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Janina Fisher Discusses Parts, Polyvagal Theory and TIST
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Trigger Warning: Please be advised, this episode contains dialogue about self-harm, abuse, and other sensitive topics. Please take care while listening and feel free to skip this episode if needed.
In this episode, Dr Janina Fisher joins Travis Goodman to unpack why traditional talk therapy often fails clients with complex trauma, chronic self-harm tendencies, and what methods can move them towards safety & healing.
Janina shares how studying with Judith Herman and working alongside Bessel van der Kolk shaped her view that people suffer because real things happened to them, not because of “personality defects.” She explains how Trauma-Informed Stabilization Treatment (TIST) grew out of her work in a state hospital with patients labelled “untreatable” who lived with constant crisis, self-hatred and unsafe behavior.
You will hear how TIST integrates parts work, structural dissociation, sensorimotor psychotherapy, Internal Family Systems, somatic therapy and Polyvagal Theory to create a practical, non-pathologizing way to work with suicidal parts, self-harm, eating disorders and dissociation.
Across the conversation we explore:
• Why many clients cannot use DBT or coping skills once the prefrontal cortex goes offline in a trauma response
• How to shift from “I want to die” to “there is a part of me that wants to die” and why that language changes impulse and shame
• Using visuals and simple somatic cues instead of complex language when clients are highly activated
• How polyvagal social engagement and co-regulation support parts work and attachment repair in-session
• What “gridlock” between parts looks like and how to help clients unblend and relate to their suicidal, ashamed and protective parts
• Why focusing only on “the event” misses the ongoing context of danger, neglect and not being seen
• How TIST offers a structured path for complex trauma, chronic suicidality and self-destructive behavior in real-world systems, including hospitals and community settings
We also talk about where Janina hopes the trauma field goes in the next decade: more trauma-informed therapists worldwide, less model tribalism, and Polyvagal Theory as a unifying lens that can plug into EMDR, IFS, somatic work and beyond.
This episode is for trauma therapists, coaches and survivors who want a clear, compassionate framework for working with extreme symptoms without pathologizing the person.
CONNECT WITH Polyvagal Institute:
WEB: www.polyvagalinstitute.org
Instagram: @polyvagalinstitute
LinkedIn: polyvagal-institute
Email: community@polyvagal.org
CONNECT WITH Travis Goodman:
Instagram: Travis.Goodman.LMFT
Recommended
Transcript
Introduction to Polyvagal Theory and Social Engagement
00:00:00
Speaker
This method is informed by by polyvagal theory because I'm always thinking about how do I facilitate the social engagement system. When my clients can socially engage with the parts, it's just, you know, when they have trouble with words, I just ask them to look kindly at the part.
Integrating Neuroscience in Trauma Healing
00:00:25
Speaker
Today's guest is Dr. Janina Fisher, a clinical psychologist and world renowned expert in trauma treatment. She has been at the forefront of integrating neuroscience attachment and somatic psychology into how we understand and heal trauma.
00:00:41
Speaker
For over four decades, Dr. Fisher has worked directly with survivors of complex trauma. She is best known for her work with the Sensory Motor Psychotherapy Institute and her groundbreaking book, Healing the Fragmented Cells of Trauma Survivors, which has become essential reading for trauma therapists around the world.
Trigger Warnings and Podcast Introduction
00:01:02
Speaker
Her approach is practical, compassionate, and deeply rooted in how trauma lives in the body. Whether you're a therapist, coach, or simply someone looking to better understand the impact of trauma, this conversation is going to offer grounded insights and real clarity.
00:01:18
Speaker
Please be advised, this episode contains dialogue about self-harm, abuse, and other sensitive topics. Please take care while listening and feel free to skip this episode if needed.
00:01:29
Speaker
Welcome to Wired for Connection, a Polyvagal Institute podcast. I am your host and my name is Travis Goodman. Welcome. Janina, I am so excited for you to be part of this dialogue on Wired for Connection here.
Dr. Fisher's Journey and Motivation
00:01:43
Speaker
um And just jumping right in, how did you land in just trauma work? How'd you get started with that? Well, if that goes back perhaps before you were born. and In 1989.
00:01:56
Speaker
oh I was born. i was born. I'll say that because the record. Yeah. 84, 1984. So five years. i was five. okay okay You were there, you just didn't hear it. um's true It's true. 1989, the first first year of my postdo no excuse me by pre-doctoral psychology internship, I heard Judith Herman speak.
00:02:21
Speaker
And she said, doesn't it make more sense that people suffer because real things happen to them than that they suffer because of infantile fantasies?
00:02:34
Speaker
And I thought, yeah, that makes perfect sense. And why is nobody talking about that? And that was my motivation. I just, in that moment, I decided that I wanted to be a trauma therapist at a time when there was very little that was known about trauma.
