Full Course Description
Janina Fisher’s Certified Clinical Trauma Professional Training Level 1 (CCTP): Working with the Neurobiological Legacy of Trauma
Session I - Trauma and the Body
- Demonstrate knowledge of three neurobiologically-based trauma responses and articulate how this information may inform choice of treatment interventions.
- Appraise how the somatosensory and autonomic effects of trauma exacerbate symptoms of PTSD in clients.
- Assess the role and treatment implications of procedural learning and memory in client presentations.
- Incorporate sensorimotor interventions into treatments to decrease symptoms of PTSD in clients.
Session II - Working with the Complications of Dysregulation: Addictions, Eating Disorders, & Self-Destructive Behavior
- Assess the relationship between autonomic dysregulation and addictive or self-destructive behavior in relation to assessment and treatment planning.
- Articulate the necessity for an integrated treatment of trauma and addictive or suicidal behavior to improve treatment outcomes.
- Assess appropriate cognitive-behavioral techniques for treating autonomic dysregulation in clients.
- Specify three somatic techniques for regulating autonomic arousal traumatic reactions in clients.
Session III - Working with Traumatic Memory: Principles and Techniques
- Determine ‘implicit memory’ and break down its role in post-traumatic stress disorders as it relates to treatment outcomes.
- Determine potential complications of addressing narrative memories of traumatic events in treatment sessions.
- Specify three interventions that address these complications and put to practical use in session.
- Analyze the efficacy of these interventions and distinguish the signs that traumatic memory has been sufficiently processed.
Session IV - Disorganized Attachment and the Traumatic Transference
- Outline the root causes of ‘disorganized attachment’ status in children and its clinical implications.
- Specify difficulties associated with disorganized attachment for symptom management.
- Articulate the role of disorganized attachment on therapeutic transference/countertransference.
- Utilize clinical strategies that reduce the complications of traumatic attachment in clients.
Session V - The Role of Dissociation in Trauma-Related Disorders
- Differentiate ‘dissociative states’ versus ‘structural dissociation’ as symptoms of trauma and express their treatment implications.
- Evaluate the role of structural dissociation in the treatment of complex trauma and personality disorders.
- Diagnose common trauma-related internal conflicts and determine their impact on clients as it relates to case conceptualization.
- Utilize mindfulness-based interventions to address resolution of internal conflicts in clients.
Session VI - Working with Shame, Fear and Anger
- Articulate the role of shame as an adaptation to trauma and its treatment implications.
- Specify the roles of fear and anger as animal defense survival responses to traumatic experiences in clients.
- Demonstrate use of both somatic and cognitive interventions to decrease shame, fear and anger in clients.
- Determine the role of re-framing in the successful treatment of post-traumatic emotional responses in clients.
Session I: Trauma and the Body
- How the body and brain respond to threat
- Implicit remembering as the hallmark of trauma-related disorders
- Triggers and triggering
- The long-term somatosensory and psychological effects of traumatic experiences
- Understanding trauma-related procedural learning
- Working with the traumatized nervous system
- Restoration of precortical functioning
- Increasing client ability to regulate the nervous system and tolerate triggering
Session II: Working with Complications of Dysregulation
- The consequences of autonomic dysregulation
- Addictive behavior
- Eating Disorders
- Suicidal and self-harming behavior
- Post-traumatic complications of abstinence and sobriety
- An integrated treatment for trauma and unsafe/addictive behavior
- Top-down approaches to regulating dysregulation
- Bottom-up somatic approaches to regulating dysregulation
- Differentiating unsafe versus ‘safer’ versus safe behavior
Session III: Working with Traumatic Memory: Principles and Techniques
- What brain science has taught us about traumatic memory
- Recognizing and understanding implicit memory in client presentations
- Do we treat traumatic events? Or do we treat their consequences?
- Remembering vs. reprocessing vs. repairing
- ‘Telling the story’
- Resolving the implicit memories
- How do we know when memories have been adequately resolved?
