Fisher, J. (2017) | References | Narcissus and the Child

What This Research Found

Janina Fisher's Healing the Fragmented Selves of Trauma Survivors presents a comprehensive framework for understanding and treating the internal fragmentation that develops in response to chronic trauma. Drawing on structural dissociation theory and Internal Family Systems concepts, Fisher explains why trauma survivors often feel at war with themselves—and how to achieve internal peace.

The structural dissociation model explains trauma's fragmenting effect. When experiences overwhelm our capacity to integrate them, the psyche fragments into "parts," each carrying different aspects of the traumatic experience. Fisher describes how trauma survivors typically develop parts organised around survival functions: a part that goes on with normal life (the "apparently normal part"), parts frozen in traumatic memory, and parts organised around defensive responses (fight, flight, freeze, submit, attach). These parts developed to manage the unmanageable—they are evidence of the psyche's remarkable survival capacity, not pathology. For survivors of narcissistic abuse, these parts often reflect the specific adaptations required to survive coercive control.

Trauma-related parts carry specific burdens and serve protective functions. The hypervigilant part scans for danger because remaining alert once meant survival. The part that numbs and dissociates developed because feeling too much was unbearable. The part that seeks approval from those who harm you developed because attachment to caregivers was necessary for survival. The inner critic developed to anticipate and prevent the abuser's criticism—if you could criticise yourself first, perhaps you could avoid their rage. Each part, however problematic its current effects, originated as protection. Fisher's approach treats these parts not as enemies to defeat but as protectors to understand.

Internal conflict reflects parts working at cross-purposes. The exhausting internal battles survivors experience—wanting connection while sabotaging intimacy, seeking safety while returning to danger, wanting to heal while undermining progress—result from parts with different survival strategies that cannot communicate with each other. The part that craves attachment doesn't know about the part that learned attachment leads to betrayal trauma. The part that wants to move forward doesn't know about the part frozen in traumatic memory. Without internal dialogue, each part acts autonomously, creating the contradictory behaviours that confuse survivors and clinicians alike.

Healing requires befriending parts rather than fighting them. Fisher's most important contribution may be reframing the therapeutic task. Rather than trying to eliminate troublesome symptoms, clinicians help survivors develop curiosity about their parts, understand each part's protective function, and build compassionate internal communication. When parts feel heard and appreciated rather than suppressed, they naturally relax their extreme positions. The goal is not to eliminate parts but to help them update—to recognise that the current environment is different from the traumatic past, that the adult self has resources the traumatised child lacked, and that they can now work collaboratively rather than at cross-purposes. This process of internal collaboration is essential for survivors developing Complex PTSD from prolonged relational trauma.

The model bridges multiple therapeutic traditions. Fisher integrates structural dissociation theory (van der Hart, Nijenhuis, Steele), Internal Family Systems (Richard Schwartz), sensorimotor psychotherapy (Pat Ogden), and mindfulness-based approaches into a coherent clinical framework. This integration allows clinicians to apply parts-based understanding regardless of their primary therapeutic orientation. Whether practising EMDR, CBT, psychodynamic therapy, or somatic approaches, the parts framework enhances treatment by helping both clinician and client understand the internal system they are working with.

How This Research Is Used in the Book

Fisher's work appears in Narcissus and the Child to explain the non-linear nature of healing and why recovery involves revisiting the same issues from progressively higher levels of awareness. In Chapter 12: The Unseen Child, the book draws on Fisher's spiral model of healing:

"Reparenting is not linear. Setbacks come: moments of falling back into old patterns, times when the inner critic wins. Fisher emphasises that healing spirals—we revisit the same issues from higher levels of awareness and resources each time. Each cycle strengthens the loving adult and heals the wounded child a bit more."

This citation supports the book's realistic portrayal of recovery from narcissistic abuse. Survivors often feel discouraged when old patterns resurface, interpreting setbacks as evidence that healing has failed. Fisher's framework reframes these experiences: revisiting familiar struggles doesn't mean healing hasn't occurred—it means you're encountering the same material with new resources and awareness. The spiral moves upward even when it curves back. Each time you meet your inner critic, your hypervigilance, your attachment wounds, you bring more capacity to understand and integrate these parts of yourself.

