Book Review: Transforming the Living Legacy of Trauma: A Workbook for Survivors and Therapists by Dr. Janina Fisher, PhD

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Introduction

Childhood trauma is a significant and pervasive issue, with far-reaching consequences for mental health. In the general population, an alarming 58% of youth in the United States report exposure to various forms of assault, bullying, sexual victimization, or maltreatment by a caregiver. Among LGBTQ youth, the rates are even higher. A recent study found that 58% of LGBTQ youth had experienced emotional neglect, 56% reported abuse, and 41% had lived with a family member with mental illness (Ramos & Marr, 2023). Further research reveals that 83% of lesbian, gay, bisexual, and queer (LGBQ) adults reported experiencing at least one adverse childhood experience (ACE), with 52% of them having faced three or more ACEs—figures far higher than those reported by their straight peers (Vanderbilt University Medical Center, 2023). These experiences often lead to worse mental health outcomes, including depression, anxiety, and complex trauma.

For transgender and gender-diverse (TGD) individuals, trauma may be further compounded by societal marginalization, bullying, and familial rejection, leading to an overwhelming sense of reliving the abuse. Many survivors feel caught in an endless cycle of re-experiencing trauma, even if the events themselves have long since passed. Those with severe trauma histories may receive diagnoses such as Borderline Personality Disorder (BPD), Complex Post-Traumatic Stress Disorder (C-PTSD), or Dissociative Identity Disorder (DID), reflecting the layers of trauma that have shaped their sense of self and safety.

In response to this overwhelming need, Dr. Janina Fisher developed Trauma-Informed Stabilization Treatment (TIST), a protocol designed to help survivors gently and effectively navigate their trauma. TIST is grounded in neurobiology, offering a parts-based approach that empowers individuals to reclaim autonomy and agency in their healing process. I first encountered Dr. Fisher’s work early in my career as a psychotherapist and art therapist, while working in a public-facing nonprofit on Vancouver’s Downtown Eastside (DTES) and as a sexual assault counselor. These early-career experiences introduced me to the complex and compounding mental health concerns that many trauma survivors face, and TIST quickly became a cornerstone of my therapeutic work.

Dr. Fisher’s workbook, Transforming the Living Legacy of Trauma: A Workbook for Survivors and Therapists, is a resource that I continue to recommend to clients navigating the lasting impact of trauma. It builds on her previous work, Healing the Fragmented Selves of Trauma Survivors, and provides survivors with practical exercises, accessible neuroscience, and compassionate guidance. This review will explore the core components of the workbook and reflect on its relevance, particularly for Two Spirit, trans, nonbinary, and queer individuals.

Overview: The Living Legacy of Trauma

In Transforming the Living Legacy of Trauma, Janina Fisher introduces the powerful concept of the “living legacy” of trauma—the persistent emotional, physical, and psychological effects that survivors carry long after the traumatic events have ended. Trauma is not merely a historical event but an active presence in the daily lives of survivors, showing up in patterns of behaviour, physical symptoms, and emotional responses that seem out of proportion to the current situation. This “living legacy” can manifest as hypervigilance, chronic pain, dissociation, or a pervasive sense of fear or shame. Fisher highlights how trauma survivors often feel as though the abuse is ongoing, trapped in an endless loop of reliving the past.

What makes Fisher’s approach especially impactful is her ability to normalize these trauma symptoms as adaptive survival strategies. Rather than pathologizing trauma responses, Fisher helps survivors understand that these patterns served a critical purpose in protecting them during periods of danger and continue to arise in an attempt to keep them safe. This reframing is empowering and compassionate, granting survivors agency in transforming their trauma responses.

One of the strengths of Fisher’s work is her integration of neuroscience into the therapeutic process. She explains how trauma affects the brain, particularly through the shutdown of the prefrontal cortex—the part responsible for reasoning and decision-making—and the overactivation of the amygdala, the brain’s alarm system. This leads to heightened emotional reactivity, difficulty regulating emotions, and an inability to distinguish past trauma from present safety. Fisher’s explanations are rooted in accessible neuroscience, helping clients understand their bodily and mental reactions.

