Janina Fisher Quote Excerpts

Kristin Chronicles

Healing Journey Homeschool

8~18~18

Janina Fisher Quote Excerpts

Healing the Fragmented Selves of Trauma Survivors: Overcoming Internal Self-Alienation.

Mindfulness-based practices: helping clients “notice” their experience rather than “get in touch with it.” “Noticing” as in mindful awareness allows the client to achieve “dual awareness,” the ability to stay connected to the emotional or somatic experience while also observing it from a very slight mindful distance.

As meditation practices, clinical hypnosis, & other uses of mindfulness will attest, the human brain is capable of holding multiple states of consciousness “in mind” simultaneously, & this ability has important therapeutic uses. The left hemisphere is associated with more positive moods & the right hemisphere with more negative states; the medial prefrontal cortex supports an observing consciousness that enables us to “hover above” whatever we are feeling so it can be experienced as a feeling in the body rather than lead to re-traumatization. Using “dual awareness,” we have the capacity to full inhabit the present moment: to feel our feet on the ground through awareness of body sensation while our visual perception takes in details of the room in which we are sitting—while, in the same moment, we can evoke an image from an earlier time in our lives that takes us “back there” to a state-specific memory.

{Page 44. Chapter 3: Changing Roles for Client & Therapist.}

Acknowledging the trauma or implicit triggered memories is never unsafe, especially when we allude to the “bad things that happened” in a more general way without vivifying the details of them or using triggering language, such as “rape,” “incest,” or “penetration.” When the therapist alludes to the “unsafe world you grew up in,” or “the years when nowhere was safe,” most clients feel validated & supported. This kind of matter-of-fact acknowledgment of the past often calms the traumatized nervous system rather than activating it: it conveys, “Someone knows how it was.”

In addition, when they talk about a traumatic event, therapist & client have a choice of focus: they can concentrate on the experience of horror (most likely to trigger implicit memories), or on the victimization & objectification (most likely to trigger shame), or they can bring attention to how the individual survived. How did he adapt to a traumatogenic environment? How did she “fight” or “flee” without incurring more punishment? How did he get up & go to school the next morning?

{Page 47. Chapter 3: Changing Roles for Client & Therapist.}

We can touch on memory by acknowledging it, naming it as a part’s memory or as an implicit feeling or body memory.

{Page 48. Chapter 3: Changing Roles for Client & Therapist.}

The therapist’s job is to create in the therapy hour a neurobiologically regulating environment that enables the client’s nervous system to experience greater safety & therefore an expanded capacity for tolerating both past & present experience.

{Page 48. Chapter 3: Changing Roles for Client & Therapist.}

Without education about the phenomenon of implicit memory & a prefrontal cortex capable of taking in this new information, post-traumatic dysregulation, hypervigilance, impulsivity, &/or shutdown will be repeatedly reinforced by the simple phenomenon of triggering.

{Page 49. Chapter 3: Changing Roles for Client & Therapist.}

All of the “interruptions” had a purpose: to help Sheila stay “here” instead of going “there,” to help her slow down & pay attention to her breathing & activation, to keep her prefrontal cortex online to make sure she could witness being witnessed, & to provide a different experience, an antidote, for her young child self.

{Page 50. Chapter 3: Changing Roles for Client & Therapist.}

In a parts approach, I might ask: “What’s it like for the parts to hear those words, ‘I believe you’?” In Sensorimotor Psychotherapy, the therapist would next ask, “What happens in your body when you notice that?” or “What happens inside when I say the words, ‘I hear you, & I believe you’?” I can also bring the client’s attention to the difference between now & then: “I am hearing you, &…I believe you,” “I’m hearing you, & I’m not angry,” “I’m hearing you & I’m not going away,” “I hear you, & I am not shocked, not horrified… Just notice that. What’s it like to have someone hear you without shock or horror?” At these moments of recognition (when the clients can experience how different “now” is, how attentively someone listens now, how it feels to be believed), the old experience is changed: there is a different ending to the story now—& that changes the feelings inside.

{Page 51. Chapter 3: Changing Roles for Client & Therapist.}

When the prefrontal cortex, inhibited by autonomic responses to traumatic memory, cuts them off from language areas of the brain, their ability to observe even their own experience verbally & sequentially is lost.

{Page 51. Chapter 3: Changing Roles for Client & Therapist.}

Note: implicit memory example: how the victim experiences themselves as a result of the trauma, rather than the traumatic event itself: shame, feeling dirty, disgusting, painfully exposed.

