomes common ground where all parts can be welcomed.

Module Six: Healing the Fragmented Selves of Our Clients

In this last module, we will focus on helping clients ‘repair’ rather than remember the past in order to resolve the legacy of trauma borne by each part. As bonds of kindness and compassion are built internally, the parts’ intense reactivity diminishes, allowing clients to welcome home disowned parts and offer them a safe, loving internal environment. Rather than emphasizing ‘integration,’ this model focuses on internal collaboration and closeness and on the establishment of internal acceptance, forgiveness, and safety. The client’s ability to attach to each rejected, disowned part with warmth and loving-kindness becomes the healing antidote to the trauma.

At the conclusion of this program, participants will be better able to:

• Describe five or more biological and psychological effects of traumatic events
• Identify five or more signs and symptoms of fragmentation and internal conflict
• Describe the relationship between trauma and structural dissociation
• Demonstrate three or more techniques to clients to make sense of their trauma-related symptoms and inner experience
• Recite three or more techniques for decreasing phobias of emotion
• Recite three or more techniques for increasing curiosity and interest 
• Describe 3 somatic interventions for regulating autonomic arousal and affect dysregulation
• Identify two manifestations of fragmented parts of the self
• Explain the use of interpersonal neurobiology in the treatment
• Explain the use of social engagement techniques in the treatment 
• Describe two or more ways of evoking client empathy for wounded child parts
• Demonstrate to clients how to use internal dialogue techniques
• Describe three or more somatic techniques for resolving traumatic memory
• Describe three or more visualization techniques for resolving traumatic memory
• Describe three or more ego state techniques for resolving traumatic memory 
• Identify two or more interventions for increasing internal secure attachment
• Identify two or more interventions for increasing internal self-compassion   
• Describe the meaning of ‘integration’ in the treatment of splitting and fragmentation
• Describe three or more techniques for shifting from internal conflict to internal harmony in clinical session
• Identify three or more signs of disorganized attachment and traumatic transference
• Explain how to reframe self destructive behavior in treatment
• Describe three or more techniques for utilizing ‘parts language’ within treatment

Mental Health Professionals including Psychologists, Social Workers, LPCs, and LMFTs.

Accreditation Statement

In support of improving patient care, this activity has been planned and implemented by CME Outfitters, LLC and Authentic Presence CME Outfitters, LLC is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team. This hybrid (live and enduring) activity is awarded 22.50 CE credit hour(s)

Continuing Education (CE) credits for psychologists are provided through the co-sponsorship of the American Psychological Association (APA)Office of Continuing Education in Psychology (CEP).

As a Jointly Accredited Organization, CME Outfitters, LLC is approved to offer social work continuing education by the Association of Social Work Boards (ASWB) Approved Continuing Education (ACE) program. Organizations, not individual courses, are approved under this program. State and provincial regulatory boards have the final authority to determine whether an individual course may be accepted for continuing education credit. CME Outfitters, LLC maintains responsibility for this course. Social workers completing this course receive 22.50 continuing education credits

This course is $1497 or 3 payments of $527. You can purchase it here.

If you for some reason are not satisfied with the course, you have 7 days to request a cancellation and a refund. Please refer to the policy section for details on how to cancel.

Disclosure Declaration

It is the policy of CME Outfitters, LLC, to ensure independence, balance, objectivity, and scientific rigor and integrity in all of their CE activities. Faculty must disclose to the participants any relationships with commercial companies whose products or devices may be mentioned in faculty presentations, or with the commercial supporter of this CE activity. CME Outfitters, LLC, has evaluated, identified, and attempted to resolve any potential conflicts of interest through a rigorous content validation procedure, use of evidence-based data/research, and a multidisciplinary peer review process. The following information is for participant information only. It is not assumed that these relationships will have a negative impact on the presentations.

Janina Fisher, Ph.D., Martana Rybnicek, Brian Spielmann and Scott J. Hershman, MD, FACEHP, CHCP have nothing to disclose.

Disclosures were obtained from the CME Outfitters, LLC staff: No disclosures to report.

Faculty of this CE activity may include discussions of products or devices that are not currently labeled for use by the FDA. The faculty have been informed of their responsibility to disclose to the audience if they will be discussing off-label or investigational uses (any uses not approved by the FDA) of products or devices.

Unlabeled Use Disclosure

Faculty of this CME/CE activity may include discussions of products or devices that are not currently labeled for use by the FDA. The faculty have been informed of their responsibility to disclose to the audience if they will be discussing off-label or investigational uses (any uses not approved by the FDA) of products or devices. CME Outfitters, LLC, the faculty, and Sunovion do not endorse the use of any product outside of the FDA labeled indications. Medical professionals should not utilize the procedures, products, or diagnosis techniques discussed during this activity without evaluation of their patient for contraindications or dangers of use.