Evolution of Trauma Understanding
00:02:59
Speaker
There was very little in the way of a treatment. approach it was all you know It was all psychodynamic talking therapy.
00:03:11
Speaker
Dr. Judith Herman phrased that. I love that um framework, right? That real things. It sounds like that clicked. Like, oh yeah, that makes sense. it's It's real things happen. And the real things can be defined, I'm sure, in a myriad of ways of how the real things are defined.
00:03:30
Speaker
And I'm wondering for you and the work you're doing now, and and this may have shifted through your years of experience and and the expertise and time spent with clients and just speaking with experts around the world, but I'm wondering how do you define trauma now in your practice? How does that look for you? Great, great question. Because, you know, in 1989, nobody was using the word trauma.
00:03:54
Speaker
and And except for... um war veterans and sexual assault survivors. And so it took years before it was accepted that child sexual abuse was was traumatic.
00:04:12
Speaker
And then it took years after that for physical abuse to be considered traumatic. Then the same with domestic violence. It's just, you know, it's it's been years.
00:04:27
Speaker
I feel very blessed because not only did I have a chance to study under Judith Herman as her postdoctoral fellow, but then I went from her program um but which was one of the first trauma clinics in the country.
00:04:47
Speaker
I went from there to Bessel van der Kolk's clinic to be a supervisor. And I actually had a choice of being a supervisor for Harvard Medical School or a supervisor for Bessel's Trauma Center.
Shift from Psychodynamic to Somatic Therapy
00:05:03
Speaker
And I chose the trauma center just at the time that his body keeps the score research was happening. So that, you know, that led us to the body.
00:05:18
Speaker
Wow. Yeah, that's such an interesting, you know, fork in the road to go to Harvard and teach her Bessel's work. Out curiosity, what was the the the shift or the the choice of I'm choosing Bessel's work versus Harvard? Was there something inside that said a gut feeling or something that led to you? or I'm a trauma therapist.
00:05:39
Speaker
My mission is to improve the quality of trauma treatment. Harvard Medical School couldn't care less about trauma. It was, you know they wanted me to be a generic supervisor of psychologists.
00:05:51
Speaker
um And I had a chance to be at a trauma clinic. So that was a very easy choice. Yeah. At that clinic, a lot of the staff were doing EMDR.
00:06:06
Speaker
So that was 1995. So EMDR was really beginning to be popular. Bessel kept saying the body keeps the score. So we were all getting trained in various somatic therapies. I trained in sensory motor psychotherapy.
00:06:26
Speaker
Hmm. and And then I taught myself IFS in 1996 because I had a number of DID clients. So I had to find a way to talk about parts.
00:06:44
Speaker
And so I read Dick Schwartz's book, The Mosaic Mind, and I taught myself IFS long before there was any training available.
00:06:57
Speaker
Yeah, so it sounds like that's what shifted you from maybe more the traditional, a couple things I'm hearing that shifted from more psychodynamic talk therapy framework to more somatic parts work was one that this really, this wave of trauma definitions of things shifting and just the culture at large of now we're seeing things differently um and also Bessel's work and you engaging in something that you felt really aligned with with your heart, it sounds like, and your gut like this is,
00:07:27
Speaker
my mission and identify with your purpose and then seeing clients and saying, oh, I got to do something different and continuous. So this was the shift of real lived experiences is what I'm hearing.
00:07:39
Speaker
And as you know, you know, we learn from our clients, right? No matter how many methods we've studied, you they never work exactly right or exactly yeah as we were taught them.
Development of Trauma-Informed Parts Model
00:07:56
Speaker
I would agree 100% that I'm always, not always, but can ah regularly pivoting and having to adapt and shift. And I too have been deep diving into IFS as of late over the past year. And it really clients do are the greatest teacher of, okay, this isn't working in the way I think.
00:08:14
Speaker
Okay, what do i need and what do I need to do differently here? And I can fully relate with that as ah as a clinician. Yeah. And even ah even as a client myself, when I was a client and doing going through my own therapy of seeing how my therapist had to pivot based on me back um and what she had to use. So, you know, as I think about your work too of this – yeah how you've developed or part of this this trauma-informed stabilization treatment. Can you define what that is for us? I know that's been part of your work. this Yeah.
00:08:44
Speaker
And um so trauma-informed stabilization treatment is a trauma-informed parts model. Mm-hmm. that integrates um clinical interventions from IFS with somatic interventions from sensory motor psychotherapy with um hypnotic ego state interventions, a polyvagal state of mind. So the tenants of polyvagal theory and
00:09:19
Speaker
Unlike IFS, well, i I developed trauma-informed stabilization treatment at a state hospital in Connecticut, where the state of Connecticut decided to budget money for a trauma treatment approach that would be effective with their most suicidal high-risk clients.
00:09:47
Speaker
And was in 2012. I mean, it was amazing. They called me up and said, would you develop a treatment model for us? Wow. Like whoever gets that chance.
