Trauma

Trauma is treatable.

And it doesn’t take years to do it.

Why Instinctual Trauma Response (ITR)?

Why Instinctual Trauma Response (ITR)? from ITR Training Institute on Vimeo.

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ITR is very flexible and adaptable.

It can be used with all ages from 3 to 99 years old.

It is adaptable to individual, couples, family, or group work.

It can be in person or virtual, hourly or intensively.

It can be done with a guide or as a self-help model depending on the person’s comfort level and their trauma history.

What is Trauma? What is ITR?

“Trauma is the biggest mental health problem of the 21st century and it is the most treatable.”  -Dr. Louis Tinnin, Psychiatrist and Co-Founder of ITR 

During ordinary, day-to-day events, our whole brain processes and stores what we experience. However, when we have a life-threatening experience or witness another person in such circumstances, our logical brain becomes overwhelmed and executive function (the ability to think our way out of the trauma) goes offline. If we cannot fight or flee the situation we go into the freeze and the emotional, robotic part of our brain takes over to help us survive and not feel the pain. This is what a healthy body and brain do instinctually and unconsciously during a traumatic experience. This is called the Instinctual Trauma Response (ITR).

ITR is a survival response in the brain to trauma. It can help us through trauma but can get stuck in everyday life and cause problems. After the trauma, the brain and body keep fragmented memories stored in the senses of sight, sound, taste, touch, and smell. We can get triggered or reminded of our past traumas and the emotional brain (limbic system) sends the same alarm to protect the body. This can cause stress, fear, and anxiety for no reason. The trauma is not time-stamped, it is timeless in the emotional brain or limbic system.

The ITR Approach

"Resolve the trauma first and see what is left!"

ITR is a noninvasive approach to resolving trauma symptoms quickly, simply, and effectively. It is an evidence-supported, brain-based, model that focuses on treating the roots of trauma rather than the symptoms. ITR was developed by Dr. Lou Tinnin, psychiatrist, and Dr. Linda Gantt, art therapist, after over 40 years of clinical experience with people coping with all kinds of trauma. ITR primarily uses Graphic Narrative® and Externalized Dialogue® to recode traumatic memory from the non-verbal/emotional brain to the verbal/logical brain without reliving the event. This greatly reduces or completely eliminates triggers and symptoms in the future. 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 helps people who suffer from triggers, intrusive thoughts, or other PTSD symptoms (negative neurological responses to non-threatening situations).

The two main tasks of ITR are Graphic Narrative® and Externalized Dialogue.

Graphic Narrative®

Graphic Narrative® is an art-informed approach that reconsolidates traumatic memories.  It “reboots” the whole brain and gives the fragmented traumatic memory order, verbal coding, and historical context. Graphic Narrative consists of quickly drawing out the trauma experience in stages giving it a beginning, middle, and end.  The drawings are done from an objective, third-person point-of-view that protects the person from re-experiencing the trauma. The story is narrated in the third-person past tense and fosters a person’s capacity for empathy for themselves and others. Once the story is re-presented in this way a person feels the event is finally over and in the past.  The event is now time-stamped and stored in long-term memory. Triggers are greatly reduced or completely eliminated.

Externalized Dialogue®

Externalized Dialogue® helps a person strengthen their True Self and recognize and relieve their hurt or stuck Parts. The loving, caring, and compassionate True Self can now lead the once dissociative Parts in the present day with new healthy strategies, reaction patterns, and habits.  It is needed to bring to light and understand Parts of the person that are hurt or stuck 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 into the future as a supportive team. Externalized Dialogue is a tool for life and can be used daily to assist in decision-making or any situation. This process is very empowering and will help produce inner peace

ITR Components:

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

Startle, Thwarted Fight/Flight, Freeze, Altered State of Consciousness, Automatic Obedience (Compliance), and Self-Repair.

Each ITR aspect has body sensations that go along with it. The trauma is stored in the body and in the emotional brain. Going into the ITR also affects our memory of the event. We may feel that the fragmented memory is “stuck” in the brain going round and round in the brain’s “limbic loop” as if it is still present and about to happen again at any time.  These bits and pieces of the trauma can become triggers that intrude into life at unexpected times. The result can be bewildering and can change how we view ourselves, others, and the world at large.

Many people get “stuck” in one of the aspects for an extended period of time. This is known as a ‘fixed state.”

What is ITR?

What is ITR? from ITR Training Institute on Vimeo.

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Fixed States of ITR

Some experiences may have several components over again as the event goes on over a period of time. A person can sometimes enter a “fixed state” and re-experience an aspect of the Instinctual Trauma Response as an intrusive symptom (even though the trauma happened long ago). For example, one could be in the fixed state of the freeze that is mistaken for depression or fight/flight mistaken for ADHD. In this case, other conventional treatments have little effect until the trauma is time-stamped and processed as in the past with a beginning, middle, and end.

ITR works with the whole brain, the way the brain works.

Many people say that participating in the ITR program radically changed their lives, and ITR Specialists often say it’s the only trauma approach they have seen that really works.

