TIR...

traumatic incident reduction

      ...Insight  

Foreword to the Book:

"Traumatic Incident Reduction (TIR)"

 

In beginning these notes, I wish to acknowledge the authors for having taken the highly unusual step of asking me — an absorber rather than a dispenser of therapy, a client rather than a colleague — to write this foreword. Their request is very much in keeping with the philosophical orientation of TIR, an approach to dealing with post-traumatic and other painful conditions that is truly, even radically, client-centered, as you will discover.

Originally, having read a number of my e-mail posts1 to a forum focused on trauma, Gerald asked me if I'd be willing to describe some of my own experiences with TIR as a contribution to this book. Initially, he and Chrys had told me they considered including my reflections as a brief case history, written from the viewpoint of a client. Following some discussion on the telephone, however, Gerald asked me if I'd be willing to tackle the ocean instead of the swimming pool, and actually to set forth what follows.

I had a brief moment of panic. The panic was very real, and probably based on a long history of self-doubt, feelings of unworthiness, passivity, and an obsessive perfectionism. That its intensity dwindled to nothing in the space of no more than perhaps ten seconds is the first of a great number of positive changes that have recently occurred in my life that I believe stem directly from my experience with the procedure that this book describes.

I first came across Traumatic Incident Reduction (TIR) on the Internet in the late months of 1997. I had been researching various concepts of traumatic bereavement, had read some insightful papers by two of the leading researchers on childhood trauma (Bruce Perry and Bessel van der Kolk) and was deeply involved in correspondence with Dr. Holly Prigerson at the Yale School of Biomedicine and Dr. Katherine Shear of Western Psychiatric Institute and Clinic concerning their theories and research into what was then being termed Traumatic Grief. Truth be told, what I was really engaging in was an attempt to find a path towards my own healing; towards ending the pain, confusion, and uncertainty that had kept my true sense of myself, my abilities, my fulfillment and any real pleasure in life at bay for the previous forty years. A description of some of my background seems relevant; forty-plus years of my past history includes a number of elements and incidents.

There was the sudden and unexpected loss of my mother, who died of a cerebral hemorrhage when I was six years old. Her death left me with unresolved mourning, morbid and overwhelming grief, and a profound sense of subconscious guilt, exacerbated by the fact that her death was never discussed, explained, or dealt with at the time that it happened. There was no funeral, no grave site or memorial, and very few mementos of her former existence. Because of that, and because of the fact that my relationship with her before her death was also ambivalent (and co-dependent, due to her own untreated depression) it is perhaps not surprising that some of my pathology included an inability to accept the reality of her death at a core level. Thus I developed an unconscious tendency to search for the lost object of attachment, coupled with learned helplessness, compulsive care-giving, low self-esteem, self-destructive behavior, abandonment anxiety disorders, and an inability to express anger, accompanied by profound irrational fear. My father too was suffering depression and a host of other devils of his own. In consequence, he was given, however untintentionally, to shaming and other forms of psychological abuse, thus creating another layer of trauma.

My family's history includes bipolar disorders (with concomitant hospital confinements and suicide attempts) and a disproportionate share of depressive disorders, on both paternal and maternal sides, some of which are probably partially genetic in origin. My own more recent history consisted of six major depressive episodes of long duration, requiring medication, and five losses of significant relationships, each of which I perceived as utter abandonment. In sum, then, as you might imagine, I had a great susceptibility to triggering of very painful negative affect throughout my life by any circumstance bearing even the faintest resemblance to earlier and seemingly similar traumata. I had been in ongoing psychotherapy for the past twenty-five years with three very competent therapists — Freudian, Jungian, and Cognitive-Behavioral — and I had been on antianxiety and antidepressant medication, including Valium, Flurazepam, various Tricyclics and, most recently, SSRIs.