00:09:58
Speaker
yeah because they were desperate. They had a group ah of patients who could not be discharged, who had to be institutionalized because they were at such high risk.
00:10:14
Speaker
wow And the but our experimental group were consisted of 12 patients who had been institutionalized from two to 10 years.
Understanding Patient Distress Through Parts
00:10:28
Speaker
Wow. And they were all young adults. So the person who had been there for 10 years had been in the hospital since she was 15. Wow. So they called you up and said, we need help. And you took that opportunity.
00:10:44
Speaker
Yeah. And they also, these patients also attacked staff. So they they were aggressive toward their own bodies and aggressive toward the bodies of staff.
00:10:55
Speaker
Wow. And so i just drew on what I knew. um it made it was really clear to me that these patients had very, very suicidal parts and that they weren't being helped with DBT because they had parts.
00:11:16
Speaker
yeah Yeah, that makes sense. i've yeah I've done DBT groups for years, actually. And I don't do strict DBT. I pull i pull it i've pulled in polyvagal theory lens, I pull in trauma-informed lens, I pull in um parts work and kind of add it into the protocols. i mean Yeah, because I realized too, some more clients and patients, they need something more than just the skill, but which is important, yes, but there's often a piece that was missing. And so I'm like, I need to give them a little bit more here.
00:11:49
Speaker
And test them here what you did, yeah. Also, the biggest problem, I mean, I actually, I like DBT. um But the biggest problem with DBT is that it requires the ability to access to your prefrontal cortex.
00:12:06
Speaker
right And the early research, again, that's why it was so valuable to be a supervisor at Bessel-Landercoach's clinic, because we always got the research reports before they were written up.
00:12:22
Speaker
And yeah one of the first findings of the brain scan research on trauma was that when the subjects got traumatically activated, the prefrontal cortex shut down.
00:12:37
Speaker
yeah So, so yeah were you called it a part or a dorsal vagal response. They couldn't, they couldn't retrieve the information. Sure. Might have, they, I mean, I have clients who love GBT, but in a crisis, they couldn't access the skills.
00:13:00
Speaker
And that makes total sense from you know, from a trauma-informed lens. You're right. Cause they're, yeah, that PFC is offline. They're going to respond from their midbrain amygdala to survive. and You can't learn really. you can't really learn. You're right in that space. We need that PFC to adapt to think critically and learn and apply and make sense, right? Because if you're ah if you're activated, no matter what's – it could be the best tool in the world. It could be the but it could be the the perfect tool.
00:13:27
Speaker
However, if you can't receive that, the tool is useless. It's a useless tool. Exactly. and And for those that aren't clinicians, can you just, you know, those are listening that aren't like therapists or coaches, because we got an array of people listening. Can you in like plain language, just describe what trauma informed stabilization treatment is just in the most basic form?
00:13:47
Speaker
Yes. Yes. So it, it in trauma informed stabilization treatment, we help, we help clients to notice their distressing feelings and and unsafe impulses as parts.
00:14:08
Speaker
So so that they the client learns that instead of saying, I want to kill myself, I want to kill myself, I want to kill myself, which tends to increase the intensity of the impulses, they learn to say, there's a part of me that wants to die.
00:14:29
Speaker
Or there's a part of me that's hurt.
00:14:34
Speaker
And that hurt is triggering the part that wants to die or wants to kill me, as the case may be. this And of course, that idea came from IFS.
00:14:46
Speaker
yeah Right? yeah But the the theoretical model that this that the parts work was based on was not IFS. It was the structural dissociation model, which is the work of Anno Vanderhart, Ellert Nannhaus, and Kathy Steele.
00:15:08
Speaker
It's a trauma treatment model known throughout Europe and very well accepted. so So the parts are are understood as as not as holding memories, but as preparing to defend against the next and the next and the next attack or abuse.
00:15:36
Speaker
yeah Because we forget, you know, the field has been so focused on events that we forget that events occur in a context.
00:15:47
Speaker
The child who grows up in an abusive family has, you know, experiences events, terrible events, But they're just as unsafe on the days that nothing happens as on the days that something happens.
00:16:03
Speaker
Right? they still They still are afraid. They still are ashamed. They still feel hopeless. Yeah. in anticipation of whatever will come next.
00:16:19
Speaker
Because one thing they can be sure of, something is going to come next. They just don't know when or how often. right And so so the assumption in the structural dissociation model is that the parts are driven by the defensive responses we all have fight, flight, um fear, submission, also known as dorsal vagal,
00:16:53
Speaker
and cry for help. yeah And and so so we helped these clients to understand, to recognize their suicidal thoughts and impulses as a suicidal part, as the fight part, their shame and depression as the submit part, their yearning for somebody to care and do something and um and kind of be there as their cry for help part.
00:17:32
Speaker
And to, know, I think to the surprise of the staff, the patients in our testing test group got better.
