Janina Fisher Discusses Parts, Polyvagal Theory and TIST

Trigger Warning: Please be advised, this episode contains dialogue about self-harm, abuse, and other sensitive topics. Please take care while listening and feel free to skip this episode if needed.

In this episode, Dr Janina Fisher joins Travis Goodman to unpack why traditional talk therapy often fails clients with complex trauma, chronic self-harm tendencies, and what methods can move them towards safety & healing. 

Janina shares how studying with Judith Herman and working alongside Bessel van der Kolk shaped her view that people suffer because real things happened to them, not because of “personality defects.” She explains how Trauma-Informed Stabilization Treatment (TIST) grew out of her work in a state hospital with patients labelled “untreatable” who lived with constant crisis, self-hatred and unsafe behavior. 

You will hear how TIST integrates parts work, structural dissociation, sensorimotor psychotherapy, Internal Family Systems, somatic therapy and Polyvagal Theory to create a practical, non-pathologizing way to work with suicidal parts, self-harm, eating disorders and dissociation. 

Across the conversation we explore:
• Why many clients cannot use DBT or coping skills once the prefrontal cortex goes offline in a trauma response
• How to shift from “I want to die” to “there is a part of me that wants to die” and why that language changes impulse and shame
• Using visuals and simple somatic cues instead of complex language when clients are highly activated
• How polyvagal social engagement and co-regulation support parts work and attachment repair in-session
• What “gridlock” between parts looks like and how to help clients unblend and relate to their suicidal, ashamed and protective parts
• Why focusing only on “the event” misses the ongoing context of danger, neglect and not being seen
• How TIST offers a structured path for complex trauma, chronic suicidality and self-destructive behavior in real-world systems, including hospitals and community settings 

We also talk about where Janina hopes the trauma field goes in the next decade: more trauma-informed therapists worldwide, less model tribalism, and Polyvagal Theory as a unifying lens that can plug into EMDR, IFS, somatic work and beyond. 

This episode is for trauma therapists, coaches and survivors who want a clear, compassionate framework for working with extreme symptoms without pathologizing the person.

CONNECT WITH Polyvagal Institute:  
WEB: www.polyvagalinstitute.org
Instagram: @polyvagalinstitute
LinkedIn: polyvagal-institute
Email: community@polyvagal.org

CONNECT WITH Travis Goodman:  
Instagram: Travis.Goodman.LMFT