ITR – Instinctual Trauma Response®

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ITR – Instinctual Trauma Response®2023-04-17T22:25:07+00:00

Instinctual Trauma Response®

Instinctual Trauma Response describes the body’s and brain’s reaction to stressful or overwhelming experiences. ITR is predictable and understandable and the components are biologically hardwired in us for our survival. There are seven components of the Instinctual Trauma Response that are likely to happen in all traumas regardless of type. These provide the scaffold on which trauma stories are constructed. The ITR components are: startle, thwarted attempt to fight or flee, freeze, altered state, automatic obedience (auto-pilot), and self-repair with body sensations through every component.

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The ITR Approach

ITR is evidence-supported and we integrate practice-based evidence into our work and deliver effective services in an individualized and context-sensitive manner. ITR is an approach that focuses on treating the roots of trauma symptoms and ending the triggers that cause them. It is a simple but profound process used to complete a traumatic event and integrate consciousness, body, brain, memory narrative, and parts.

ITR was developed by Dr. Louis Tinnin, psychiatrist, and his wife, Dr. Linda Gantt, an art therapist, after over 40 years of working in hospitals and out-patient clinics. Together they have helped thousands who found relief after trying many other methods. ITR works by directly and intentionally “re-coding” traumatic memories so that they finally are placed in the past. It includes the Graphic Narrative® for ending the story and Externalized Dialogue® for reversing dissociation and victim mythology.

Graphic Narrative®

Graphic Narrative is a timeline guided and uses storytelling aspects to end triggers. This service consists of tasks compiling the trauma story with a series of drawings, storyboarding, and compassionate recounting of the story to reveal and sequence fragmented trauma memories (“memory shrapnel”) and put words to them—providing a beginning, middle, and end. The event then feels settled, completed, and in the past. This is time-limited based on a person’s history and is used with the Externalized Dialogue for a full ITR Program.

Externalized Dialogue®

Externalized Dialogue is an ongoing task needed to bring to light and understand parts of the person that are frozen in the past, and are the source of negative symptoms, behaviors, or beliefs (Victim Mythology). The person learns about these parts and how to best help them in the present-day with their True Self. Dialogue between the True Self and parts helps the person settle and bring together their parts so they can move ahead fruitfully. It is a tool for life. This service can be separate sessions or added on at any time.
The ITR program schedule is flexible. It can be done virtually or in person. It can usually be completed in 20-30 hours, 2-6 hours per day, over a period of a week or two.

“Resolve the trauma first and see what’s left.”

In the 1990s, Dr. Tinnin conducted clinical studies to compare different methods of accessing traumatic material. He compared hypnosis, sodium amytal, and nitrous oxide. He discovered that the catharsis of reliving a trauma was not the curative element as he had predicted. He realized that the key to a person’s improvement was being able to finish the story. Those whose stories were told in an unemotional fashion did better than those whose stories were emotionally told but interrupted before the ending. With this important finding, Dr. Tinnin and Dr. Gantt began working on specific methods to keep a person from reliving painful events. They devised an image narrative approach (which they later called Graphic Narrative™). They soon found if they used the components of the Instinctual Trauma Response as an outline for each story, it enabled them to identify many of the fragments of a story that caused troubling symptoms. Once the stories were complete and then told back to a survivor (a process called a “re-presentation”), they often spontaneously commented that they felt the event was truly over. Along with this, symptoms were greatly reduced or disappeared. The next step is Externalized Dialogue™ where a person learns to communicate and understand the dissociated parts of them that hold “victim Mythology” (negative beliefs or behaviors) based on those now finished past events. We call this a “tool for life.”

We find many people are given a devastating diagnosis when in fact they are “stuck” in a fixed state of the ITR caused by a traumatic event. It’s not who you are, it’s what happened to you, AND it’s totally treatable.

During sessions of intensive trauma resolution, memories are re-coded into the verbal brain so the while brain understands the event is over. The chaos of visual, auditory, and body memories left from traumatic events are now organized n a logical and natural way.

The approach of Graphic Narrative, or storytelling with images in the third-person, with the cognitive component of Externalized Dialogue, is quickly becoming the “gold standard” for trauma resolution. There is no re-living and a person soon sees how these simple tasks work for them no matter how disturbing the event was.


Although doctors prescribe several types of medications for conditions such as anxiety, there is no medication that goes to the root cause. Medications can be useful in taking the edge off however, our motto is: Resolve the trauma first and see what’s left

If you are currently taking medications we urge you to stay on them until you complete your program. After you return home you will be able to evaluate your experience and decide with your doctor whether your medications can be reduced or eliminated.

Visit and watch Dr. Tinnin’s video on medications.


Intensive Trauma Resolution is self-pay. We do not diagnose or take insurance. It is 100% confidential work. No notes are taken unless requested. We will recommend follow up work. We are happy to discuss your program with your primary mental health provider (with release).


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ITR – Intensive Trauma Response

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“My wife went thru a therapy program using this Instinctual Trauma Response program and had excellent results. It eliminated all her flashbacks, her panic attacks and so on. It did what was being explained to her. Be careful about being critical until you understand more. This therapy will eventually be the standard for treating PTSD.”

Charlie, 36 Years

“I am more free to be myself, to be real with everything my life has held, and to allow myself to experience a full range of emotions regarding my life. ITR helped me put together various puzzle pieces I’d been looking at in counseling and couldn’t make sense of. Probably the biggest change is that I know it is a very good thing that I am alive and life is beautiful. There is a big change in my perspective.”

Alexandra, 27 Years

“I feel so much freer and happier now and have been able to use tools I learned (grounding, external dialoging) to get through rough times. I am back on my “feet”, stronger than ever, enjoying a new line of work for now, many friends, life in general and perhaps most important: a much better sense of myself–all parts of myself that I now understand, accept guide and love.”

Female, 46 Years

“Whether acute or sustained, the effects of trauma on the brain can lead not only to anguish for the client, but also to frustration for the clinician. These painful conditions, so often resistant to even the most sophisticated therapies, are now, thanks to the dedication of Drs. Tinnin and Gantt, able to be approached with a new and remarkably successful methodology. This is a model for responsible and effective care.”

Judith A. Rubin, Ph.D., ATR-BC, Department of Psychiatry, University of Pittsburgh

“The therapeutic implications of this concept are profound, and are addressed in detail, providing theory and application of techniques that embrace both cognitive and non-verbal somatic/behavioral elements.”

Robert Scaer, MD, Author of The Body Bears the Burden, The Trauma Spectrum and Eight Keys to Body-Brain Balance.
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