For many trauma survivors, especially those who are non-verbal or find it challenging to articulate their experiences, Fisher’s use of visual aids like diagrams and worksheets is invaluable. These tools make complex neurobiological concepts approachable, allowing clients to visually map their experiences and recognize the connections between trauma and their current symptoms. The inclusion of step-by-step exercises throughout the workbook, such as body scans and mindfulness practices, enables clients to engage with their trauma in a way that feels safe and manageable, even when verbal expression is difficult.

Fisher also emphasizes the importance of “dual awareness,” a cornerstone of Trauma-Informed Stabilization Treatment (TIST). This involves helping clients develop the ability to observe their trauma responses while simultaneously recognizing that they are in the present moment. Dual awareness allows survivors to create distance between their traumatic memories and their present-day experiences, fostering a sense of safety and control. Fisher’s workbook guides survivors through this process, providing practical exercises that encourage mindfulness and self-compassion, and ultimately helping them to reconnect with their bodies and emotions in a healthier way.

This accessible and compassionate approach makes Transforming the Living Legacy of Trauma a critical resource for those dealing with complex trauma, particularly for Two Spirit, trans, nonbinary, and queer individuals, who may face additional layers of societal and familial trauma. The workbook’s focus on understanding trauma through a non-pathologizing, neuroscience-based lens allows for a healing process that honours the resilience and survival strategies of trauma survivors while gently guiding them toward greater autonomy and emotional regulation.

Key Concepts and Takeaways

In Transforming the Living Legacy of Trauma, Janina Fisher masterfully integrates psychoeducation with practical exercises, empowering trauma survivors to not only understand but also transform their symptoms. The book offers a variety of key insights and therapeutic approaches that can significantly benefit survivors, particularly those with complex trauma histories. Below are some of the most impactful takeaways from the book:

Trauma and the Nervous System

Fisher explains in depth how trauma impacts the nervous system, causing disruptions that lead to survival-based responses such as hyperarousal, dissociation, and numbing. These responses, while distressing in the present, originated as adaptive mechanisms designed to protect the individual from overwhelming threat. Fisher emphasizes that the nervous system, particularly the autonomic nervous system, is often locked in a state of perpetual vigilance or shutdown as a result of trauma.

Fisher’s psychoeducational approach helps clients understand these responses at a biological level, often the first step toward healing. By helping clients recognize responses like hyperarousal, emotional numbing, or dissociation, therapists can guide them toward new coping strategies. These strategies teach the body to feel safe again and foster more adaptive ways to handle stress.

For queer, trans, and nonbinary clients, recognizing these responses as adaptive demystifies overwhelming feelings of shame or fear. Understanding that their trauma-related reactions are normal survival mechanisms provides a compassionate lens through which clients can view their experiences.

Parts Work: Engaging with Dissociated Selves

A cornerstone of Fisher’s Trauma-Informed Stabilization Treatment (TIST) is the concept of parts work, which involves recognizing and working with dissociated parts of the self. These parts are trauma-related fragments of the individual’s psyche that hold specific emotions, memories, or survival instincts. Fisher identifies that trauma survivors often dissociate as a way to cope with unbearable experiences, leading to the creation of fragmented parts that continue to exist in a state of vigilance, pain, or fear.

The process of parts work invites clients to develop a compassionate, non-judgmental relationship with these dissociated parts. Fisher guides therapists through the steps of helping clients identify and “unblend” from these parts—moving from an over-identification with trauma-related emotions to a place where they can observe and interact with these parts from a grounded, mindful perspective. This approach fosters dual awareness, helping clients maintain their sense of self in the present while acknowledging the pain and needs of their dissociated parts. Techniques such as mindful dialogue, somatic grounding, and internal family systems-like interactions help clients re-establish connections with their wounded parts in ways that promote healing and integration.

For trans, nonbinary, and Two Spirit individuals, this approach can be particularly powerful. Many gender-diverse people experience a sense of dissociation or fragmentation due to internalized societal rejection, dysphoria, or the trauma of living in a world that often invalidates their identity. Parts work allows these individuals to approach these fragmented aspects of themselves with curiosity, fostering self-compassion and helping them reclaim the parts of themselves that may have been suppressed or disowned due to trauma.

Mindfulness and Curiosity: Fostering Safety in Healing

Fisher repeatedly emphasizes the importance of cultivating mindfulness and curiosity in the therapeutic process. Mindfulness, in this context, refers to the ability to stay present and observe one’s internal experiences without becoming overwhelmed or reactive. Curiosity complements this by encouraging clients to explore their emotions and bodily sensations with openness rather than judgment or fear.

