Trauma Informed Stabilisation Treatment (TIST) in Brisbane & Online (Australia)
"Healing happens when we understand our parts, not when we fight against them."
Understanding yourself through the lens of parts can genty shift your relationship with trauma.
If you have been told you're "too complex" or felt like most talk or even trauma therapy just scratches the surface, this is for you.
You've tried different therapies, maybe worked with multiple therapists, and while you've gained insights about your trauma, the overwhelming feelings, sudden shifts in mood, and sense of fragmentation persist. You might notice that sometimes you feel like different versions of yourself - one moment coping well, the next moment completely overwhelmed, as if you weren't even present.
You wonder if there's a way to work with these different aspects of yourself rather than trying to force them into one coherent whole that never quite fits.
Perhaps you've noticed that certain situations trigger completely different reactions depending on the day - or even the hour. Last week, you might have handled a difficult conversation with calm assertiveness, but today, a similar interaction leaves you feeling small, speechless, or filled with rage you can't quite explain. It's not that you're inconsistent or unstable - it's that different parts of you hold different responses that once kept you safe.
Maybe you find yourself experiencing sudden shifts that feel almost like switching channels. You might be going through your day feeling competent and in control, then something seemingly minor happens - a certain tone of voice, a particular situation - and suddenly you're flooded with emotions that feel too big, too young, or simply not yours. Or perhaps the opposite: you go numb, feel disconnected from your body, watch yourself from a distance as if you're observing someone else's life.
You might have parts that hold contradictory beliefs about yourself. One part perhaps knows intellectually that the trauma wasn't your fault, while another part carries deep shame and certainty that you deserved it. One part perhaps desperately wants connection, while another pushes people away at the first sign of closeness. These feel contradicting and they're different aspects of your experience that developed under different circumstances, each trying to protect you in the ways they learned.
Some people notice gaps in memory or time - not dramatic blackouts necessarily, but realizing they don't quite remember how they got somewhere, or that hours have passed in what felt like minutes. Others find belongings they don't remember purchasing, or discover they've sent messages or had conversations they have only vague recollection of. Your parts may have been handling life when you weren't fully present.
You might recognise the experience of feeling much younger than your actual age in certain moments - your voice changes, your posture shifts, you feel vulnerable in ways that seem disproportionate to what's happening around you. This isn't regression in the pathological sense; it maybe a younger part of you stepping forward, still carrying the fear or need from when they first formed.
Or perhaps you've noticed yourself being unusually harsh or critical - toward yourself or others - in ways that surprise you afterward. There may be a protective part who learned that staying vigilant, finding fault first, or maintaining emotional distance prevented further harm. That part isn't mean; they're scared and doing their best with strategies that once worked.
These experiences are signs that your system found creative ways to survive experiences that were too much to hold as one coherent whole. TIST offers a way to understand these parts, honor what they've done for you, and help them learn that the situations they're protecting you from have changed.
That's where TIST comes in.
What is TIST?
Trauma Informed Stabilisation Treatment (TIST) is a therapeutic approach developed by Dr. Janina Fisher specifically for individuals who have experienced complex trauma and structural dissociation. Rather than viewing your reactions and different states as symptoms to eliminate, TIST recognizes them as intelligent survival strategies that helped you cope with overwhelming experiences.
TIST integrates neuroscience research on trauma with structural dissociation theory, combining elements from mindfulness-based cognitive therapy, Sensorimotor Psychotherapy, ego state techniques, and Internal Family Systems. The approach works with the understanding that when childhood trauma involves neglect, abandonment, or chronic adverse experiences, it can leave individuals with fragmented aspects of self and experience- what we call "parts."
Instead of asking "what's wrong with you?" TIST asks "what happened to you and how did parts of you learn to survive" and more importantly, "what are your parts trying to protect you from?" This shift moves away from shame and pathology toward understanding and compassion.
How does TIST work?
TIST follows the gold standard three-phase approach to trauma treatment:
Phase 1: Safety and Stabilisation
We begin by helping you understand structural dissociation and identify your different parts. You'll learn that the intense and overwhelming thoughts, feelings, and sensations you experience are often driven by implicit trauma memories - things your body remembers even when your conscious mind doesn't. We focus on building your capacity to notice and be curious about your parts rather than being overwhelmed by them.
This phase involves developing skills to regulate your nervous system, reduce reliance on survival adaptations (like self-harm, disordered eating, or substance use), and create internal cooperation between your parts. We work on expanding your window of tolerance so you can manage distressing experiences without becoming dysregulated.
Phase 2: Processing Trauma
Once you have developed sufficient stability and internal resources, we begin processing the traumatic memories held by your parts. This is done carefully and at a pace that feels manageable. The focus is on resolving the impacts of trauma, not reliving it. We work with the parts holding trauma memories to help them understand that the danger has passed and they no longer need to stay stuck in survival mode.
