Healing Beyond Coping: A Journey with Trauma-Informed Stabilization Treatment (TIST)

Friendship with two people comforting each other

Introduction: Navigating the Path from Fragmentation to System Communication

Healing from trauma is rarely a straightforward journey, especially for those whose developmental harm intersects with marginalized gender and sexual identities. Trauma can sever one’s connection to the present moment, complicate the sense of self, and create deeply ingrained emotional patterns. This case study follows Robyn (they/she), a fictitious client created to illustrate the therapeutic possibilities offered through Trauma-Informed Stabilization Treatment (TIST). Robyn’s story, while grounded in real therapeutic principles, does not reflect any actual client at Clayre Sessoms Psychotherapy; all details have been carefully fictionalized to ensure privacy and ethical practice.

When Robyn first sought therapy, they were overwhelmed by emotions and memories that often felt beyond their control. Years of family rejection and societal invalidation had left them struggling to trust their feelings, their body, or their ability to self-soothe. Each day was a maze of self-protective mechanisms that often led them into cycles of shame and impulsivity, obscuring the person they wanted to become.

Through a trauma-sensitive and personalized approach, Robyn embarked on a journey of self-compassion and self-reclamation. This case study explores how TIST helped Robyn gradually reconnect with their body and emotions, transforming trauma responses into pathways for resilience and healing. Using TIST’s foundational principles, Robyn’s journey illustrates how working with “parts” of the self enabled them to foster self-trust, learn emotional regulation, and discover self-compassion. Though Robyn’s story is fictionalized, it reflects real therapeutic principles, showing that healing is possible, even when the journey seems insurmountable.

Background and Client’s Presenting Issues

Robyn, a queer nonbinary individual in their early 30s, came to therapy after years of struggling with severe emotional dysregulation, nervous system instability, and chronic feelings of disconnection. Their early life was marked by developmental trauma, including experiences of abuse and neglect, which left them with a profoundly dysregulated nervous system and strong emotional responses. These early wounds set the foundation for Robyn’s trauma responses and contributed to their difficulties in emotional regulation.

As Robyn began their social transition and came out as nonbinary, the sense of isolation and rejection deepened. Their biological family responded to their coming out with abandonment, and friends, despite multiple reminders, frequently misused their name and pronouns. In medical settings, Robyn encountered frequent invalidation and dismissals, with healthcare providers often overlooking or disregarding their physical symptoms. This neglect eventually led to a major, preventable illness, leaving Robyn with ongoing chronic health issues. The repeated healthcare dismissals intensified their feelings of powerlessness and compounded their perceived sense of threat.

Life in Vancouver has added additional stressors for Robyn, as the city’s high rent and food prices make it challenging to survive. Like many others, Robyn has found it difficult to build a sense of community in a city where social connection often feels out of reach. These environmental stressors further destabilized Robyn’s nervous system, exacerbating their emotional responses and making it even harder to manage everyday challenges.

In the past, Robyn attended DBT group classes and individual therapy to help lessen their emotional responses. While DBT provided valuable coping strategies, these approaches did not address the underlying causes of their nervous system dysregulation and traumatic responses. Robyn was left feeling insurmountable shame, believing they were somehow at fault for their inability to control their emotions or soothe their nervous system. The shame, combined with ongoing nervous system collapses, brought them to the brink of suicidality. Yet, when they turned to the healthcare system for support, they were offered medications without access to sustained trauma therapy.

Seeking a comprehensive approach to their trauma and emotional pain, Robyn began working with me at Clayre Sessoms Psychotherapy. Together, we embarked on a journey using Trauma-Informed Stabilization Treatment (TIST), a method designed by Dr. Janina Fisher, PhD to address the root causes of trauma responses by recognizing and working with the different “parts” of the self. This case study explores Robyn’s path from fragmentation to resilience, showing how TIST offered them a way to navigate life with greater stability, self-compassion, and connection.