The book's discussion of reparenting—providing yourself with the nurturing and unconditional love the narcissistic parent never gave—directly connects to Fisher's parts work. The "wounded inner child" and the "loving adult" that recovery literature describes are, in Fisher's framework, specific parts of the internal system. Healing involves strengthening the adult self's capacity to care for wounded parts, much as a good-enough parent would have cared for the actual child. This internal reparenting builds the self-compassion that narcissistic abuse systematically destroyed.

Why This Matters for Survivors

If you survived narcissistic abuse, Fisher's work explains why healing can feel like fighting yourself—and offers a way out of that internal war.

Your conflicting impulses make sense. The part that still craves your abuser's approval isn't betraying you—it's the attachment-seeking part that developed because, as a child, attachment to your caregiver was survival, regardless of how that caregiver treated you. The part that sabotages relationships isn't self-destructive—it learned that intimacy leads to betrayal and is trying to protect you. The part that numbs you when you should be feeling isn't weakness—it developed because feeling the full weight of your experience would have been unbearable. These parts developed for good reasons. They're still doing their jobs because no one told them the war is over. This is the biological reality behind trauma bonding—parts that formed under conditions of intermittent reinforcement don't simply disappear when the relationship ends.

The self-sabotage that frustrates you is protection in disguise. Why do you push away people who treat you well? Why do you struggle to maintain the progress you make in therapy? Why do you return to situations you know are harmful? Fisher's framework answers: protective parts, developed during trauma, don't trust that safety is real. Progress feels dangerous because it means dropping defences that once kept you alive. Connection feels dangerous because connection was the context of your deepest wounds. Parts that protected you through the worst resist changes that might leave you vulnerable again. Fighting these parts intensifies the conflict; befriending them gradually convinces them that you have new resources, that the danger has passed, that they can finally rest. Understanding this is essential for working within your window of tolerance.

You are not your symptoms. The hypervigilance that exhausts you is a part, not your identity. The dissociation that disconnects you is a part, not who you are. The shame that tells you you're worthless is a part, not the truth about you. Fisher's framework distinguishes between your Self—your core, undamaged essence—and the protective parts that developed around trauma. This distinction is liberating: you are not broken. Your Self remains intact beneath the protective adaptations. Recovery involves strengthening your Self's capacity to lead your internal system with self-compassion rather than self-attack.

Healing happens through relationship with your parts, not despite them. You cannot heal by suppressing, overriding, or eliminating the parts that trouble you. They hold survival wisdom and traumatic material that must be processed. Fisher's approach invites you to get curious about your parts: What does this part protect me from? When did it develop? What does it need to feel safe? When parts feel understood rather than attacked, they naturally soften. The inner critic doesn't need to be silenced—it needs to know that you've survived, that you're safe, that there are other ways to protect yourself now. This is the work of developing affect regulation from the inside out.

Clinical Implications

For psychiatrists, psychologists, and trauma-informed healthcare providers, Fisher's framework offers practical guidance for working with survivors whose symptoms involve internal fragmentation.

Recognise that treatment resistance often reflects protective parts. The patient who cancels appointments, withholds information, or seems to undermine their own progress may not be "resistant"—they may have parts that fear what will happen if defences are dropped. A part may believe that talking about trauma will make it worse, that trusting the therapist will lead to betrayal, or that feeling emotions will be overwhelming. Rather than confronting resistance, clinicians can get curious about it: "I notice something in you seems hesitant about going further. I wonder if there's a part that has concerns about this?" This invites dialogue with the protective part rather than a power struggle with the patient.

Teach dual awareness as a foundational skill. Fisher emphasises "dual awareness"—the ability to notice part-based reactions while staying connected to present reality. "Part of me is terrified right now, and I'm also sitting in a safe room with my therapist." This capacity prevents both flooding (being overwhelmed by part activation) and dissociative disconnection (being too far from the material to process it). Building dual awareness is often a prerequisite for deeper trauma work. Patients who cannot achieve it may need more stabilisation before proceeding.