00:17:44
Speaker
Some of them got dramatically better and were able to leave the hospital. Some got ah in god moderately better And were able to move into halfway houses. and one, the 10-year person failed out of the study because she attacked her therapist, assaulted her therapist. So that was a deal breaker.
00:18:15
Speaker
yeah out of the 12, 11 improved, who had not improved over years.
Changing Perspectives on Trauma Patients
00:18:23
Speaker
wow And so the state of Connecticut was happy and and they wanted a name for this treatment.
00:18:33
Speaker
And we couldn't call it parts. We couldn't call it dissociation, which is even a worse word than parts. So I said, let's call it trauma-informed stabilization treatment.
00:18:46
Speaker
And because the bureaucrats will like that title. right The legislature slateer who allocates money for mental health will like that.
00:19:00
Speaker
Yeah. Yeah. Yeah. No, that makes sense. I mean, and thank you. Sharing that story is, i love what you said is that events happen in a context. They're not in a vacuum, right? That we got to remember the context.
00:19:13
Speaker
Right. And from a trauma-informed lens, you could see why then, even if, the events aren't taking place, the painful, hurt hurting, you know, activating, threatening events, why we can still be on edge, hypervigilant, right? Because the body's job, and this is at the, I see the integration of polyvagal theory here is that the body is still trying and wired to survive. So has to, in a way, kind of has to stay in that space still, because it's used to anticipating what's coming next, how do I navigate, survive, etc. Whatever the means might be to survive, and any myriad of ways, fight, flight, shutdown, all those different ways the body found a way to to navigate it and why...
00:19:56
Speaker
we still can and and how we approach that. And so with this you know trauma-informed stabilization treatment um program, like what is the first, in your mind, the first or most important step in helping these people navigate towards healing?
00:20:13
Speaker
Well, but you know, what what we did, which... again, we were, you know, we were kind of flying by the seat of our pants because it was a treatment that had never existed before.
00:20:27
Speaker
So, so where, where we started was to, um meet with each person in the study and say, you know, you have been a mental patient for whatever number of years.
00:20:46
Speaker
Um, And we think that actually you should be treated as a trauma patient. i That that yeah part of what you're dealing with hasn't been addressed.
00:21:02
Speaker
And they were so grateful. saying I remember our first client, she she was like, I'm not a mental patient anymore.
00:21:13
Speaker
I'm a trauma patient. yeah And she felt like she had dignity and work instead of being locked up and at the bottom of the heap. that's so So that was very highly motivating for this group.
00:21:32
Speaker
And then we actually used my psychoeducational flip chart. the We brought it around and yeah and showed the structural dissociation theory to each of these patients.
00:21:48
Speaker
And we asked them, do these parts that we've just described, do they seem familiar to you? And about two-thirds of them said, oh yes, yes.
00:22:02
Speaker
very, very familiar. And then we could have a whole conversation like, which ones get triggered the most? Which ones are the biggest challenges for you?
00:22:14
Speaker
And so we were then having a conversation not about their problem behaviors. We were having a conversation about their parts.
00:22:25
Speaker
And then we asked them, would they be willing to assume that any, this this is an intervention I borrowed from IFS.
00:22:37
Speaker
Would they be willing to assume that any distressing thought, feeling, or physical reaction was a part? Hmm. Right now in IFS, you wouldn't say it that way. In IFS, you would say, you know, is this part curious, compassionate, calm, etc.
00:22:58
Speaker
But if you but that's an unwieldy question to be asking people frequently. So it seemed easier. yeah to have them notice distressing feelings and um and impulses.
00:23:17
Speaker
And some of them really got it right away. And I remember our first moment of success, a woman who had been, who had made so many suicide attempts, I can't even remember what the total was.
00:23:36
Speaker
now ah She had had self-harm to the point that she was scarred all over her body. She had assaulted several members of the staff And but she really got she really got the parts as she heard about them in the model.
00:23:59
Speaker
yeah And so very quickly she started reporting. I wanted to hurt myself so badly, but I just kept saying, that's the fight part.
00:24:12
Speaker
That's the fight part. I don't have to do what it wants. And she just repeated it to herself every time she felt the impulse and, and got through the whole day without harming herself for probably the first time.
00:24:30
Speaker
Yeah. Wow. So that, That was very, very encouraging. And her I actually know because once in a, probably once a year, ah she sends me a message on Facebook.
Language and Techniques in Trauma Therapy
00:24:47
Speaker
She, she's been living on her own in the community with her cat, who is her significant other. They're much safer than a human. You know, humans are tricky to be, to be in relationship to.
00:25:05
Speaker
Um, and, and she is holding her own. wow Every once in a while, her, her Facebook message usually is something like, I'm having trouble with an eating disorder. I'm having trouble with more impulses to self-harm.