Why This Case Study Matters: Lessons in Trauma Healing and Empowerment

Robyn’s journey illustrates the profound and lasting impact of developmental trauma, compounded by societal invalidation and marginalization. This case study offers insight into how trauma not only shapes emotional and physical responses but can also fracture one’s sense of identity and belonging. Robyn’s experiences of family rejection, healthcare dismissal, and isolation highlight challenges that many face yet may struggle to share openly. In detailing Robyn’s path to healing, this case study serves as a guide and a source of hope for both therapists and clients who navigate the complex intersections of trauma, identity, and emotional dysregulation.

At Clayre Sessoms Psychotherapy, the use of trauma-informed, body-centred approaches centres on creating safety, understanding, and connection within the therapeutic space. This case study specifically showcases the Trauma-Informed Stabilization Treatment (TIST) model, which offers an integrative approach for addressing trauma responses by working with “parts” of the self. Through TIST, clients like Robyn learn to understand and regulate their body’s signals, gain insight into how trauma responses are survival mechanisms, and cultivate a compassionate relationship with the parts of themselves that have been struggling to find safety.

Each phase of Robyn’s therapeutic journey—from psychoeducation and emotional differentiation to building body trust—demonstrates the transformative potential of trauma-informed care. For therapists, this case study offers a structured approach for addressing complex trauma and dissociation, underscoring the importance of gradual, mindful work to foster healing. For clients, it shows that growth and self-compassion are achievable even in the face of profound challenges, emphasizing the resilience that can emerge when one is supported in reconnecting with their own body, emotions, and inner strength. Robyn’s journey is a reminder that healing is a pathway worth embarking upon, one step at a time, and that transformation, while gradual, is within reach.

Therapeutic Process and Key Findings

Phase 1: Building Safety and Understanding Through Psychoeducation

In this foundational phase, Robyn focused on understanding how trauma impacts the brain and learned tools for managing trauma responses. Psychoeducation included principles from Transforming the Living Legacy of Trauma: A Workbook for Survivors and Therapists, which emphasize viewing trauma responses as adaptive survival mechanisms, promoting self-compassion rather than self-judgment (Fisher, 2021).

We began with Worksheet 1: The Living Legacy of Trauma, which encouraged Robyn to map how trauma shaped their reactions to present-day stressors. This process helped Robyn reframe intense emotional responses as part of their body’s protective mechanisms. Fisher’s Worksheet 3: Getting to Know Your Brain further supported this understanding by exploring the triune brain model, helping Robyn recognize how the brain’s survival responses could lead to emotional dysregulation. This framework validated their responses and set the stage for practical, everyday interventions like grounding exercises aligned with Fisher’s 10% Solutions, a gradual, self-compassionate approach to reducing trauma symptoms in manageable steps.

Together, we introduced grounding practices, such as identifying supportive sensory stimuli to help Robyn regulate responses to stress. This phase laid a foundation of self-awareness, building a safe environment for the deeper work that would follow.

Phase 2: Differentiation and Mindfulness – Meeting the Parts

With a foundation of safety in place, Robyn moved into exploring their internal parts, following the TIST framework’s structural dissociation model. Using Worksheet 19: The Structural Dissociation Model, Robyn identified several internal parts, including “critic” and “protector” parts that often appeared as self-judging or self-sabotaging behaviours in times of stress. This step introduced them to Fisher’s Worksheet 22: Speaking the Language of Parts, allowing them to communicate with these parts from a stance of curiosity and compassion rather than resistance.

Mindfulness practices facilitated this internal dialogue, enabling Robyn to observe and label their parts without blending with them. Techniques such as “unblending” helped them develop a sense of their “normal life self,” a stable aspect of identity from which they could engage with their parts without becoming overwhelmed. Through this compassionate approach, Robyn learned to observe parts as they surfaced, reducing the intensity of emotional responses and fostering self-compassionate awareness.