Move at the pace of the most vulnerable parts. A common clinical error is moving at the pace of the patient's healthy, motivated parts while overwhelming their vulnerable or protective parts. The part that wants to heal may be ready to process trauma memories, but the part that carries those memories may not be. Fisher advises attending to all parts, not just the ones who show up for appointments. When a patient becomes dissociative, dysregulated, or avoidant, the clinician can wonder aloud which part has been activated and what it needs. This pace may feel slow but prevents the retraumatisation that can occur when treatment outpaces the internal system's readiness.

Help patients develop compassion for their protective parts. Many survivors hate their symptoms, fighting against hypervigilance, dissociation, self-sabotage. Fisher helps patients shift from adversarial relationships with their parts to curious, appreciative ones. "This part has been working hard to protect you for decades. Can we get curious about what it's protecting you from?" When patients can appreciate the protective intention even of their most troublesome parts, internal conflict decreases and integration becomes possible. The clinician models this compassionate stance, which the patient gradually internalises.

Consider pharmacological support within the parts framework. While Fisher's approach is primarily psychotherapeutic, psychiatric support may be valuable. Medications that reduce hyperarousal can help hypervigilant parts relax enough for therapeutic work. Medications that stabilise mood can widen the window of tolerance within which parts work can proceed. However, medications that numb or suppress may prevent the internal dialogue necessary for integration. Clinicians should consider how pharmacotherapy affects not just symptoms but the internal system's capacity for the work of integration.

Broader Implications

Fisher's framework extends beyond individual therapy to illuminate patterns across families, relationships, and social systems.

The Intergenerational Transmission of Fragmentation

Narcissistic parents typically have their own fragmented internal systems—parts that carry unprocessed trauma, parts that seek the narcissistic supply that soothes their wounds, parts that cannot tolerate their children's separate selfhood. Intergenerational trauma transmits not just through explicit abuse but through the parent's parts interacting with the child. The parent's rageful part triggers the child's fearful part. The parent's needy part elicits the child's caretaking part. The child develops parts in response to the parent's parts, often without either generation understanding the process. Fisher's framework suggests that healing intergenerational cycles requires working with parts at every level—helping parents integrate their own parts so they don't project them onto their children.

Relationship Dynamics and Partner Selection

Adults with fragmented internal systems often choose partners whose parts interact with their own in familiar ways. The hypervigilant part finds a partner whose unpredictable part keeps it activated. The people-pleasing part finds a partner whose needy part requires endless attention. The part that believes love means suffering finds a partner who provides suffering. These are not conscious choices but parts finding their counterparts. Recovery involves helping all parts participate in partner selection, not just the parts that repeat familiar patterns. When the vulnerable parts that learned love equals pain can finally have a voice, different choices become possible.

Workplace and Professional Settings

Survivors often find workplace dynamics triggering because professional settings activate parts developed in family-of-origin trauma. The critical supervisor activates the part that expects parental criticism. The competitive colleague activates the part that learned relationships are zero-sum. The performance review activates the part that believes mistakes lead to abandonment. Understanding workplace struggles through a parts lens helps survivors distinguish between current reality and part-based reactions. It also helps organisations recognise that employees' apparently disproportionate responses to workplace stress may reflect activated parts, not poor work ethic or professional unsuitability.

Therapeutic Community and Group Treatment

Fisher's framework has implications for group therapy and survivor communities. Groups provide opportunities for parts to be witnessed and accepted by others—powerful healing experiences for parts that developed in isolation and secrecy. However, other survivors' parts can also trigger one's own: a group member's rageful part may activate another member's fearful part. Group leaders trained in the parts framework can help members notice these dynamics, naming them as parts interactions rather than interpersonal conflicts. This awareness transforms potential ruptures into therapeutic opportunities.

Treatment Programme Design

Residential and intensive outpatient programmes treating complex trauma benefit from parts-informed design. Staff should understand that patients' challenging behaviours often reflect protective parts activated by the treatment environment—parts that fear the intimacy of group settings, distrust authority figures, or become activated by other patients' distress. Programmes that punish these behaviours as "non-compliance" misunderstand their function and may inadvertently confirm parts' beliefs that authority is dangerous. Trauma-informed programmes create safety for all parts, including the ones that initially resist treatment.

