Healing the Fragmented Self in Couples Treatment
Couples Conference
Sunday, April 2, 2017
Healing the
Fragmented Self in
Couples Treatment
Couples Conference 2017
April 2, 2017
Janina Fisher, Ph.D.
• To survive, human beings need psychological distance
from overwhelming events. The sense of self must also
be kept separate from the ongoing trauma
• Disowning “the bad child” or “wounded child” (the
child who endured the abuse and humiliation) is a survival
response: it preserves self-esteem, motivates us to be the
“good child,” helps us go to school and do our homework
• We also disown the trauma by disowning the
traumatized parts, parts that carry the shame and the
anger, the most wounded parts, the needy parts, and, most
of all, the angry, vengeful parts
Fisher, 2009
• It can be adaptive to disown neediness, grief, and anger.
When a child disowns needs that can’t be met or feelings
that are unacceptable, adaptation to the environment is
enhanced–at the cost of further alienation from self.
Those feelings and needs are ‘bad’ or ‘not me’
• And because parents are a child’s ‘mirror,’ failed
parental attachment precludes internalizing a coherent
sense of ourselves, not just a loss of care and connection
• Alienation and fragmentation helps maintain
attachment to the family necessary then but interferes
with self-acceptance and self-forgiveness we need later
Fisher, 2016
Copyright 2017: Janina Fisher, Ph.D.
Do Not Copy without Permission
1
Healing the Fragmented Self in Couples Treatment
Couples Conference
Sunday, April 2, 2017
We remember these early
experiences with our bodies
• Our adaptations to early experience are
encoded in the body in the form of visceral responses,
emotions of fear or pleasure, habits, beliefs, even
autonomic and muscle memory—all divorced from the
events that shaped us in childhood.
• “Remembering” with our bodies and our
emotions is adaptive in intent: it helps us to
automatically avoid whatever feels bad or threatening and
move toward what feels good or safe. We know
instinctively whom and what we like and can react more
quickly and automatically.
Fisher, 2010
• When we “remember” attachment experiences
implicitly, we don’t know that we are ‘remembering.’
When we feel warmth around the heart, clenching in the
stomach, impulses to reach out, or feelings of suffocation, it
doesn’t “feel” like memory. It feels like something being
felt right “now” in response to current relationships
• These non-verbal physical and emotional memory states or
muscle memories do not “carry with them the internal
sensation that something is being recalled. . . . We act, feel,
and imagine without recognition of the influence of past
experience on our present reality.” (Siegel, 1999)
“When the images and sensations of
experience remain in ‘implicit-only’
form. . ., they remain in unassembled
neural disarray, not tagged as
representations derived from the past . . .
Such implicit-only memories continue
to shape the subjective feeling we have
of our here-and-now realities, the sense
of who we are moment to moment. . .”
Siegel, 2010, p. 154
Copyright 2017: Janina Fisher, Ph.D.
Do Not Copy without Permission
2
Healing the Fragmented Self in Couples Treatment
Couples Conference
Sunday, April 2, 2017
•  And the sense of ‘who we are moment to
moment’ also affects our sense of ‘who’ the
other is—moment to moment.
•  If disconnected implicit memories evoke a sense
of ‘who I am’ associated with feelings or beliefs
such as ‘I’m abandoned,’ ‘unlovable,’
‘unnoticed,’ ‘too emotional or ‘too detached,’
then we are vulnerable to those parts and feeling
memories being triggered by our partners
•  We are also vulnerable to identifying with
some parts/feelings and despising or disowning
other parts with feelings that were once risky
“If aspects of the person remain undigested—cut off,
denied, projected, rejected, indulged or otherwise
unassimilated—they become the points around which
the core forces of greed, hatred, and delusion attach
themselves. They are black holes that absorb fear and
create the defensive posture of [an] isolated self, unable
to make satisfying contact with others or with the
world. . . . . [Personality] is built on these points of
self-estrangement; the paradox is that what we take to
be so real, our selves, is constructed out of a reaction
against just what we do not wish to acknowledge. We
tense up around that which we are denying, and we
experience ourselves through our tensions.”
Epstein, 1995, p. 19.
