ÿAmong the most profound manifestations of childhood trauma is that of Dissociative Identity Disorder (DID). Theorists suggest DID can be both adaptive and dysfunctional in nature. "The Dissociation of Abigail" will illustrate how childhood trauma can affect the perception, cognition, and behavior of an individual into their adult years. This case study will discuss client intake, assessment, and potential treatment.ÿ Abigail, a tall, attractive, and well-groomed divorced mother of 5 children in her late 30s, presents herself in the therapist?s office complaining of the inability to remember key periods of her life. Discussion with the client reveals she is, in fact, extremely intelligent, intuitive, and well versed on a myriad of subjects; including an acute knowledge of psychology that would arguably be the envy of many professional therapists. Within moments of beginning the intake, the therapist becomes keenly aware that this client is also exceedingly spiritual, with the ability to quote chapter and verse of biblical reference, not only as a matter of reference, but with the insight to integrate it in context with a myriad of contemporary issues.ÿ As the therapist listens, Abigail recounts a lifetime of sexual abuse and boundary violations by family members of not only herself, but also two of her children. The client complains of an inability to recall diverse periods of her life. Recently, however, she has begun experiencing recurring psychologically and emotionally distressing, thoughts, images, and dreams of satanic rituals involving family members and persons and places of her childhood in which she is forced to participate. The client offers her life has been accentuated with dysfunctional relationships. Consequently, she is prone to reclusion, and has little interest in outside persons, places, or activities, which significantly impairs social, occupational, and other activities. Predisposed to consider Abigail?s symptoms in context of Posttraumatic Stress Disorder (PTSD) (American Psychiatric Association, 2000), the therapist is presented with two lengthy journals Abigail has maintained at the request of her current therapist. Within the first journal, disjointed transitions are noted, alternating between first, second, and third person, present- and past-tense. While the journal opens with eloquence and exceptionally light-handed penmanship and flourishes, it unexpectedly transitions to heavy-handedness with angry intonations directed at Abigail herself. As the journey through the journals continues, several other such transitions are noted, along with highly distinctive differences in penmanship and writing style.ÿ More importantly, the writings reflect distinct differences in cognitive process. Cryptanalysis of the writings discloses six psychologically significant profiles, as if six different individuals were writing the journals. Disjointed and appearing unexpectedly independent junctures, they appeared to be conflicted and often vying for dominance in expressing their opinions and beliefs. If one were to thematically categorize these six profiles into individual context, they would find the intellectual (strives for intellect and perfection); the preacher (core of morals, ethics, and values); the abuser (the mother); the victim (childlike; timid, shy, and afraid); the reckoner (endeavors to evoke shame and deliver punishment); and a highly pronounced highly sexual vixen personality (sexually motivated, arguably the personality for male gratification/survival).ÿ

Recent years have seen an extraordinary number of major disasters, critical incidents and other events that have had major impacts on our world. The 2004 tsunami, hurricanes Rita and Katrina, and the wars in Iraq and Afghanistan affect millions of lives daily. Potential events such as Avian Flu pandemic, global warming and the increasing threats of spreading unrest in the Middle East are concerns that weigh heavily on us all. November 8-11, 2006, the Rocky Mountain Region Disaster Mental Health Institute held their Annual four-day Disaster Mental Health Conference. The theme of the conference was "TAKING CHARGE IN TROUBLED TIMES: Response, Resilience, Recovery and Follow-up." This edition contains the major papers presented at the conference and summaries of additional presentations. They address some of the major crisis events confronting our societies in recent years, namely, large disasters such as hurricanes Katrina and Rita; case studies such as Abu Ghraib, and traumatic events such as a night club suicide bombing, the role of cultural sensitivity and ethics in disaster settings, resilience, and the importance of planning, education and taking care of our first responders and mental health professionals. An additional concern with information includes information about preparation of communities and families for deployment and return of military personnel. The importance of planning for how mental health personnel can respond in the event of an Avian Flu Pandemic is also discussed. Presenters are drawn from researchers and responders from Wyoming, the United States, and the United Kingdom. http: //www.rmrinstitute.org The Rocky Mountain Region Disaster Mental Health Institute is a 501(c)3 Non-profit Organization

