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INTEGRATING MODELS Many trauma survivors feel like they are trapped in an unpredictable storm of overwhelming emotions and behavioral impulses they cannot control. By integrating the logical architecture of Trauma Model Therapy (TMT) with the practical emotion regulation and distress tolerance skills of Dialectical Behavior Therapy (DBT) created by Marsha M. Linehan, the combination of models helps a person move beyond just firefighting daily emotional crises to establishing genuine internal stability. The model combination provides the immediate behavioral safety to handle intense feelings in the present and the deep framework required to safely decode and heal the past. TMT Trauma Model Therapy DBT Dialectical Behavior Therapy + DBT is built on Biopsychosocial Theory and requires a "dialectical" synthesis of radical acceptance and behavioral change. THEORY OF THE MODEL The theory of the model for TMT is a trauma-driven, unified theory that views complex psychiatric symptoms as a system of adaptation to childhood trauma and attachment failures. It is a "metapsychology" that bridges biological, psychological, and social domains. In DBT, psychopathology is a response that people have to an invalidating environment which can be affected by different vulnerabilities such as biological differences between individuals and/or past experiences (i.e.could be trauma). PSYCHOPATHOLOGY CONCEPTUALIZED AS In TMT, psychopathology is conceptualized as a logical and adaptive response to an abnormal environment. Initially, the "disorder" is not located within the individual's biology, but in the relationship between the developing child and a traumatic environment. The trauma can then cause biological dysregulation based on fight-flight-freeze physiology. Much of psychopathology is conceptualized as a dissociative compartmentalization of self-states – dissociation is the central organizing principle that results in a fragmented self organized into discrete self-states, alters or parts. A variety of terms can be used to describe parts. In DBT, symptoms can be changeable with skill acquisition and utilization. Healing occurs in a validating environment (i.e. therapy or effective social relationships). PERSPECTIVE OF SYMPTOMS In TMT, symptoms (e.g., self-harm, eating disorders, addictions, voices) are viewed as survival strategies. They are "solutions" to the problem of unbearable pain when no other coping mechanisms are available. Symptoms are often due to the actions, emotions, or beliefs of dissociated parts, each of which may have its own history, feelings, beliefs and functions. Symptoms are seen as solutions, adaptations, and protective strategies that once helped the person but later create problems when the time, context, and circumstances have changed. DBT makes the following assumptions: 1. People are doing the best they can. 2. People want to improve. 3. People need to do better, try harder, and be more motivated to change. 4. People may not have caused all of their own problems, but they have to solve them anyway. 5. New behavior has to be learned in all relevant contexts. 6. All behaviors (actions, thoughts, emotions) are caused. 7. Figuring out and changing the causes of behavior work better than judging and blaming. Directly Quoted From: DBT's General Handout 4 ASSUMPTIONS TMT assumptions are that most psychopathology is trauma-based. This can involve both Big T and little t trauma. The Locus of Control Shift is a universal cognitive adaptation to abuse. The Problem of Attachment to the Perpetrator is a core clinical conflict. A genuine commitment to recovery is essential. “The problem is not the problem” - symptoms have a function and purpose as survival strategies and defenses. The mechanism of change in DBT involves learning skills in a validating environment. MECHANISMS OF CHANGE The TMT mechanism of change involves cognitive restructuring of trauma-based beliefs (dismantling the "Bad Me" identity) combined with the development of healthier self-regulation skills. Change is driven by relational engagement with a client’s system of parts: the therapist plays an active role in this process, emphasizing psychoeducation, grounding, and commitment to recovery as elements of healing. The system of parts participates in treatment and change through recognition, communication, cooperation, and integration of parts. DBT measures change by: 1) decreasing client identified “problem behaviors” that are causing harm to self or others. 2) being able to use DBT skills to create “a life worth living.” HOW IT MEASURES CHANGE TMT measures change in a few ways. Standardized psychometric testing (e.g., DES, DDIS) are utilized. Clinical indicators such as a reduction in self-blame and dissociative "lost time," and an increase in healthy self-regulation. Diagnosis, treatment planning, and interventions flow from mapping and understanding the internal dissociative structure. Comprehensive DBT is a high-intensity, team-based program consisting of four essential components: weekly psychoeducational skills groups, individual coaching, 24/7 phone support, and a clinician consultation team. This model requires a high level of shared accountability, where a team of DBT-trained counselors provides on-call support for all program participants, regardless of their specific individual caseloads. In contrast, many clinicians provide "DBT-informed" care by integrating skills into individual sessions or offering standalone skills groups as a supplement to other therapeutic approaches. While the comprehensive model remains a standard for high-acuity cases, recent research by Lee et al. (2022) indicates that standalone skills groups can produce clinical outcomes comparable to the full comprehensive program over a six-month period. HOW IT WORKS TMT works in simple yet powerful ways. TMT is based on 5 core principles and the three phases of any trauma treatment model. 1. Education and Stabilization: building safety, a map of the system, and clarifying the problems to be addressed in therapy. 