This phase cultivated emotional distance from reactive responses, allowing Robyn to connect more authentically with their internal experience and develop a grounded, less reactive relationship with their emotions.

Phase 3: Engaging with the Protective Roles of Parts

In this phase, we expanded on differentiation by exploring the specific protective roles of Robyn’s parts, particularly those that manifested as self-criticism or avoidance. With Worksheet 20: Identifying the Traumatized Parts, Robyn was able to recognize how these parts had been essential for their survival in the face of trauma, even though these protective mechanisms had become maladaptive in adulthood.

We introduced Worksheet 18: Changing Our Attachment Patterns, which helped Robyn identify how their parts developed based on attachment needs that were unmet or unsafe in early life. Robyn’s “critic” part, for example, emerged as a way to pre-empt external judgment, while the “protector” part often attempted to manage interactions by promoting self-silencing to avoid conflict. Through these exercises, Robyn began to perceive each part as an ally rather than a hindrance, learning to value their intention and function.

This phase shifted Robyn’s perspective from frustration with their internal responses to an appreciation of these parts as adaptive survival responses. By empathizing with their parts, Robyn fostered a cooperative relationship within themselves, encouraging trust between their “normal life self” and these protective internal voices.

Phase 4: Cultivating Emotional Regulation and Trust in the Body

Once a compassionate relationship was established with their parts, Robyn’s work turned toward emotional regulation and re-establishing trust in their body. Fisher’s Worksheet 7: Differentiating Past and Present was central in helping Robyn ground themselves, discerning past trauma cues from present experiences. This worksheet promoted present-moment awareness, which was crucial for rewiring Robyn’s nervous system, reinforcing a sense of emotional safety.

With these insights, Robyn incorporated Sensorimotor Psychotherapy’s body-centred practices to increase somatic awareness. Exercises such as mindful breathing, grounding taps, and posture adjustments helped Robyn reconnect with their body in empowering ways. Grounding techniques such as placing a hand on their heart or gently rocking back and forth became tools for emotional self-soothing, transforming Robyn’s relationship with their body from one of disconnection to one of safety and stability.

This phase allowed Robyn to use their body as a resource for emotional regulation. By turning physical sensations into cues for grounding, they could engage with their parts compassionately and enhance resilience, embodying a sense of presence rather than dissociating under stress.

Phase 5: Expanding the Window of Capacity and Integrating Parts

The final phase focused on expanding Robyn’s window of capacity, building resilience and integrating parts into a cohesive self. With the support of Worksheet 6: How Do You Try to Regulate Your Traumatized Nervous System?, Robyn was encouraged to track emotional responses, noticing moments of dysregulation and practising mindful interventions. This tracking helped Robyn develop a clearer understanding of what types of activities or environments might narrow their capacity, allowing them to practice preemptive self-regulation.

We also incorporated Worksheet 26: Welcoming Your Younger Selves, which invited Robyn to create an internal environment where all parts could coexist peacefully. By welcoming their “younger selves,” Robyn learned to hold space for emotions that arose from childhood wounds, offering them compassion and validation. This integration created a harmonious internal landscape, expanding their window of capacity and allowing them to navigate a broader emotional range without feeling overwhelmed.

Over time, Robyn’s parts became resources for insight and resilience, enhancing their emotional flexibility. They began to engage in life with a fuller sense of self, navigating relationships and goals with more ease. Fisher’s approach fostered a deep sense of belonging within, as Robyn envisioned a future of self-acceptance, autonomy, and meaningful connection.

By incorporating Transforming the Living Legacy of Trauma, each phase in Robyn’s journey was grounded in practical exercises that validated, empowered, and transformed their relationship with themselves. These steps aligned seamlessly with TIST principles, guiding Robyn toward a cohesive, resilient sense of self.

