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Cathy Dodge Smith

Let's consider why Traumatic Incident Reduction (TIR) would be expected to be different with an autistic client. One of the hallmarks of autism is a lack of connection with the real world, so the world view of an autistic individual is limited and often very inaccurate. A second hallmark of autism is difficulty with intrapersonal and interpersonal relationships so that insight into how to make relationships better, or work at all, would be expected to be limited. So, within a TIR session where we expect our clients to come up with their own insights, that's really a tall order. Then the meltdowns I've talked about; as a Davis facilitator I understand these as prolonged and severe disorientations, analogous to a PTSD episode, in which the emotional reaction is really out of sync with true facts and conditions in the current situation. Added to all this are the phobias and the extreme aversions that many autistic individuals experience, which can limit full participation in life. One of the things that makes working with autistic clients challenging is that often we simply have to wait until they give us that little window of time when they are able and willing to proceed. If I were to use the guidelines in my TIR Workshop manual, I would have to conclude that there was not enough ego strength or resiliency in these individuals for them to be able to engage for a successful TIR session. You know what they say about fools who rush in where angels fear to tread... A less foolish person than I am, and especially someone new to TIR, would likely never have tried to use TIR with autistic clients. However, based on the wonderful results I have seen using TIR with many of my other clients who do not have autism, and some of the really significant problems that some of my autistic clients were presenting, I decided to try TIR with a few of them. In the remainder of this lecture, we'll consider two specific case studies. Veronica, a sixteen-year old who basically lived as a recluse in her mother's basement, and Joshua, a young boy obsessed with drum kits who was given to periods of extremely oppositional behavior. Cathy Dodge Smith uses Davis Methods in her practice (Davis Dyslexia Correction Program, Davis Autism Approach, and Davis Attention Mastery ). She is also a Certified TIR Facilitator. This article is from her presentation at the 2014 Symposium. Originally appeared in AMI/TIRA Newsletter, Volume XII, Number 1 (March 2015).

Loving Healing Press

Metapsychology Monographs

Autism Spectrum Disorder and Traumatic Incident Reduction (TIR): An Introduction

Susan Sluiter

I developed renewed faith in the power of psychotherapy after I attended a Traumatic Incident Reduction (TIR) course in 2011. It opened many doors for me as I began to understand the impact of previously overlooked, objectively minor traumatic incidents on psychological disorders and problems. This article is about the application of this powerful tool over the entire spectrum of psychological problems and disorders and how this brings about impressive and permanent change. The optimal use of this tool in psychotherapy requires a shift in epistemology in which we begin to view mental health through a trauma lens.
 The definition of psychological trauma can vary. From a TIR perspective, trauma can be defined as any incident that had a negative physical or emotional impact on an individual. This is a very subjective issue as the something could be perceived as traumatic by one individual, but as commonplace and harmless by another. The important thing is the emotional and physical impact the incident had on the individual, its subjective impact.
 The reason it is so important to view trauma in the broadest way possible is because it explains the chronic mood states of our clients as well as how subconscious intentions and automatic emotional responses affect their current lives. These will be explained below. Traumatic incidents, when understood in the broadest sense possible, have a massive effect on our neurobiology, emotional states and behavioral patterns. Therefore, they can be seen as the driving force behind almost all psychological problems and disorders. When I say traumatic incidents "in the broadest sense possible," I refer to the everyday incidents of trauma that are objectively perceived as minor, such as an embarrassing comment by a teacher, conflict with a friend, breaking your mother's expensive vase, etc. It involves an understanding of how the emotional knocks we take on a daily basis affect our neurobiology and continue to have an impact on us in later life. The understanding of subconscious intentions, automatic emotional reactions and responses and chronic mood states are so crucial when it comes to looking at mental health through a trauma lens. Minor and major psychological and physical trauma involves a complex description of the effects on the brain.
 This article includes detailed case studies including specific incidents such as birth trauma and jealousy and rage. We will look in detail at how trauma results in Goleman's "Amygdala Hijacking" and how we can help the client break destructive cycles. I also explain why sheer willpower is insufficient to change behavior in the face of traumatic restimulation. Additionally, the article explains how TIR avoids re-traumatization even as clients revisit past incidents.