Phase 3: Integration and Moving Forward
The final phase focuses on helping your parts work together more cohesively. Integration doesn't mean parts disappear or merge into one - rather, it means they become more aware of each other, cooperate better, and can function in the present rather than remaining stuck in trauma time. You develop a stronger sense of wholeness and connection to yourself.
Read More Understanding Structural Dissociation
To understand TIST, it's helpful to understand the concept of structural dissociation. This theory explains how trauma can cause a division in personality, creating different "parts or states" of self. This isn't always about multiple personalities, it's about understanding how our system fragments when experiences become too overwhelming.
Our brains have two hemispheres that can function interdependently. Research indicates that the left hemisphere helps us "keep on keeping on" with daily life, while the right hemisphere mobilizes physical survival resources and holds emotional and trauma experiences. When trauma is severe or chronic, this natural division can become more pronounced, creating distinct parts that remain separated rather than integrated.
Types of Structural Dissociation:
Primary Dissociation: Typically seen with single-incident trauma or PTSD, involving one "going on with normal life" part and one trauma part. The trauma part holds the traumatic memories while the going on with normal life part manages daily functioning and avoids trauma reminders.
Secondary Dissociation: Common with complex PTSD from repeated trauma, particularly when it occurs in childhood or involves betrayal by caregivers. This involves one going on with normal life part and multiple trauma parts, each holding different survival strategies like fight, flight, freeze, submit, or attach responses.
Tertiary Dissociation: Seen in Dissociative Identity Disorder (DID) following severe, prolonged complex trauma. This involves multiple going on with normal life parts and multiple trauma parts, each with distinct roles and levels of awareness.
Common Parts and Their Functions
In TIST, we recognize that parts developed for protective reasons. Common types include:
Fight parts: These parts are hypervigilant and protective. They may express anger, judgement toward others, or hold self-harm behaviors as a way of maintaining control or expressing pain that couldn't be expressed during trauma.
Flight parts: These parts seek escape through distance, avoidance, or numbing behaviors like substance use, disordered eating, or dissociation.
Freeze parts: These parts hold fear and terror. They may cause you to feel frozen, experience panic attacks, or isolate to feel safe.
Submit parts: These parts hold shame and express themselves through hopelessness, self-hatred, people-pleasing, or self-sacrifice. They learned that compliance reduced harm.
Attach parts: These parts hold the deep need for connection and may feel desperate for rescue or relationship, similar to a young child's dependency needs.
TIST can help with:
Complex PTSD (C-PTSD)
Dissociative disorders including DID, OSDD and UDD
Childhood trauma, abuse, and neglect
Disorganized attachment patterns
Borderline personality patterns
Chronic dysregulation and mood instability
Self-harm and suicidal ideation
Eating disorders and addictive behaviors
Persistent shame and self-blame
Difficulty maintaining relationships
Anxiety and Depression
Somatic complaints
Many people who engage in TIST notice:
Greater understanding and compassion for their different parts
Reduced shame about their trauma responses
Improved ability to regulate emotions and stay present
Decreased reliance on harmful coping strategies
Better internal communication and cooperation between parts
Increased sense of safety in their body
More stability in relationships and daily functioning
Ability to be curious rather than overwhelmed by their experiences
Parts shifting from "trauma time" to present awareness
With TIST, you can learn to work with your trauma and survival parts rather than against them, transforming survival strategies into integrated strengths.
FAQs about TIST
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TIST differs from traditional trauma therapies in several key ways. Unlike approaches that focus primarily on processing traumatic events, TIST emphasizes understanding and working with the fragmented parts of self that developed as a result of trauma. Rather than viewing symptoms as problems to eliminate, TIST recognizes them as intelligent adaptations that once served protective functions.
TIST is specifically designed for complex trauma and structural dissociation, making it particularly effective for individuals who have tried other therapies without success. It integrates body-based (somatic) approaches with cognitive and parts-work methods, addressing how trauma is stored in the nervous system, not just in memory.
The approach empowers clients to be curious about their parts and builds internal collaboration, rather than trying to create a unified "single self." This is especially important for individuals with dissociative disorders where integration means cooperation, not elimination of parts.
TIST works really well with somatic approaches for trauma treatment -
No. While TIST was developed specifically for working with inpatients with Self harm, Suicidality, BPD, Eating Disorders, Addictive Disorders and structural dissociation, it can benefit anyone who has experienced complex trauma. Many people with C-PTSD, borderline personality patterns, or chronic childhood trauma experience some degree of fragmentation or "parts," even if they don't meet criteria for a dissociative disorder.
If you've noticed that you sometimes feel like different versions of yourself, struggle with conflicting thoughts or emotions, or find yourself reacting in ways that don't match your adult understanding of situations, TIST may be helpful. The approach is adaptable and can be applied based on the level of dissociation present, from secondary dissociation (common in C-PTSD) to tertiary dissociation (seen in DID).
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TIST is a phased approach, and the timeline varies significantly based on individual circumstances. The stabilization phase (Phase 1) typically takes several months to a year or more, as building safety, understanding parts, and developing regulation skills is foundational work that cannot be rushed.