- Creating a healing story
Session IV: Disorganized Attachment and the Traumatic Transference
- Attachment and trauma
- The effect of having attachment figures who are neglectful or abusive
- “Frightening and frightened” parenting
- Disorganized attachment and its consequences
- Understanding the effect of disorganized attachment on the therapeutic relationship
- Traumatic transference challenges
- The therapist as a trigger and a neurobiological regulator
- Using the social engagement system to overcome the challenges
Session V: The Role of Dissociation in Trauma-Related Disorders
- Dissociation: normal versus pathological dissociation
- Dissociative states versus structural dissociation
- Understanding the structural dissociation model as a trauma model
- Using mindfulness techniques to identify emotional and behavioral responses as ‘parts’
- Recognizing internal conflicts as survival-related conflicts driven by structurally dissociated parts
- Mindfulness-based interventions to strengthen client resources and prefrontal functioning
- Developing empathic relationships to one’s parts
- Resolving inner conflicts and healing the past
Session VI: Working with Shame, Fear and Anger
- The role of emotion in trauma treatment
- Shame as a survival strategy
- Using somatic and mindfulness-based interventions to address the effects of shame
- Fear as an animal defense response
- Changing client relationships to fear
- Anger as an animal defense response
- Re-framing anger as a ‘bodyguard’ or protection
- Using somatic and mindfulness-based interventions to address fear and anger
Janina Fisher’s Certified Clinical Trauma Professional Training Level 2 (CCTP-II): Treatment of Complex Trauma and Dissociative Disorders
Session I - Introduction to the Treatment of Dissociation
Session II - Increasing Awareness of Dysregulated Parts and Dissociative States
- Determine three signs or symptoms of ‘complex trauma’ as it relates to case conceptualization.
- Differentiate dissociative compartmentalization vs. alterations in consciousness.
- Apply the Structural Dissociation model as related to clinical treatment.
- Determine signs of altered consciousness in traumatized clients.
- Discriminate symptoms caused by activity of trauma-related parts.
- Discriminate signs of voices found in dissociative disorder versus schizophrenic clients.
- Specify therapist interventions that increase patient ability to identify and determine dissociated parts to improve client level of functioning.
- Articulate role of mindfulness-based techniques in the treatment of dissociation.
Session III - Working with Traumatic Memory in DID: Implicit Memory and Animal Defense Survival Responses
- Determine signs of dissociative parts in the therapy hour.
- Determine manifestations of parts observed in physical presentation and facial expression in session.
- Differentiate characteristics of fight, flight, freeze, attach and submit parts.
- Utilize the term ‘blending’ as it applies to structurally dissociated parts for symptom management.
- Implement parts language as an intervention in the therapy of dissociative and dysregulated clients.
- Determine and analyze dissociative “switching” to improve client engagement.
- Utilize clinical strategies to increase internal communication in clients.
- Determine the therapist’s role in ‘coaching’ internal dialogue skills to improve treatment outcomes.
Session IV - Traumatic Attachment and the Treatment of Dissociative Disorders
- Determine the distinction between trauma-related explicit memory and implicit memory for purpose of client psychoeducation.
- Differentiate implicit memories versus situational emotional responses.
- Determine the complications of treating event memories with dissociative disorder clients to improve clinical outcomes.
- Utilize clinical strategies to determine the role of animal defense survival responses in dissociative disorders and their relationship to traumatic memory.
- Determine characteristic trauma-related internal conflicts found in trauma-related disorders as related to clinical treatment.
- Utilize clinical strategies to develop client’s ability to determine internal conflicts as struggles between parts to improve clinical outcomes.
- Determine indications and best practices for processing traumatic memories to inform the clinician’s choice of treatment interventions.
- Apply the meaning of the term “integration” in the treatment of dissociation as it relates to case conceptualization.
Session V - Working with Regression, Aggression and Passivity
- Apply the concept of “controlling strategies” as a complication of disorganized attachment to improve client level of functioning.
- Determine the implications of the controlling strategies in dissociative disorders as related to clinical treatment.
- Differentiate the interaction between traumatic attachment and self-destructive behavior to improve treatment outcomes.
- Articulate the effects of traumatic/disorganized attachment on the transference.
- Demonstrate uses of right brain-to right brain communication to address attachment-related issues.
- Utilize interventions for enhancing internal collaboration.
- Apply the use of the social engagement system (Porges) to improve client engagement.
- Facilitate increased access to states of self-compassion to improve client level of functioning.
Session VI - Integration and Healing
- Articulate the role of regression and aggression as survival responses to threat.
- Analyze personality disorder diagnoses in the light of research on disorganized attachment in clients.
- Specify verbal and somatic interventions for working with client dependency as related to clinical treatment.
- Demonstrate use of somatic and cognitive interventions to ameliorate devaluing and verbally aggressive behavior.
- Articulate the role of depression as an adaptation to trauma.
- Specify cognitive and somatic interventions for addressing chronic depressive states in clients.
- Determine how to address depression and passivity as a part to improve client level of functioning.
- Apply the use of positive re-framing in work with parts of the personality as it relates to treatment outcomes.
- Articulate the traditional view of integration used in dissociative disorders treatment.
- Evaluate the complications of a focus on ‘integration’.
- Demonstrate interventions for increasing internal communication and cooperation among parts.
- Demonstrate internal collaboration as an alternative to traditional models of integration in a clinical setting.
- Determine how “healing” has been defined historically as it relates to clinical practice.
