Continuing Education

Building Internal Safety and Connection: Trauma-Informed Stabilization Treatment Level 2

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.

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Course Details

The agenda for the pre-recorded portion of this course is below.

Pre-recorded Teaching Module 1: The Building Blocks of a Skilled TIST Therapist – 1 hour – 1 CE
The ‘building blocks’ of the TIST approach are necessary for success in using it. It can be stabilizing for clients to understand and apply the model to themselves, and it prepares clients for addressing the underlying wounds of the child parts at the appropriate time. In this module, we review the basic skills and describe the skills needed to help clients begin to listen to their parts and to give them a voice by speaking on their behalf. As we increase our ability as therapists to tune into the parts and resonate with them, we can also stimulate the client’s attunement to them and role model compassionate understanding. By becoming vocal advocates for the parts, we teach clients to relate to themselves like the ingenious, brave, resilient children they once were.

Learning Objective(s) for this module include:

Define the basic skills of TIST: mindfulness, naming signs of parts, identifying blending, and differentiating adult self from part
Describe techniques for helping clients attune to their parts
Identify ways of increasing self- and parts-compassion

Pre-recorded Teaching Module 2: The Art of Working with Protector Parts – 1.5 hours – 1.5 CEs
Without a way of working with protector parts, client and therapist often find themselves stuck therapeutically. Access to the wounded child parts requires building trust with parts that defend against emotion, vulnerability and even acknowledgement of the trauma. In TIST, we assume that all resistance, stuckness, and difficulties in collaboration reflect the protectors’ inherent distrust of and defenses against the therapist and therapy. Rather than trying to work around these parts, clients can be helped to appreciate and respect their roles in survival and their protective intentions, no matter how destructive the behavior. In this module, we will cover the steps and skills needed for clients to be able to validate the protectors, earn their trust, and negotiate agreements that support safety and stabilization.

Learning Objective(s) for this module include:

Detect signs and symptoms of protector parts and their defenses
Discuss the role of phobias of emotion and vulnerability in trauma treatment
Explain interventions that build trust and collaboration with protectors

Pre-recorded Teaching Module 3: The Do’s and Don’ts of TIST – 1 hour – 1 CE
Learning any new model requires simplification and constant repetition, especially when we are treating clients with C-PTSD. Having a structured guide to the use of TIST decreases the number of decisions the therapist must make and keeps the approach consistent. This module covers the simple “Do’s and Don’ts” of working with TIST-from what we should ‘always’ do to what we should ‘never’ do. Participants will learn to avoid certain therapeutic interventions and to consistently emphasize others. This module will help therapists to focus and prioritize their efforts so that the work is more effective. We will also discuss pacing so that clients can effectively move from overwhelming symptoms, emotions and beliefs of defectiveness to a more regulated, organized state in which they can appreciate their resilience and the parts that support that.

Learning Objective(s) for this module include:

Name the order of priority in using TIST interventions
Recite the steps of the NULAA protocol for clients
Differentiate signs of clients’ adult selves from signs of child parts

Pre-recorded Teaching Module 4: Challenges of Implementing the TIST Model w/DID Clients – 1.5 hours – 1.5 CEs
Clients with DID or Dissociative Identity Disorder pose a special set of challenges for the therapist. The independence of the different parts, losses of consciousness and time, the impulsive and self-destructive behavior of parts acting ‘behind the back’ of the client’s adult consciousness. In the therapy, parts of DID clients often ‘come out’ to make a relational connection to the therapist followed by other parts that push the therapist away or sabotage the therapy. Learning how to use TIST to navigate the additional complexities posed by DID symptoms is essential to the therapist’s skill set for working with these clients.

Learning Objective(s) for this module include:

Indicate the symptoms that differentiate DID from DDNOS or CPTSD
Summarize TIST interventions for time loss and dissociative fugue experiences
Describe three ways of addressing dissociative switching in the therapy hou

Pre-recorded Teaching Module 5: Working with Sadistic and Malevolent Trauma – 1.5 hours – 1.5 CEs
Many complex fragmented or dissociative clients come to therapy to deal with the effects of sadistic malevolent traumatic experiences, such as ritual abuse, satanic cult abuse, human trafficking, mind control practices, or other organized group traumas. These clients are generally highly symptomatic, more fragmented, and more easily overwhelmed by extreme parts adapted to extreme circumstances. Following these experiences, post-hypnotic suggestion and future threats stimulate anticipatory terror on top of immediate aftermath fears, instill beliefs that the victim is complicit and therefore ‘bad,’ and condition negative cognitions meant to keep the client compliant for years to come. The result is an extremely dysregulated nervous system, shattered self-esteem, and the potential for self-destructive behavior, including return to the cult or slave trafficking ring. Being able to help these clients requires therapist understanding of the nature and effects of these extreme experiences.

