An open letter from Michael S. Armstrong, M.D

Reprinted with permission of author

I sought training in TIR after reading promising anecdotes of therapeutic results in Interpsych's Traumatic Stress mailing list. I have an interest in treating the consequences of trauma: many of the patients referred to my private psychiatric practice suffer from various post-traumatic syndromes. I was also interested in learning more about TIR because, coming from a cognitive-behavioral background, I've had a keen interest in theories of the underlying mechanism of desensitization of traumatic memories. TIR made sense as a straightforward exposure method, yet nonetheless was apparently capable of dealing with very complex material. The opportunity to learn more about TIR came when Gerald French visited Sydney in 1998 to run a TIR Level 1 Workshop, which I was fortunate to attend. Subsequently I've used TIR in my private psychiatric practice for about a year.

Does the promise of accounts I read on the Traumatic Stress mailing list and on the TIR web site live up to expectations? Overall I'd have to say yes. I've had outcomes which I cannot describe as other than brilliant. I've had patients with a history of little apparent benefit from years of psychotherapy, in whom TIR sessions over several months led to major changes in their level of functioning and quality of life experience. I've found TIR a useful adjunct to other psychotherapies, with its power to effectively resolve painful memories.

I've had a small number of patients who've either failed to respond to TIR or had very limited benefit. For the most part they also seem to be people who thus far haven't responded to any other therapeutic approach. The main drawback with TIR is that it can be very time consuming as much as several hours. Nonetheless I have found that most memories can be resolved within the space of an hour or so, and some in significantly shorter periods.

I eagerly await publication of controlled trials of TIR in peer-reviewed journals in order that this powerful and elegantly simple method of exposure treatment for traumatic memories can start to become more widely known and practiced. I strongly recommend TIR as a useful new strategy to add to ones therapeutic armamentarium.

Michael S. Armstrong MD, FRC Psych,
President, Institute of Australasian Psychiatrists