• Secure “internal” attachment: we feel warmly toward
ourselves and our parts, accepting each as “doing the best it
can.” We forgive our-selves for flaws and mistakes
• Insecure-avoidant attachment: while not hostile toward
our parts, we are disconnected from them and since we can’t
feel them, we don’t acknowledge them; we’re out of touch
• Insecure-ambivalent attachment: we are so blended with
the intense vulnerability of young parts that we cannot ‘be
there’ for ourselves; we want someone else to be!
• Disorganized attachment: we cannot accept ourselves
because we are locked in an internal struggle between
yearning for acceptance and self-judgment/rejection Fisher, 2013
Copyright 2017: Janina Fisher, Ph.D.
Do Not Copy without Permission
3
Healing the Fragmented Self in Couples Treatment
Couples Conference
Sunday, April 2, 2017
•  “We look for a partner who will parent our inner child
and then spend the rest of the relationship fighting about
child rearing practices.” (Conway, 1995)
•  With whom we fall in love is in part determined by the
unmet needs of our abandoned child selves, but once
having fallen in love, now the partner can only hurt
and disappoint the child self. After all, our partners
think they have married a grown-up, not a hurt child!
•  Without an ability to care for that young part
ourselves, we can only feel unmet, unloved, rejected,
disappointed, and angry
Fisher, 2017
We tend to ignore the “internal
community” of child selves
“Through the day, we regularly pass from
personality to personality. Because of the
speed and fluidity of this process for most of
us, and the fact that we have such a limited
vocabulary for distinguishing among these
inner entities, we do not usually attend to the
ways in which this inner community conducts
its business.”
Schwartz, 1995
Structural Dissociation: Parts of One
Partner will Trigger Parts of the Other
Apparently Normal Part
of the Personality
Fight
EP
Flight
EP
Emotional Part of the
Personality
Freeze
EP
Submit
EP
Attachment
Cry EP
When each partner is triggered, the limbic activation inhibits
the frontal lobes and thus the Apparently Normal Personality,
leaving the traumatized parts in control of the interaction
Adapted from Van der Hart, Nijenhuis & Steele, 1999; Fisher, 2007
Copyright 2017: Janina Fisher, Ph.D.
Do Not Copy without Permission
4
Healing the Fragmented Self in Couples Treatment
Couples Conference
Sunday, April 2, 2017
What threatens the couple’s stability is not just the
triggering but the dynamic tensions between their
competing survival response models:
• Her wish to “talk about it” evokes his flight responses,
• Triggering her fight responses and pursuit of him
• When she pursues angrily or needily, it triggers his fear,
causing withdrawal
• She experiences the withdrawal for self-protection as
passive aggression and becomes angrier but submits to
maintain the connection
• Each feels unsafe and blames the other
Fisher, 2007
• Overwhelming emotions: desperation, despair, shame
and self-loathing, hopelessness and helplessness, rage
• Chronic expectation of danger: hypervigilance, fear
and terror, mistrust, “post-traumatic paranoia”
• Body sensations: numbing, dizziness, tightness in the
chest and jaw, nausea, constriction, sinking, quaking
• Impulses: motor restlessness, ‘hang-dog’ posture,
impulses to “get out,” violence turned against the body
• Beliefs: “I hate myself,” “No one cares,” “I’m not safe
here”
Fisher, 2012
• Loss of ability to communicate: client becomes mute,
shut down, unwilling to speak, or accusatory, attacking
• Critical voices: usually shaming, punitive, controlling
• Constriction: withdrawal, social isolation, agoraphobia
• Regressive behavior: loss of functional ability, verbal
ability, ability to negotiate or collaborate
• Increasing preoccupation with others: and loss of any
inner sense of ‘OK-ness’ without their attunement
• Alternating dependence and counterdependence
• Unchecked fight/fllight behavior
Fisher, 2014
Copyright 2017: Janina Fisher, Ph.D.
Do Not Copy without Permission
5
Healing the Fragmented Self in Couples Treatment
Couples Conference
Sunday, April 2, 2017
Julie
She: “What do
you mean
you’re
‘sorry’?”
He: “Don’t
you start in on
me like that!”
