Trauma-Informed Stabilization Treatment (TIST Level 1): Healing the Fragmented Selves of Trauma Survivors
Janina Fisher · Ph.D.
This program has limited approval for both LIVE and DISTANCE LEARNING CEs. PLEASE CLICK ON THE SPECIFIC CE INFORMATION LINK BELOW FOR FULL PROFESSION/STATE DETAILS.
- Session 1Apr 18, 20249-11am PDT2 CEs
- Session 2May 1, 20249-11am PDT2 CEs
- Session 3May 16, 20249-11am PDT2 CEs
- Session 4May 30, 20248-10am PDT2 CEs
- Session 5Jun 13, 20249-11am PDT2 CEs
- Session 6Jun 20, 20249-11am PDT2 CEs
For those who attend the live calls, this program has limited CE approval, on a per-session basis, for Live CEs for the following:
**YOU CAN ONLY EARN CES FOR THE CALLS YOU ATTENDED LIVE FOR THE ENTIRE 2 HOUR DURATION.**
** THE LIVE CEs EXPIRE ON 8/30/2024**
CE’s are included in the cost of the course.
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.
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/Recorded Live Sessions
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
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 2: Foundational Skills for Trauma-Informed Stabilization – 2 Hours – 2 CEs
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 3: Suicidality, Self-Harm, Addictions, and Eating Disorders – 1.5 Hours – 1.5 CEs
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 4: The Challenge of Traumatic Attachment 1.5 Hours – 1.5 CEs
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 5: Developing Internal Communication and Collaboration – 1.5 Hours – 1.5 CEs
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 6: Healing the Fragmented Selves of Our Clients – 1.5 hours – 1.5 CEs
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.
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
Overview – 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. Session Content:
• Structural Dissociation – the more trauma, the more splitting to avert future threats (15 mins)
• TIST = using the medial prefrontal cortex to ‘heal’ the parts (15 mins)
• Learning parts language as a second language (15 mins)
• “Speaking the language” of parts (15 mins)
• The challenge of vulnerable parts (15 mins)
• The challenge of protector parts (15 mins)
• Q & A (30 mins) Live Zoom Session 2 – May 1, 2024 – 9-11am PDT – Foundational Skills for Trauma-Informed Stabilization – 2 Hours – 2 CEs
Overview – 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. Session Content:
• Signs and Symptoms of Internal Struggles (15 mins)
• Heighten mindful awareness by using the “Language of Parts” (15 mins)
• What to say: the language of the parts (15 mins)
• How the Parts Dominate: “Blending” (15 mins)
• Mindful “Unblending”: Unblending is a two-step process (10 mins)
• A Protocol for Unblending (10 mins)
• The Importance of Unblending (10 mins)
• Q & A (30 mins) Live Zoom Session 3 – May 16, 2024 – 9-11am PDT – Suicidality, Self-Harm, Addictions, and Eating Disorders – 2 Hours – 2 CEs
Overview – 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. Session Content:
• Re-framing self-destructive behavior as a parts issue (15 mins)
• When clients get “highjacked” by an unsafe part (15 mins)
• Communicating with Protectors (15 mins)
• Allying with Protectors (15 mins)
• Key Negotiating Strategies (15 mins)
• Strengthening the Normal Life Part (15 mins)
• Q & A (30 mins) Live Zoom Session 4 – May 30, 2024 – 8-10am PDT – The Challenge of Traumatic Attachment – 2 Hours – 2 CEs
Overview – 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. Session Content:
• If the reactive impulsive nonverbal right brain is dominant (15 mins)
• If the client has a working PFC. (15 mins)
• If there is no working PFC (15 mins)
• How do we co-regulate fragmented, traumatized clients? (15 mins)
• Elements of co-regulation (15 mins)
• “Dyadic dancing” with clients (15 mins)
• Q & A (30 mins) Live Zoom Session 5 -June 13, 2024 – 9-11am PST – Developing Internal Communication and Collaboration – 2 Hours – 2 CEs
Overview – 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. Session Content:
• Internal communication (30 mins)
• Prioritizing relationships between the client and wounded parts (15 mins)
• “Direct access” work with parts (15 mins)
• Rupture and repair of internal attachment (10 mins)
• Attachment repair versus memory processing (10 mins)
• Resolving inner conflicts (10 mins)
• Q & A (30 mins) Live Zoom Session 6 – June 20, 2024 – 9-11am PDT – Healing the Fragmented Selves of Our Clients – 2 Hours – 2 CEs
Overview – In this last session, 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. Session Content:
• Our ability to help is contingent (15 mins)
• Diagnosing the causes of difficulty with clients who are stuck (30 mins)
• If the client’s non-verbal right brain and parts are dominant. . . (15 mins)
• Challenges of working with a system, not an individual (15 mins)
• De-coding treatment blocks (15 mins)
• Q & A (30 mins)
TIST Level 1 – Healing the Fragmented Selves of Trauma Survivors
Learning Objectives
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.
