Vocational Consultants in
Traumatic Incident Reduction (TIR)
According to a 4-year study conducted by the Research Triangle Institute for the V.A., fully half of the nearly one million individuals exposed to life-threatening situations in Vietnam suffer to varying degrees the (by now) well-known symptoms of Post Traumatic Stress Disorder (PTSD). This comes as no surprise to the vast majority of those working in any capacity to help these veterans. Though numerous hospital and outpatient programs exist that offer treatment for PTSD, their effectiveness is at best debatable, due in part to the fact that the majority of Vietnam and other veterans suffering post-traumatic stress do not seek treatment there . . . or anywhere. Many amongst that majority, however, are reached by vocational consultants. The latter find, too often, that their efforts to assist vets to become job ready - and to enable them to remain in meaningful employment once obtained - are frustrated by the untimely emergence of one or more of the classic symptoms of PTSD in the clients they are trying to help, such as flashbacks, unreasoning fear, uncontrollable grief, unprovoked rage, and an inability to communicate effectively or work with authorities. Any one of these represents a major handicap and can prevent the consultant from being able to do his job: he cannot handle his client, the client cannot handle significant employment, the consultant is severely restricted by problems imposed by one or more of the client's PTSD manifestations - unwillingness or inability to act predictably [keep appointments, for example] - or a combination of all of these factors.
Such consultants have lacked tools with which they might rapidly and permanently eliminate at least the most debilitating of these symptoms when they encounter them in a client. The technique called Traumatic Incident Reduction (TIR), developed by Frank A. Gerbode, M.D. and others shows major promise of being just such a tool.
The PTSD experience is characterized by the fact that the survivor is living in the past instead of the present. In effect, he is continually reliving and reexperiencing one or more partially repressed past traumatic incidents (TI's). The perceptions and feelings contained in these TI's overlie and become confused with events and objects in the here-and-now. As Freud pointed out, the paradoxical effect of repression is to cause the persistence of the repressed material. The Freudian analysand was to contact and abreact (act out) past TI's, thus releasing the trapped emotional charge, which would otherwise find symptomatic expression. But abreaction alone is not enough to undo repression. PTSD victims characteristically act out their TI's almost continually without long-term relief; hence, many if not all of the symptomatic handicaps mentioned above.
The only real antidote for repression is unrepression - fully viewing the repressed material. A thorough, systematic, and efficient method for doing so has heretofore been lacking. In order to achieve full unrepression, the client must contact and view the past trauma thoroughly, unhurriedly, systematically, and repeatedly in a given session, to a point of resolution, or "end point". One contact or viewing is almost never enough. The TIR technique, when used by itself, simply and without interruptions, can cause a remarkable and permanent elimination of charge contained in past traumas.
TIR offers the following advantages as a tool for those working in the veteran arena:
A Training Module
Though the technique itself is deceptively simple, in order for a facilitator to be able to administer TIR effectively, he must be able to create a very safe "space" - one in which communication between facilitator and client (or "viewer") flows very smoothly, and in which the client/viewer knows that nothing he says will have any present or future negative consequences. We have found that an overwhelming majority of both lay and professional students of TIR encounter significant difficulties in creating such a space. Understanding certain discoverable - and teachable - laws by which communication operates and knowing how to apply them is essential to effective facilitation. The vital importance of these subsidiary skills mandates our spending much of the first two full days of any four-day workshop on discussion and specific exercises dealing with communication. (All parts of the course are weighted heavily in favor of practical exercises and application of materials presented.) The goal and term objective of this first section of the workshop is that each student should have acquired insights into the nature of effective communication and skills in its use that will enable him not only to facilitate TIR but to greatly enhance the quality and effectiveness of his communication in any setting.
In addition to an unusual - but again, teachable, and broadly applicable - degree of expertise in the handling of communication, efficient and successful application of TIR demands of a facilitator that he or she pay strict attention to a number of "ground rules", or codes, the observance of which is vital to the efficacy of the technique. Much of another day in a TIR workshop is devoted to an explication of these rules, and exercises in their observance. The goal of this section is that each student fully recognize and understand the importance of these guidelines, and that he be able to operate within them at will.
The final part of the course teaches the actual technique of TIR. As noted earlier, the procedure itself is quite simple and easily explained and demonstrated. Exercises in the material are again a major part of the section. Depending on progress made and space and time available, students may have the opportunity to practice the procedure with each other under supervision. With or without the chance to experience such "real life" application of TIR while taking the course, the expected outcome of this last section is that each student will have acquired a working understanding of the basic principles and applications of the TIR technique. In conjunction with the pure communication skills attained earlier in the course, that understanding should render him fully capable of making a significant difference in an individual's ability to gain long-term relief from at least the most debilitating symptoms of PTSD - and thereby to obtain and/or retain meaningful employment.