She: “I have
every right to
call you on
your shit”
He initially
shuts down,
then moves
out a week
later
Sympathetic Hyperarousal
“Window of Tolerance”*
Optimal Arousal Zone
Parasympathetic Hypoarousal
Ogden and Minton (2000);
Fisher, 2007
*Siegel (1999)
He: “Sorry,
I’m late,
honey”
She: “I feel so
hopeless—why does
he treat me this way?
Sam
• This couple’s conclusions reflected habitually learned
interpretations, i.e. how they made meaning of their
frightened and frightening caregiving as children
• Past and present become confused when their triggered
responses are interpreted as indicators of threat: “It’s
not safe here,” “He/she doesn’t care,” “I’m powerless,” or
“I’m being controlled, and I’m trapped”
• Thoughts like these do not creatively make meaning of
present experience: they are repetitive and habitual. Rather
than strengthen, they de-resource clients and cast doubt
on the safety or sanity of their relationships: “What am I
doing here?”
Fisher, 2007
• To be safe in relationship to others, we need compassion
for ourselves when others disappoint or hurt our feelings.
Internal attachment bonds allow us to tolerate differences,
loneliness, frustration, and anxiety
• What if the quality of our internal attachment bonds
are even more crucial for the sense of well-being than
attachment to others? If so, then therapy must focus on
cultivating compassion for disowned selves and experience.
• The first step is education: the therapist must teach and
model an appreciation for all parts of the self, to be
curious about the client’s parts, to model attitudes of respect
and nonjudgmental acceptance Fisher, 2014
Copyright 2017: Janina Fisher, Ph.D.
Do Not Copy without Permission
6
Healing the Fragmented Self in Couples Treatment
Couples Conference
Sunday, April 2, 2017
• Disowning one’s needy parts, as well as one’s angry or
counterdependent parts, however, interferes with selfacceptance and self-care. It is not OK to have needs, to
have self-compassion
• Self-acceptance has the paradoxical effect of putting us
in touch with the very parts we have disowned: we can
feel the parts that yearn for care, feel needy or lonely—
often quickly followed by critical parts reacting harshly
• In order to fully accept ourselves, we need to develop a
relationship to the wounded parts of ourselves AND to
the parts of us that are hostile to vulnerability
Fisher, 2012
• While yearning to ‘like’ themselves, the disowning of
vulnerable, ashamed, angry, or depressed parts results in
our clients’ experiencing a profound alienation from
self: ‘I don’t know myself, and I don’t like myself’
• But to be safe in relationship to others, we need internal
compassion for ourselves. Relationships trigger our
deepest needs and emotions. Internal bonds provide
crucial protection against feeling alone and overwhelmed
• Therapy must focus on cultivating compassion for our
disowned selves. But because alienation was once safer,
the first step is overcoming the fear of and hostility of
our “roommates”
Fisher, 2015
“Sam” and “Julie”
Both are high-functioning professionals
in human services
Apparently Normal Part
of the Personality
Fight
Part
Flight
Part
Emotional Part of the
Personality
Freeze
Part
Julie alternates between
Attach’s fear of abandonment
and Fight’s mistrust, anger
and hypervigilance
Submit
Part
Attachment
Cry Part
Sam relied on Submit-ing as a
child and still does, but when
Julie’s Fight overwhelms him,
he freezes and then flees
Adapted from Van der Hart, Nijenhuis & Steele, 1999; Fisher, 2007
Copyright 2017: Janina Fisher, Ph.D.
Do Not Copy without Permission
7
Healing the Fragmented Self in Couples Treatment
Couples Conference
Sunday, April 2, 2017
How Do Their Survival Strategies
Mesh or Conflict?
Apparently Normal Part
of the Personality
Fight
Part
Flight
Part
Emotional Part of the
Personality
Freeze
Part
Submit
Part
Attachment
Cry Part
Each partner is asked to identify which part or parts got
triggered and caused conflict between them. The therapist
helps to create mutual empathy by naming the contrasting
survival strategies and celebrating their adaptive nature
Van der Hart, Nijenhuis & Steele, 1999
The Parts may have different views of
the partner. . .