Describe a range of thinking, feeling and relating patterns in the lives of clients as a “living legacy” of trauma survival, thereby reducing shame, increasing self-compassion and communicating respect for the dignity and worth of each client, regardless of their circumstances.
Explain how to teach clients about fragmentation of neurological networks, each experienced as “I”, as a natural response to overwhelming experiences.
Explain how to list at least 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 to demonstrate 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.
Explain how regulation of a client’s nervous system state can support initiation of an internal dialogue with parts for purposes of making safe, stable functioning possible.
List traditionally underserved client populations, diagnoses or behavior patterns for which TIST may be an effective mode of treatment, (Inpatient, Borderline Personality Disorder, OCD, Anxiety, Depression, Suicidality, Substance Abuse, PTSD) as well as situations in which TIST might be contraindicated (lacking adequate support or self-regulation skills for keeping oneself safe between treatment sessions).
Identify two manifestations of fragmented parts of the self.
Describe 3 somatic interventions for regulating autonomic arousal and affect dysregulation.
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 invoking client empathy for wounded child parts.
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.
TIST Level 1 – Healing the Fragmented Selves of Trauma Survivors
Live Session Learning Objectives
Live Session 1
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.
Live Session 2
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.
Live Session 3
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 “highjacked” by an unsafe part.
Live Session 4
Integrate three components of “Dyadic Dancing” with clients so that they do not feel a loss of empathy when working with their parts.
List three somatic strategies the therapist can use to enhance the session.
Apply three elements of co-regulation during a session to enter a receptive, curious, open but attentive state.
Live Session 5
Apply three techniques for facilitating internal communication between clients and activated parts.
Explain the three phases of the Rupture and Repair of Internal Attachment cycle.
Explain the key difference between “attachment repair” versus “memory processing” as it pertains to IFS and Trauma-Informed Stabilization Treatment (TIST).
Live Session 6
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.
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At the conclusion of this course, an email will be sent with the instructions for obtaining the Distance Learning CEs. If you are applying for the 10.5 Distance Learning CEs, a post-test is also required.
CostCEs for this training are included in the cost of the course.
Continuing Education credits offered:
Psychology: Not offered for this training.
Counseling:
Distance Learning: 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 10.5 CE Credit hours.
Live: Academy of Therapy Wisdom has been approved by NBCC as an Approved Continuing 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 2 CE Credit hours for each live session for a possible total of 12 CE Credit Hours.
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Social Work:Distance Learning: This program has been approved for 10.5 Distance Learning Social Work Continuing Education hours for relicensure, in accordance with 258 CMR. NASW-MA Chapter CE Approving Program, Authorization Number D-92557
Live: This program has been approved for a possible total of 12 (2 CEs for each live session attended) Live Social Work Continuing Education hours for relicensure, in accordance with 258 CMR. NASW-MA Chapter CE Approving Program, Authorization Number D92555 1-6.
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Distance Learning: 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 10.5 hours of continuing education credit for LMFTs, LCSWs, LPCCs, as required by the California Board of Behavioral Sciences.
Live: 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 2 hours of continuing education credit per session for LMFTs, LCSWs, LPCCs, as required by the California Board of Behavioral Sciences.
New York Marriage and Family Therapists – Distance Learning and Live: EngagedMinds Continuing Education 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 marriage and family therapists #MFT-0117.
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