Understanding Self-Harm and Suicidality

Fisher's framework illuminates self-destructive behaviours that can otherwise seem incomprehensible. Self-harm often reflects parts in conflict: a part that holds unbearable emotion, a part that will do anything to make the emotion stop. Suicidal ideation may represent a part so burdened by traumatic material that it sees death as the only escape. Understanding these behaviours as parts-based allows clinicians to work with the parts involved—offering the part that carries unbearable pain other ways to be heard, helping the part that wants to die understand that it's the pain that needs to end, not the person. This reframe often reduces the toxic shame and isolation that intensify self-destructive behaviour.

Limitations and Considerations

Fisher's important work has limitations that warrant acknowledgment for responsible clinical application.

The evidence base is clinical rather than experimental. Fisher's framework emerged from clinical observation rather than randomised controlled trials. While the approach resonates with many clinicians and survivors, and is consistent with established theory, rigorous outcome research comparing parts-based approaches to other trauma treatments is still limited. Clinicians should be transparent about the state of the evidence while remaining open to approaches that help individual patients.

Not all trauma survivors experience prominent parts phenomena. While structural dissociation theory suggests all trauma involves some degree of fragmentation, the degree varies substantially. Some survivors do not relate to the parts framework and may be better served by other trauma approaches. Clinicians should offer the framework as one lens rather than impose it on patients who don't find it useful.

Cultural considerations require adaptation. Fisher's framework emerged from Western clinical contexts where individual selfhood is emphasised. In collectivist cultures, concepts of self and parts may be understood differently. The language of "parts" may resonate differently across cultural contexts, and clinicians should adapt the framework to patients' cultural backgrounds rather than assuming universal applicability.

The approach requires clinician training and self-awareness. Working with parts requires the clinician to notice their own parts reactions to the patient's parts. A clinician whose critical part gets activated by a patient's vulnerable part may inadvertently replicate the dynamics that created the patient's difficulties. Fisher emphasises that clinicians doing this work need their own parts awareness, supervision, and often their own therapy.

Historical Context

Healing the Fragmented Selves of Trauma Survivors appeared in 2017, synthesising ideas that Fisher had been developing and teaching for decades. The book represented a practical integration of two important theoretical streams that had been developing somewhat separately.

The theory of structural dissociation of the personality, developed by Onno van der Hart, Ellert Nijenhuis, and Kathy Steele, provided a theoretical framework explaining how trauma fragments the psyche into parts with different functions. Their 2006 book The Haunted Self laid the theoretical groundwork but was highly technical, aimed primarily at researchers and specialist clinicians.

Internal Family Systems therapy, developed by Richard Schwartz beginning in the 1980s, provided a practical therapeutic approach to working with parts. IFS offered specific techniques for identifying parts, understanding their roles, and facilitating internal dialogue. However, IFS was not originally trauma-focused and was sometimes viewed with scepticism by the trauma treatment community.

Fisher's contribution was bridging these streams—taking the trauma-specific theoretical rigour of structural dissociation and the practical clinical utility of IFS to create an approach specifically designed for trauma treatment. Her background as an instructor at Harvard's Trauma Center (directed by Bessel van der Kolk) and her decades of experience with the Sensorimotor Psychotherapy Institute gave her credibility across therapeutic orientations.

The book's accessibility was deliberate. Fisher wrote not only for clinicians but for survivors themselves, recognising that understanding one's internal system is therapeutic in itself. This dual audience—clinicians and the survivors they serve—has contributed to the book's influence in both professional training and survivor self-help contexts.

The parts framework has gained significant traction in trauma treatment since the book's publication, influencing how clinicians conceptualise complex trauma and appearing in training programmes internationally. It has also crossed into popular awareness through social media, where survivors share their experiences of working with their parts.

Healing the Fragmented Selves of Trauma Survivors: Overcoming Internal Self-Alienation

APA Citation