Trauma Informed Stabilization Treatment (TIST)
Trauma is a complex and multifaceted experience that deeply impacts individuals on emotional, psychological, and physiological levels.
Trauma-Informed Stabilization Treatment (TIST), developed by Janina Fisher, offers a holistic approach to addressing all forms of trauma by understanding the intricate workings of the autonomic nervous system and employing various therapeutic techniques to promote stabilisation, integration of inner and outer experience and new experiences which develop a sense of self-efficacy and personal power.
One of the key ways TIST promotes stabilisation is by focusing on implicit memory rather than explicit memory of trauma. Think of implicit memory as body memories or feeling memories rather than memory that has a verbal story or narrative attached to it.
Therapeutically, it can be helpful to focus on implicit memories, especially in the initial stages of trauma treatment. Firstly, the individual may not have an explicit memory of the trauma. Secondly, implicit memory often underlies the most disruptive symptoms of trauma that cause so much trouble for the individual, such as flashbacks, dissociation, and hypervigilance.
Since implicit memory is primarily not conscious (before treatment), it creates tremendous confusion about what is happening for the person internally. A person experiencing implicit memory that include a range of large emotions and/or shutdown responses may wonder, “why am I reacting so strongly, is something wrong with me, am I going crazy?”.
By focusing on implicit memory in trauma treatment first, the person can learn to recognize the reactions as body memories, or in other words, the way the body remembered responding to a past threat that is triggered in the here and now. This helps to make sense of the reactions and simultaneously helps reduce the intensity and duration of large reactions.
Understanding the Autonomic Nervous System
The autonomic nervous system (ANS) plays a crucial role in regulating bodily functions, including heart rate, digestion, and respiratory rate. It consists of two main branches: the sympathetic nervous system (SNS), responsible for the body's "fight or flight" response, and the parasympathetic nervous system (PNS), which helps the body rest and digest. In cases of trauma, the ANS can become dysregulated, leading to heightened states of arousal or hypoarousal.
Signs of Autonomic Nervous System Hyperarousal (Sympathetic) and Hypoarousal (Parasympathetic)
Hyperarousal of the nervous system manifests as symptoms such as increased heart rate, hypervigilance, anger, irritability, panic and difficulty concentrating. On the other hand, hypoarousal presents as feelings of numbness, dissociation, lethargy, and a sense of being disconnected from one's surroundings. Recognizing these signs is crucial in learning to notice signs of dysregulation and to be able to apply ways of up or down regulating the nervous system back into a balanced state. The goal is not to eliminate the nervous system responses because they are crucial to survival, but to be able to move flexibly through them - to not get stuck in hyper or hypo aroused states.
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Identifying Survival States
In response to trauma, individuals enter various survival states, including fight, flight, freeze, submit, and attach. These states represent adaptive responses aimed at ensuring survival in the face of perceived threat. By understanding these survival states, individuals can gain insight into their automatic responses and develop strategies to regulate them effectively.
Reframing Survival States
Rather than viewing survival states as maladaptive behaviours, TIST reframes them as ingenious strategies for coping with overwhelming experiences. By acknowledging the adaptive nature of these responses, individuals can cultivate self-compassion and resilience on their healing journey.
Understanding How the Brain Naturally Compartmentalizes
The brain has a remarkable ability to compartmentalize information, both as a protective mechanism in response to trauma and in skillful, intentional ways such as athletes blocking out distractions while engaged in sports. However, if compartmentalization becomes rigid and automatic, one’s experience can become fragmented and confusing. TIST seeks to facilitate inner integration by creating safe spaces and means for exploring and processing fragmented aspects of the self.
Utilizing "Parts" Language
Drawing from Internal Family Systems (IFS), TIST incorporates "parts" language to help individuals identify and communicate with different aspects of themselves. By acknowledging and honoring these parts, individuals can foster self-awareness and work toward an inner sense of harmony.
Tapping into the Wisdom of the Body With Sensorimotor Psychotherapy Approaches
Sensorimotor psychotherapy techniques are integral to TIST, as they focus on working with the physical sensations that accompany survival states. By attending to bodily experiences, individuals learn to regulate their nervous system responses and cultivate a sense of safety.
Conclusion
Trauma-Informed Stabilization Treatment offers a comprehensive framework for understanding and addressing trauma by integrating knowledge of the autonomic nervous system, survival states, implicit memory, the brain’s ability to use compartmentalization, and a variety of therapeutic skills.
By embracing a holistic approach that honours the varying complexity of traumatic experiences, TIST empowers individuals to recognize the factors that keep traumatic responses in place and to use tools that help pave the way for new responses that align with how they truly want to live.
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