Exploring the Body’s Inherent Capacities through Sensorimotor Psychotherapy

Following the successful completion of Trauma-Informed Stabilization Treatment (TIST), a new phase in Robyn’s healing journey could involve exploring Sensorimotor Psychotherapy (SP). As a Certified Sensorimotor Psychotherapist, I would carefully guide Robyn in working with somatic memories, enabling them to reconnect with their body in ways that encourage healing and resilience. Before beginning this next phase, I would prioritize Robyn’s enthusiastic consent, honouring their autonomy and readiness for body-centred therapy.

Sensorimotor Psychotherapy, developed by Dr. Pat Ogden in collaboration with Dr. Janina Fisher, emphasizes the integration of trauma through body-based interventions, particularly when verbal processing alone may not address all facets of a client’s experience (Ogden & Fisher, 2015). For Robyn, SP could provide the opportunity to work with somatic patterns shaped by trauma, fostering a greater capacity for self-regulation and embodied awareness.

Exploring Trauma-Related Body Patterns

In Sensorimotor Psychotherapy, identifying and working with trauma-related body patterns is central. For Robyn, habitual postures, such as defensive body stances or shallow breathing, may reflect the body’s adaptations to past threats (Ogden & Fisher, 2015). Through gentle, mindful interventions, Robyn could explore new postures and movements that evoke safety and confidence. For example, grounding techniques like connecting with the support of the floor could enhance their emotional stability, promoting an empowered sense of presence (Fisher, 2021).

Differentiating Past from Present Through the Body

Exercises designed to distinguish past trauma from present experiences could be valuable for Robyn. Guided by Fisher’s “Differentiating Past and Present,” Robyn might practice grounding in the here-and-now using sensory cues, reinforcing the ability to perceive the present as separate from past trauma responses (Ogden & Fisher, 2015). Such practices would gradually weaken the link between somatic sensations and past trauma, empowering Robyn to experience the body as a safe, trustworthy ally.

Strengthening Empowering Actions

Sensorimotor Psychotherapy also emphasizes embodying physical responses that convey strength and self-protection. Robyn could explore symbolic gestures like placing a hand on their chest or practicing a gentle “push away” motion, actions that reinforce their sense of agency and boundary-setting (Ogden & Fisher, 2015). This somatic language provides new pathways for empowerment, aligning with the autonomy developed through TIST.

Integrating Somatic Memories with Parts Work

Sensorimotor Psychotherapy seamlessly integrates parts work by addressing how trauma-related parts hold specific somatic imprints. For example, Robyn’s protector part might be associated with tension or a particular posture. Through body-centred interventions, they could experiment with releasing these physical manifestations, enabling more compassionate and flexible self-dialogue (Fisher, 2021; Ogden & Fisher, 2015).

Cultivating Embodied Presence and Awareness

Finally, cultivating embodied presence empowers clients to experience the body as a source of grounding and self-compassion. Through tailored mindfulness practices, Robyn could reconnect with positive somatic experiences, supporting self-regulation and reinforcing the body’s role in healing. By noticing subtle sensations and connecting with their body’s natural rhythms, Robyn could experience their body as a resource for calm and resilience, extending the foundational work established in TIST.

Exploring Art Therapy for Robyn’s Healing and Self-Discovery

After completing Trauma-Informed Stabilization Treatment (TIST), art therapy offers Robyn a unique, nonverbal avenue for exploring and integrating their inner world, fostering self-discovery, autonomy, and resilience. As a Board Certified Art Therapist (ATR-BC), I work with art-based therapies that are particularly effective for individuals healing from complex trauma, as the creative process engages the body and mind in ways that transcend traditional verbal interventions (Fisher, 2021; van der Kolk, 2014). Given Robyn’s journey through TIST, art therapy could enable a deeper connection with their self-compassionate “normal life self,” allowing them to express their experiences visually, which can be especially healing for trauma survivors (Malchiodi, 2015).