Going On with Normal
Life Part
Fight
Part
Flight
Part
He/she is
abusive, not
to be trusted
—don’t let
him/her in!
What’s the
big deal
about
closeness?
Emotional Part of the
Personality
Freeze
Part
Submit
Part
S/he’ll
hurt
me!
I must
obey. . .
Attachment
Cry Part
I can’t
live
without
him/her!
Adapted from Van der Hart, Nijenhuis & Steele, 1999; Fisher, 2013
Child
Wise Adult
Wise Adult
Her Name
His Name
Teen
Child
Teen
Two wise Adults met and fell in love, seeing in each other the chance
to build a different kind of life than they lived as children . . .
What they didn’t expect was that their younger selves would come, too!
Fisher, 2007
Copyright 2017: Janina Fisher, Ph.D.
Do Not Copy without Permission
8
Healing the Fragmented Self in Couples Treatment
Couples Conference
Sunday, April 2, 2017
Sam is late
Child
Terrified of
abandonment,
afraid she’s
done something
wrong
Wise Adult
Wise Adult
Julie
Sam
Teen
Angry at
break of trust,
lashes out,
blames
Child
Feels
ashamed,
“less than,”
unlovable
Teen
“I’m out of
here! You
can’t do that to
me!”
Fisher, 2007
•  With high-conflict couples, it is better to avoid verbal
‘discussion’ or ‘processing’ as it inevitably leads to
increased conflict, not resolution
•  Diagramming is a structured way of de-constructing
what happened and re-framing it without threatening
either individual
•  Each partner tends to take more responsibility for their
contribution to the problem when the conflict is assigned
to the teenage protector parts! And each tends to
disclose vulnerability more easily when it is assigned to
a child part and diagrammed rather than discussed
•  When couples take home the diagram, they have a way
to ‘diagnose’ an impending fight and interrupt it by
checking their past diagrams
•  Diagramming is akin to ‘mindfulness on a page,’ a
much easier mental ability than internal awareness
•  The diagram method is a ‘no fault’ approach: it
keeps the couple focused on process and pattern.
Because it is structured, it is hard for couples to use it as
a weapon.
•  And it facilitates self-compassion for one’s own child
parts and teenage protectors. . .
Copyright 2017: Janina Fisher, Ph.D.
Do Not Copy without Permission
9
Healing the Fragmented Self in Couples Treatment
Couples Conference
Sunday, April 2, 2017
• Human beings need encouragement to ‘befriend’
themselves and their parts for practical reasons: we can’t
integrate that which we disown, despise, or deny.
• In therapy, clients need the therapist to hold empathy
for the parts AND challenge resistance to befriending:
“What do you imagine would happen if you really knew
them and got close to them?” “If you befriended them,
what are you afraid would happen?”
• Typically, when we encourage befriending, we hear: “But I
hate them,” “I wish they’d go away,” “I wish they would
just grow up!” These statements must always be reframed as another part: “a part that hates the other parts”
or a “part that wants to disown” them.
Fisher, 2011
• Most of us are not curious or compassionate when it
comes to our own selves as we are to others. They say, “I
wish I could get rid of this quality. . . I hate this part of me.”
• The therapist has to be clear that wise adults don’t hate
children or child parts! “It doesn’t make sense that you—a
person who is so compassionate—would feel hatred for these
young parts. . .” “When you see upset children, do you hate
them? Or do you feel badly for them?”
• We have to help clients question their reactions: “Let’s
be curious about what part of you is so dead set against your
having a relationship with these parts?” “What is that part
worried about?” “Could you ask inside?” Fisher, 2012
• A relationship between a wise-minded “Self” and child
parts has to begin with mindful curiosity about the parts’
feelings, thoughts, and impulses. An absence of curiosity
suggests old patterns and automatic reactions
• Curiosity and exploration of who these parts really are
naturally enhances empathy: “How old might this part be?
Very young? Middle-sized? A teenager?”
• As curiosity challenges the automatic animosity toward
parts and they come to be better understood, the therapist
asks an Internal Family Systems question: “And how do
you feel toward that part now?”
Fisher, 2011
Copyright 2017: Janina Fisher, Ph.D.