- Articulate ‘bottom-up’ approaches to healing that have developed over the past ten years.
- Determine the ‘negativity bias’ and its effects on psychological health and resilience in clients.
- Outline the role of self-acceptance and compassion in the healing process to improve clinical outcomes.
Session I: Introduction to the Treatment of Dissociation
- What distinguishes ‘complex trauma’ symptoms from the symptoms of simple PTSD?
- The Structural Dissociation model as a trauma model
- Assessment and diagnosis of dissociative symptoms
- Assessment questions and measures
- Mindfulness-based techniques in the treatment of dissociation
- Teaching mindfulness skills to fragmented individuals
- Differentiating structurally dissociated parts of the personality
- Using the language of parts
Session II: Increasing Awareness of Dysregulated Parts and Dissociative States
- Treatment challenges in working with complex trauma and dissociation
- Identifying signs and symptoms of dissociative parts
- Differentiating the presence of fight, flight, freeze, attach and submit parts
- Increasing dual awareness
- Dissociative switching and “blending”
- Helping clients increase their ability to “unblend” from trauma-related parts
- Helping clients decrease dissociative “switching”
- Distinguishing psychotic versus dissociative symptoms
Session III: Working with Traumatic Memory in DID: Implicit Memory and Animal Defense Survival Responses
Session IV: Working with Regression, Aggression and Passivity
- Memory systems: explicit and implicit, voluntary versus involuntary
- The role of procedural memory in complex trauma
- Helping clients differentiate implicit and procedural memories from situational responses
- Dissociative compartmentalization as a complication in memory processing
- Loss of a sense of time and place due to fragmentation
- Re-thinking the role of witnessing client’s traumatic experiences
- Discuss indications and best practices for processing traumatic memories in this population
Session V: Traumatic Transference in the Treatment of Dissociative Disorders
- Traumatic attachment and animal defenses
- The “controlling strategies” in individuals with disorganized attachment
- Regression and aggression as controlling strategies driven by trauma-related parts
- Working with regressive states and child parts
- Aggression in therapy: devaluing and self-destructive behavior
- Working with verbally abusive and devaluing parts
- Depressive states as an adaptation to trauma
- Interventions for addressing chronic depressive states
Session VI: Integration and Healing
- Stimulation of the attachment system in therapeutic relationships
- Effects of traumatic/disorganized attachment on the transference
- Why some clients become more dysregulated rather than less
- Co-regulation and right brain-to right brain communication
- How therapists can use contingent co-regulation in treatment
- Internal attachment versus self-alienation
- Using the social engagement system
- Rupture and repair: visualization techniques for repairing childhood attachment failure
- ‘Integration’ as the goal of dissociative disorders treatment
- What does it mean to be “integrated”?
- The evolution of treatment models for dissociative disorders
- Identify interventions for increasing internal communication and cooperation among parts
- Markers of progress in fragmented individuals
- How should clients and therapists define “healing”?
- Self-acceptance and compassion in the healing process
- Best practices in trauma treatment
Trauma Defined: Bessel van der Kolk on The Body Keeps the Score
- Evaluate how trauma influences the activity of the key areas of the brain and how that dictates behavior patterns in clients.
- Articulate the clinical research surrounding the effectiveness of yoga, mindfulness meditation, and theater in healing trauma in clients.
The Latest Clinical Research Surrounding:
- The impact of trauma on brain activity
- Neurofeedback, EMDR and “body work” on symptom reduction
- The effectiveness of movement, mindfulness and theater activities in trauma treatment
Overcoming Trauma-Related Shame and Self-Loathing with Janina Fisher, Ph.D.
- Discriminate the clinical implications of physiological and cognitive contributors to shame.
- Determine cognitive-behavioral, ego state, and psychoeducational interventions to address shame in clients.
The Neurobiology of Shame
Shame’s Evolutionary Purpose
- The role of shame in traumatic experience
- Shame as an animal defense survival response
- Effects of shame on autonomic arousal
Making Meaning of Shame
- Shame and the attachment system
- Rupture and repair in attachment formation
Working from the “Bottom Up”
- Feelings of disgust, degradation, and humiliation are interpreted as “who I am”
- Cognition and the body
- Internal working models predict the future and determine our actions
A New Relationship to the Shame: Acceptance and Compassion
- The role of procedural learning and memory
- Physiological effects of mindful dual awareness
- Using mindfulness-based techniques to inhibit self-judgment
The Social Engagement System and the Healing of Shame
- Re-contextualizing shame as a younger self or part
- Bringing our adult capacity to our childhood vulnerability
- Healing shame through compassionate acceptance
- Social engagement and the ventral vagal system (Porges)
- The incompatibility of shame and social engagement
- The therapist’s own social engagement system as a healing agent