The Therapeutic Power of Creating

Art therapy’s foundation lies in the transformative power of creation, a process that provides a safe space for expression while activating neural networks associated with calm and presence (King, 2016; Csíkszentmihályi, 2004). Engaging in this form of therapy can induce states of “flow,” where time seems to slip away, and Robyn may find themself fully immersed in creative expression. This state supports healing by encouraging a relaxed, yet focused, experience that can reduce self-judgment and increase their sense of connection with their emotions and body (Haiblum-Itskovitch, Czamanski-Cohen, & Galili, 2018). Working alongside an art therapist trained in co-regulation and empathic attunement, Robyn could access nonverbal trauma memories and process them through imagery, shapes, and colours (Malchiodi, 2019).

Exploring Preverbal Memories and Somatic Expressions

Complex trauma often includes preverbal memories, which can remain inaccessible through language alone. Art therapy provides an avenue to access these embodied memories safely, supporting Robyn in moving beyond cognitive and somatic processing to a deeper understanding. Exercises, such as “body tracing” or creating “safe place” collages, allow Robyn to visualize their inner landscape and feelings, offering a space for dialogue with parts of themself that still hold traumatic imprints (Hass-Cohen & Carr, 2020). These art-based interventions enable Robyn to externalize their experiences, creating a coherent narrative that their conscious mind can engage with and integrate without re-traumatization (van der Kolk, 2014).

Building Autonomy and Flow in the Artmaking Process

Art therapy also allows Robyn to make choices regarding their art materials and methods, reinforcing a sense of autonomy and personal agency. Whether they prefer fluid mediums like watercolour, which can evoke freer, flowing expressions, or more resistive materials like clay, each choice allows them to engage in the artmaking process with intentionality and self-reflection. Through these artistic decisions, Robyn exercises their autonomy, an empowering process that builds on the inner agency developed in TIST. Research suggests that engaging in creative tasks can strengthen communication between brain regions associated with reward, cognitive control, and memory, fostering self-regulation and enhancing self-compassion (Huotilainen et al., 2018; King, 2016).

Creating Symbols and Metaphors for Healing

The use of symbols in art therapy allows Robyn to represent complex feelings or trauma responses in ways that feel safe and approachable. For instance, they might choose to draw a symbolic representation of their “protector part” or create a visual map of their journey toward wholeness. Symbols and metaphors serve as external representations of internal experiences, making it possible for Robyn to interact with these elements creatively and mindfully (Malchiodi, 2019). By revisiting these symbols, Robyn can witness their progress, creating a narrative of resilience and growth that both honours their experiences and propels them toward future possibilities.

Art Therapy as a Path to Self-Integration

Art therapy offers Robyn an empowering space to consolidate their journey, visually integrating the various parts of themself and creating a cohesive sense of identity. Through progressive art exercises, Robyn can create a visual “timeline” of their healing process or represent different aspects of their identity as they relate to both their past experiences and future aspirations. This integrative approach allows them to engage with their emotions and body in ways that feel authentic and grounded, enhancing their self-acceptance and facilitating a renewed relationship with their body and mind (Fisher, 2021; Hass-Cohen & Carr, 2020).

With art therapy’s potential to deepen emotional awareness and foster resilience, Robyn’s journey toward self-discovery and autonomy continues beyond TIST. Each art-based exercise holds the potential to evoke insights, healing, and empowerment, offering them a creative path to wholeness that honours every aspect of their experience.

Conclusion: Embracing Growth and Transformation

Robyn’s journey through Trauma-Informed Stabilization Treatment (TIST) and body-centred practices led to profound and lasting changes, shifting from a state of inner fragmentation to one of clarity, self-compassion, and empowered self-understanding. Over time, Robyn developed the capacity to observe their emotions with non-judgment, gradually moving away from the patterns of reactivity that once defined their experience. Through the consistent practice of “unblending” from reactive parts, Robyn learned to create an inner space where their thoughts and feelings could be held with compassion, fostering a sense of agency that aligned with their true values rather than reactive impulses.