Do Not Copy without Permission
10
Healing the Fragmented Self in Couples Treatment
Couples Conference
Sunday, April 2, 2017
•  There is a way for all wounded human beings to
experience the love and comfort they didn’t get ‘then:’
they can receive it internally from a compassionate and
attuned part of the personality who “gets it”
•  “Secure attachment,” “comfort,” “attunement” are all
somatic experiences: we feel warm, our bodies relax, we
feel an energetic connection and sense of safety. When
our wise minds begin to provide those felt sensory
experiences for young child parts, they can begin to heal
•  As in all attachment relationships, this work requires what
can seem like an endless and monotonous attention to the
dysregulated feelings of the child parts
Fisher, 2013
Attunement:
Rupture: a part is
triggered by something;
the client feels the
emotional reaction
when the Adult self
provides the missing
experience of
comfort or
acceptance, the felt
sense of attunement
is evoked in the
here-and-now
Repair:
rather than
ignore or suppress
feelings, the Adult self
relates to them as a
child’s feelings
Sensorimotor Psychotherapy Institute
• First, we ask the client to notice a part or a pattern
associated with distress: “Can you feel the frightened part
here with you now? How can you tell she’s there now?”
• We encourage inner communication: “Ask her if she can
feel you here with her now? Let her know that we are
listening, and we want to understand how scared she is.”
Then, the therapist uses the Four Befriending Questions
to frame the core fear and answer the question: what
does the part need from the Adult in order to feel safer??
What is the ‘missing experience’?
• The adult self is then asked to meet the need: either
verbally, somatically or emotionally
Fisher, 2009
Copyright 2017: Janina Fisher, Ph.D.
Do Not Copy without Permission
11
Healing the Fragmented Self in Couples Treatment
Couples Conference
Sunday, April 2, 2017
• “Could you ask that part what she is worried about
if she shows her emotions? What she’s concerned
about happening if she feels that way?”
• Could you ask her what she is afraid would happen
if she got angry or started crying?”
• “And if people were mad at her, what is she afraid
would happen next?”
• “What does she need from you—right here, right
now—to feel safer?”
Fisher, 2007
• Each response by the part becomes another opportunity
for repair facilitated by the therapist’s guidance: “She’s
telling you that she wants to believe you understand, but
she’s afraid to trust. . . Do you ‘get’ that? Let her know
that with your feelings and your body that you understand
why it’s hard for her to trust you. . .”
• “Yes, you can feel him relaxing just a little bit when you
acknowledge the truth. . . Not many grownups ever did
that, huh?
• “What’s it like for her to have you take responsibility?
To let him know that you realize you have been pushing
him away?”
Fisher, 2016
• To maximize the sense of attunement so that it can be
experienced in the body, the therapist tries to help the
client connect to his/her spontaneous compassion for
children or small creatures: “If this little girl were
standing in front of you right this minute, what would you
want to do? Feel it in your body. . . Reach out to her? Take
her hand? Or pick her up and hold her?
• “Feel what that’s like to have this little boy in your
arms? To feel his hand in yours? Is it a good feeling?
• “Take in the warmth of his body and the feeling of
holding him safely. . . Ask him if he would feel less scared
if you did this every time he got afraid?
Fisher, 2013
Copyright 2017: Janina Fisher, Ph.D.
Do Not Copy without Permission
12
Healing the Fragmented Self in Couples Treatment
Couples Conference
Sunday, April 2, 2017
“Visceral experiencing is crucial. It is
not sufficient for the patient to say that
he is sad or fearful, or for the therapist
to presume that he is from a dynamic
processing of the clinical material; the
patient must feel the sadness or the fear
in his gut or his heart or his face or his
sinew.”
Fosha, 2000
• Consistent use of these techniques, like the Four
Befriending Questions, is necessary to build neural
pathways holding the experience of attunement
• Like any caregiver, the client must be able to ‘read’
feeling and bodily communications from parts and to
ask, “If this feeling/sensation/image were a communication
from a young part of me, what would that part be trying to
tell me?”
