Traumatic Incident Reduction:
Cognitive-Emotive Resolution of the Post-Traumatic Stress Disorder by Robert H. Moore, Ph. D.

Problem Profile | Primary and Secondary Trauma | PTSD and Cognition |
Traumatic Incident Reduction | Notes | Bibliography | The Author

Notes

1. Since this classic example of the conditioned response is not of one energized by trauma, the magnitude and persistence of the salivation response will tend to diminish as the number of chain-linked secondary stimuli increases. The highly charged and painful PTSD response, on the other hand, demonstrates considerable strength and persistence through an almost indefinitely long chain of associated secondary stimuli.
   
   
2. Emergency relief workers, paramedics, and trauma teams find TIR a highly effective procedure for use with survivors of natural disasters, violent crimes, and the like. It may be used as soon after the trauma as survivors are physically/medically able to receive it. It enables them to emerge from their ordeals without residual PTSD symptomatology.
   
   
3. The actual length of a TIR session is dictated largely by the number and complexity of the incident(s) being viewed and by the ability of the viewer to confront them.
   
   
4. Of course, some PTSD veterans are completely correct when they identify their wartime experiences as primary.
   
   
5. Regarding the paradox of those who suffer emotionally yet seem to think just as rationally, day-to-day, as the majority of the population, and vice versa, Meichenbaum (1977) makes a provocative observation:
   

   It may not be the incidence of irrational beliefs that is the distinguishing characteristic between normal and abnormal populations (since) nonclinical populations may also hold many of the unreasonable premises that characterize clinical populations... The nonpatient may be more capable of "compartmentalizing" (upsetting) events and be more able to use coping techniques such as humor, rationality, or what I have come to call "creative" repression." (p. 190-191)

   In this connection, it may very well be worth investigating the traumatic backgrounds of patient and nonpatient populations matched as to their incidence of irrational beliefs. Perhaps the unsuspected secondary impact of past trauma has something to do with the patient population's apparent inability to "creatively repress" the activation of their faulty thinking.
   
   

6. "All theorists are faced with a dilemma in trying to explain how inappropriate affect can be severed from cognition. The same events can be interpreted as cognitive reorganization, as 'expression' of affect, or as extinction of a conditioned emotional response by nonreinforcement or counterconditioning. The cognitive explanation has a major advantage for psychotherapists in that its referents -- the conceptions and misconceptions of the patient -- are more accessible to direct observation (Raimy, 1975, p. 83).
   
   
7. A complete outline of the TIR Viewing Procedure, narrative and thematic TIR flow charts, the Rules of Facilitation, and a case illustration of thematic TIR in application are contained in Dryden and Hill's (eds) 1992 book, Innovations in Rational-Emotive Therapy, published by Sage Publications, Inc., Newbury Park, California. The TIR Workshop Manual, demonstration video (available in American [VHS] and European [PAL & SECAM] formats), and a schedule of TIR training workshops in the U.S. and Western Europe are available from Frank A. Gerbode, M.D., Institute for Research in Metapsychology, 431 Burgess Drive, Menlo Park, CA 94025. Phone: 415-327-0920; fax 415-325-0389. For information about TIR training workshops in collaboration with the Institute for Rational-Emotive Therapy, contact Robert H. Moore, Ph.D., Institute for Rational-Emotive Therapy, 575 Duncan Ave. S., Clearwater, FL 34616. Phone/fax: 813-443-1120. Continuing Education credits awarded.
   

NOTE: The need for precision in application of TIR is such that prior clinical training in the procedure is strongly recommended.