My Journey with Trauma-Informed Stabilisation Treatment (TIST): Rediscovering the Wisdom of Parts Work in Complex Trauma Therapy

Trauma-Informed Stabilisation Treatment (TIST) is a therapeutic model that has profoundly influenced my understanding and practice of working with complex trauma.

I hope that, through continuing to develop my knowledge and skills in this approach, I can contribute to making trauma-informed, parts-oriented therapy more accessible to people in Aotearoa New Zealand who are seeking meaningful and lasting change.

What is Trauma-Informed Stabilisation Treatment (TIST)?

TIST is an integrative, parts-oriented therapy developed by Dr Janina Fisher for working with complex trauma, particularly when trauma histories are associated with relational and attachment difficulties, self-destructive behaviours, chronic emotional dysregulation, dissociation, and compulsive coping patterns.

TIST integrates elements of Sensorimotor Psychotherapy, Internal Family Systems principles, and ego state approaches. It aims to support emotional and autonomic regulation, strengthen affect tolerance, develop a greater sense of internal safety, and increase the capacity to respond to everyday stress with more flexibility and self-compassion.

My Path to TIST

I have extensive experience supporting clients with PTSD and complex trauma. At one stage in my clinical journey, however, I encountered a point where my existing therapeutic toolkit felt insufficient.

I was working with a client who had developed strong trust within our therapeutic relationship and was committed to regular face-to-face sessions. Despite this commitment, I felt I had reached the limits of the interventions I was familiar with. The client had also not experienced sufficient improvement despite receiving psychiatric support and medication.

Clients with similar experiences are sometimes described as “treatment-resistant”. However, this term never fully resonated with me, because it can overlook the profound adaptations people have developed in response to overwhelming experiences.

I began noticing that when I introduced a parts-based understanding of inner conflicts, something shifted. The client was able to relate to their reactions with greater curiosity and compassion rather than judgement.

This experience motivated me to explore the literature on parts-oriented approaches. I discovered Dr Janina Fisher’s book Healing the Fragmented Selves of Trauma Survivors, which introduced me to TIST and became the beginning of my formal training journey in this model.

Why TIST Resonates with My Practice

No single therapeutic approach is suitable for everyone. Therapy is ultimately about finding the right fit between the person, the therapist, and the therapeutic approach.

In my clinical experience, TIST has been particularly meaningful for some clients who have struggled to benefit fully from more traditional cognitive approaches such as CBT, DBT, or ACT. Some therpists also explore parts-oriented approaches when other trauma treatments, including EMDR or somatic approaches, have not been the right fit at a particular stage of a client’s healing journey.

I have also found the principles of TIST valuable in couples work. Over time, attachment wounds and protective responses often emerge within intimate relationships. Understanding these responses as adaptations rather than personal flaws can help couples develop greater empathy for themselves and each other.

TIST concepts can also support parents in recognising how their own trauma responses may influence their relationship with their children, creating opportunities for more intentional and compassionate parenting.

Reflections on TIST’s Potential

Based on my clinical learning and experience, I believe the principles of TIST have potential across different cultural contexts because they honour a universal human experience: our minds and bodies develop adaptive responses to help us survive overwhelming experiences.

For me, TIST represents more than a therapeutic model — it is a way of understanding human suffering with greater compassion, curiosity, and respect for the wisdom behind our survival responses.