2. Trauma Processing: including ambivalent attachment patterns and negative self-beliefs. 3. Resolution and Integration: Consolidating the fragmented self. DBT does not specifically address dissociation. PERSPECTIVE ON DISSOCIATION The TMT perspective of dissociation is that dissociation is a structural defense used to wall off unbearable affect and memories. Dissociation is understood and treated as a primary focus of therapy. DBT does not address integration. HOW IT VIEWS INTEGRATION In TMT, Integration is the blending of fragmented parts of the self. It involves the gradual removal of dissociative barriers so that the Self can act as a unified, conscious identity. Integration = increased cooperation followed by blending and sometimes full fusion of parts when and if desired. Not all individuals want full integration. ~Special thanks to Jessica Endres for her contribution to this chart For the Clinician: Integrating TMT with DBT gives clinicians a dual framework that couples immediate, structured distress tolerance skills with the macro-level trauma architecture needed to resolve the root causes of affective instability. For the Client or Patient: Experiencing the combined approach of TMT and DBT provides you with real-time, actionable skills to surf the waves of intense emotional storms while simultaneously working through the deeper, historical trauma that triggers them. "While stabilizing coping skills are necessary to manage distress in the present, the ultimate goal of Trauma Model Therapy is to resolve the underlying trauma system so that those extreme coping mechanisms are no longer required." — TRAUMA MODEL THERAPY, LEVEL 2 LEARN MORE ABOUT TMT CLINICIANS ...who also utilize Dialectical Behavior Therapy Dr. Colin A. Ross Texas Jennifer Woodrome Texas Richard Cross Scotland (United Kingdom) Rachel Allen Texas, Colorado Veronica Gaytan de la Rosa Texas Lexi Eller Texas Jessica Endres Texas Faith Mosher Texas Rebecca Nantale Uganda Denise Dalgarn Utah, Kansas, California, Texas Jordan Madden Wisconsin, Minnesota TMT PLAYS WELL WITH OTHERS LEARN HOW TMT INTEGRATES WITH OTHER EVIDENCE-BASED MODELS CBT + TMT Compare CPT + TMT Compare DBT + TMT Compare EST + TMT Compare EMDR +TMT Compare IFS + TMT Compare TIST + TMT Compare

Trauma Model Therapy (TMT) is an essential clinical and diagnostic framework for PSYCHIATRIC-MH NURSE PRACTITIONERS < Back to List of Professions Previous Profession Next Profession For Psychiatric-Mental Health Nurse Practitioners (PMHNPs), who stand at the intersection of neurobiology, pharmacology, and holistic patient care, Dr. Colin A. Ross’s Trauma Model Therapy (TMT) provides a vital clinical anchor. It shifts the provider’s role from symptom prescriber to systems-level healer, offering a framework that explains the physiological "why" behind the psychiatric "what." By utilizing TMT, PMHNPs can deliver more precise medication management while addressing the structural trauma that biological interventions alone cannot reach. A Neurobiological Framework for the Medical Model PMHNPs are trained in the biological basis of mental illness, but many find that medication has its limits in trauma survivors. TMT provides the missing neuro-behavioral context. The TMT Perspective: High-dose antipsychotics or mood stabilizers often mask what TMT identifies as protective dissociative states or hyper-aroused survival responses. TMT views the chemical imbalance as a secondary consequence of a nervous system perpetually stuck in a threat-response cycle. Clinical Value: This allows the PMHNP to use a "trauma-informed prescribing approach. For example, when you realize a patient’s symptom of agitation is actually a survival response to perceived helplessness, you might reach for a grounding skill or a different class of medication rather than simply increasing a sedative. Decoding "Treatment Resistance" through Attachment PMHNPs often treat patients labeled "treatment-resistant" because they fail multiple medication trials. TMT identifies that many of these patients are actually struggling with the Problem of Attachment to the Perpetrator. The Dynamic: If a patient is biologically tethered to a traumatic past, their system may reject stability because safety feels unfamiliar and dangerous. This can manifest as non-compliance or paradoxical reactions to treatment. The TMT Intervention: The PMHNP uses TMT to explain this paradox to the patient. By resolving the Locus of Control Shift (the belief that they are fundamentally bad or broken), the patient’s system becomes more receptive to both pharmacological and therapeutic interventions. Differentiating Dissociation from Psychosis One of the most critical skills for a PMHNP is the differential diagnosis between primary psychotic disorders and trauma-based dissociation. The Diagnostic Gap: Many trauma survivors are misdiagnosed with Schizophrenia because they hear voices. In TMT, these are often understood as dissociative parts of the self rather than hallucinations. The Integration: TMT provides the PMHNP with specific tools (like the DDIS) to differentiate between these states. This prevents the tragedy of over-medicating a trauma survivor with heavy neuroleptics for a dissociative process that actually requires Stage 1: Stabilization and parts-work. Holistic Stabilization: Beyond the Prescription Pad The nursing heart of the PMHNP role is centered on holistic care. TMT provides a concrete set of nursing interventions to help patients regulate their autonomic nervous systems. The Approach: Instead of just managing side effects or symptoms, the TMT-informed NP teaches the patient how to manage their internal environment. The Skill: By explaining the components of Trauma Model Therapy, the NP empowers the patient to see their symptoms as data. A spike in anxiety isn't just a chemical surge; it’s a signal from a survival system that can be managed through cognitive reframing and grounding. "Playing Well" with Psychopharmacology and Nursing Theory TMT acts as the operating system that