Looking Through the Trauma Lens: Powerful Permanent Change with Traumatic Incident Reduction (TIR)

Elca Erlank

This article briefly reflects the extent to which substance dependency and traumatic events, which may lead to a diagnosis of a post-traumatic stress disorder, are becoming a feature of life all over South Africa. Many social workers are familiar with current evidence-based approaches and are skilled at adapting them to local cultural and contextual conditions. Exploring and continuing learning various evidence-based approaches to render more effective services are an important aim of social work practice. Metapsychology and Traumatic Incident Reduction (TIR), an Applied Metapsychology technique, are introduced to challenge social workers to render more integrated and effective services.

 The prevalence and comorbidity of substance dependency and PTSD

 Looking at statistics about substance dependency, as well as the high tendency of being a victim of trauma in South Africa, is it evident that social workers are confronted and challenged on a daily basis to improve their knowledge and skills in this regard. In South Africa, drug consumption is twice the world norm (CDA-2011) and 15% of South Africa's population has a drug problem (CDA-2011).Over 30% of the South African population have an alcohol problem or are at risk of having one and alcohol affects 17.5 million of South Africans. Studies show that people who start drinking before the age of 15 are four times more likely to become alcoholics than people starting to drink later in their life. The recently-released United Nations World Drug Report had named South Africa as one of the drug capitals of the world. When it comes to the abuse of alcohol and usage of dagga, this country is rated to be one of the top ten narcotics and alcohol abusers in the world (Addiction Drug Alcohol Statistics, S. A. 2012

 About the Author
 Elca Erlank, Ph.D. became a TIR trainer in 2012. She has trained with both Gerald French and Yvonne Retief. Elca is a social worker, in South Africa with 22 years experience in various related fields of social work services. She had specialized in the field of substance dependence and received her doctorate degree in 2003.

Substance Dependency, PTSD and Traumatic Incident Reduction (TIR) in South Africa: A Social Work Perspective

Ashley Doyle

A large percentage of the population experiences some type of trauma in their lifetime; however, they don't all develop a diagnosable disorder. Even though no research can definitively predict what types of traumas will elicit a diagnosable disorder, there has been some indication as to who is more at risk for the development of trauma-related disorders, specifically Acute Stress Disorder (ASD) and Posttraumatic Stress Disorder (PTSD). Yet other disorders may also be elicited such as anxiety disorders, depressive disorders, or personality disorders. Children, the elderly, and the disabled are labeled at-risk due to their dependency on others, sparse coping strategies and resources, and economic disadvantages. Additionally, individuals who experience extra stressors, low-self esteem, and have a poor sense of self are also at risk of developing a disorder rather than use resiliency (Petersen & Walker, 2003). One extreme reaction to trauma exposure is the elicitation of a personality disorder, specifically Borderline Personality Disorder (BPD).

 The focus of this paper is three-fold. First, it compares two treatment approaches: Dialectical Behavior Therapy (DBT) and Traumatic Incident Reduction (TIR). These are different in technique and philosophy when regarding the processing of traumatic events. Second, it reviews the evidence for co-morbidity (simultaneous occurrence) between BPD and PTSD. Finally, this paper will propose a strategic plan for the most effective treatment for individuals with BPD and PTSD symptoms.

 Metapsychology Monographs #8

A Proposed Treatment Connection for Borderline Personality Disorder (BPD): Dialectical Behavior Therapy (DBT) and Traumatic Incident Reduction (TIR)

Kadie McCourt

"Sexual addiction is strongly anchored in shame and trauma. Research conducted over the past fifteen years has consistently shown the prevalence of emotional, physical and sexual abuse in this population" (Cox & Howard, 2007, p. 1). As well, there is also high co-morbidity of sexual addiction with other addictive disorders. An additional layer of sexual addiction is the underlying shame associated with the actions and behaviors the client engages in for this addiction. This intense shame is likely to fuel and perpetuate the cycle of the addiction. With such a strong link, it is important for clinicians to address the underlying trauma while assisting clients with sexual addiction (Cox & Howard, 2007).

