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We use art therapy, guided imagery and an externalized dialogue as well as individual psychotherapy. These techniques make it possible to process a trauma without re-living it. We strive to promote a lasting recovery through a program that is both structured and supportive.

Our methods are based on the Instinctual Trauma Response Model developed by Dr. Louis Tinnin and Dr. Linda Gantt which combines information from the latest neurological studies with concepts from animal survival strategies.

Processing the Trauma Narrative
Reversing Dissociation
Resolving the Victim Mythology

Narrative trauma processing is the first of three basic tasks in trauma therapy as we conduct it at ITT. In our approach the more conventional goal of dealing with the meaning of the trauma comes only after narrative closure is achieved and the traumatic dissociation is repaired. Only then do we expect the person to be able to gain a perspective that makes it possible to change one’s assumptive world and replace the mythology of being hopelessly vulnerable.

The goal of narrative processing is for the patient to reconstruct a complete narrative of the traumatic experience. That is, we ask patients to tell the story of their traumas. The creation of a detailed coherent narrative with a beginning, middle, and end brings together the fragmented images of the trauma. Telling the story from start to finish, complete with all the details is crucial to helping patients bring closure to the traumatic memory. The ITT staff members are trained to use a variety of techniques, such as guided relaxation and art therapy to assist patients recover the critical elements of their traumatic experience without re-living it. Once these dissociated experiences are identified, we find that patients have fewer intrusive, arousal, and avoidant symptoms.

Most people who have survived a trauma become aware of separate aspects of their personality that they may try to ignore or disown. These personality states represent the traumatized self that is experienced in flashbacks or "voices" that have points of view . The task of reversing dissociation is to engage in active dialogue between these opposing voices that are different or even opposed to conscious thoughts. Our simple and rapid procedure of externalized dialogue has proven very effective in reversing dissociation. We use methods of Parts Psychology drawn from Richard Schwartz’s Internal Family Systems (IFS) approach.

Externalized dialogue uses the technique of "self talk" to work with these dissociated parts.

In externalized dialogue session the therapist works with the patient to facilitate discussion with the frozen traumatized self or "voices." The patient holds a dialogue with the split-off self that was suspended in time during the trauma response. The patient simply talks to that self by video or writing. Then the patient speaks for the dissociated self. What the patient experiences is a change in which the dissociated self and the present self become so alike that they can no longer be differentiated.

Most people feel diminished by the traumatic dissociative split and then restored when the split is resolved. Dissociative voices often make unwanted demands and one may feel some compulsion to obey. Video dialogue helps to:

Embrace the disowned parts
Reclaim lost emotions
Discuss differences of opinion and resolve conflict
Know the voices as parts that can be reclaimed

The task of resolving victim mythology is also simplified by the use of externalized dialogue. Patients are encouraged to actively question the assumption that one is permanently damaged. The patient reviews the dialogue in which he or she explores the mythology of a damaged individual trying to survive in a dangerous world. In that review the person discovers that his or her hope for happiness would be doomed by that mythology and that it is necessary to change those dire assumptions. This technique provides our patients the opportunity to immediately confront the fact that they cannot be happy in the assumptive world of their victim mythology. We help them to reevaluate the issues of safety and risk and record their conclusions on tape or in writing for later study and self-confrontation.

Trauma work requires the patient to recover all of the details and images of the traumatic experience and to construct a narrative that unites the memory fragments and brings closure to the experience. This must be done at both conscious and unconscious levels. Trauma work converts the unfinished experiential memory fragments into a coherent memory of the past event. To accomplish this, it is necessary to reach the nonverbal mind, despite verbal resistance and prepare the narrative for verbal presentation to the person. The patient can then assimilate and avow the experience.

Art therapy provides access to nonverbal memory. The patient completes a graphic narrative of the trauma in a manner that unites the fragmented images and brings closure to the experience. The drawing "unfreezes" the fixed image, illuminates the traumatic altered state of consciousness, and fills the gaps in conscious memory. Amnesia is frequently reversed by drawing, as if "the hand remembers what the head forgets." This is because the graphic narrative is "out there," relatively detached from the artist, making it easier to manage emotional distance and hold an objective viewpoint. Once closure is achieved through graphic narrative the traumatic event becomes historical memory rather than unfinished experience.