integrates nursing science with psychological resolution: With Jean Watson’s Theory of Caring: TMT provides the transpersonal framework for the healing relationship, using the Attachment Model to build trust. With Pharmacotherapy: TMT provides the "Why" for the "What." It allows the PMHNP to explain to the patient, "We are using this medication to lower the noise in your survival system so that we can do the TMT work of restructuring your beliefs. " With the Nursing Process (ADPIE): TMT enhances the assessment and diagnosis phases by adding a trauma-specific lens, ensuring the implementation is truly trauma-focused. Why PMHNPs Need TMT in Their Toolkit As the primary providers of psychiatric care in many settings, PMHNPs who use TMT can: Reduce Polypharmacy: By treating the underlying trauma system, NPs often find they can simplify medication regimens as the patient’s natural regulation improves. Improve Patient Outcomes: Patients feel seen when their NP explains their survival history, leading to higher levels of treatment engagement and trust. Bridge the Gap: TMT allows the NP to speak the language of both the medical model (to doctors) and the "recovery model (to patients and therapists). "Psychiatric nursing without Trauma Model Therapy is often just chemical management of a soul in pain. TMT empowers the PMHNP to treat the person, not just the synapse." — The Holistic Ethos of TMT ENROLL IN TRAINING 1 Level 1 Level 1 training is focused on introducing you to the model, the 5 Principles of TMT, helping you learn how to conceptualize TMT, how to diagnose properly, and how to become competent in detecting and working with complex trauma & dissociation. You will have a chance to watch multiple role plays with Dr. Ross during this training. CE Info 7 General Hours CE Provider: Get Into Your Head Training Price $350 Enroll Now 2 Level 2 Level 2 training will focus on general strategies you as a therapist need to know and employ in order to do the most effective work with any type of client who has experienced trauma. We will immerse you in the TMT Mindset and cover ethics. You will watch new role plays with Dr. Ross. We will also cover how to pair TMT with well-known modalities like EMDR & DBT. CE Info 9.25 Clinical/1.25 Ethics Hours CE Provider: Get Into Your Head Training Introductory Price $200 Request to Enroll 3 Level 3 Level 3 training will focus on tangible activities you can do with clients who experience complex PTSD, dissociation, or who have DID. This will include direction on how to work with complicated cases and DID parts/alters or DID systems. You will watch more role plays with Dr. Ross. We will also cover how to pair TMT with well-known models like IFS and Ego State Therapy. CE Info General & Ethics Hours Approved by NBCC Introductory Price $200 Coming Soon < Back to List of Professions Previous Profession Next Profession Testimonials

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Find a certified trauma and dissociation specialist. Search our global provider directory to connect with a trusted Trauma Model Therapy (TMT) clinician. Browse the official global TMT directory for Certified Clinicians that treat complex PTSD, trauma, abuse, and all other mental health issues. WE WOULD LIKE YOU TO MEET Jessica A. Garrett, MA, NCC, LPC-S Licensed Professional Counselor Supervisor, Texas License #82724 Licensed Professional Counselor, Colorado License #0013131 Accepting Clients Yes Meeting Options Online & In-Person Practices In Colorado Texas TMT Designation Trauma Model Therapy Consultant in Training Clinical Bio I am a Licensed Professional Counselor (LPC) providing psychotherapy, clinical supervision, and professional consultation. I specialize in working with individuals who have experienced complex trauma, dissociation, and other trauma-related disorders, and I am passionate about helping clients find healing in ways that align with their values, morals, and belief systems. I earned my Bachelor of Science in Psychology from Texas A&M University and my Master of Arts in Counseling and Human Services from the University of Colorado Colorado Springs. Before moving to Texas, I lived and practiced in Colorado, where I began my career as a Licensed School Counselor. When my husband received orders for another military deployment, I transitioned into private practice so I could maintain the flexibility to support our children and the many animals that are an important part of our family while continuing to provide quality mental health care. My clinical work began primarily with pre-teens and adolescents. After becoming a Certified EMDR Therapist, I expanded my practice to serve Military Veterans, where I found my passion for treating individuals living with the effects of complex trauma and dissociative experiences. Working with this often misunderstood and frequently misdiagnosed population has become the focus of my career. I am deeply committed to lifelong learning and continually invest in advanced training, consultation, and mentorship to strengthen my clinical skills and provide the highest quality care possible. This is what led me to become trained in Trauma Model Therapy. I believe that effective trauma treatment requires both specialized knowledge and genuine compassion, and I strive to create a therapeutic environment where clients feel safe, understood, and empowered to move toward lasting healing. What I Really Want You to Know As a Licensed Professional Counselor, I believe that every person's story is unique. My role is to provide a supportive, collaborative space where you can better understand your thoughts, feelings, and experiences. Through that understanding, you may find meaning or peace from past wounds, relief from current struggles, and hope for a healthier, more fulfilling future. While I cannot promise specific outcomes, I do believe that meaningful change is possible, and that life can get better. Counseling is a partnership. Together, we will identify goals based on what matters most to you and what you want to work toward. Some goals