Needless to say, after slipping into another deep depression following yet another loss of a significant relationship in the Fall of 1997, with all the familiar accompaniment of the associated massive triggering of emotional affect from earlier traumas, I was ready to consider the possibility of a different approach to my worsening condition. And several days before my forty-seventh birthday, I embarked on a course of TIR — one that led me, in a matter of a very few days, to a place of complete resolution and to a kind of peace I had never experienced. The experience enabled me to effect changes in my self and my perception of the world that I and those who know me well have had no hesitation in labeling dramatic.

I employ the term "dramatic" in full awareness of the fact that its use may engender a certain skepticism among therapists jaded by anecdote. So be it. I could find no better word in Webster's Second Edition, unabridged, which defines it as: "of, or pertaining to, the drama; vivid; expressed with action," and of drama: "a composition, usually in prose, arranged for enactment and intended to portray the life of a character, or to tell a story, with dialogue tending toward some result." The process of Traumatic Incident Reduction contains all of these elements. It allows one to tell one's "story"... to reenact it; to compose a dialogue with oneself that seemed inevitably, to me, to lead to a very significant result: the action of the "drama" resolving into a much-desired outcome. In my case, the outcome has been healing, peace, satisfaction, fulfillment, and the cessation of often unbearable pain and distress.

Traumatic Incident Reduction gave me the ability to resolve and eliminate all the major negative affects surrounding my mother's death and the subsequent additional traumas. It gave me the ability finally to acknowledge and accept the reality of that death and loss, and I am now in the process, with other members of my family, of creating the actual, physical, previously unfinished grave-marker destined to become her memorial. It gave me profound relief from all the unconscious feelings of guilt on both an inexplicable emotional level and a very real and present cognitive level.

TIR has allowed me to restructure a very deep and impairing belief-system that had kept me from the joys and fulfillment that I now know I deserve and desire and have begun to attain. It has restored to me my self-esteem and heightened my confidence, else you would not be reading this. Recently, I have experienced several situations any one of which, at any time in the past, would have triggered intense feelings of abandonment, rejection, anxiety or apprehension in me. Since my few sessions of TIR and Unblocking (that's another remarkable tool you'll learn about in this book), I have met those situations positively and optimistically, and without any of the negative emotional charge that would have dominated my responses in the past.

With what was for me astonishing rapidity, TIR ameliorated all aspects of my depressive symptoms, both mental and physical. It has allowed me, for the first time in twenty five years, to feel wholly comfortable in discontinuing all antidepressant medication, despite my concern over the fact that earlier this year my father tried to do the same and ended up in his worst depression ever, followed by an almost-successful suicide attempt, four months of hospitalization, extensive ECT, and now a tenuous recovery. Following TIR, with medical approval and encouragement, I stopped taking a daily 50 mg. of the SSRI, Paxil.

TIR has allowed me to accept and undertake increased responsibility in my life and in my community and to embark a new career of which I had previously only dreamed. The support that I have gotten from my community has been equally rewarding. TIR, in fact, has given me back my life.

Do I think these changes will be long-lasting and permanent? Yes.

Do I know why? Yes.

Could I explain why? Yes...but the authors of this book do it better than I could.

Do I think that I will ever be clinically depressed again? Probably not... and again I assert that my being able to understand this is one of the added benefits of the constructive quality of life changes that are common in TIR.

Do I think I'm the exception rather than the rule in the degree of transformation I have experienced? Possibly...but then I've lately encountered a lot of impressive anecdote out there suggesting that my experience is not that uncommon.

Recently, in the Traumatic-Stress Forum begun on the Internet by Professor Charles Figley of FSU, there was extended discussion of a series of questions regarding if and how trauma might actually be "cured" (a word I've seen enclosed by quotation marks much more often than not when used by professionals in the context of traumatic sequelae). One of the participants in the Trauma List posted the following:

"My guess is that clients are brimming with their own wisdom regarding what is in the way of their cure, and that likewise, many are just waiting for therapists to ask some simple questions. Which brings me to another question — what keeps therapists from asking these questions?"
I am convinced that the therapist/facilitator using TIR is asking, perforce, some of the most important of these very simple questions, and (if s/he has been well trained) asking them in such a way that a client like myself can glean enormous insight, wisdom and relief in the flow of his or her own answers.

