Phobia of Vulnerability: Working with Dissociation and Avoidance in Trauma Treatment

Dr Janina Fisher

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Child abusers exploit their victims’ vulnerability. Without the power to escape or fight back, often attached to the perpetrator, children are helpless in an unsafe world. They can’t cry or look frightened or voice any emotion for fear of punishment. Their only defences are submission and dissociation. They instinctively go on with normal life because they have no choice other than to appear “fine.”

These automatic strategies are adaptive in a threatening unsafe environment, but they become obstacles in treatment. Years later, when traumatised clients come for ‘help,’ their phobias of emotion and vulnerability pose a challenge for the client and therapist. Thinking or talking about the events, emotions, and body sensations is overwhelming and frightening. Even a little emotion, even acknowledging their hurt, can lead to shutting down or intellectualising. Therapists want to help clients process the memories and emotions, only to get blocked by the client’s phobia of feeling.

Successfully working with traumatised clients begins with facing the degree to which our interest in vulnerability stimulates fear. The perpetrator was only interested in their vulnerability. Therapists need to be interested in how clients survived and adapted, how their dissociative abilities preserved their ability to go on with life. Fortunately, modern trauma treatment affords us many ways to help survivors by capitalizing on their dissociative abilities as a therapeutic tool.

You will learn:

How dissociation facilitates survival-related “avoidance”
Differentiating intentional from instinctual avoidance?
Using dissociative abilities to heal traumatic wounds

About Dr Janina Fisher

Janina Fisher, Ph.D. is a licensed clinical psychologist in private practice; Assistant Educational Director of the Sensorimotor Psychotherapy Institute; an EMDRIA Approved Consultant and Credit Provider; former president of the New England Society for the Treatment of Trauma and Dissociation; and a former instructor, Harvard Medical School.

An international writer and lecturer on the treatment of trauma, she is co-author with Pat Ogden of Sensorimotor Psychotherapy: Interventions for Attachment and Trauma and author of Healing the Fragmented Selves of Trauma Survivors: Overcoming Self-Alienation and Transforming the Living Legacy of Trauma.

Dr. Fisher lectures and teaches nationally and internationally on topics related to the integration of the neurobiological research and newer trauma treatment paradigms into traditional therapeutic modalities.

Janina has presented for Delphi in 2010 – 2014 – 2019 – 2021 – 2022 – 2023. Her 2021 – 2022 – 2023 webinars are available On-Demand. She will be presenting again in 2024.