may be long-term, while others focus on more immediate concerns. I may offer guidance, insights, and suggestions along the way, but you remain the expert on your own life and ultimately decide the direction of your counseling journey. My goal is to help you discover healthier choices that align with your values, beliefs, and the life you want to create. It's also important to know that counseling is an intensely personal process. At times, it may bring difficult memories or emotions to the surface, and progress is not always immediate or linear. Growth often takes time and requires your active participation, honesty, and willingness to engage in the process. Although there are no guarantees, counseling has the potential to provide many meaningful benefits, including developing healthier coping skills, creating lasting behavioral changes, reducing symptoms of emotional distress, strengthening relationships, and improving your overall quality of life. How I weave Trauma Model Therapy Into My Practice I discovered Trauma Model Therapy (TMT) while searching for ways to better serve my clients experiencing dissociation. After coming across a YouTube video of Dr. Colin Ross discussing TMT, I found that his personal story deeply resonated with my own experiences. I immediately enrolled in the TMT Certification Training and have never looked back. Having trained in and worked with many different trauma therapies, I've come to appreciate the strengths of each while also recognizing their limitations. What I love about TMT is that it complements many existing trauma-focused approaches rather than replacing them. It provides a framework for clinicians while offering concepts that can be explained to clients in a way that is both understandable and empowering. This allows both client and therapist to share a common language and be on the same page. TMT offers clear, practical concepts that can be applied immediately in clinical practice. Although I've been trained in many therapeutic modalities, this is the first approach I've found that truly brings them together in a cohesive way. I believe that as more therapists become trained in TMT, trauma work will feel less overwhelming, allowing more clients to receive the compassionate, effective support they deserve. Visit My Website to Book < Back to List of Providers Previous Next BOOKING DETAILS I'm a Good Match For... Women Men Adults (18-25) Adults (26-54) Adults (55+) Fee Details $130-$175 Appointment Availability Weekdays Waitlist available Languages Spoken English MORE ABOUT MY PRACTICE INSURANCES ACCEPTED Aetna Carelon (formerly Beacon) Evernorth (Cigna) Optum Tricare United Healthcare BCBS PPO Cigna Medicare Texas Medicaid UMR SERVICES OFFERED In-Person Counseling Online Counseling Group Counseling Individual Counseling MODELS & METHODS Clinical Hypnosis Cognitive Behavioral Therapy (CBT) Cognitive Processing Therapy (CPT) Deep Brain Reorienting Ego State Therapy Emotionally Focused Therapy (EFT) Eye Movement Desensitization and Reprocessing (EMDR) Humanistic Therapy Motivational Interviewing Psychodynamic Therapy I CAN HELP WITH Adjustment Issues Bipolar Disorder Complex PTSD Depression Dissociative Identity Disorder Obsessive-Compulsive Disorder Self-Esteem Sexual Abuse Trauma Anxiety Borderline Personality Disorder Coping Skills Dissociative Disorders LGBTQIA PTSD Self-Harming Stress Women's Issues < Back to List of Providers Previous Next LEARN ABOUT THIS CLINICIAN'S TMT DESIGNATIONS Trauma Model Therapy Consultant in Training The TMT-CIT designation represents an elite tier of clinical leadership reserved for independently licensed practitioners who have mastered the full, new three-level TMT curriculum. This intensive onboarding process pairs applicants with a Consultant Mentor for observed consultations and a final evaluation, ensuring they can seamlessly step into the roles of coach, evaluator, and ethical steward of the TMT global mission. More Details < Back to List of Providers Previous Next

Trauma Model Therapy (TMT) is a game-changer for ADDICTION PROFESSIONALS < Back to List of Professions Previous Profession Next Profession For addiction professionals, the revolving door of treatment is a familiar and frustrating phenomenon. Trauma Model Therapy (TMT) provides the missing link for providers who find that traditional Substance Use Disorder (SUD) protocols often fail when faced with the hidden driver of addiction: complex trauma and sometimes even dissociation. Integrating TMT into addiction treatment shifts the focus from managing a brain disease to resolving a survival strategy. Trauma Model Therapy is a great aid to Certified Alcohol and Drug Counselors (CADC) I/II, Licensed Alcohol and Drug Counselors (LADC), Master Addiction Counselors (MAC), Certified Addiction Professionals (CAP), Master's Level Certified Addiction Professionals (MCAP), Substance Use Disorder (SUD) Counselors, National Certified Addiction Counselors, and Licensed Chemical Dependency Counselors. Reframing Addiction as an "Adaptive Survival Strategy" In TMT, symptoms are not viewed as pathological errors but as brilliant adaptations to a traumatic environment. The TMT Perspective: Substance use is often a form of chemical dissociation. If a client’s internal world is a site of unbearable pain or intrusive trauma memories, using a substance is a logical, albeit costly, way to get out of their head. Clinical Value: This immediately reduces the shame and self-loathing that fuels the addiction cycle. When a clinician says, "Your drinking was the best tool you had at age 15 to survive that household," it builds a bridge of alliance that tough love models often burn. Solving the "Locus of Control Shift" in Addiction A cornerstone of Trauma Model Therapy is the Locus of Control Shift, where a child takes the blame for abuse to maintain the hope that they can change the outcome. The Carryover: This "bad me" identity follows the survivor into adulthood and manifests as the core belief: "I am an addict because I am fundamentally flawed/bad." The TMT