How to Help Clients Process Trauma with Janina Fisher

Today, we delve into the transformative journey of trauma processing. Helping clients process trauma is a crucial for healing for those who have endured traumatic experiences and is a key focus of our popular Trauma-Informed Stabilization Treatment certification (TIST) with Janina Fisher, Ph.D., founder of Trauma-informed Stabilization Treatment (TIST).

What is Trauma Processing According to Janina Fisher?

Working with clients in clinical practice, processing trauma involves much more than just recounting events; it’s about understanding and integrating the impact of trauma on that person’s life. This process is vital in helping individuals move beyond their traumatic experiences, release the grip of painful and debilitating trauma response symptoms, and foster resilience. A key component in this journey is recognizing trauma symptoms not as mere aftermath but as valuable survival adaptations.?

These symptoms, often misunderstood, are ingenious ways the mind and body have adapted to cope with overwhelming experiences. Dr. Janina Fisher, a renowned expert in trauma therapy, emphasizes this perspective in her Trauma-Informed Stabilization Treatment (TIST). Fisher’s approach helps clients reframe their symptoms as adaptive responses, enabling them to approach their healing with a sense of empowerment and understanding. By viewing troubling symptoms through this lens, therapists can support their clients in transforming their trauma into a pathway for growth and recovery.

Video Transcript of Adaptive Therapy Responses with Janina Fisher Ph.D.:

“My old teacher, a colleague of Judith Herman’s, who with Judy founded one of the first trauma clinics in the US, she used to say, ‘Don’t worry if your clients have no memories. Trauma survivors have symptoms instead of memories. Yes. They have been impacted by traumatic events, but what’s left behind is often an array of symptoms, sometimes baffling symptoms, rather than clear-cut memories.’

So, we typically see trauma survivors coming with all the symptoms of major depression, the symptoms of PTSD, all of the anxiety disorder symptoms, chronic pain symptoms, addictions, eating disorders, and diagnoses of borderline personality disorder. I think these are the effects. An event causes effects. The event in and of itself is not the vehicle for either healing or information gathering. It’s the effect left behind.

And I asked my clients, ‘How did the depression help you survive?’ And without a moment’s thought, they say, ‘Oh, yes, the depression was like my cave. I could hide inside it.’ How about the irritability? How did that help you survive? And they say, ‘Oh, the irritability helped me to push people away.’ How about loss of interest? How did that help you survive? And they say, ‘Well, then it didn’t matter if they took everything away from me. It didn’t matter if they humiliated me for something I was interested in, because I didn’t care anymore.’

And so, I’m always trying to make the point that these effects, these symptoms, represent adaptations, survival adaptations that help this individual to survive, and in some cases, even thrive.”

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Helping Trauma Survivors Get Unstuck: A Fragmented Selves Approach in Therapy

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How to understand perplexing clients using the TIST perspective so you can see the fragmented selves at work.

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Understanding and Processing Trauma Symptoms as Survival Adaptations

In this video, Dr. Fisher shares her powerful understanding and also recounts for us the insightful words of a teacher, a colleague of Judith Herman, who sheds light on a profound aspect of trauma therapy: trauma survivors often present symptoms in place of clear-cut memories of their traumatic experiences. These symptoms can range from major depression, PTSD, anxiety disorders, chronic pain, addictions, and eating disorders, to borderline personality disorder. They are not just random effects of trauma, but are survival adaptations to be acknowledged and valued as part of any trauma processing protocol you may employ in psychotherapy sessions.

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Key Points to Keep In Mind About Processing Traumatic Experiences

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1. Trauma and Memory

Trauma survivors may not have explicit memories of their traumatic events. Instead, their experiences manifest as various symptoms.

2. Symptoms as Adaptations

These symptoms are adaptations that helped the survivors cope with their trauma. For instance, depression can act as a ‘cave,’ providing a hiding place; irritability can serve to push people away, creating a protective barrier; loss of interest can be a defense mechanism against further emotional hurt or humiliation.

3. Therapeutic Approach

The therapeutic approach involves understanding these symptoms as adaptive mechanisms. This understanding can be crucial in helping clients see their symptoms not just as disorders but as survival strategies that served a purpose.

4. Healing and Adaptation

Recognizing these symptoms as adaptations can be empowering for trauma survivors. It helps in reframing their experiences and symptoms, acknowledging their strength and resilience in surviving their trauma.

5. Role of the Therapist

Therapists play a crucial role in guiding trauma survivors to understand and reframe their symptoms as survival strategies. This approach can lead to more effective healing and coping strategies.

This perspective aligns with the broader understanding of trauma-informed care, which acknowledges the complex impact of trauma on an individual’s mental, emotional, and physical well-being. It highlights the importance of viewing symptoms through the lens of survival and adaptation, offering a more compassionate and empowering approach to trauma therapy.

3 Questions to Help Clients Process Trauma

Here, we offer some approaches you might take when addressing the most common trauma-related symptoms as survival strategies:?

• Exploring the Role of Anxiety: “How has your anxiety helped you?” or, if the idea of symptom as protective mechanism is established, you might be more elaborative and ask, “How has your anxiety served as a protective mechanism for you? For example, has it made you more alert to potential dangers or helped you avoid certain harmful situations?”
• Understanding Avoidance Behaviors: “In what ways has avoiding certain places, people, or activities helped you feel safer or more in control after your traumatic experience?” or perhaps you′d simply ask, “How has avoiding [that] been helpful to you?”
• Reflecting on Emotional Numbness: As a way to begin to increase awareness of symptoms as survival adaptations, especially is a client is presenting resistance to the idea, you might ask, “Can you think of times when feeling emotionally numb or detached has helped you cope with overwhelming situations or intense emotions related to your trauma?” and perhaps a simple follow up might be, “Is there any other way your shutting down seems to help?”

Asking these questions as part of processing trauma with clients can help them see their symptoms not just as negative consequences of trauma but as adaptive strategies that have played a role in their survival and coping. This can help them regain a sense of control and wellbeing, because they can begin to work with the behaviors instead of only feeling powerless or hopeless about them.?

Shifting perspective in this way also helps open the door to finding more healthy and productive means to achieving the same safety and survival. Client empowerment here is a major step in the healing process, and in potentially reducing the extremity of the behavior.

Ready to go further with your clients as a trained trauma therapist? A great first step is to get to know the work of Dr. Janina Fisher and consider getting certified in the TIST trauma therapy technique. Learn more here: Getting Certified as a Trauma Therapist and we look forward to supporting you throughout your path as a mental health professional.

Who is Janina Fisher?

Janina Fisher, Ph.D. is an esteemed faculty of Academy of Therapy Wisdom and leads our most respected and most highly-attended trauma therapy training programs. She is the Assistant Educational Director of the Sensorimotor Psychotherapy Institute, a former instructor at Harvard Medical School, and an international expert on the treatment of trauma and dissociation. She is the author of Healing the Fragmented Selves of Trauma Survivors: Overcoming Self-Alienation?(2017) and?Transforming the Living Legacy of Trauma: a Workbook for Survivors and Therapists?(2021). Best known for her work on integrating newer neurobiologically-informed interventions into traditional psychotherapy approaches, she is the co-author with Pat Ogden of?Sensorimotor Psychotherapy: Interventions for Attachment and Trauma?(2015).