 To assist clients in overcoming a sexual addiction there are minimal options. Unlike gambling where absolute abstinence from the behavior is the desired effect, this type of a decision regarding sex will hinder a healthy relationship. One strategy is to use a Sexual Boundary Plan (Weiss, 2004). Fortunately, with Traumatic Incident Reduction (TIR) and related techniques, this is not the only strategy to assist clients with a sexual addiction.

 It is important to remember that a sexual addiction is similar to alcoholism in that the individual uses sex to cope with pain and numb difficult feelings. For the sex addict, sex is mood altering like a drug, and the individual needs more and more to achieve the same elevated feeling. Often this results in more frequent sexual behaviors and increased risks. Sex becomes the focus in a person's life and thus there is no room for healthy relationships. In addition to abuse experiences, other traumas for the sexual addict are betrayal, abandonment or rejection. "If the betrayal is severe enough, trauma results. Fear and terror become the catalyst that allows betrayal to move into the area of trauma" (Cox & Howard, 2007, p.6).

 From the Metapsychology Monographs Series

Sexual Addiction and Traumatic Incident Reduction (TIR): An Introduction

Nancy L. Day

Program developer Edna B. Foa, Ph. D. summarizes Prolonged Exposure (PE) therapy as a cognitive-behavioral treatment program for individuals suffering from Post-Traumatic Stress Disorder (PTSD). The program consists of a course of individual therapy designed to help clients process traumatic events and thus reduce trauma-induced psychological disturbance. The standard treatment program consists of nine to twelve 90-minute sessions. (SAMHSA, 2003)

Frank A. Gerbode, M. D., psychiatrist, and one of the principal developers of Traumatic Incident Reduction (TIR) summarizes TIR as a procedure that involves tracing back sequences of traumatic incidents to their roots while completing the incomplete receptive cycles that have accumulated in the sequences. What must be assimilated and accommodated from a traumatic incident are one's reactions to the incident--including one's thoughts, sensations, feelings, and perceptions. (Gerbode, 1995)

Although there are some remarkable similarities between PE and TIR, there are also some very distinct differences. In this paper, I'll both compare and contrast Prolonged Exposure with Traumatic Incident Reduction.

Loving Healing Press Inc

A Comparison of Traumatic Incident Reduction (TIR) and Prolonged Exposure (PE) Therapy

Pamela V. Valentine

The following article is based on materials presented at the Proceedings of the Tenth National Symposium on Doctoral Research in Social Work (1998). 

 Statement of the Research Problem
 Conducted in the Tallahassee Federal Correction Institute (FCI) in Florida, this experimental outcome study examined the effectiveness of Traumatic Incident Reduction (TIR) (Gerbode, 1989) in treating trauma-related symptoms of female inmates who were victims of interpersonal violence. TIR is a brief (in this case, one session), straightforward, memory-based, therapeutic intervention most similar to imaginal flooding. A memory-based intervention implies that the symptoms currently experienced by a client are related to a past event and that lasting resolution of those symptoms involves focusing on the memory rather than focusing on symptom management. TIR is straightforward in that the roles of both the client and therapist are very clearly defined and strictly followed. 

 There are several reasons for studying the influence of TIR on previously traumatized female inmates. Since 1980, the rate of family homicide has increased fivefold (Joffe, Wilson, & Wolfe, 1986). Women are the target of much violence, as illustrated by the following: 75% of adult women have been victims of at least one sexual assault, robbery, or burglary (Resnick, et al., 1991); and 53.7% are victims of more than one crime. Abundant data suggest that PTSD can result from having been a victim of crime or having witnessed a violent crime (Astin, Lawrence, & Foy, 1993; Breslau, Davis, Andreski & Peterson, 1991; Resnick, et al., 1991). Therefore, the number of women affected by PTSD is growing as violence and sexual abuse increase in society as a whole (Ursano & Fullerton, 1990). There is a lack of empirical research on the traumatic effects of interpersonal violence (e.g. robbery, rape, incest, physical assault). Since inmates are typically victims of interpersonal violence (Gabel, Johnston, Baker, & Cannon, 1993), the inmate population studied was particularly suitable for TIR.

