What is Traumatic Incident Reduction Therapy (TIR)?

What is Traumatic Incident Reduction Therapy (TIR)?

Traumatic incident reduction therapy, or TIR, treats the effects of trauma, including post-traumatic stress disorder (PTSD.) Since trauma is a major risk factor for substance abuse and addiction, and treating the trauma is central to successful recovery, traumatic incident reduction therapy is used in many addiction treatment settings to help people heal from traumatic experiences.

 

How Trauma Affects the Brain

Traumatic events include being the victim of or witness to violence or death, surviving a natural disaster, or experiencing physical, sexual or emotional abuse. An estimated 70 percent of Americans have experienced trauma in their lifetime. Trauma has far-reaching effects on an¬†individual’s life, and it has an important impact on brain function.

Exposure to trauma in childhood changes the physical structures and chemical functions of the brain as it develops, according to a study in the journal Depression and Anxiety. 1 It leads to major depression, bipolar disorder and other mental illnesses and cognitive problems later on. It also dramatically increases the risk of substance abuse and addiction down the road. A study from the American Journal of Psychiatry reported that 24 percent of males and 45 percent of females between the ages of 15 and 19 who were receiving addiction treatment had a history of PTSD, a rate fivefold that of the general population of adolescents. 2

Sexual Assult and Trauma

Sexual assault commonly leads to symptoms of trauma or post-traumatic stress disorder in women. One study found that around 80 percent of women who are in rehab have a lifetime history of experiencing a trauma, most often related to sexual or physical abuse.

Service and Trauma

Veterans and first responders also have a high incidence of trauma resulting from combat or witnessing violence, accidents and death. According to the U.S. Department of Veterans Affairs, 30 percent of Vietnam veterans and 20 percent of veterans from Operation Iraqi Freedom develop post-traumatic stress disorder each year.

Post-Traumatic Stress Disorder

Post-traumatic stress disorder is a psychiatric disorder that may result from trauma. Symptoms of PTSD may occur right after a traumatic event, or it can occur months or years later. These symptoms reduce quality of life and sense of wellbeing, and they lead many people to drugs or alcohol as a form of self-medication.

The symptoms of post-traumatic stress disorder are divided into four categories. In order to be diagnosed with PTSD, a person must experience the following for a period of at least 30 days:

  • One or more re-experiencing symptom
  • One or more avoidance symptom
  • Two or more arousal and reactivity symptoms
  • Two or more cognition and mood symptoms

Four Categories of PTSD Symptoms

Re-Experiencing Symptoms

Re-experiencing symptoms make everyday functioning difficult. They can be triggered by a situation, object, person, thought, or word. Re-experiencing symptoms include:

  • Flashbacks, which involve re-living the traumatic experience in a way that feels very real and is often accompanied by an increased heart rate or profuse sweating
  • Nightmares, which can occur nightly and be very intense
  • Frightening thoughts about the experience that are intrusive and hard to control.
Arousal and Reactivity Symptoms

Arousal and reactivity symptoms are usually constant, and they can take a major toll on your ability to perform the tasks of daily living. These types of symptoms include:

  • Being easily frightened or startled
  • Experiencing feelings of stress or constantly being on edge
  • Experiencing sleep problems and disruptions
  • Having sudden outbursts of anger.
Avoidance Symptoms

Avoidance symptoms throw a wrench in your routine and are triggered by reminders of the trauma. These symptoms include:

  • Avoiding people, places, events or objects that remind you of the trauma.
  • Avoiding and suppressing negative feelings and thoughts related to the trauma.
Cognition and Mood Symptoms

Cognition and mood symptoms can lead to feelings of isolation as you withdraw from friends and family. Cognition and mood symptoms include:

  • Memory loss concerning key features of the traumatic experience
  • Negative thoughts about yourself, others or the world
  • Negative feelings like shame, guilt or blame
  • A loss of interest in activities you once enjoyed

Post-traumatic stress disorder often co-occurs with anxiety and depression. People who aren’t diagnosed with PTSD may still experience some of the symptoms of the disorder, which can reduce their overall quality of life and lead to substance abuse and addiction.

