A: It is highly effective in eliminating the negative effects of past traumatic incidents. It is especially useful when:

You have a specific trauma or set of traumas that you feel has adversely affected you, whether or not you have been given a formal diagnosis of PTSD.

You find yourself reacting inappropriately or overreacting in certain situations and have the feeling or idea that some past trauma might have something to do with it.

You experience unaccountable or inappropriate negative emotions, either chronically or in response to certain experiential triggers.

A: TIR has been in use since 1984 in very close to its current form. It has undergone minor modifications over the years, mostly in the interest of greater simplicity and teachability.

A: 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 (client) arrives at quite spontaneously, without any prompting from the facilitator (practitioner) and hence owns as personal experience. By providing a means for completely facing a painful incident, TIR can and does deliver the positive results one would have had if one had been able to fully experience the trauma at the time it occurred, without flinching or repressing anything.

A: TIR is contraindicated for use with clients who:

Have ongoing problems with street drugs or alcohol. Clients need to be stably off such substances before work can begin.

Take certain kinds of medications that don’t work well with these techniques. In general, these fall into the category of sedatives, strong pain-killers, and major and minor tranquilizers. Selective serotonin reuptake inhibitors (SSRIs) have been found not to interfere with the work, since they do not tend to reduce awareness. The same is true for some other medications. Consult with your facilitator.

Have a psychiatric disorder that interferes with their ability to mentally focus on a specific area.

Have been sent to work with a facilitator by an outside party, for instance, a concerned relative or the courts, but are not themselves interested in being helped. This is not to say that such clients cannot be worked with, but to make progress with these techniques a client’s willingness to do the work must first be obtained.

Are in life situations that are too painful or threatening to permit them to concentrate on anything else, such as the work of the session. Such individuals may benefit from Consultation or may need some other kind of intervention before beginning this work.

A: Visit the Research & Publications page and/or the Applied Metapsychology International Research & Publications Pages. The research and implementation of TIR was reviewed by the U.S. Substance Abuse and Mental Health Services Administration (SAMHSA), leading to TIR being included in 2012 in the National Registry of Evidence-based Programs and Practices” (NREPP). https://www.tira.org/faq/

A: Please visit TIRBook.com and TIRvideo.org.

A: View the sections of this website, using the buttons along the top. For example, visit the Research & Publications section, visit the Applied Metapsychology International website, visit www.TIRbook.com, or Contact Us directly. https://www.tira.org/faq/

A: Applied Metapsychology, including TIR and LSR, is a highly disciplined and structured practice. This creates the many safeguards built into the work, and provides the level of success we have come to expect. Applied Metapsychology International (AMI) and the TIR Association recognize people who have successfully completed one or more of the AMI professional skills workshops with a Certified Trainer. AMI maintains a Certification Program for facilitators as well as trainers, to give special recognition to those who have completed an internship at one or more levels of training, as these people have furthered their knowledge and have demonstrated a professional level of competence. See also Professional Training https://www.tira.org/faq/ 

A: Both the facilitator and the viewer need to schedule sufficient time for TIR to be taken to an end point. One and half to two hours is about average, though the sessions can be much longer or shorter than that. After you have some experience, you and your facilitator will often have a better idea of what is a normal session length for you. Session length also depends upon the severity or complexity of what is being addressed.

A: Not at all. While almost everyone has some traumatic experiences that can be relieved and resolved with TIR, not everyone has PTSD.

A: A list of certified facilitators can be found in the practitioner section of this web site. There are also many more graduates of TIR workshops, who can deliver TIR if there is not a certified facilitator in your area. You will find these workshop graduates listed on the practitioner page as well. https://www.tira.org/faq/

A: Resolution of an unwanted condition can sometimes be achieved in as short as one or two sessions. However, a condition that has been in existence for a while, or that has many aspects usually takes longer to completely resolve. A single incident such as a car accident, operation, loss of a loved one, etc., is commonly complete for the viewer in a matter of a few hours. Larger issues, such as a lack of self-esteem or self-confidence, or on-going relationship problems, which may have a number of contributing factors, can take several sessions to resolve. Life Stress Reduction, which consists of a case plan tailored for the individual client’s goals and which usually makes use of a number of techniques besides TIR, typically takes 15-20 hours.

A: Often people find it easier to face the memory of these events in the safe time and space of a TIR session than it is to haul the weight of the traumatic memories around with them while trying to keep those memories from resurfacing. However, some people are not ready for TIR right away. The subject of Applied Metapsychology contains a large array of other techniques, useful in reducing stress (see Life Stress Reduction) and building confidence. These other techniques are not just to prepare a client to be able to do TIR, but produce significant progress in themselves.

A: Fees vary in different parts of the world. They are set by the facilitator in private practice or by organizations employing TIR facilitators.

A: Contact your nearest facilitator to find out. Practitioners who are licensed therapists and already accept insurance for other services may work with your insurance company. The open-ended session length required by TIR does not fit the standard model, but some therapists have worked out arrangements with insurance companies in their areas. Facilitators who are not licensed therapists have no provision for accepting insurance.

A: Traumatic experiences are not the only reason we may feel limited or less able than we would like to be. There are also upsets, worries, confusions, uncertainty, and just plain not feeling that we are living up to our potential. If you have areas of your life that you would like to improve or develop, there is a great adventure waiting for you in Life Stress Reduction and the Ability Enhancement Viewing Curriculum. One of the many nice things about person-centered work is that you will never be accused of being in denial. If you show up with issues, concerns or goals, a well-trained facilitator will be able to make up a case plan tailored specifically for you, a sort of road map from where you are to where you’d like to be.