• Until these young parts feel securely attached to
THEM, the client will continue to be driven in the same
ways and suffer the same debilitating, overwhelming
feelings and symptoms
Fisher, 2016
Rupture: the
client is
dysregulated by an
empathic failure, a
topic or emotion
outside the window
Attunement: the
repair allows both
parties to feel the relief
of re-established calm
and connection,
building increased
trust and resilience in
the relationship
Repair: the therapist
experiments to find just
“the right” verbal or
nonverbal intervention to
regulate the client’s
distress
Sensorimotor Psychotherapy Institute
Copyright 2017: Janina Fisher, Ph.D.
Do Not Copy without Permission
13
Healing the Fragmented Self in Couples Treatment
Couples Conference
Sunday, April 2, 2017
When clients get “highjacked” or
triggered in session . . .
• Increase mindful attention to signs of PARTS: “Let’s be
curious about the part of you that just shut down—what
triggered that part?” “Let’s be curious about the part of you
that’s saying, ‘This isn’t going to help!’”
• Notice out loud the moment-by-moment signs of parts
activity: thoughts, feelings, [body] reactions: “When we
talk about this, they get activated, huh? How can you tell?”
• Consistently use “they” or “she” to describe symptoms
of shame, depression, suicidality, shutdown: “She seems
very numb—is that right?” “She feels very ashamed, huh?”
“Someone came to the rescue and shut you down!” Fisher, 2016
When the client gets highjacked, p. 2
• Ask “menu questions” inside: “Could you ask her if she
wants to shut down? OR is someone shutting her down?”
• Re-frame: “The part that makes her shut down must be very
worried about this therapy. He is being very careful, isn’t he?
Could you ask him what he’s worried about?”
• Remember that you are talking to the whole GROUP:
assume that all parts are listening.
• Use the language of parts consistently: “Is the ashamed
part the same as the shutdown part? Or different?” When
we use the language of parts, we increase mindfulness.
Every time we elicit mindfulness, we help clients regulate
Fisher, 2016
• The social engagement system is an innate system
connected to the vagus nerve, which regulates
movements of the eyelids, facial muscles, middle ear
muscles, laryngeal and pharyngeal muscles, and head
tilting and turning muscles
• As the caregiver interacts with the infant in a responsive
manner, she or he elicits social engagement responses from
the infant or capitalizes on those that occur spontaneously
• The development of an infant’s social engagement
system is dependent upon the caregiver’s ability to
stimulate and interactively regulate social interaction
Ogden, 2006; Fisher, 2007
Copyright 2017: Janina Fisher, Ph.D.
Do Not Copy without Permission
14
Healing the Fragmented Self in Couples Treatment
Couples Conference
Sunday, April 2, 2017
• In the therapy hour, the therapist must make use of his
or her own social engagement muscles, making sure to
utilize facial expression, head movements, intonation, and
gaze to evoke the client’s social engagement system.
Talking about social engagement does not in itself engage
the ventral vagal system
• The social engagement system is body-oriented: it
relies upon the “muscles that give expression to our faces,
allow us to gesture with our heads, put intonation into our
voices, direct our gaze, and permit us to distinguish
human voices from background sounds.” (Porges, 2004, p. 21)
Ogden, 2004; Fisher, 2007
“Not only is the therapist . . . unconsciously
influenced by a series of slight and, in some
cases, subliminal signals, so also is the
patient. Details of the therapist’s posture,
gaze, tone of voice, even respiration, are
[unconsciously] recorded and processed. A
sophisticated therapist may use this
processing in a beneficial way, potentiating
a change in the patient’s state without, or in
addition to, the use of words.”
Meares, 2005, p. 124
The Social Engagement
System of the Therapist
• Amplifying client capacity for self-compassion and loving
feelings towards all parts requires a therapist whose social
engagement system responds to all parts
• As the therapist’s voice exudes compassion for the
ashamed part, once humiliated by parent figures and now
by the judgmental part, the client’s body will respond with
increasing warmth or openness
• When the therapist is not afraid even of the suicidal part
but responds with smiles and warmth to its determination
not to lose control and dignity, the client’s body will relax
—and thereby suicidal intensity will lessen Fisher, 2016
Copyright 2017: Janina Fisher, Ph.D.