00:25:25
Speaker
And I just, message her back and I say, be curious about the part that wants to restrict your eating. Be curious about this part that, you know, ask the self-harming part what it's worried about.
00:25:42
Speaker
Yeah. Right. Yeah. Yeah. And yeah that little bit of, of reminder kind of sets her straight again.
00:25:53
Speaker
Yeah. Well, going and just to what I heard, it was most profound, stood out to me as you were talking, so many things, but the first that stood out was this humanity that we called out humanity and the other, that it went from pathology to, you know, this is trauma and I'm a human. And so they, something spoke to them, like, I'm not this, this dysdiagnosis, but I'm dealing with a significant of trauma and my behaviors make sense given that you know, kind of all the modalities you're I'm seeing integrate together, polyvagal theory, IFS, other and the trauma-informed practices from Europe, <unk> like, oh, this makes sense. You're now giving language, which is shifting them to get out of that kind of how I see it, and correct me if I'm wrong, what kind of shame disconnected less than human self um to a human being who suffered tremendously and now has these behaviors that are protective parts trying to help them navigate that
00:26:48
Speaker
and anticipate preventing further pain, which is I think the beauty of IFS is that language it gives that these are trying to prevent and protect, which is non-pathologizing. And then the the nervous system polyvagal theory is also non-pathologizing because it's saying, hey, this is making sense that your body's wired to survive and it's doing its best to navigate with the tools that it has given your...
00:27:10
Speaker
your context or story that you found yourself in Yes, there's the events, but you can't separate events from story and context. If you do that, I always tell clients to work with, it's like if I only take an event or the symptoms, quote unquote, or behaviors, it's like flipping, opening a book, flipping somewhere three quarters of the way through and starting there and reading a paragraph about a character in the story,
00:27:35
Speaker
without knowing where they came from, but just judging them based on this one paragraph. Right. Or two paragraphs. While it may give me some information about this character in this moment, there's no story.
00:27:47
Speaker
There's no narrative. And when we know the story, the narrative, we can then understand why this might make sense. And it makes it human versus I'm less than human or subhuman.
00:28:00
Speaker
But you know, here's what's interesting. in In trauma-informed stabilization, we don't focus on events. At all. i mean, hardly.
00:28:10
Speaker
i am if Because it's all... It's really the goal of trauma-informed care is a is an attachment relationship between essentially the prefrontal cortex self and the parts.
00:28:32
Speaker
So that the parts, you know, I just did a session today with with a client who just had to put her dog to sleep. And she has many parts who are very sad.
00:28:45
Speaker
because they were very attached to this dog. She was sad, but interestingly, parts parts feel grief differently from from adults.
00:28:58
Speaker
And so the parts were feeling sad and scared because crying was dangerous in their world. Mm-hmm.
00:29:10
Speaker
And so in TIST, which is what we call trauma-informed stabilization treatment for short, in TIST, we help clients relate to what the part is feeling rather than what the part experienced.
00:29:28
Speaker
so So first, there is the noticing that the part is sad and scared. And then I ask clients, actually use this this hand technique where I say, notice the part that is feeling so sad and so scared.
00:29:48
Speaker
And then notice you noticing that part. So there's ah they're actually in relationship. Yeah. Rather than blended. Yeah.
00:30:00
Speaker
And then once and then once whence the client can feel themselves noticing the part instead of being the part.
00:30:17
Speaker
Then I ask them to stay because these parts have never had anybody stay. mean, they've never had anybody to recognize what they're feeling, right? So first they have this experience of they're feeling something and it's being recognized.
00:30:36
Speaker
Hmm. And then I ask clients to stay with that part. and And then when they can stay with the part, I ask them if they can care about how the part feels.
00:30:51
Speaker
And that's really ah a healing moment because these parts have never had anybody care about how they felt. yeah right So we never ask my client knows roughly she pretty much knows her story so she could say i know why they're scared to be sad i get it yeah and then i say yes so let the parts know that you totally understand it why they're scared to be sad yeah and yeah so it's all it's all about
00:31:32
Speaker
really what I think of as creating a healing relationship to these parts and providing them with what Bruce Ecker calls a reconsolidation approach, right? Where they have new experiences in place of the old yeah or actually side by side with the old.
00:31:59
Speaker
Yeah, and as I do that, this I like how you give that visual with the hands, like you know this part that's activated, this protective part, or the part that wants to self-harm or drink, whatever the thing is to protect. And you, can you notice that you're observing this? you know You're sitting and witnessing this, right? and Right, right.
00:32:15
Speaker
Sitting there, and that, i think my guess is, because I've done this clients too, sometimes that could take quite a bit of time to get to that place just to notice. Absolutely, you nailed it. right Right.
00:32:26
Speaker
It can take a very long time. yeah well And you know, there's, it's, it's, this method is informed by, by polyvagal theory, because I'm always thinking about how do I facilitate social engagement system, system the social engagement system.
