Overcoming Trauma and Grief
"Trauma creates one of four types of people: victims, rescuers, or perps - and if you're really lucky and really strong and very willing and brave, survivors".- Allison Anders
Defining Trauma
A trauma, by definition, is an incident that is so painful, emotionally or physically, that one tends to flinch away from it, not to let oneself be aware of it, or, in Freud's terms, to repress it. It is the flinch and not the "objective" description of the incident that makes it a trauma. Hence an event that is challenging and exciting for one individual may be traumatic for another. The one for whom it is a mere challenge can "stay with it" and master it; the one who experiences it as a trauma is not.
The effects of a trauma contain psychologically repressed material. As people, there are many things that happen daily, in our country, home town neighborhood and even our own homes, which cause psychological stress, which can have an adverse effect on our daily functioning.
However, these stressors are often discarded by us, or as Freud would put it "sublimated, in the service of the ego". In other words, we all unconsciously (and at times) consciously, put these events aside, so that we can tend to far more important and gratifying things, such as work, play, family and relationships, that we value and want to cultivate.
However, when a trauma occurs, it acts as the "big disrupter" in our lives, taking the place in our minds, for that which important and vital to our survival, replacing it with worry, incredible sadness and a feeling of powerlessness, that can be crippling, and lead to a decline in functioning, which can result in further paralysis. It can also be linked to chronic medical conditions, such as Hypertension, Diabetes and Obesity. Trauma is also significantly increases the risk for people to experience relationship and work problems, Depression, Anxiety and PTSD. Trauma is often a significant predictor in accidents, strokes and heart attacks.
."Grief is perhaps an unknown territory for you. You might feel both helpless and hopeless without a sense of a 'map' for the journey. Confusion is the hallmark of a transition. To rebuild both your inner and outer world is a major project". -Anne Grant
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, and 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.
As Freud had explained in his theory of personality, a person often represses unwanted memories, in the service of the Ego. This allows the person to function in the world. However, what Freud did not say was why? This is indeed a more profound question and the basis for many current research studies.
Traumatic Incident Reduction
According to available research TIR, grew out of the work of Carl Rogers and Sigmund Freud. TIR is a brief, one-on-one, non-hypnotic, person-centered, simple and highly structured method for permanently eliminating the negative effects of past traumas. It involves repeated viewing of a traumatic memory under conditions designed to enhance safety and minimize distractions. The client does all the work; the therapist or counselor offers no interpretations or negative or positive evaluations, but only gives appropriate instructions to the client to have him view a traumatic incident thoroughly from beginning to end. Hence, we use the term "viewer" to describe the client and "facilitator" to describe the person who is helping the client through the procedure by keeping the structure of the session intact and giving the viewer something definite to do always. The facilitator confines herself simply to giving a series of set instructions to the viewer; she offers no advice, interpretations, evaluations, or reassurances - but rather offers sincere and appropriate acknowledgment as well as unconditional positive regard.
TIR has been in use since 1984 in something like its current form. It has undergone minor modifications over the years, mostly in the interests of greater simplicity and teachability.
The viewer locates a specific trauma that he is interested in working on -- one with a specific, finite duration. Then he treats the incident like a "videotape". First, he "rewinds" it to the beginning, then "plays" it through to the end -- without (usually) talking about it while he is viewing it. After he has viewed it, the facilitator then asks him what happened, and he can then describe the event or his reactions to going through it.
After the viewer has completed one review (and one description), the facilitator has him "rewind the videotape" to the beginning and run through it again in the same fashion. The facilitator does not prescribe the degree of detail, sensory modalities, or content the viewer is to get on each run-through. The viewer will view as much as he is relatively comfortable viewing. After several run-throughs, most viewers will become more courageous, contacting the emotion and uncomfortable details more and more thoroughly. Typically, the viewer will reach an emotional peak after a few run-throughs and then, on successive run-throughs, the amount of negative emotion will diminish, until the viewer reaches a point of having no negative emotion about the incident. Instead, he becomes rather thoughtful and contemplative and usually comes up with one or more insights -- often major -- concerning the trauma, life, or himself. He displays positive emotion, often smiling or laughing, but at least resulting in calm and serenity. At this point, the viewer has reached an "end point" and the facilitator stops the TIR procedure.
The viewer locates a specific trauma that he is interested in working on -- one with a specific, finite duration. Then he treats the incident like a "videotape". First, he "rewinds" it to the beginning, then "plays" it through to the end -- without (usually) talking about it while he is viewing it. After he has viewed it, the facilitator then asks him what happened, and he can then describe the event or his reactions to going through it.
After the viewer has completed one review (and one description), the facilitator has him "rewind the videotape" to the beginning and run through it again in the same fashion. The facilitator does not prescribe the degree of detail, sensory modalities, or content the viewer is to get on each run-through. The viewer will view as much as he is relatively comfortable viewing. After several run-throughs, most viewers will become more courageous, contacting the emotion and uncomfortable details more and more thoroughly. Typically, the viewer will reach an emotional peak after a few run-throughs and then, on successive run-throughs, the amount of negative emotion will diminish, until the viewer reaches a point of having no negative emotion about the incident. Instead, he becomes rather thoughtful and contemplative and usually comes up with one or more insights -- often major -- concerning the trauma, life, or himself. He displays positive emotion, often smiling or laughing, but at least resulting I calm and serenity. At this point, the viewer has reached an "end point" and the facilitator stops the TIR procedure.
A TIR session is not ended until the viewer reaches an end and feels good. This may take anywhere from a few minutes to 3-4 hours. Average session time for a new viewer is about 90 minutes. Average total session hours to eliminate PTSD symptoms is 15 (usually about 10 sessions).
It is highly effective in eliminating the negative effects of past traumatic incidents. It is especially useful when:
a. A person has a specific trauma or set of traumas that she feels has adversely affected her, whether she carries a formal definition of "PTSD".
b. A person reacts inappropriately or overreacts in certain situations, and it is thought some past trauma might have something to do with it.
c. A person experiences unaccountable or inappropriate negative emotions, either chronically or in response to certain experiential triggers.
In the great majority of cases, TIR correctly applied results in the complete and permanent elimination of PTSD symptomatology. It also provides valuable insights, which the viewer arrives at quite spontaneously, without any prompting from the facilitator and hence can "own" entirely as his own.
By providing a means for completely confronting a painful incident, TIR can and does deliver the positive gain a person would have had if he had been able to fully confront the trauma at the time it occurred.
There is a great deal of information out there on the subject: Please reference the Trauma Incidence Reduction website at www.tira.info.com; www.tira.org.;"Traumatic Incident Reduction: Brief Treatment of Trauma-Related Symptoms in Incarcerated Females" by Pamela Vest Valentine, Ph. D. Ph. D., The Florida State; www.trauma-pages.com
Considering recent events, I felt it necessary to publish this, in the hopes that this information could provide support to clinicians, in helping them to look at a different paradigm for helping their clients.