Do Not Copy without Permission
15
Healing the Fragmented Self in Couples Treatment
Couples Conference
Sunday, April 2, 2017
The Social Engagement System of
the Therapist, cont.
• As our “shining eyes” communicate that all parts are
welcome and valued, the client will slowly increase his/her
capacity to turn “shining eyes” on younger selves
• With our help, the Adult self can learn to listen to the
parts, facilitating integration of our empathy with an intuitive
understanding of the part from the ‘inside out:’ “She’s not
afraid to be alone; she’s afraid she’ll be rejected”
• As our faces soften and our voices become warmer, our
clients soften as well, relaxing their bodies and feeling a
pervasive sense of warmth. Our acceptance becomes their
acceptance.
Fisher, 2016
Principles of Neuroplastic Change
• The first principle is that neuroplasticity is
“induced by changes in the amount [and kind]
of sensory stimulation reaching the brain” (Schartz
& Begley, 2002, p. 16).
• That means that we need to ask ourselves: what
kinds of stimulation is my client’s brain is getting
now? Does that stimulation reinforce the traumarelated patterns? Or challenge them?
• How do we change the “amount and kind of
sensory stimulation reaching the brain”? Fisher, 2010
• The second principle is that neuroplasticity has to
be “directed:” calculated, repetitive patterns of
stimulation are necessary to obtain specific
brain change. That requires us to be active,
unafraid to be repetitive or to ‘direct’ the client in
changing his/her habitual actions and reactions
• Third, neuroplasticity requires focused attention.
Attention stimulates neuronal firing in the areas we
wish to restructure and also helps the brain to retain
the new learning.
Fisher, 2010
Copyright 2017: Janina Fisher, Ph.D.
Do Not Copy without Permission
16
Healing the Fragmented Self in Couples Treatment
Couples Conference
Sunday, April 2, 2017
• The next and perhaps most important principle:
neuroplastic change requires that we first
consistently inhibit the old responses and then
engage in intense repetition of new, more
adaptive responses. We can’t develop new patterns
if we habitually engage in procedurally-learned
patterns or fail to practice new ‘habits’
• Sensorimotor Psychotherapy and other body or
mindfulness-based psychotherapies incorporate
many of these principles already
Fisher, 2010
For further information, please contact:
Janina Fisher, Ph.D.
5665 College Avenue, Suite 220C
Oakland, California 94611
510-891-1809
[email protected]
Sensorimotor Psychotherapy Institute
[email protected]
www.sensorimotorpsychotherapy.org
Copyright 2017: Janina Fisher, Ph.D.
Do Not Copy without Permission
17
Healing the Fragmented Self in Couples Treatment
Couples Conference
Sunday, April 2, 2017
A Monthly Webinar Series
on Complex Trauma and Dissociation
A ten-month remote-learning webinar program for
mental health professionals interested in developing
greater comfort and expertise in working with complex
trauma and dissociation while staying abreast of recent
trauma-related research and treatment advances.
All programs are recorded and available for later viewing online.
For more information or to register, email Dr. Fisher or go to
www.janinafisher.com
Janina Fisher, PhD. is a clinical psychologist specializing in treatment of complex PTSD and dissociation. She
is also an instructor & supervisor at the Trauma Center, past President of the New England Society for the
Treatment of Trauma & Dissociation, a trainer for the Sensorimotor Psychotherapy Institute, an EMDR Approved
Consultant, and an international presenter on the neurosience research and treatment of trauma-related disorders.
Just out!
Healing the Fragmented
Selves of Trauma
Survivors: Overcoming
Self-Alienation
Janina Fisher
To order, go to:
http://
www.janinafisher.com
“Healing the Fragmented Selves of Trauma
Survivors: Overcoming Self-Alienation”
Janina Fisher
August 7-11, 2017
Eastham, Massachusetts
A weeklong summer
seminar that meets from
9-12:30 each morning,
leaving the afternoons
free to enjoy the beaches,
wildlife, woods, and
ponds of Cape Cod
To register, go to:
www.cape.org
Copyright 2017: Janina Fisher, Ph.D.
Do Not Copy without Permission
18