00:32:49
Speaker
yeah When, when my clients can socially engage with the parts, It's just, you know, and when they have trouble, when they have trouble with words, I just ask them to look kindly at the part.
00:33:09
Speaker
Right? Yeah. Like the part just needs someone to notice them with kindness. Yeah.
00:33:20
Speaker
Right? Yeah. Right? can you Can you smile at that part? yeah Or well off what happens is they start to spontaneously smile. i mean, you can just see the the warm feelings that come up for the parts once once's they're not what's they not blended and activate it yeah and Yeah, and I think to your point, um I do ah similar something similar, that unblending can take time, and I think that social engagement system is so key. It's it's R in a way. I think of think Dr. Tina Bryson said this, or or I'm misquoting, so I'm sorry if I misquote this, but you know it's kind of like with children. Our children are borrowing our prefrontal cortex.
00:34:11
Speaker
Her and Dr. Dan Siegel's work, right, that they're borrowing that. In a way, I think clients... that are trauma, you know, highly traumatic events and stuck in trauma loops, in a way are borrowing social engagement grounded venture to polyvagal, like our grounded presence to witness them without judgment, in a way borrowing that from us initially
Focus on Context and Emotional Response in Trauma
00:34:31
Speaker
early on. Is that how you would see that too? Oh, absolutely.
00:34:34
Speaker
hey And I've said to my client from this morning, many times I've said, I've said, just channel me. Yeah. yeah I like that. Right? That's, that, cause that's, that is so important. And that's part of yeah what I teach the therapists who train in this model.
00:35:01
Speaker
Right? It's like, it's not about being a good technician. Right? Yeah. Right. It's about, you know, how do you, what employ the approach?
00:35:16
Speaker
in a way that does model what what the client can do to heal the parts. Yeah. Yeah. I think, a again, to your point, what you said earlier was they may not have been able to be witnessed or be with when they've been activated in a protective part or a survival state where they've been left.
00:35:41
Speaker
Right. by themselves or by the people around them in a way, they've been or hurt by that. And so makes sense why now they struggle with that, and that's the first step it sounds like, to learn to be with and to witness and to pay attention with curiosity. um And can I just sit here, and we are there too, or whoever's working with them is part of embodying that presence, which is that co-regulation, venture borrowing,
00:36:07
Speaker
And it sounds like as that first step begins to take place, then they have the capacity or they they build capacity with us alongside them to then be able to have that self-energy or whatever, you know, so many different wise mind, whatever word you want to call wise mind, self-energy, venture energy, whatever word to sit with and witness their own parts and notice and name, um to quote let Dr. Les Aria, right? Notice and name, um you know, and nurture what's happening here.
00:36:37
Speaker
um And so that's that first step for you too, is not so much talking about the events, because like you said, a lot of clients know the story, right? They know the logical, I know the events, I know this, and um It's almost like, you know I've heard it said many times, awareness doesn't change anything, right? Awareness itself doesn't change.
00:36:56
Speaker
Right, right, exactly. And the nice thing about about TIST is that it works with clients who have a lot of clear cut event memories and it works with clients who have no memory, which is really really fortunate.
00:37:16
Speaker
And yeah you know, the, the, the back to the whole issue of context, um, right. What we don't get when we, when we're working with event memory is the focus on the effects.
00:37:35
Speaker
So, so things like not being seen, not being recognized, not being, um you know,
00:37:46
Speaker
heard, those are all part of the trauma context, not necessarily part of the off event, but they're central to what our clients are left with, how it affects them.
00:38:03
Speaker
Well, that's where I see, I think the, and I'd love to hear your confirmation. I think you said this in not so many words, but the primacy or the importance of the social engagement system is that um they are seen.
00:38:19
Speaker
they are listened to, they are and in turn will lead to being soothed and feeling safe and secure, right? that i Because that's been, I think, the bigger wound in a way is that not so much the trauma itself. And I think even Dr. Gabramate said, right, it's not so much the event itself, but it's a story we tell ourself or, you know, um what's the narrative I bring up in my head of not so much the event, but what happens in the following, like who's there or not there, or what do I...
00:38:48
Speaker
How do I make sense of this in my own world? Right. Exactly. Right. um Was it my fault? Was it their fault? Was it because i was too stupid? I was too this. I was too that.
00:39:06
Speaker
Yeah. Yeah. Yeah. Which, again, which parts carry? yeah Big time. And they could carry it. They could be very powerful, too. Those parts are very strong. Someone can be very strong.
00:39:18
Speaker
And understandably so. Absolutely. Yes, ah absolutely. And I think it really helps that that's this approach was developed in a state hospital where the most extreme severe clients were our first our first guinea pigs yeah because i always i feel a sense of confidence even when working with very complex clients that you know that it will work and it just as you said it could take a long time
00:40:00
Speaker
Yeah, i I think for you know those understanding research and or understanding how it works, I think there is something to say working with some of the most complex, traumatized individuals because that's that's the hardest, right? Because there's a lot of, in that sense, probably the most protectors, the most defense mechanisms, right? Because they've, in a way, they've had to have so many...