For individuals with complex trauma, treatment often extends over several years. This isn't because TIST is ineffective - rather, it reflects the reality that healing from chronic, developmental trauma takes time. The brain and nervous system need repeated, safe experiences to update old survival patterns.
Progress isn't always linear. There may be periods of significant growth followed by times when old patterns resurface, especially during stress. This is normal and part of the healing process. Your therapist will work at a pace that feels manageable and safe for you and your parts.
That said, SP requires some baseline capacity to notice and remain present with internal experience. If you're currently experiencing significant dissociation, overwhelming emotional flooding, or acute crisis, building stabilization skills first may be recommended before engaging in trauma processing. An initial consultation helps determine whether this approach aligns with your current needs and capacities.
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This is one of the most common questions, especially for individuals with DID or OSDD. In TIST, the goal is not to eliminate parts or force them to merge into a single identity. Instead, the focus is on what's called "functional integration" - helping you become aware of your parts and become aware of each other, reduce internal conflict, cooperate, and share resources.
For some people, parts may naturally blend over time as they no longer need to remain separate. For others, particularly those with DID, parts may remain distinct but learn to work together harmoniously. Both outcomes are valid and healthy. The emphasis is on reducing suffering and improving functioning, not on achieving a specific configuration of self.
Your parts developed for good reasons and have kept you safe. TIST honors this and focuses on helping parts update their understanding so they know the danger has passed, rather than trying to make them disappear.
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Yes, TIST can be effectively delivered through telehealth. Many clients actually prefer online sessions as they can engage in therapy from a safe, familiar environment where they have access to comfort items, supportive people or pets, and their own resources for regulation.
Online therapy can be particularly beneficial for individuals with complex trauma who may struggle with the vulnerability of being in a therapist's office, or for those whose parts feel safer in their own space.
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Like all therapeutic approaches, TIST has limitations and has faced some critique. It's important to be aware of these when considering treatment:
Requires significant time and resources: TIST is a longer-term therapy requiring considerable commitment. The phased approach means months to years of treatment, which may not be accessible to everyone due to financial constraints or limited availability of trained therapists.
Limited research base: While TIST is based on established theories (structural dissociation, neuroscience research), it is a relatively newer, integrated approach and doesn't yet have the extensive research base of some other trauma treatments like EMDR or CPT. More empirical studies are needed to establish its effectiveness across diverse populations.
Language concerns: Some of the terminology in structural dissociation theory has been critiqued as potentially ableist or pathologizing. Terms like "apparently normal part" or "emotional part" can feel invalidating. Many practitioners, including Dr. Fisher, have adapted language to be more respectful (e.g., "going on with normal life parts" and "trauma parts").
Risk of destabilization when working with professionals who lack training and certification in dissociation: Working with parts and trauma memories can sometimes lead to increased awareness of painful experiences, which may feel destabilizing, especially early in treatment. This is why Phase 1 (stabilization) is so crucial and why the approach must be implemented by trained therapists who understand pacing and safety.
May reinforce fragmentation when working with professionals who lack training and certification in dissociation: Some critics worry that focusing on parts might reinforce dissociative barriers rather than promoting integration. However, TIST practitioners emphasize that acknowledging parts is about validating existing experience, not creating division, and that this acknowledgment is necessary before integration can occur.
Therapist training variability: The effectiveness of TIST depends significantly on the therapist's training and understanding of both trauma and dissociation. Not all therapists who claim to practice TIST have adequate training, which can lead to ineffective or potentially harmful treatment.
Despite these limitations, many individuals with complex trauma and dissociative experiences find TIST to be one of the first approaches that truly validates their experience and provides a framework for understanding themselves. As with any therapy, it's important to discuss concerns with your therapist and ensure the approach feels right for you.
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Finding the right therapist is crucial for effective TIST. Look for a therapist who has:
Specific training in TIST from Dr. Janina Fisher or recognized training programs
Understanding of structural dissociation theory and complex trauma
Training in somatic or body-based approaches (like Sensorimotor Psychotherapy or Somatic Experiencing)
Experience working with dissociative disorders if you have DID or OSDD
A trauma-informed, non-pathologizing approach
Willingness to work at your pace and respect your parts' perspectives
It's also important that you feel safe with and connected to your therapist. The therapeutic relationship is one of the most important factors in healing from complex trauma. Don't hesitate to interview potential therapists or request a consultation to ensure it feels like a good fit.
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We'll start with an initial consultation to explore appropriately your history, current concerns, and therapy goals. This meeting allows us to determine whether TIST aligns with your needs and whether we're a good therapeutic fit.
The therapeutic relationship is foundational to effective trauma work, so it's essential that you feel safe and comfortable. If either of us determines we're not the best match, I'm happy to provide referrals to other qualified practitioners.
If we decide to work together, we'll establish a regular session schedule and begin building the foundation for this healing work.