Brief Treatment of Trauma-Related Symptoms in Incarcerated Females with Traumatic Incident Reduction (TIR)

Frank A. Gerbode

Most common approaches to post-traumatic stress reduction fall into two categories: coping techniques and cathartic techniques. Some therapists give their clients specific in vivo (literally "in life") methods for counteracting or coping with the symptoms of PTSD--tools to permit their clients to learn to adapt to and to learn to live with their PTSD condition. Others encourage their clients to release their feelings, to have a catharsis. The idea is that past traumas generate a certain amount of negative energy or "emotional charge", and the therapist's task is to work with the client to release this charge so that it does not manifest itself as aberrant behavior, negative feelings and attitudes, or psychosomatic conditions.

Coping methods and cathartic techniques may help a person to feel better temporarily, but they don't resolve trauma so that it can no longer exert a negative effect on the client. Clients feel better temporarily after coping or having a catharsis, but the basic charge remains in place, and shortly thereafter they need more therapy.

The Need for Anamnesis (recovery of repressed memories)

Traumatic Incident Reduction (TIR) operates on the principle that a permanent resolution of a case requires anamnesis (recovery of repressed memories), rather than mere catharsis or coping. To understand why clients have to achieve an anamnesis in order to resolve past trauma, we must take a person-centered viewpoint, i. e. , the client's viewpoint and, from that viewpoint, explain what makes trauma traumatic.

Critical Issues in Trauma Resolution: The Traumatic Incident Network

Robert H. Moore

"Traumatic Incident Reduction (TIR) and Primary Resolution of the Post-Traumatic Stress Disorder" provides a brief discussion illuminating the concept of PTSD: how it arises, what maintains it, how it progresses to increasingly constrain a person's life. PTSD also involves faulty thinking, but focus on such present-time reactions is ineffective without addressing the original trauma. PTSD is the consequence of attempts to avoid re-experiencing. Traumatic Incident Reduction (TIR) is a technique for overcoming this tendency, allowing the sufferer to experience the traumatic incident in a special, safe way. In the case of multiple traumas, this can be complex, needing to deal with each. It is necessary to find the original trauma, which invariably has led to more recent ones, and fully resolve it in one sitting. This provides complete relief from the burden of the past trauma. An individual session, designed to handles a single incident, may take between 20 minutes and 3 hours (average 1.5 hours). The primary incident may be obvious to the sufferer, or hidden. People with anxiety problems but no flashbacks may find forgotten traumas, the resolution of which through "Thematic TIR" can eliminate current symptoms. Currently occurring emotional and somatic symptoms are traced back in time until a root incident is found. Emotion and thinking are intertwined: correcting one will correct the other. TIR focuses on the emotion. Once the trauma is fully processed, the person is able to think rationally about it. Dr. Moore is a licensed marriage and family therapist, school psychologist and mental health counselor with graduate degrees in counseling psychology from Lehigh (1965) and Walden (1977) Universities. He is a Fellow and Diplomate of the American Board of Medical Psychotherapists; a Diplomate of the International Academy of Behavioral Medicine, Counseling and Psychotherapy. With over thirty years of practice, seventeen as Director of the Institute for Rational Living in Florida, he has co-edited or contributed to six popular books by Albert Ellis; authored chapters on various applications of Cognitive Behavior Therapy and Traumatic Incident Reduction for professional texts by Windy Dryden, Larry Hill and Janet Wolfe; hosted his own nationally syndicated daily talk radio program; and produced over three hundred psychologically-topical news and public service segments for radio and television. "Dr Moore's monograph will guide you in deciding whether you will benefit from TIR, and may inspire you to train to become a 'facilitator' who can help others with this powerful family of techniques."

Metapsychology Monographs - The book series

Metapsychology Monographs - The book series

Metapsychology Monographs books in order

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