00:40:25
Speaker
I think of a castle, right? They've had to had so many walls put up or trenches or, to you know, things in place to prevent further pain. And so it's like we have to work through so many more, you know, trenches, moats, walls, bridges, et cetera, to break it to the what's in the keep. what's What are they really protecting here inside that keep, right? The heart of the castle.
00:40:45
Speaker
And if you can do that, right, if we can help this work, this and get to this place or regardless of time. and I think sometimes time, people get stuck in time, at like and least in my experience, like, well, you know, time, they get ah fixated on time, which I also think is a protective part, but that's for a different conversation.
00:41:02
Speaker
um But, you know, I think you're right. I think it's important that we can see it work with some of the most difficult experiences cases and and that we also see the beauty and wow, these people have overcome tremendous tremendous, intense, like what they have gone through is also, I think speaks to the resilience of the resiliency of humanity and that being witnessed by another human, which is really a lot of the work that you and your team were doing is we are a grounded presence, really showing love and care and sitting with and being that, know,
00:41:37
Speaker
The co-regulatory, you know, everything that they really need to be seen, soothe secure, which is that human connection more than anything else, which opened the door. And not for all of them, like you said, sometimes people still get stuck for whatever reason. Right.
00:41:54
Speaker
And that is, I think, something to note too, that that's where we can't control it. I can't fix that. I can't change that. I could just show up in a way I could just continue to show up trusting the process, but knowing that I can't necessarily impose someone to change or get better or choose this.
Therapeutic Techniques for Complex Trauma
00:42:10
Speaker
I could just say I'm here.
00:42:12
Speaker
But you know, right I think that most of those step points come because there are parts in the in conflict.
00:42:23
Speaker
So I call it gridlock. you know but When pirates are kind of in this exquisite tug of war, and so and yeah less the client can notice it rather than participate in it, we're kind stuck. I love that.
00:42:43
Speaker
Well, and here's a great question, just because you said it, and um you know and we'll close out after this and and wrap up, but when what's something that you lean on or a quick intervention or two that you found successful when you do see a client in gridlock, like that either someone either clinician listening could help or maybe a client could use on themselves? What's something like, ooh, this tends to be helpful for them getting out of gridlock?
00:43:08
Speaker
Yeah. You know, i i love I love to use, this actually comes um as a result of my somatic training because words are harder to process yeah for people having trauma responses.
00:43:24
Speaker
It was so good. I think people need to hear that more. I think that words are hard to process when you're activated by a trauma response. You're right. I think we forget that sometimes, right? Yeah. Yeah. Wow. oh so And I have, I've spent years talking to people who couldn't process what I was saying.
00:43:41
Speaker
So I use, I use this to represent blending, right. As opposed to unblending, right. You know, or I can say, you know, you, your parts are at loggerheads.
00:43:57
Speaker
I, I even developed a hand gesture for self because I had a client who had had 10 years of IFS before she started seeing me.
00:44:08
Speaker
So, and she thought, she said, you know, if self is a part and my parts are scared of self, I said, oh no, on the contrary, self is a place in your brain.
00:44:22
Speaker
oh It gives you a wide angle lens. So this became our symbol for self because, and said the parts were not scared.
00:44:34
Speaker
As long as self was part of the brain, that was okay. yeah Yeah, the visual, I think I too sometimes forget that personally as well, that and a gentle reminder for all of us that if we're highly activated, of course words are harder, or to even process language, right? Because that takes a higher level of functioning or a higher level of power to... And if we're activated, we're in survival state. So words are like, pfft, what do you mean...
00:45:06
Speaker
you know if anything were And I've seen this too. Sometimes words activate parts more, protective parts more. In a way, they can I've seen it being used as more fuel to the fuel to the fire, so to speak. They'll take that and turn it against themselves. Like, well, look, so you can't even do what Travis is saying.
00:45:23
Speaker
oh You can't even do the basics, right? Well, look at you, right? so Right. yeah I had a client with a big, super judgmental fight part.
00:45:33
Speaker
yeah Who kept saying to the client, you can't even do therapy. right Yeah. ah well yeah Here's another visual. I often use my phone because it's always, notice the part and notice you.
00:45:54
Speaker
I like that. Yeah. Yeah. I think it's so important. to and um It's a reminder even for me as i as I'm talking with you, of like I need to use visuals more frequently um because it is. It's so true that we forget that there's other ways of tuning into this process when words or language or no matter how helpful it might be that sometimes a visual just makes the difference of like, am I here? you know am i Can I notice this part and notice myself here? And can I see this and name it and just see it or the phone? And and that's a great, simple, accessible intervention.