By promoting mindfulness and curiosity, Fisher helps trauma survivors develop a healthier relationship with their internal world. Rather than viewing trauma symptoms as something to fear or suppress, clients are encouraged to see them as messages from parts of themselves that need attention and care. Fisher’s workbook includes numerous exercises that guide clients in tuning into their body’s sensations, thoughts, and emotions, offering opportunities to reconnect with themselves in a safe and controlled way.

For many trauma survivors, especially those marginalized or experiencing ongoing systemic oppression, the process of reclaiming the body and mind can be daunting. Fisher’s approach offers a gentle entry point, where clients can take small steps toward understanding and healing their trauma responses. Her focus on curiosity allows clients to explore their inner worlds without the pressure to immediately resolve or fix their trauma, thereby creating a sense of safety and agency in the healing process.

Practical Applications for Therapy

One of the most valuable aspects of Transforming the Living Legacy of Trauma is how well it lends itself to collaborative use between therapist and client. This workbook is not just a self-help guide; it’s a tool designed to facilitate shared exploration and healing within the therapeutic relationship. It is ideally suited for therapists and clients to work through together, ensuring exercises, reflections, and breakthroughs are professionally supported. The workbook’s structure, along with the accompanying flip chart, offers a cohesive and accessible resource that deepens the therapeutic process.

For therapists providing gender-affirming care to trans*, nonbinary, and queer clients, Fisher’s framework offers multiple entry points for addressing trauma in a way that honours each client’s unique identity and experiences. The exercises within the workbook—such as identifying triggers, recognizing trauma-related patterns, and working with dissociated parts—are particularly beneficial for clients whose trauma is compounded by societal marginalization, such as transphobia or homophobia. These tools enable therapists to guide their clients through the complexities of trauma while validating the intersections of their identities and offering practical steps toward healing.

Fisher’s parts-based approach is highly effective when working with clients who have internalized feelings of shame, rejection, or transphobia as part of their trauma legacy. Trans and nonbinary clients, often invalidated or rejected by society, may develop self-critical parts mimicking oppressive messages, but Fisher’s approach helps externalize and challenge these. By guiding clients in recognizing these self-critical parts as survival mechanisms—adaptive responses developed to protect themselves from further harm—therapists can help clients cultivate empathy for themselves and reconnect with their authentic identity.

Additionally, therapists can apply the workbook’s mindfulness practices in real-time, encouraging clients to stay grounded in their body’s responses during sessions. By doing so, therapists create a safe space for clients to experiment with dual awareness, observing trauma responses while remaining present in the therapeutic environment. This collaborative, supportive process fosters a sense of agency in the client, empowering them to engage more deeply in their healing journey.

In essence, Transforming the Living Legacy of Trauma is an invaluable tool for trauma-informed therapists working with gender-diverse populations. It allows for a co-created path toward healing, offering both clients and therapists the opportunity to explore trauma together with compassion, mindfulness, and a deep respect for the individual’s lived experience.

How This Workbook Stands Out

Transforming the Living Legacy of Trauma stands apart from other trauma resources by seamlessly bridging the gap between psychoeducation and deep personal work. This workbook is not simply a self-help guide for trauma survivors—it is a comprehensive therapeutic tool designed to guide both clients and therapists through the intricate process of trauma recovery. Janina Fisher’s talent for making neuroscience accessible provides survivors with a roadmap for understanding their trauma reactions, empowering them to take steps toward healing.

One of the key features that makes this workbook exceptional is Fisher’s ability to translate complex neurobiological concepts into practical, actionable steps. Her clear explanations of how trauma affects the brain—particularly the amygdala, prefrontal cortex, and nervous system—help survivors grasp why their bodies and minds react the way they do. Fisher’s approach fosters both safety and empowerment, enabling survivors to approach their healing journey with greater self-compassion and understanding.

The worksheets in the workbook offer clients practical tools to engage with their trauma. These exercises help clients map their experiences, track progress, and develop a deeper understanding of their trauma-related behaviours. The interactive nature of the workbook makes it well-suited for both individual and group therapy settings, creating a shared language for trauma processing. Whether the focus is on dissociation, parts work, or nervous system regulation, Fisher’s tools are adaptable to a variety of therapeutic needs.

