WHAT IS TRAUMATIC INCIDENT REDUCTION (TIR)?

TIR is a brief, one-on-one, non-hypnotic, person-centred, simple and structured method for permanently eliminating the negative effects of past traumas. The client usually comes up with one or more insights - often major - concerning the trauma, life, or themselves. They may display positive emotion, but will at least experience calm and balance, feeling no more negative emotion in relation to their trauma(s).

A TIR session is not ended until the client reaches an end point and feels good. This may take anywhere from a few minutes to 3-4 hours. Average session time for a new client is 90 minutes. Firstly you will meet with your therapist for a 50 minute session where you will talk about what you are experiencing. At this time your therapist will be able to give you an estimated length of time of your TIR session, which can then be scheduled.

 

It is highly effective in eliminating the negative effects of past traumatic incidents. It is especially useful when:

• A person has a specific trauma or set of traumas that they feel has adversely affected them, whether or not they carry a formal definition of "PTSD".

• A person reacts inappropriately or overreacts in certain situations, and it is thought some past trauma might have something to do with it.

• A person experiences unaccountable or inappropriate negative emotions, either chronically or in response to certain experiential triggers.

What is the anticipated outcome of TIR?

In the great majority of cases, TIR correctly applied results in the complete and permanent elimination of PTSD symptomatology. It also provides valuable insights for the client.

By providing a means for completely confronting a painful incident, TIR delivers the positive gain a person would have had if he had been able to fully confront the trauma at the time it occurred.

How and why does TIR work?

A trauma contains repressed material. Contained in a trauma, too, is one or more intentions. At the very least, there is the intention to push it away, to blot it out, to repress it. And there are usually other intentions as well, such as the intention to fight back, to get revenge, to run away, or (quite commonly) the intention to make sure that nothing like this incident ever happens again.

For every given activity (and for every given intention) there is a corresponding period of time, and so long as you have an intention, you remain in the period of time defined by that intention (and activity). Holding onto an intention holds you in the period of time that commenced with the formulation of that intention. There are only two ways of ending an intention:

1. Fulfilling the intention, whereupon it ends spontaneously. 
2.  
   Unmaking it. Even if you don't fulfill an intention, you can decide not to have that intention anymore and cause it to end. This, however, requires a conscious decision. You have to be aware of the intention and why you formed it.

But what if the intention is buried in the middle of a repressed trauma? In this case, neither condition (1) nor (2) can be satisfied, and the intention persists indefinitely. The person remains in the period of time defined by that intention, i.e., the person remains in the traumatic incident. The incident floats on as part of present time and is easily triggered (i.e., the person is easily reminded of it, consciously or unconsciously).

The only way a person can exit from that period of time (and from the intentions, feelings and behaviors engendered by the trauma) is by confronting the incident, whereupon one can see:

• What intentions were formulated at the time of the incident.

• Why they were formulated at that time.

Then, and only then, one can satisfy condition (2), above, for ending an intention, and one can let go of the intention. Without a thorough anamnesis, condition (2) cannot be satisfied. TIR allows that anamnesis to take place.

What research exists to support the effectiveness of TIR?

Charles Figley and Joyce Carbonell have studied four different approaches to trauma resolution: TIR, EMDR, VKD, and TFT. In their view, all are very effective.

Lori Beth Bisbey completed a study of 57 victims of violent crime in February 1995. The study compared TIR to DTE and waiting list controls, using a variety of test instruments, on crime victims with PTSD. Waiting list controls showed no significant improvement over time; DTE showed significant improvement over controls (P < .01) on test instruments relating to PTSD; TIR performed significantly better than DTE (P < .01) on most test instruments. This study was part of her Ph.D. thesis and was done under the auspices of the California School of Professional Psychology, San Diego, CA.

Wendy Coughlin completed a study of TIR on Panic and Anxiety Disorders in May 1995. Her study concluded that "there was a substantial and statistically significant reduction in State Trait Anxiety for the entire sample. State Anxiety levels dropped by nearly one-third of their original levels. Based on the STAI scoring, the drop moved the group average from an anxiety level which would cause clinical concern and personal discomfort to a level that is considered normal for most people." This study was part of her Ph.D. thesis and was done under the auspices of Union Institute, Cincinnati, Ohio.

Pamela V. Valentine completed a study of TIR applied to 123 incarcerated females at the Federal Correction Institute in Tallahassee, Florida in 1997. Her work was presented at the Tenth National Symposium on Doctoral Research in Social Work in 1998. The study showed, after treatment using TIR, "…a statistically significant decrease in symptoms of posttraumatic stress disorder and its related subscales and of depression and anxiety." This study was part of her Ph.D. thesis and was done under the auspices of Florida State University.

What are the contraindications and risks of TIR?

TIR is contraindicated for use with clients who:

• Are psychotic or nearly so. TIR is most definitely an "uncovering" technique and hence is not appropriate for such clients.

• Are currently abusing drugs or alcohol. Clients must inform their therapist of any medications or drugs they use regularly. They should avoid taking pain killers, sleeping pills, tranquilizers or any other medication or drugs which might impair physical or mental abilities, for at least 24 hours prior to a session. Some substances require a longer abstinence before a session can take place.

• Are not making a self-determined choice to do TIR. For TIR to work, the client has to really want to do it. If the client is there under duress (e.g. trying to please someone) TIR will not work. It may be possible, however, to explain to a reluctant client what TIR is and "sell" him on the idea of doing it. But the client must be well-motivated before starting.

• Are in life situations that are too painful or threatening to permit them to concentrate on anything else, such as a TIR session. If the client is afraid of being murdered, or is preoccupied about the possibility of having cancer, or engaged in constant fighting with their spouse, such issues/situations would have to be addressed first before the client will be ready to do TIR.

• Have no interest in or attention on past traumas. A general rule is to follow the interest of the client. If, when the client isn't interested in looking at past traumas, you address what the client is interested in looking at, the client may then become interested in looking at past incidents.

Since the TIR technique is completely client-titrated, client-timed, and non-forceful, clients will protect themselves if they are getting in too deeply by simply discontinuing the procedure. Hence there are no known cases of negative effects from properly facilitated TIR. As the client’s interest is followed at all times, resistance is not often encountered. If the client resists, it is considered that the correct material is not being addressed.