In reviewing the many thoughts that others have recently shared with me concerning the question of whether all trauma can be cured, I have concluded that the answer is Yes. I do believe all non-physical trauma can be cured. And that the cure can be as complete and permanent as we desire it to be. I also now know that the cure need be neither as difficult nor as time-consuming as most of us, clients and therapists alike, have in the past been led to believe.

This book describes the basic techniques, structures, and communication skills necessary for the effective administration of TIR. The authors also describe "Unblocking", another valuable procedure that can enable you as a therapist or facilitator to address situations where your client's memory of a specific traumatic event seems to be unavailable, or where repetitive traumas seem to have occluded the ability of the client to know what areas of life most need to be addressed.

Since I hope I am speaking from the viewpoint of your client, or as one trying to put myself in his or her shoes, I urge you to be open to the possibility that a remarkably high percentage of clients know what they need in order to change, and will find it by themselves if allowed to look in the absence of certain kinds of proffered "help" and "support."2 I believe that any one of us (who meets certain prerequisites) is capable of tracing unwanted feelings, sensations and perceptions back to their origins and, in the simple act of "viewing" those origins, of eliminating their pain and of changing forever for the better, their bitter cognitive associations.

Again, it is possible to learn to ask a remarkably few questions that open up the possibility of healing; simple questions...like, "tell me what happened". As well, the authors of this book stress the therapeutic value of a therapist's not asking, or saying, much else; of granting the client the empowerment that comes (I can attest) from having confronted his or her own devils and nightmares — uninterpreted, unevaluated, and unaided — and from having had the freedom to reach his or her own conclusions concerning their true nature and significance.

A therapist I spoke with, recently addressed the issue well,3

"In any case", with trauma, we are apparently not dealing with any total or permanent structural changes, since many people seem to completely get over the negative charge associated with the events. So, cure seems to me to be a reasonable word to describe there no longer being an ongoing problem. If the charge is gone, why not use the word "cure"? If we remember that the same incident may be experienced as traumatic for one person and not another, then we conclude that the trauma is in the experience, not the event. Similarly, it is not in the memory. So, if memories are still there without the traumatic charge (and the traumatic charge doesn't come back) then I'd call that cure. I think part of the problem has been our limited expectations based on our previously limited tools. People have grown to expect only to feel 'less bad', or to feel bad less often.... I think that if we set our sights on anything less than cure, we will wind up settling for less than we need to."

I want to acknowledge the authors of this book for placing, as all facilitators do, such a large amount of trust in their clients — their "viewers" — and for allowing me (without ever even having met me) the very healing opportunity to write this foreword . If this description of my own experiences and of the transformations I have undergone as a result of my own personal and profound encounter with TIR has served in any way to whet your appetite for more, I shall have performed a valuable service.

We may not have a solution for many of the illnesses in this world. We may not have a cure for cancer or AIDS or arthritis. I believe that we have, with TIR, a cure for trauma-induced mental and emotional complications, even severe ones. With this in mind, I urge you to use the knowledge and the wisdom contained in this book to the best of your abilities. I think it will make quite a difference in the world — a place that I now truly enjoy and look forward to being in for quite some time.

 

With Best Regards,

Peter Shefler

Emerson Point, Maryland
January, 1998


1 These were posts on the subject of my own recovery, by way of TIR, from the trauma that characterized my childhood.

2 "Help" and "support" which, in my extensive experience as a client, I have all too often found to be an integral part of the therapist's armamentarium.

3 This exerpt is from the Traumatic Stress Forum, and was written By Harry D. Corsover, Ph.D., Licensed Psychologist.