Reflections on Intersectionality

While Transforming the Living Legacy of Trauma does not explicitly address intersectionality, Janina Fisher’s framework is flexible enough to be applied within an anti-oppressive and intersectional approach to therapy. As a therapist working with Two Spirit, trans, nonbinary, and queer clients, I have found that the workbook’s concepts can be adapted to reflect the unique intersections of race, gender, sexuality, and trauma. Trauma is not experienced in isolation, and for individuals with marginalized identities, societal oppression often compounds personal trauma histories.

Fisher’s parts work is particularly valuable in this context. Dissociative parts may hold personal pain as well as internalized messages of inferiority or shame, particularly for clients who have experienced rejection or discrimination. Fisher’s framework allows clients to approach these parts with curiosity and compassion, fostering a deeper understanding of how societal trauma intertwines with personal experiences.

The workbook’s emphasis on mindfulness and dual awareness provides therapists with opportunities to explore how intersecting identities influence a client’s experience of safety and belonging. By applying an intersectional lens, therapists can help clients recognize how their trauma responses—whether hypervigilance, dissociation, or emotional numbing—are adaptive mechanisms shaped by both personal trauma and societal exclusion. This intersectional approach enhances therapy, honouring clients’ resilience while addressing societal influences.

Conclusion

Transforming the Living Legacy of Trauma is a must-read for trauma survivors and therapists alike. It bridges the gap between understanding trauma and working through it, empowering individuals to reclaim their lives from the long shadow of trauma. Janina Fisher’s expertise and empathy shine through every page, making this book a trusted companion on the path to recovery.

Her grounded, reassuring tone makes the workbook a trusted companion. Fisher’s framework is adaptable and can be integrated into both individual and group therapy, offering a flexible, interactive structure that fosters personal growth and healing.

For trauma survivors, especially those from marginalized communities—such as Two Spirit, trans, nonbinary, and queer individuals—this workbook provides not only a means of self-exploration but a validating, non-pathologizing way of understanding the impact of both personal and systemic trauma. It emphasizes that trauma responses are not signs of weakness or failure but adaptive survival strategies that can be transformed into tools for growth and resilience.

Ultimately, Transforming the Living Legacy of Trauma is more than a therapeutic resource—it is a compassionate invitation to healing. Fisher’s expertise, combined with her deep respect for the humanity of trauma survivors, ensures that this workbook will continue to be a foundational tool for both therapists and clients. It is a must-read for anyone seeking to understand trauma on a deeper level and to navigate the path of healing with clarity, compassion, and hope.

Let’s Continue the Conversation

If this workbook or Trauma Informed Stabilization Treatment (TIST) resonates with you, whether you’re a therapist seeking to integrate this protocol into your online therapy practice, or someone navigating the complexities of trauma recovery, I’m here to provide support. I’m a certified TIST practitioner and a senior facilitator of the TIST training program. You may book an individual therapy session or peer consultation with me. I invite you to bookmark this blog for more book reviews.

References

Fisher, J. (2021). Transforming the living legacy of trauma: A workbook for survivors and therapists. PESI Publishing & Media.

Fisher, J. (2017). Healing the fragmented selves of trauma survivors: Overcoming internal self-alienation. Routledge.

Disclaimer: This blog offers general educational information and does not constitute professional advice or establish a therapist-client relationship. Please consult a healthcare provider for personalized guidance. Any decisions based on the content are the reader’s responsibility, and Clayre Sessoms Psychotherapy assumes no liability. All case studies are hypothetical with fictional names and do not reflect actual people. We prioritize your privacy and the confidentiality of all of our clients. We are committed to maintaining a safe, supportive space for 2SLGBTQIA+ community care.

Clayre Sessoms is a trans, queer, and neurodivergent Registered Psychotherapist (RP), Certified Sensorimotor Psychotherapist, and Board Certified Art Therapist (ATR-BC), offering online therapy for trans*, nonbinary, queer, and 2SLGBTQIA+ allied adults and teens across Canada. With a deep commitment to trauma-attuned gender-affirming care, Clayre integrates talk therapy, experiential collaboration, and creative expression to support clients to grow, heal, or navigate change. When not working with clients or supervising newly-licensed therapists, Clayre finds solace in nature, where she recharges her creativity and compassion.

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