Learning Objective(s) for this module include:

Explain the traumatic impact of organized group abuse
Identify the complications in therapist countertransference posed by these clients
Evaluate the challenges of resolving traumatic memory for sadistic malevolent abuse

Pre-recorded Teaching Module 6: Resolution of Traumatic Memory – 1.5 hours – 1.5 CEs
The assumption that the goal of trauma treatment should be the processing of traumatic events has been unquestioned for many decades. Now, advances in our understanding of trauma have directed us toward a somewhat different goal: the resolution of implicit and explicit components of memory that continue to intrude on the client’s present experience. In TIST, treating implicit memory is seen as more important to the resolution of trauma than treating explicit memory. To further complicate the issue of addressing memory, fragmentation of the personality also results in fragmentation of implicit and explicit memory and increases internal conflicts between parts that block disclosure and parts that are desperate to tell someone. Each part anxiously anticipates a repetition of the past without any sense that ‘it’ is over. How do we help clients resolve the past when the past is still present for the parts?

Learning Objective(s) for this module include:

Name the most common challenges in successful memory work with fragmented, dissociative clients
Differentiate “memory repair” techniques from “memory processing” techniques
Identify the role of self-compassion in resolving traumatic memory

Module 1: The Building Blocks of a Skilled TIST Therapist
The ‘building blocks’ of the TIST approach are necessary for success in using it. It can be stabilizing for clients to understand and apply the model to themselves, and it prepares clients for addressing the underlying wounds of the child parts at the appropriate time. In this module, we review the basic skills and describe the skills needed to help clients begin to listen to their parts and to give them a voice by speaking on their behalf. As we increase our ability as therapists to tune into the parts and resonate with them, we can also stimulate the client’s attunement to them and role model compassionate understanding. By becoming vocal advocates for the parts, we teach clients to relate to themselves like the ingenious, brave, resilient children they once were. Module 2: The Art of Working with Protector Parts
Without a way of working with protector parts, client and therapist often find themselves stuck therapeutically. Access to the wounded child parts requires building trust with parts that defend against emotion, vulnerability and even acknowledgement of the trauma. In TIST, we assume that all resistance, stuckness, and difficulties in collaboration reflect the protectors’ inherent distrust of and defenses against the therapist and therapy. Rather than trying to work around these parts, clients can be helped to appreciate and respect their roles in survival and their protective intentions, no matter how destructive the behavior. In this module, we will cover the steps and skills needed for clients to be able to validate the protectors, earn their trust, and negotiate agreements that support safety and stabilization. Module 3: The Do’s and Don’ts of TIST
Learning any new model requires simplification and constant repetition, especially when we are treating clients with C-PTSD. Having a structured guide to the use of TIST decreases the number of decisions the therapist must make and keeps the approach consistent. This module covers the simple “Do’s and Don’ts” of working with TIST-from what we should ‘always’ do to what we should ‘never’ do. Participants will learn to avoid certain therapeutic interventions and to consistently emphasize others. This module will help therapists to focus and prioritize their efforts so that the work is more effective. We will also discuss pacing so that clients can effectively move from overwhelming symptoms, emotions and beliefs of defectiveness to a more regulated, organized state in which they can appreciate their resilience and the parts that support that. Module 4: Challenges of Implementing the TIST Model with DID Clients
|Clients with DID or Dissociative Identity Disorder pose a special set of challenges for the therapist. The independence of the different parts, losses of consciousness and time, the impulsive and self-destructive behavior of parts acting ‘behind the back’ of the client’s adult consciousness. In the therapy, parts of DID clients often ‘come out’ to make a relational connection to the therapist followed by other parts that push the therapist away or sabotage the therapy. Learning how to use TIST to navigate the additional complexities posed by DID symptoms is essential to the therapist’s skill set for working with these clients. Module 5: Extreme Cases: Ritual Abuse, Trafficking, Sadistic and Malevolent Abuse
Many complex fragmented or dissociative clients come to therapy to deal with the effects of sadistic malevolent traumatic experiences, such as ritual abuse, satanic cult abuse, human trafficking, mind control practices, or other organized group traumas. These clients are generally highly symptomatic, more fragmented, and more easily overwhelmed by extreme parts adapted to extreme circumstances. Following these experiences, post-hypnotic suggestion and future threats stimulate anticipatory terror on top of immediate aftermath fears, instill beliefs that the victim is complicit and therefore ‘bad,’ and condition negative cognitions meant to keep the client compliant for years to come. The result is an extremely dysregulated nervous system, shattered self-esteem, and the potential for self-destructive behavior, including return to the cult or slave trafficking ring. Being able to help these clients requires therapist understanding of the nature and effects of these extreme experiences. Module 6: Resolution of Traumatic Memory
The assumption that the goal of trauma treatment should be the processing of traumatic events has been unquestioned for many decades. Now, advances in our understanding of trauma have directed us toward a somewhat different goal: the resolution of implicit and explicit components of memory that continue to intrude on the client’s present experience. In TIST, treating implicit memory is seen as more important to the resolution of trauma than treating explicit memory. To further complicate the issue of addressing memory, fragmentation of the personality also results in fragmentation of implicit and explicit memory and increases internal conflicts between parts that block disclosure and parts that are desperate to tell someone. Each part anxiously anticipates a repetition of the past without any sense that ‘it’ is over. How do we help clients resolve the past when the past is still present for the parts?