Summary of “Exploring Inner Landscapes” by Janina Fisher, Ph.D.

January 31, 2004

 by Joan Atkinson

In her Exploring Inner Landscapes: Collaborative Techniques for Identifying Old Conflicts and New Solutions in Dissociative Disorder Patients, Dr. Fisher describes a highly useful and effective approach that addresses the challenges we face when working with patients who struggle with dissociative disorders.

Informed by the research on attachment, neurobiology and dissociation and her years of clinical experience and study, Dr. Fisher, through lecture, demonstration and case examples shows us an approach that incorporates knowledge of brain development and dissociation with our day-to-day work with patients.  This technique combines the Structural Dissociation and Internal Family Systems Psychotherapy models of treatment with an collaborative approach that engages the whole system.

Viewing the process of integration as the somatic and empathic connections between parts of self, Dr. Fisher works with the competing survival responses of the parts.  Not only is this focus on the intra-personal relationship more powerful than focusing on the interpersonal, patient-therapist relationship, there is less likelihood that the therapist will be inducted into the system. In this method, the patient and therapist collaborate and observe the internal responses to triggers and work toward understanding and decoding the system.  Forgoing interpretations, developing trust and communication between the parts and using the adult self as an internal therapist are the primary tasks.  Attending to all levels of response including the frontal cortex, limbic, and deregulated autonomic responses, is key.  Dr. Fisher uses diagrams to map and sequence the cognitive, emotional and sensorimotor reactions to triggering events as well as ways the system can interrupt the habitual responses.

In summary, Dr. Fisher has developed a technique that addresses the range of the patient’s response to trauma in a calming and respectful manner.  Her approach re-engages the frontal lobes, fosters curiosity and mindfulness, and decreases flooding. As the internal system calms, the patient can develop alternative responses and will ultimately move toward self-mastery and the resumption of development.

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