Q&A

How Trauma Fragments the Self: Understanding Symptoms Through a Parts-Based Lens

Janina Fisher explores structural dissociation, parts work, and how relating compassionately to trauma responses can support healing.

The effects of trauma can be difficult to recognize when they appear as emotional and bodily reactions to ordinary experiences. These reactions can reflect implicit, nonverbal memories and survival responses that continue to be triggered after the danger has passed.

Drawing on her workbook, Embracing Our Fragmented Selves, clinical psychologist and author Janina Fisher explains how structural dissociation and parts work can help clinicians make sense of these responses. Using a clinical case example, she explores how symptoms can be understood as communications from wounded or protective parts, how the body can signal that a part has been triggered, and how this perspective can reduce shame and support self-compassion.

What do you think is most important for clinicians to understand about the effects of trauma?

The effects of trauma go well beyond flashbacks and unwanted memories of abuse. Less easy to recognize as trauma are the implicit, nonverbal effects that can be triggered by very small things in everyday life. Chronic feelings of fear, hopelessness, dread, shame and mistrust are among the most commonly experienced effects of trauma.

For example, my client Annie was triggered by waking up in the morning, eating, inactivity and almost any interpersonal interaction. Waking up evoked dread, eating evoked nausea, inactivity stimulated shame and inadequacy, and contact with people triggered both mistrust and longing—all of which were part of the implicit legacy of growing up in a neglectful, abusive family.

In your new book, Embracing Our Fragmented Selves: A Workbook for Trauma Survivors and Therapists, you describe trauma as fragmenting the self. Could you explain what you mean by that, and how it shapes the way people experience themselves?

“Fragmentation” refers to the effects of structural dissociation. Because the brain is made up of many separate structures, each with its own function, dissociation increases the compartmentalization between them, allowing distance from the overwhelm, splitting off emotion from observed experience and enabling adaptation to the traumatic environment. Feelings and behaviors that might increase danger are dissociated so that the child does not act on them.

The split between the right and left hemispheres becomes exaggerated, so that the left brain part of the personality is detached from the trauma and can carry on with everyday life as if nothing has happened. The right brain part of the personality holds the implicit, nonverbal memories, as well as subparts that serve the cause of survival in the face of ongoing danger. These subparts are driven by the survival defense responses of fight, flight, freeze in fear, submit and cry for help. After the trauma is over, these parts continue to be triggered by benign daily experiences.

One of the central ideas in your workbook is understanding symptoms as expressions of different parts. How does this change the way clinicians make sense of their clients' symptoms?

Understanding symptoms as expressions of parts helps clients put their difficulties and internal conflicts into perspective, thus reducing shame. For example, my client Annie was able to stabilize after years of instability when she began to notice her symptoms as communications from her parts. She could feel her early morning dread as a young part dreading the abuse that might await her. She could feel her shame and thoughts of failure as coming from parts that believed their inadequacy was causing the abuse, and she could feel her longing for contact as coming from young parts looking to be loved and cared for.

At the same time, she learned to observe her avoidance of closeness and social situations as the work of mistrustful parts that believed it was safer to keep a distance from others. As she understood her symptoms and parts better, both of us had a way to make sense of her shifting moods and reactions so that we could work on them.

Your work brings together structural dissociation theory, parts work, and sensorimotor psychotherapy. How do these approaches complement one another in clinical practice?

Understanding the effects of trauma on the body and nervous system, as well as on the emotions, is fundamental to clinical practice. Parts work enables the client to address painful feelings without becoming overwhelmed, while the structural dissociation model provides a theoretical framework that ties it all together.

Why is it important to work with the body, as well as thoughts and emotions, in trauma therapy?

Both emotions and thoughts have an effect on the body and nervous system that is important to understand and work with. This allows work with thoughts and feelings to be titrated and supported somatically.

As Annie and I focused on the implicit reactions of her parts, we observed that she would often experience the reaction first in her body. She could notice tightness in her stomach or shaking in her knees as signs that a part had been triggered. As she focused on the part, she would next notice the emotions connected to the bodily response. If she could continue to observe both her body and emotions, she would become aware of the thought or belief connected to the trigger. For example, she might feel a tightening in her throat connected to a part that felt lonely and wanted to cry. After a few weeks of noticing that part’s emotion, she was able to see that it was connected to the belief that she could only be safe if someone cared about her.

Your workbook encourages readers to meet even their most wounded or protective parts with support, appreciation, and acceptance. What does it mean to embrace our fragmented selves, and how does that help people heal?

To “embrace” our fragmented selves means transforming survivors’ relationships with their symptoms, painful feelings and negative thoughts so that they can experience self-compassion. Relating to their symptoms as wounded child parts helps survivors connect with their own empathy and compassion.

For Annie, understanding the feelings and impulses of her parts was the first step. Once she could understand them, she could feel closer to them and have more empathy for them. Experiencing her compassion helped the parts feel safer with her and safer in the world.