ITR Clinical Benefits

  • Gets to the root of the problem rather than focusing on coping skills
  • Uses standardized procedures
  • Minimizes disabling responses to future traumas
  • Instructs how to anticipate and ward off instinctual responses in tough situations- managing triggers and fixed states
  • Makes it possible to give words to traumatic events and bring closure to them without reliving them
  • Integrates the whole self into present-day awareness
  • Expands consciousness, giving greater access to normal emotion
  • Reduces or eliminates troubling symptoms caused by traumatic events
  • Achieves results in a relatively brief period
  • Provides effective ways to greatly reduce stress and deal with negative beliefs, thoughts, and behaviors
  • Empowers a person with new life skills to use on their own in the present and in the future.
  • Does not require developing a relationship with the facilitator (ITR can be used with a team approach)
  • Does not need time between sessions to digest the material
  • Can be used with all ages from 3 to 99 years old
  • Is adaptable to individual or group therapy as well as to conventional weekly sessions.

The ITR® Difference

ITR®

Other Approaches

Takes fragments of the traumas that cause flashbacks & nightmares and puts them into historical context with a beginning, middle, and end, so they can be stored in long-term memory and are no longer triggers.

Focus on coping skills (progressive relaxation, deep breathing, thought-stopping).

Images are drawn from an observer perspective to create Graphic Narrative® (doing play therapy with children) using the structure of the Instinctual Trauma Response to organize the event. Words are added to present the story to the whole brain for memory re-consolidation. —“The image comes first”

Uses cognitive skills and reframing.

If a traumatic event is not thoroughly resolved, it feels like the event will happen again. ITR makes it possible to truly “finish the story!”

Concentrates on how the person’s thoughts, feelings, and behaviors are connected in the present.

As the traumas are truly finished, the person will have more capacity for problem-solving and can use Externalized Dialgue® to work with Parts and end dissociation.

What happened in the past is not considered as important as present-day functioning.

Single traumas can be completed in a matter of hours; a program can be done as an intensive (20-30 hours per week), several long weekends, or 2-3 hours weekly sessions. Weekly :50 minutes sessions are also successful. It just takes longer.

Some therapists insist on a long period of stabilization before trauma processing begins; which can be years of weekly sessions.

Can be used with children as young as 3 years old as well as older children, adolescents, and adults.

Young children and those with developmental delays cannot be treated with some types of trauma work.

Does not have an individual re-live the event. The client is a 3rd person observer and the story is put in past tense.

Some approaches stress abreaction (re-experiencing the emotion dissociated from the original trauma) and others use prolonged exposure.

Integrates nonverbal and verbal memories.

Deals primarily with verbal material.

The ITR® Difference

ITR® - Takes fragments of the traumas that cause flashbacks & nightmares and puts them into historical context with a beginning, middle, and end, so they can be stored in long-term memory and are no longer triggers.

Other Approaches - Focus on coping skills (progressive relaxation, deep breathing, thought-stopping).

ITR® - Images are drawn from an observer perspective to create Graphic Narrative® (doing play therapy with children) using the structure of the Instinctual Trauma Response to organize the event. Words are added to present the story to the whole brain for memory re-consolidation. —“The image comes first”

Other Approaches - Uses cognitive skills and reframing.

ITR® - If a traumatic event is not thoroughly resolved, it feels like the event will happen again. ITR makes it possible to truly “finish the story!”

Other Approaches - Concentrates on how the person’s thoughts, feelings, and behaviors are connected in the present.

ITR® - As the traumas are truly finished, the person will have more capacity for problem-solving and can use Externalized Dialgue® to work with Parts and end dissociation.

Other Approaches - What happened in the past is not considered as important as present-day functioning.

ITR® - Single traumas can be completed in a matter of hours; a program can be done as an intensive (20-30 hours per week), several long weekends, or 2-3 hours weekly sessions. Weekly :50 minutes sessions are also successful. It just takes longer.

Other Approaches - Some therapists insist on a long period of stabilization before trauma processing begins; which can be years of weekly sessions.

ITR® - Can be used with children as young as 3 years old as well as older children, adolescents, and adults.

Other Approaches - Young children and those with developmental delays cannot be treated with some types of trauma work.

ITR® - Does not have an individual re-live the event. The client is a 3rd person observer and the story is put in past tense.

Other Approaches - Some approaches stress abreaction (re-experiencing the emotion dissociated from the original trauma) and others use prolonged exposure.

IITR® - ntegrates nonverbal and verbal memories.

Other Approaches - Deals primarily with verbal material.

The Basic ITR Program

The ITR program schedule is flexible and can be done virtually or in person. Intensively it can usually be completed in 20-30 hours, 2-6 hours per day, over a period of a week or two. It can be done in hourly or group as well. Check with your ITR Certified Trauma Specialist.

ITR Tasks:

  1. Finish the story
  2. Repair traumatic dissociation
  3. Resolve Victim Mythology

Treatment Plan:

Phase One:

  1. Prescreen: ITR overview: symptoms, concerns, goals, assessments (if appropriate then move on to 2)
  2. ITR Psychoeducation: trauma and the brain
  3. Grounding/Safe Place

Phase Two:

  1. Create a Timeline
  2. Graphic Narrative® (as needed) finish the story. Draw the story, re-present, and re-watch the story.
  3. True Self/Parts education as it relates to ITR
  4. Externalized Dialogue® (as needed) communicates with parts, relieves, restores, and resolves Victim Mythology
  5. Parts Mapping

Phase Three:

  1. Resolution/check-in/follow-up assessments

Medications

Although doctors prescribe several types of medications for conditions such as anxiety, depression, or voices, they are often not effective if the root cause of the symptom is trauma. 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 ITR program. Afterward, you will be able to evaluate your experience and decide with your doctor whether your medications can be reduced or eliminated.

We offer more than hope. We offer healing. Work with an ITR Certified® Trauma Specialist.

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