Intervention: By teaching the principles of Trauma Model Therapy, addiction professionals help clients realize they aren't "bad people trying to be good," but "injured people trying to be safe." Resolving this shift is often what prevents the chronic relapses that occur when a client achieves sobriety but still hates their sober self. Managing the Duality: The Problem of Attachment Addiction professionals often struggle with clients who are labeled as "treatment resistant" or "manipulative." TMT reinterprets these behaviors through the Problem of Attachment to the Perpetrator. The Parallel: For many addicts, the drug is the attachment figure. It is the thing that comforts them while simultaneously destroying them—mimicking the original traumatic bond with a caregiver. The Skill: TMT gives addiction counselors a language to discuss this love-hate relationship with the substance without becoming a parental/authoritarian figure, which avoids triggering the client's original trauma responses. TMT as a Tool for High-Functioning Dissociation Dr. Ross’s research highlights that many addicts are actually dissociating rather than just getting high. The Diagnostic Gap: Many SUD professionals miss the signs of structural dissociation. A client may black out not just because of the chemical, but because the chemical is facilitating a dissociative switch. The Integration: TMT teaches addiction professionals how to use the Dissociative Experiences Scale (DES) and the Dissociative Disorders Interview Schedule (DDIS) to screen for underlying dissociative disorders. If the dissociation isn't treated, the addiction will likely remain the primary grounding mechanism. Playing Well with 12-Step and Harm Reduction TMT is uniquely suited to work alongside existing addiction frameworks: With 12-Step: TMT provides a psychological deep dive for Step 4 (fearless moral inventory), helping the client see that their defects of character were actually survival traits. With Harm Reduction: TMT’s focus on stabilization in the early treatment stage aligns perfectly with harm reduction. It prioritizes keeping the client safe and in their body before demanding they process the trauma that they are using substances to avoid. Why Addiction Professionals Need TMT in Their Toolkit According to Dr. Ross’s research, the prevalence of childhood trauma in the addiction population is nearly universal. Learning TMT allows an addiction professional to: Stop "Whack-a-Mole" Treatment: Address the trauma system so that when the client stops using one substance, they don't immediately cross-addict to another. Increase Retention: Clients stay in treatment longer when they feel understood at the attachment level rather than just the behavioral level. Prevent Burnout: Understanding the Locus of Control Shift helps clinicians realize that a client's "resistance" is a survival skill, making it much easier to stay empathetic and effective. "If you don't treat the trauma, the addiction has a job to do. When you treat the trauma, the addiction becomes unemployed." — The Core Ethos of Recovery in TMT ENROLL IN TRAINING 1 Level 1 Level 1 training is focused on introducing you to the model, the 5 Principles of TMT, helping you learn how to conceptualize TMT, how to diagnose properly, and how to become competent in detecting and working with complex trauma & dissociation. You will have a chance to watch multiple role plays with Dr. Ross during this training. CE Info 7 General Hours CE Provider: Get Into Your Head Training Price $350 Enroll Now 2 Level 2 Level 2 training will focus on general strategies you as a therapist need to know and employ in order to do the most effective work with any type of client who has experienced trauma. We will immerse you in the TMT Mindset and cover ethics. You will watch new role plays with Dr. Ross. We will also cover how to pair TMT with well-known modalities like EMDR & DBT. CE Info 9.25 Clinical/1.25 Ethics Hours CE Provider: Get Into Your Head Training Introductory Price $200 Request to Enroll 3 Level 3 Level 3 training will focus on tangible activities you can do with clients who experience complex PTSD, dissociation, or who have DID. This will include direction on how to work with complicated cases and DID parts/alters or DID systems. You will watch more role plays with Dr. Ross. We will also cover how to pair TMT with well-known models like IFS and Ego State Therapy. CE Info General & Ethics Hours Approved by NBCC Introductory Price $200 Coming Soon < Back to List of Professions Previous Profession Next Profession Testimonials

Learn more about Trauma Model Therapy CLINICAL CURIOSITY < Back Previous Next In Trauma Model Therapy (TMT), Clinical Curiosity is defined not as an intellectual pursuit of a patient's history, but as an intentional, non-judgmental stance that seeks to discover the hidden logic behind seemingly irrational behaviors. Instead of asking "What is wrong with this person?" Clinical Curiosity asks "How did this symptom help this person survive an impossible environment?" When a TMT Clinician models authentic curiosity toward high-risk or destructive behaviors—such as self-harm, addiction, or severe dissociation—it allows the person to safely drop their defenses and stop fighting themselves. By shifting the internal narrative from self-condemnation to curious exploration, the patient or client can finally understand the survival purpose of their pain, correct the core cognitive errors driving their symptoms, and safely step into a unified recovery. Clinical Curiosity is the antidote to toxic shame Toxic shame is the pervasive, crushing belief that one is inherently broken, defective, or uniquely bad because of what they survived. This shame thrives in secrecy and self-condemnation, leaving individuals trapped in a cycle of hiding their most painful impulses and behaviors. Clinical Curiosity serves as the direct antidote to this pathology by replacing judgment with investigation. When a therapist encounters an extreme behavior—such as self-harm or severe addiction—and responds with