00:46:36
Speaker
And as I think about our time, I'm wondering, you know, one more question, is if you don't mind, is, you know, just to pivot a little bit, is over the, you know, with all the work and all the shifting you've seen, um from you know working with Dr. Judith Herman and Bessel and and all just and all your work too with how trauma has shifted over the years, where do you see like where you see it going the next five, 10, 15 years?
Future of Trauma Therapy Models
00:47:03
Speaker
like what What would you envision it? What would you like to see?
00:47:06
Speaker
um Well, you know actually, what what I would like to see yes is so basic and simple. I would like to see more therapists worldwide really understand trauma because so many of the therapists who are in my audiences or who are in my trainings, they still think that if they can get the client to talk about the events, that will cure them.
00:47:41
Speaker
And so it's like all the work that we've done in the field has not caught up to what I call Jane Schmo average therapist or even, you know, the average client.
00:47:56
Speaker
or potential client. yes frank It's information that's so valuable. And it's not because people like me and Gabor and others haven't been trying.
00:48:10
Speaker
But you know yeah um I think, and also, if I could have all my wishes come true. Yes, that's what I mean. yeah Absolutely. where I'll find my wand.
00:48:22
Speaker
Got it. Okay, great. I would love for the different models to be less siloed because there is so much You know, if you're an EMDR therapist, that is the one, the only and the best.
00:48:40
Speaker
If you're an IFS therapist, that's the one, the only and the best. And it's like, no, trauma is complex. Survivors are complex and they need help.
00:48:53
Speaker
They need a variety of models. And that's where polyvagal theory is so helpful because it can be it can be a way of thinking that's used in any model.
00:49:08
Speaker
Right. It's not so siloed.
00:49:12
Speaker
And I thank you for that wisdom. um In this case, I will say Dr. Fisher in that sense. And Janina to both of you, to all of you. Okay, perfect.
00:49:24
Speaker
Is to all of you. Is that I wholeheartedly resonate with that. that um And I think... A major reason why I have continued my work with the Institute, the Polyvagal Institute, is because of the vision of Dr. Porges as a unifier.
00:49:40
Speaker
Right. That it isn't about one thing. It's not about the silo, but it's about an integrative human connection. Like, how do we work, actually genuinely work together to understand? Right. so Learn from each other's strengths, knowing that it isn't one person, one man, one woman to solve it all, but we really need all of us. right And that's how I work too, is I really firmly believe that it really requires its relation.
00:50:09
Speaker
It has to be relational. And it's not about me versus them them because that just creates more. In my view, creates more trauma, makes more pain. um And so i love that you said that. I'm so thank you for saying that. And again, that's why I continue working with the Institute is because that's their the heartbeat of their vision. Right.
00:50:29
Speaker
um And so i I love backing and being part of organizations and people that have that same vision because that's what how I see, again, the world healing is really this unification and relationship and working together, not against that we all have something unique to offer. um Because like like you said beautifully, because big our clients are multidimensional. They really are. They require...
00:50:52
Speaker
It's more than just a, you know, a Phillips screwdriver, right? Or a hammer. We need multiple tools. And at the primacy of that is our relationship, is our connection at the end of the day.
00:51:03
Speaker
Because ah again, tools without connection is meaningless too. I mean, at the end of the day, I could give all the right interventions, but without...
Conclusion and Contact Information
00:51:09
Speaker
Safety and connection, it's going to fall flat. um Absolutely. and So as we wrap up, if people, if clients or therapists or coaches want to find your work, if they would love to even learn the TIST, where would we find you? Where should we go?
00:51:26
Speaker
um You can find me at janinafisher.com. Mm-hmm. that's the best place That's the easiest place.
00:51:36
Speaker
and And I'm very excited because this year, in the last two months, um we began a training for French therapists in TIST, a training for German therapists in TIST,
00:51:55
Speaker
We've done a South American training for South American therapists, and we've been doing trainings for Italian therapists for several years.
00:52:06
Speaker
and And not to mention our sort of home in the English trainings. Wow. um Wow. That's phenomenal. It's very cool.
00:52:18
Speaker
I'm sure for you to see too, like exciting. Oh, it's very exciting. It's very exciting. And that's that's amazing. And I hope too that more people get their hands on it.
00:52:30
Speaker
Yeah. So if you're those that are listening, the link will be in the description to to click on that. And so I thank you so much for your time today and blessings to all the work that you're doing and will continue to do.
00:52:42
Speaker
So thank you. Thank you. Thank you. And thank you Thank you because you bring so much together. Thanks. Well, ah have a great rest of your day Thank you.
00:52:57
Speaker
Thank you for listening to Wired For Connection, a polyvagal podcast. This show is produced by the Polyvagal Institute, an international nonprofit organization dedicated to creating a safer and more connected world.
00:53:12
Speaker
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00:53:24
Speaker
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00:53:35
Speaker
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00:53:48
Speaker
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