A significant outcome of Robyn’s therapeutic work was their increased ability to sit with discomfort—an expansion, not only of distress tolerance but of their capacity to hold a fuller range of experiences, from pain to joy. This transformation allowed Robyn to find moments of peace and presence, deepening their connection to their body, which they began to see as a resilient ally rather than a source of vulnerability or shame. As van der Kolk (2014) suggests, reconnecting with the body is essential in trauma recovery, enabling individuals to rediscover agency and joy that may have felt out of reach for years.

Robyn’s parts transformed from perceived obstacles into supportive allies, each part revealing itself as an essential aspect of their story and resilience. This shift—from viewing parts as hindrances to embracing them as facets of self—allowed Robyn to foster a compassionate internal dialogue. The parts that once operated from a place of fear and reactivity evolved into balanced, nuanced responses, enriching Robyn’s daily interactions and choices (Fisher, 2017).

This case study underscores the transformative potential of trauma-informed and body-centred approaches, particularly for those whose lives have been shaped by rejection, societal invalidation, and complex trauma. By providing a therapeutic space grounded in safety, curiosity, and empathy, Robyn was able to redefine their relationship with their body and emotions, finding a selfhood that transcends past pain. Robyn’s journey exemplifies that healing is attainable; through steady, mindful work, individuals can reclaim a sense of purpose, wholeness, and self-acceptance.

For those who see reflections of their own story in Robyn’s, trauma-informed approaches like TIST and body-centred practices offer pathways not only to healing but also to growth. By fostering a therapeutic environment where every part of oneself is acknowledged and valued, individuals can cultivate resilience and reconnect with a deep sense of peace within their bodies, minds, and lives.

Continue the Convo

If Robyn’s journey resonates with you, I warmly invite you to connect. For those who may feel that traditional therapy has fallen short in addressing the ongoing sense of threat stemming from deep-seated trauma, this work could offer a new path. Together, we can explore whether trauma-informed stabilization treatment (TIST) might be the right fit for you, allowing space for healing beyond coping skills alone. You’re welcome to book a first session with me to discuss your unique needs and discover if this approach aligns with your goals.

For fellow clinicians, if you’re seeking to deepen your understanding of TIST—whether you’ve recently completed the training or are curious about how it may benefit your clients—I offer peer consultations tailored to your practice needs. These sessions provide a supportive space to explore the application of TIST, address questions, and build confidence in working with clients through this transformative approach.

You may book individual therapy sessions or peer consultations online at your convenience. I also invite you to bookmark this blog for future reflections, insights, and updates in trauma-informed and body-centred care.

I invite you to visit Dr. Janina Fisher’s website and published paper to learn more about Trauma Informed Stabilization Treatment (TIST).

References

Csíkszentmihályi, M. (2004). Flow: The psychology of optimal experience. Harper Perennial.

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. New York: Routledge.

King, R. (2016). Art therapy, trauma, and neuroscience: Theoretical and practical perspectives. Routledge.

Malchiodi, C. A. (2015). Art therapy and the brain: An introduction to the neuroscience of art therapy. Guilford Press.

Malchiodi, C. A. (2019). The art therapy sourcebook (2nd ed.). McGraw-Hill Education.

Ogden, P., Minton, K., & Pain, C. (2006). Trauma and the body: A sensorimotor approach to psychotherapy. New York: W.W. Norton.

Ogden, P., & Fisher, J. (2015). Sensorimotor Psychotherapy: Interventions for trauma and attachment. New York: W.W. Norton.

Steele, K., Van der Hart, O., & Nijenhuis, E.R.S. (2004). Phase-oriented treatment of structural dissociation in chronic traumatization. Journal of Trauma & Dissociation, 6(3), 11-43.

van der Hart, O., Nijenhuis, E.R.S., & Steele, K. (2006). The haunted self: Structural dissociation and the treatment of chronic traumatization. New York: W.W. Norton.

van der Kolk, B.A. (2014). The body keeps the score: Brain, mind, and body in the healing of trauma. New York: Viking.

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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