a calm, analytical desire to understand its origin rather than a rush to punish or eliminate it, the environment completely shifts. By exploring the behavior as an adaptive puzzle to be solved rather than a moral failure to be scolded, the clinician models a new way of relating to the self. This objective investigation dissolves the isolation of shame, allowing the individual to look at their own actions without the blinding fog of self-hatred. How Clinical Curiosity ties into Therapeutic Neutrality In TMT, Therapeutic Neutrality is the discipline of maintaining a steady, objective, and non-reactive presence, ensuring the TMT Clinician does not take sides in a person's internal conflicts, over-react to crises, or impose their own values on the treatment. Clinical Curiosity is the fuel that makes therapeutic neutrality possible. Without active curiosity, neutrality can easily look like cold detachment or rigid indifference, both of which can re-traumatize a person who expects abandonment. Instead, curiosity provides a warm, highly engaged objectivity. It allows the clinician to sit with heavy disclosures, erratic behaviors, or intense emotional storms with a calm focus, wondering about the purpose of the presentation rather than rushing to fix it, judge it, or fear it. By staying curious about why an internal part is lashing out or shutting down, the TMT Clinician preserves the client's ultimate autonomy and avoids entering into a historical re-enactment of control or rescue. How Clinical Curiosity ties into the 5 Principles of TMT In Trauma Model Therapy, Clinical Curiosity is the mechanism used to bring the 5 core principles of the model into active practice. It translates theory into live, relational healing: The Locus of Control Shift & Attachment to the Perpetrator: Instead of pathologizing an individual's persistent self-blame or their complicated bond with someone who harmed them, curiosity asks how taking the blame originally gave a helpless child a sense of control and power over an impossible environment. The Problem is Not the Problem: Curiosity is the exact tool used to look past the surface crisis—such as a sudden behavioral crash or a relapse—and investigate the underlying emotional conflict or trigger that the behavior was desperately trying to soothe. Addiction is the Opposite of Desensitization: Curiosity explores how compulsive substances or behaviors are being utilized as precise, artificial regulators for a chronically overwhelmed autonomic nervous system. The Victim-Rescuer-Perpetrator Triangle: Curiosity allows the TMT Clinician to track which role is currently active in the room without getting sucked into the dynamic, asking how adopting these rigid relational positions historically protected the person from total vulnerability. How curiosity aids the healing process Curiosity actively accelerates the healing process by shifting the brain out of an automatic defense posture and into an active state of learning. When an individual is stuck in a loop of self-judgment, their nervous system remains highly activated, treating their own internal impulses as a present-tense threat. By adopting the clinician’s curious stance, the person learns to pause and safely observe their internal sensations, thoughts, and triggers from a healthy distance. This process de-escalates the body's alarm system, making room for true emotional processing. Curiosity transforms terrifying, chaotic symptoms into predictable, structured pieces of information that can be organized, understood, and ultimately updated to the present reality. How Clinical Curiosity contributes to the transition from surviving to thriving Survival requires rigid defenses, predictable walls, and the constant anticipation of danger, leaving very little room for flexibility, spontaneous joy, or growth. Clinical Curiosity provides the psychological bridge necessary to cross from that survival state into a thriving life. By exploring the original blueprint of their coping strategies, individuals realize that the very behaviors that are now complicating their lives were once the brilliant, logical adaptations that kept them alive. This realization allows them to genuinely honor their past survival system rather than hating it. Once the historical logic of the system is fully understood and appreciated, the rigid need for those old defenses naturally falls away. This opens up internal space for curiosity to turn outward, empowering the individual to explore new possibilities, build flexible relationships, and actively design a life based on authentic choice rather than chronic fear. Learn more about how TMT CAN HELP YOU HEAL Learn more about TMT FOR MENTAL HEALTH CLINICIANS

INTEGRATING MODELS Trauma survivors often feel like they are constantly at war with fragmented, conflicting parts of themselves that drive them to freeze, shut down, or self-sabotage. By integrating the logical architecture of Trauma Model Therapy (TMT) with the neurobiologically grounded parts-work of Trauma-Informed Stabilization Treatment (TIST), the combination of models helps a person move beyond just trying to suppress impulsive survival behaviors to actively de-escalating the body's internal alarm system. The model combination provides the immediate somatic stabilization required to bring safety to a fractured nervous system and the deep clinical framework to safely guide those protective parts home into a unified, whole self. TMT Trauma Model Therapy TIST Trauma-Informed Stabilization Treatment + TIST, developed by Dr. Janina Fisher, is a neurobiologically grounded model that integrates Structural Dissociation Theory, mindfulness, and somatic psychology (specifically Sensorimotor Psychotherapy). TIST posits that complex trauma fractures the psyche into distinct, trauma-related survival parts to preserve the functional, day-to-day self. The model treats complex trauma, borderline personality disorder, and treatment-resistant depression not as character flaws, but as chronic, somatic autonomic nervous system dysregulation. THEORY OF