A: Up until recently, there have been two main approaches to PTSD:

• Coping techniques

• Cathartic techniques

Some therapists give their clients specific in vivo methods for counteracting or coping with the symptoms of PTSD. These clients learn to adapt to, to live with, their PTSD condition. They learn, for instance, how to avoid situations that trigger them, how to distract themselves when they are triggered, how to re-breathe in a paper bag to avoid hyperventilation. Women who have been assaulted or raped may take self-defense classes.

Others encourage their clients to “release their feelings”, to have a catharsis. The idea is that past traumas generate a certain amount of negative energy or “emotional charge”, and the therapist’s task is to work with the client to release this charge so that it does not manifest itself as aberrant behavior, negative feelings and attitudes, or psychosomatic conditions. This notion, derived from Freud’s libido theory, is a “hydraulic” theory of psychopathology. Charge generated in past traumas supposedly exerts a pressure towards its expression. If not expressed in affect appropriate to the experienced trauma, it must express itself in inappropriate ways. Therapists espousing this theory use methods such as implosion therapy, psychodrama, and focus groups to help the client release the charge.

Coping methods and cathartic techniques may help a person to feel better temporarily, but they don’t actually improve the client’s stability. Clients feel better temporarily after coping or having a catharsis, but the basic charge remains in place, and shortly thereafter, they feel a need for more therapy. In cathartic work, the presence of an affective discharge indicates that the client has contacted a past trauma and “worked it through”, but not that she has eliminated it. Coping strategies don’t provide a permanent solution either. A week, a day, or an hour later, some random environmental stimulus, such as a loud noise or the sound of helicopters can trigger anew the same charge.

TIR could be regarded as a kind of exposure technique, in that, as with any exposure method, the point of TIR is to help the viewer become more aware of the traumatic incident. Exposure theorists rely on a desensitization model, in contradistinction to TIR’s person-centered model, but the two techniques converge on the need for repeated exposure to the trauma.

(Editor’s note: “Direct Therapeutic Exposure” (DTE), is a tool long used by the Veterans’ Administration in the US and others to treat PTSD. Research by Lori Beth Bisbey, PhD has shown DTE to be more effective than no intervention at all, but not as effective as TIR.)

There are certain features of TIR that do not form part of the DTE however:

TIR embodies the concept of an “end point“, with certain particular characteristics. DTE’s “end point” occurs when the client feels little or no distress as a result of confronting the incident. In TIR, we usually await the onset of positive emotion, not just the absence of negative emotion. Plus there are the other components of a true end point, as described in TIR: insight, extroversion of attention from inward to outward, from stuck in the past to into the present, and frequently, the expression of what the intention was that the viewer made in the incident.

TIR is stricter about not permitting any input from the facilitator concerning detail or content of the incident. In DTE, the therapist reads a script to the viewer, and the viewer goes through at the therapist’s pace. In TIR, the viewer confronts only what she feels comfortable confronting on any particular run-through. Exposure in TIR is client-determined, rather than therapist-determined. In TIR, we endeavor to reach an end point in a single session; in DTE, working on a given incident typically takes a few sessions.

TIR includes specific ways of checking for earlier and similar incidents that might be triggered when running through a later one. A sequence of incidents can be traced back to its root in a single session and resolved.

When the client suffers from unaccountable uncomfortable feelings, emotions, sensations, psychosomatic pains, and unwanted attitudes, but there are no obvious major traumas in evidence that could be addressed, a type of TIR called “Thematic TIR” can be used to trace these “themes” or feelings back to the incidents they came from and eliminate them, also in a single session.

Proponents of certain techniques have claimed that they can permanently eliminate the effects of PTSD. Charles Figley and Joyce Carbonell at Florida State University have studied these techniques — TIR, Francine Shapiro’s Eye Movement Desensitization and Reprocessing (EMDR), Neuro-Linguistic Programming’s Visual / Kinesthetic Disassociation (VKD), and Roger Callahan’s Thought Field Therapy (TFT) — to determine what the active ingredient was. Although their study wasn’t designed as an outcome study, it suggests that all four techniques are effective.

Like TIR, EMDR, and VKD contain elements of exposure, but they also contain other elements, such as inducing eye movements or producing other repetitive, bilateral stimuli (as in EMDR), or creating a deliberate state of dissociation (as in VKD). Otherwise they differ from TIR in the same ways that DTE does. TFT is utterly different from TIR, relying, as it does, on manipulating acupuncture meridians.

A: Both are direct “exposure” techniques, meaning that they get results by having trainer practitioners help the client resolve the negative effects of past experiences by looking at them, being “exposed” to them. Besides the differences in how each is done, one main difference is that while EMDR can leave a client in a triggered state at the end of a session, due to many traumatic incidents having been touched upon, TIR has the client focus on one incident or series of closely related incidents in one session. In the great majority of cases, a TIR session ends with the client feeling complete and satisfied that what has been opened up in that session is complete.

A: Although TIR has not generally been described as a mindfulness therapy, the TIR approach does place great emphasis on the non-judgmental observation of inner experience through disciplined repetitive practice. It therefore has a great deal in common with mindfulness. TIR is designed to enable clients to be more open to and mindful of their inner experience. This is done in a great many exercises that train the client to focus attention on one thing at a time repetitively, noticing more and more details and subtleties, increasing the client’s willingness to face more and more challenging feelings and thoughts. TIR could also be described as a technology for enabling clients to ‘dis-identify’ with thoughts, emotions, and any other inner experience, seeing inner experience as separate from the self. Like Gendlin’s Focusing and Gestalt, TIR is a structured methodology for applying a mindful philosophy to one-on-one therapeutic practice. (Source https://www.tira.org/faq/ )