About Janina Fisher
Psychotherapist, Consultant, Trainer
After more than thirty years in the trauma field, I’ve watched our understanding of trauma transform and our approaches to treatment become gentler and more effective. Along the way, I have had the good fortune to have been taught by or worked alongside the giants in the field of psychological trauma: first, Judith Herman, then Bessel van der Kolk, and Pat Ogden. And as much as these pioneers taught me, the most powerful and gifted teachers I have had are my patients. These survivors have given me a window into the inner experience of the legacy of trauma, taught me what always to say and what never to say, and helped to validate or disprove what the experts were claiming. It has been a privilege to learn with them and from them.
We now understand that trauma’s imprint is both psychological and somatic: long after the events are over, the body and mind continue to respond as if danger were everpresent. We hold what happened as a ‘living legacy’ of emotional and body memories that keep the trauma alive for decades. My professional mission has been to bring this understanding of trauma to both clients and their therapists as a psychotherapist, consultant, and trainer of clinicians looking for answers to helping their traumatized clients. I believe the key to healing is not knowing what happened but transforming how our younger selves still remember it. When we accept the child we once were and welcome them into our minds and hearts, we can finally heal.
Janina Fisher, Ph.D. is a licensed clinical psychologist and a former instructor, Harvard Medical School. An international expert on the treatment of trauma, she is an Advisory Board member of the Trauma Research Foundation and the author of three books, Healing the Fragmented Selves of Trauma Survivors: Overcoming Self-Alienation (2017), Transforming the Living Legacy of Trauma: a Workbook for Survivors and Therapists (2021), and The Living Legacy Instructional Flip Chart (2022). She is best known as the creator and trainer of Trauma-Informed Stabilization Treatment (TIST), a parts approach to resolution and healing.
Understanding Trauma and its Treatment
We don’t survive trauma as a result of conscious decision-making. At the moment of life threat, humans automatically rely upon survival instincts. Our five senses pick up the signs of imminent danger, causing the brain to turn on the adrenaline stress response system. As we prepare to fight or flee, heart rate and respiration speed oxygen to muscle tissue, and the thinking brain, our frontal cortex, is inhibited to increase response time. We are in survival mode, in our animal brains. Later, we may pay a price for these instinctive responses: we have made it without bearing witness to our own experience.
Afterward, we are left with an inadequate record of what happened, no felt sense of its being over and little awareness of how we endured it. If we have immediate support and safety afterward, we may be left shaken, but the events will feel behind us. If the events have been recurrent or we are young and vulnerable or have inadequate support, we can be left with a host of intense responses and symptoms that tell the story without words and without the knowledge that we are remembering events and feelings from long ago. Worse yet, the survival response system may become chronically activated, resulting in long-term feelings of alarm and danger, tendencies to flee or fight under stress, debilitating feelings of vulnerability and exhaustion, or an inability to assert and protect ourselves. To make the challenge even greater, therapeutic approaches that emphasize talking about the events often result in more, not less, activation of trauma responses and symptoms.
Since the 1980s and 90s, newer treatment paradigms have developed that more directly impact the somatic and emotional legacy of trauma. Sensorimotor Psychotherapy, developed by Pat Ogden, Ph.D., directly addresses the effects of trauma on the nervous system and body without the need to use touch. Easily integrated into traditional talk therapies, Sensorimotor Psychotherapy utilizes mindfulness techniques to facilitate resolution of trauma-related body responses first before attempting to re-work emotional responses and meaning-making. Clients report an appreciation of its gentle and empowering interventions and find it equally or more effective than either narrative approaches or EMDR. Eye Movement Desensitization and Reprocessing (EMDR), developed in the 1980s by Francine Shapiro, is today one of the most popular and well-researched methods of trauma treatment. Like Sensorimotor Psychotherapy, EMDR does not focus on narrative recall but on reprocessing key elements of traumatic events, i.e, the legacy. Finally, Internal Family Systems, developed by Richard Schwartz in the early 1990s, is rooted in the assumption that symptoms and unresolved issues reflect disowned and unintegrated parts of the self. This assumption of inherent multiplicity is helpful to trauma survivors baffled by the paradoxical symptoms with which they struggle, while its mindful pace creates a feeling of safety for the client.