THE MODEL The theory of the model for TMT is a trauma-driven, unified theory that views complex psychiatric symptoms as a system of adaptation to childhood trauma and attachment failures. It is a "metapsychology" that bridges biological, psychological, and social domains. TIST conceptualizes psychopathology as the structural dissociation of the personality driven by a fragmented nervous system. When a person survives chronic trauma, their personality splits into a "Going On with Normal Life" self (ANP - Absolute Normal Personality) and various animal defense sub-personalities (EP - Emotional Personality). Symptoms and destructive behaviors occur when these younger, traumatized survival parts "blend" with or hijack the conscious mind, causing the individual to perceive and react to the present world as if the trauma is still actively occurring. PSYCHOPATHOLOGY CONCEPTUALIZED AS In TMT, psychopathology is conceptualized as a logical and adaptive response to an abnormal environment. Initially, the "disorder" is not located within the individual's biology, but in the relationship between the developing child and a traumatic environment. The trauma can then cause biological dysregulation based on fight-flight-freeze physiology. Much of psychopathology is conceptualized as a dissociative compartmentalization of self-states – dissociation is the central organizing principle that results in a fragmented self organized into discrete self-states, alters or parts. A variety of terms can be used to describe parts. In TIST, high-risk and self-sabotaging symptoms—such as self-harm, suicidal ideation, substance abuse, eating disorders, and severe cutting—are viewed as desperate somatic stabilization strategies. They are not signs of a pathology to be eradicated, but rather the brilliant, involuntary attempts of mammalian survival parts to regulate or numb intolerable physiological states. The symptom is seen as a coping mechanism that successfully kept the client alive during impossible circumstances but has outlived its original utility. PERSPECTIVE OF SYMPTOMS In TMT, symptoms (e.g., self-harm, eating disorders, addictions, voices) are viewed as survival strategies. They are "solutions" to the problem of unbearable pain when no other coping mechanisms are available. Symptoms are often due to the actions, emotions, or beliefs of dissociated parts, each of which may have its own history, feelings, beliefs and functions. Symptoms are seen as solutions, adaptations, and protective strategies that once helped the person but later create problems when the time, context, and circumstances have changed. TIST makes these assumptions: The client is not broken or manipulative: Their behavior represents a highly organized, neurobiological adaptation to an unsafe environment. Stabilization must precede processing: Traditional trauma processing or narrative exposure cannot occur safely while a client is actively destabilized or unsafe in their body. Psychoeducation is therapeutic: Giving clients a biological map of their trauma responses reduces toxic shame and restores intellectual agency. Every extreme behavior belongs to an animal defense part: Self-destructive impulses are mapped directly to five specific survival responses: Fight (rage, self-hatred), Flight (addiction, avoidance), Freeze (anxiety, hypervigilance), Submit (depression, shame, passivity), or Attach/Cry for Help (fear of abandonment, enmeshment). ASSUMPTIONS TMT assumptions are that most psychopathology is trauma-based. This can involve both Big T and little t trauma. The Locus of Control Shift is a universal cognitive adaptation to abuse. The Problem of Attachment to the Perpetrator is a core clinical conflict. A genuine commitment to recovery is essential. “The problem is not the problem” - symptoms have a function and purpose as survival strategies and defenses. TIST would suggest that change occurs through mindful dual awareness and somatic disidentification. The primary mechanism relies on helping the client's adult, functional self observe their internal sensations and impulses without acting on them. By shifting from "I want to die" to "I notice a part of me is in a Submit state and wants to give up," the client creates a psychological space between their true identity and the trauma response, allowing the nervous system to settle back into its window of tolerance. MECHANISMS OF CHANGE The TMT mechanism of change involves cognitive restructuring of trauma-based beliefs (dismantling the "Bad Me" identity) combined with the development of healthier self-regulation skills. Change is driven by relational engagement with a client’s system of parts: the therapist plays an active role in this process, emphasizing psychoeducation, grounding, and commitment to recovery as elements of healing. The system of parts participates in treatment and change through recognition, communication, cooperation, and integration of parts. TIST measures clinical progress through increased behavioral safety, somatic regulation, and the presence of internal connection, specifically tracking: The Pause: The client’s ability to notice a somatic trigger or part activation before engaging in an impulsive behavior (e.g., self-harm or substance use). Time in the Window of Tolerance: An objective increase in the amount of time the client can remain grounded, present, and operational in their functional adult self. Internal Compassion: A shift in the client’s internal dialogue from self-contempt to mindful curiosity and warmth toward their younger protective parts. HOW IT MEASURES CHANGE TMT measures change in a few ways. Standardized psychometric testing (e.g., DES, DDIS) are utilized. Clinical indicators such as a reduction in self-blame and dissociative "lost time," and an increase in healthy self-regulation. Diagnosis, treatment planning, and interventions flow from mapping and understanding the internal dissociative structure. TIST utilizes a practical, top-down and bottom-up somatic-mindfulness protocol that bypasses the need for detailed trauma narratives: Psychoeducation: The clinician teaches the client about structural dissociation and maps out their specific symptoms to the Fight, Flight, Freeze, Submit, and Attach parts. Somatic Tracking: The client learns to identify physical markers (e.g., racing heart, numbing, muscle tension) that signal a part has been triggered. Externalization and Language Shifts: The therapist gently reframes the client's absolute statements into parts language (e.g., replacing "I hate myself" with "The Fight part is directing its anger inward right now"). Internal Attachment: The functional adult self is coached to extend comfort, validation, and physical safety to the younger, somatic parts, reassuring them that the danger has passed. HOW IT WORKS TMT works in simple yet powerful ways. TMT is based on 5 core principles and the three phases of any trauma treatment model. 