{Page 51. Chapter 3: Changing Roles for Client & Therapist.}

It therefore becomes imperative for the therapist to act as an educator & temporary “auxiliary cortex.” When the therapist is willing to reinterpret the client’s “self-defeating story” & give it psychoeducationally informed meaning, it has a different effect than providing empathy or challenging distorted cognitions. When the therapist provides a template for understanding the trauma-related symptoms or the animal defenses, clients are reassured that there is logic to their actions & reactions: what I call “trauma logic.”

{Page 52. Chapter 3: Changing Roles for Client & Therapist.}

How To Heal: The Client’s Job ~ If clients like Tessa are willing to embrace the structural dissociation model, learn to consciously & voluntarily “split off” the intense affects & assign them to younger, more vulnerable parts, they can achieve the necessary mindful distance to feel some relief without having to resort to denial or disconnection. Only when they are able to “see” the parts in these paradoxical responses will they be able to begin healing their wounds.

{Page 59. Chapter 3: Changing Roles for Client & Therapist.}

Addressing Child Parts ~ Acknowledging the enormity of what this child part has experienced can also evoke compassion, as long as the therapist is clearly asking, “What kinds of things has this child experienced?” rather than “What happened to you at this age?” The latter is more likely to trigger implicit reliving, while the former helps the client “see” the child as a helpless, innocent victim.

{Page 60. Chapter 3: Changing Roles for Client & Therapist.}

The assumption that upset is always a communication from a part is not a scientific fact, of course—it represents a way of relating to triggered states or implicit memories in a mindful, compassionate, non-pathologizing way. Underlying this assumption is a mindfulness-related bias that noticing our thoughts, feelings, & body experience with interest, curiousity, & compassion is likely to lead to positive change.

{Page 60. Chapter 3: Changing Roles for Client & Therapist.}

Remembering in fact should serve a larger purpose: to help the client “be here now” by transforming the past & changing the ending to each part’s story. Remembrance should be used as a catalyst to evoke a deeper appreciation of how the client has survived “with heart & soul intact” & a gratitude for all the parts that helped the client survive & now deserve to be a part of a safe & healthy present.

{Page 64. Chapter 3: Changing Roles for Client & Therapist.}

In a parts model, however, each distressing or uncomfortable thought, feeling, or body sensation is treated as a part (rather than an expression of the individual’s whole self). By deliberately & consistently using the language of parts rather than the language of “I,” the therapist helps the client to observe each trauma-related feeling or reaction as a message from a part or parts: “Which ‘I’ feels ashamed & apologetic? And which ‘I’ is disgusted by all the apologizing?” When we ask these questions, we evoke curiousity & facilitate mindful observing. There is now a very slight distance between the observer & what is being observed.

{Page 71. Chapter 4: Learning to See Our “Selves”: An Introduction to Working with Parts.}

The first task in therapy was to challenge their assumptions & ignite their curiousity in two ways: first, by using the “language of parts,” rather than the language of “I,” &, secondly, by asking them to use mindful observation, instead of their automatic negative interpretations, to “track” the moment-to-moment signs of their parts’ thoughts, feelings, visceral reactions, & movement impulses as they responded to triggers around them with competing survival responses. Mindful observation evokes activity in the prefrontal cortex, counteracting trauma-related cortical inhibition & inducing a very slight sense of separation from the feeling, thought, or part.

{Page 72. Chapter 4: Learning to See Our “Selves”: An Introduction to Working with Parts.}

Befriending means that we “radically accept” that we share our bodies & lives with these “room-mates” & that living well with ourselves requires living amicably & collaboratively with our parts. The more we welcome rather than reject them, the safer our internal worlds.

{Page 75. Chapter 4: Learning to See Our “Selves”: An Introduction to Working with Parts.}

The first skill I teach clients with DID is to keep track of their daily activities by recording what they are doing or whatever is happening every hour on the hour on an hourly time schedule.

{Page 169. Chapter 8: Treatment Challenges: Dissociative Systems & Disorders.}

If we want to help clients with dissociative disorders, the best approach is to rely on:

• Increasing conscious mindful awareness of parts, as discussed in Chapter 4, & of the signs of triggering, switching, & blending.

• Psychoeducation.

• Helping clients learn to speak the “language of parts.”

• Piecing together a continuous sense of consciousness, challenging clients to observe the emotional, cognitive, & action patterns connected to different parts.

• Emphasizing practice & repetition of new patterns or actions until they become familiar.

• Renegotiating internal relationships: using internal communication to develop greater trust & collaboration among the parts.

{Page 177. Chapter 8: Treatment Challenges: Dissociative Systems & Disorders.}