Traumatic Incident Reduction Therapy and How it Helps

Traumatic incident reduction therapy is used to reduce negative symptoms resulting from experiencing a trauma. It’s helpful for people who have a specific trauma that’s affected their life. A diagnosis of PTSD doesn’t need to be made in order for TIR to work. It’s effective for anyone who believes a past trauma is responsible for certain dysfunctional behaviors, intrusive thoughts or negative emotions.

Traumatic incident reduction therapy is a form of exposure therapy that involves repeated re-tellings of a traumatic experience. It works to desensitize individuals so that they no longer identify with the thoughts and emotions resulting from the traumatic experience. They begin to regard the trauma and the inner experiences it causes as separate from the self. Depending on the severity of the trauma and how many traumas a person has experienced, TIR can be effective after just one session, or it can take as many as five or more sessions to fully achieve its aim.

What Occurs in TIR?

Traumatic incident reduction therapy begins with an assessment to determine the effects of the trauma and what the ideal outcome of therapy will be. Then, in a safe and supportive environment, the trained therapist listens without comment or judgment as the client tells the story of the trauma to completion over and over again. During the re-tellings, clients pay attention to their emotions and behaviors and examine how the trauma has affected their own life and the lives of the people close to them.

Each time the story of the trauma is re-told, repressed memories and new details may come up. During the therapy sessions, clients let go of the resistance to re-experiencing the trauma. They release difficult and painful emotions and negative patterns of thinking. Traumatic incident reduction therapy is complete when clients become unattached to the trauma and the experience loses its ability to affect them in negative ways. Clients typically experience important realizations and insights that are further explored in future sessions or during other types of therapy.

The Effectiveness of Traumatic Incident Reduction Therapy

Researchers at Florida State University and the University of Alabama conducted a comprehensive study of traumatic incident reduction therapy and found it to be effective for treating symptoms of trauma.3 The study found that TIR:

  • Reduced symptoms of depression significantly, and these improvements were maintained at the 90-day follow-up
  • Significantly reduced anxiety symptoms, also maintained at the three-month follow-up
  • Reduced symptoms of PTSD, including anxiety, avoidance, hyper-arousal and intrusive thoughts

    The Traumatic Incident Reduction Association reports that when it done correctly by a therapist trained in TIR, traumatic incident reduction therapy leads to the complete and permanent elimination of symptoms of PTSD.4

    Traumatic Incident Reduction Therapy and Addiction Treatment

    Traumatic incident reduction therapy is commonly used in trauma-informed addiction treatment programs. The improved or eliminated PTSD symptoms resulting from traumatic incident reduction therapy helps to remove the need to self-medicate with drugs or alcohol. When used as part of a comprehensive addiction treatment program, TIR can help end substance abuse or addiction and dramatically improve your quality of life. The Substance Abuse and Mental Health Services Administration stresses that since there is no single pathway to recovery that works for every person, a holistic treatment program is best.5 A holistic approach to treatment involves a variety of traditional and complementary treatment therapies that address all of an individual’s multiple needs and leads to whole-person healing. Other trauma-based therapies used in high quality rehab include:
    • Seeking Safety, a counseling model that focuses on moving forward from the present and helps individuals feel safe
    • Acceptance and commitment therapy, a which helps trauma survivors develop psychological flexibility and accept, rather than avoid, their traumatic experience
    • Dialectical behavior therapy, which helps individuals develop skills for coping with difficult emotions and relationship problems stemming from trauma
    • Mindfulness-based meditation, which helps people manage intrusive, distracting thoughts and negative emotions by residing in the present moment rather than in the past

    Trauma is Treatable

    The dysfunctional thoughts, behaviors and emotions associated with trauma don’t have to be a permanent. They can be changed. People can heal from trauma and leave behind distressing symptoms of PTSD for good. Traumatic incident reduction therapy is one of a number of trauma-based interventions that help people recover from traumatic experiences and find safety and happiness in life again. If you have suffered a trauma that’s preventing you from living a quality life, TIR can help you reclaim your life once and for all and enjoy better mental health and a happier future.

    Resources

    1. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3051362/
    2. https://www.ncbi.nlm.nih.gov/pubmed/9167501
    3. https://bobcat.militaryfamilies.psu.edu/sites/default/files/placed-programs/Valentine%20&%20Smith%202001%20-%20RCT%20of%20TIR%20with%20female%20inmates.pdf
    4. https://www.tira.org/faq/
    5. https://www.samhsa.gov/find-help/recovery