1. Education and Stabilization: building safety, a map of the system, and clarifying the problems to be addressed in therapy. 2. Trauma Processing: including ambivalent attachment patterns and negative self-beliefs. 3. Resolution and Integration: Consolidating the fragmented self. TIST views dissociation as a necessary structural defense mechanism rather than a cognitive failure. It is the body's ultimate biological circuit breaker, utilizing the autonomic "Freeze" or "Submit" pathways to dull physical and emotional agony when escape is impossible. Because dissociation is an active somatic boundary designed to keep the core self separate from overwhelming trauma memory, TIST respects it as a protector and focuses on regulating the underlying autonomic flooding that triggers it. PERSPECTIVE ON DISSOCIATION The TMT perspective of dissociation is that dissociation is a structural defense used to wall off unbearable affect and memories. Dissociation is understood and treated as a primary focus of therapy. Integration in TIST is defined not as the blending or dissolving of parts into a single personality, but as systemic collaboration, communication, and internal attachment. Integration is achieved when the "Going On with Normal Life" adult self establishes undisputed internal leadership. The individual parts no longer need to hijack the body to communicate their pain; instead, they live in a stable, interconnected alliance where the adult self safely manages the internal ecosystem and protects the vulnerability of the whole person. HOW IT VIEWS INTEGRATION In TMT, Integration is the blending of fragmented parts of the self. It involves the gradual removal of dissociative barriers so that the Self can act as a unified, conscious identity. Integration = increased cooperation followed by blending and sometimes full fusion of parts when and if desired. Not all individuals want full integration. For the Clinician: Integrating TMT with TIST equips clinicians with a powerful neurobiological lens to stabilize severe, high-risk somatic survival responses before attempting deeper, narrative trauma processing. For the Client or Patient: Experiencing the combined approach of TMT and TIST provides you with immediate, body-centered tools to de-escalate overwhelming urges by understanding them as involuntary biological defense states rather than personal failures. "Self-destructive behavior is a logical, adaptive, and necessary strategy for surviving an impossible childhood environment when no other options are available." — TRAUMA MODEL THERAPY, LEVEL 2 LEARN MORE ABOUT TMT CLINICIANS ...who also utilize Trauma-Informed Stabilization Treatment Jennifer Woodrome Texas Cristina Mapelli Italia (Italy) TMT PLAYS WELL WITH OTHERS LEARN HOW TMT INTEGRATES WITH OTHER EVIDENCE-BASED MODELS CBT + TMT Compare CPT + TMT Compare DBT + TMT Compare EST + TMT Compare EMDR +TMT Compare IFS + TMT Compare TIST + TMT Compare

Learn more about Trauma Model Therapy THE FIVE TMT PRINCIPLES < Back Previous Next The 5 Trauma Model Therapy Principles serve as the foundational logic for what happens to a person who experiences trauma. They help develop empathy and understanding of self. #1: Attachment to the Perpetrator Children are biologically wired to attach to their caregivers for survival—even if they are the ones doing the hurting. This creates a confusing knot where love and pain become linked, which often explains why adult relationships can feel so complicated or unfulfilling later in life. #2: The Locus of Control Shift It is terrifying for a child to realize their world is unsafe, so the brain makes a brilliant trade: It decides, "I am the bad one in a good world," rather than "I am a good child in a dangerous world." This gives the child a false sense of control (if I am bad, I can work harder to be "good" and stay safe), but it leaves the person carrying a lifelong weight of unearned shame. #3: The Problem is Not the Problem TMT doesn't view your symptoms—like depression, dissociation, or anger—as the primary issue. Instead, TMT sees them as the solutions the brain created to survive an impossible situation. TMT Clinicians look past the behavior to find the original wound that your system is still trying to protect. #4: Addiction is the Opposite of Desensitization - All Addiction is a Form of Avoidance Addiction is a way to anesthetize pain, but a person cannot heal what they cannot feel. To truly take the power away from a traumatic memory, the person has to stop using their "drug of choice" (whether that’s a substance, a behavior, or an emotion) so that they can finally encounter and process the feelings they’ve been running from. #5: The Victim-Rescuer-Perpetrator Triangle Trauma often traps us in a repetitive cycle where we play one of three roles: the helpless victim, the over-extended rescuer, or the critical perpetrator . This happens in our relationships with others and even in how we talk to ourselves. TMT helps people step out of this triangle so they can live with authentic power and clear boundaries. Learn more about how TMT CAN HELP YOU HEAL Learn more about TMT FOR MENTAL HEALTH CLINICIANS

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