Trauma treatment is invariably complicated by the fact that most traumatic experiences involve incompetence or cruelty perpetrated by other human beings. Thereafter, even loved ones no longer feel safe: they feel threatening
Coming to therapy is a cry for help, requiring vulnerability.
But being offered help has often come to be associated with powerlessness, manipulation, and humiliation. Even when clients sincerely want something different for themselves, they cannot control the triggering of instinctive survival defences, nor the fact that each survival response is inherently in conflict with another. Should the client commit to therapy or flee? Combat the therapist’s every effort? Or “submit” by coming but not fully participating?
In this workshop, you will explore the complex relationships between these internal trauma-related conflicts and resistance in psychotherapy. Using techniques drawn from Sensorimotor Psychotherapy, Internal Family Systems, and other mindfulness-based psychotherapy models, participants will learn how to de-code resistance and help clients become aware of their therapy-related conflicts and resistance as a normal aspect of trauma treatment.
What we clinicians often label “resistance” may reflect inherent trauma-related conflicts activated by all forms of treatment and all types of therapists. Resistance can manifest in any of the following ways:
A passive aggressive ‘no’ to every therapeutic intervention
Unchecked self-destructive behaviour
A struggle for therapeutic control
Desperation for help alternating with resistance to accepting it
Purchase today! You have a chance to become part of the solution instead of part of the problem.
CPD
CPD
This online program is worth 12.5 hours CPD.
Handouts
File type
File name
Number of pages
PDF
Manual - Transforming Trauma-Related Resistance and Stuckness
(4.3 MB)
Janina Fisher, PhD, is a licensed clinical psychologist and former instructor at The Trauma Center, a research and treatment center founded by Bessel van der Kolk. Known as an expert on the treatment of trauma, Dr. Fisher has also been treating individuals, couples, and families since 1980.
She is past president of the New England Society for the Treatment of Trauma and Dissociation, an EMDR International Association Credit Provider, Assistant Educational Director of the Sensorimotor Psychotherapy Institute, and a former Instructor, at Harvard Medical School. Dr. Fisher lectures and teaches nationally and internationally on topics related to the integration of the neurobiological research and newer trauma treatment paradigms into traditional therapeutic modalities.
She is co-author with Pat Ogden of Sensorimotor Psychotherapy: Interventions for Attachment and Trauma (2015) and author of Healing the Fragmented Selves of Trauma Survivors: Overcoming Internal Self-Alienation (2017) and the forthcoming book, Working with the Neurobiological Legacy of Trauma (in press).
Speaker Disclosures:
Financial: Dr. Janina Fisher has an employment relationship with the Sensorimotor Psychotherapy Institute. She is a consultant for Khiron House Clinics and the Massachusetts Department of MH Restraint and Seclusion Initiative. Dr. Fisher receives royalties as a published author. She receives a speaking honorarium, recording royalties and book royalties from Psychotherapy Networker and PESI, Inc. Dr. Fisher has no relevant financial relationships with ineligible organizations.
Non-financial: Dr. Janina Fisher is on the advisory board for the Trauma Research Foundation. She is a patron of the Bowlby Center.
Objectives
Evaluate the effects of traumatic experience on attachment formation.
Determine the role of implicit memory in post-traumatic symptoms.
Investigate manifestations of animal defence survival responses.
Differentiate common conflicts between survival defences observed in relationships.
Determine the aspects of psychotherapy that evoke defensive responses in traumatized clients.
Assess the association between client resistance or stuckness and trauma-related survival defences.
Practice methods of evoking curiosity in stuck or resistant clients that move therapy forward.
Evaluate the role of ‘positive re-framing’ symptoms in trauma treatment.
Utilize Sensorimotor Psychotherapy interventions to help clients notice resistance without shame.
Determine use of the structural dissociation model for understanding resistance.
Utilize parts-related interventions to help clients resolve their resistance and/or “stuckness”.
Determine any signs of therapist resistance to resistant clients and how to plan therapy sessions around this issue.
Outline
DAY ONE
What do we mean by resistance and stuckness?
Depression, shame, self-loathing
Chronic suicidality or self-destructive behaviour
Belief that nothing will work
Difficulty coming to or being present in therapy
Struggles for control of the process
Therapy as a threat, not a refuge
Phobias of vulnerability
Phobias of closeness or being visible
Phobias of abandonment and distance
Trauma-related fear and mistrust
How manifestations of stuckness and resistance reflect animal defences
Survival responses and strategies
Introduction to the Structural Dissociation Model
Understanding resistance and stuckness as defensive, not offensive
How we interpret resistance may increase, not decrease it
Triggering aspects of psychotherapy
Decreasing the ‘threat’
Positively re-framing stuckness and resistance as adaptive
Acknowledging and sharing the dilemma: the client wants help but not at the cost of vulnerability
Using the therapeutic relationship
Navigating the threat of closeness and the threat of distance
Making use of the “social engagement system”
Therapeutic benefits of laughter and playfulness
DAY TWO
Helping clients deconstruct inner conflicts and struggles
Making use of the Structural Dissociation Model in therapy
Helping clients understand internal conflicts as struggles between parts
Using the language of parts to articulate and highlight contradictory behaviour
Honouring the parts who defend by resisting
Increasing client ability to observe trauma-related patterns
Introducing mindfulness as a therapeutic tool
Increasing curiosity and interest
Using psychoeducation to challenge existing beliefs and patterns
”Befriending” the resistance
Letting go of our need for the client to change or engage
Facilitating empathy for parts who defend and parts that feel injured
Re-framing resistance and stuckness as “the parts,” not the whole of the client
Cultivating compassionate internal relationships
Creative solutions for old and obsolete survival strategies
”Negotiated settlements” with defender parts
Internal soothing and comfort for hurt and fearful parts
Therapeutic support for resistance and acceptance of stuckness
Creating a sense of “we” that includes the parts who collaborate and the parts who resist as well as the therapist
Healing the wounds of the past
Providing ‘missing experiences’ of healthy attachment
Therapy as a play space: balancing permissiveness and structure
”Being” the therapeutic relationship instead of talking about it
Enjoying the struggles rather than resisting them
Target Audience
Counselors
Social Workers
Psychologists
Case Manager
Addiction Counselors
Therapists
Marriage & Family Therapists
Nurses
Other Mental Health Professionals
Reviews
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Additional Physical CPD
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