ÿI developed renewed faith in the power of psychotherapy after I attended a Traumatic Incident Reduction (TIR) course in 2011. It opened many doors for me as I began to understand the impact of previously overlooked, objectively minor traumatic incidents on psychological disorders and problems. This article is about the application of this powerful tool over the entire spectrum of psychological problems and disorders and how this brings about impressive and permanent change. The optimal use of this tool in psychotherapy requires a shift in epistemology in which we begin to view mental health through a trauma lens. The definition of psychological trauma can vary. From a TIR perspective, trauma can be defined as any incident that had a negative physical or emotional impact on an individual. This is a very subjective issue as the something could be perceived as traumatic by one individual, but as commonplace and harmless by another. The important thing is the emotional and physical impact the incident had on the individual, its subjective impact. The reason it is so important to view trauma in the broadest way possible is because it explains the chronic mood states of our clients as well as how subconscious intentions and automatic emotional responses affect their current lives. These will be explained below. Traumatic incidents, when understood in the broadest sense possible, have a massive effect on our neurobiology, emotional states and behavioral patterns. Therefore, they can be seen as the driving force behind almost all psychological problems and disorders. When I say traumatic incidents ?in the broadest sense possible,? I refer to the everyday incidents of trauma that are objectively perceived as minor, such as an embarrassing comment by a teacher, conflict with a friend, breaking your mother?s expensive vase, etc. It involves an understanding of how the emotional knocks we take on a daily basis affect our neurobiology and continue to have an impact on us in later life. The understanding of subconscious intentions, automatic emotional reactions and responses and chronic mood states are so crucial when it comes to looking at mental health through a trauma lens. Minor and major psychological and physical trauma involves a complex description of the effects on the brain. This article includes detailed case studies including specific incidents such as birth trauma and jealousy and rage. We will look in detail at how trauma results in Goleman?s ?Amygdala Hijacking? and how we can help the client break destructive cycles. I also explain why sheer willpower is insufficient to change behavior in the face of traumatic restimulation.ÿ Additionally, the article explains how TIR avoids re-traumatization even as clients revisit past incidents.

Accommodates both the cosmopolitan narrative of the Jewish diaspora with traditional Jews and their culture.

ÿThe following article is based on materials presented at the Proceedings of the Tenth National Symposium on Doctoral Research in Social Work (1998).ÿ Statement of the Research Problem Conducted in the Tallahassee Federal Correction Institute (FCI) in Florida, this experimental outcome study examined the effectiveness of Traumatic Incident Reduction (TIR) (Gerbode, 1989) in treating trauma-related symptoms of female inmates who were victims of interpersonal violence. TIR is a brief (in this case, one session), straightforward, memory-based, therapeutic intervention most similar to imaginal flooding. A memory-based intervention implies that the symptoms currently experienced by a client are related to a past event and that lasting resolution of those symptoms involves focusing on the memory rather than focusing on symptom management. TIR is straightforward in that the roles of both the client and therapist are very clearly defined and strictly followed.ÿ There are several reasons for studying the influence of TIR on previously traumatized female inmates. Since 1980, the rate of family homicide has increased fivefold (Joffe, Wilson, & Wolfe, 1986). Women are the target of much violence, as illustrated by the following: 75% of adult women have been victims of at least one sexual assault, robbery, or burglary (Resnick, et al., 1991); and 53.7% are victims of more than one crime. Abundant data suggest that PTSD can result from having been a victim of crime or having witnessed a violent crime (Astin, Lawrence, & Foy, 1993; Breslau, Davis, Andreski & Peterson, 1991; Resnick, et al., 1991). Therefore, the number of women affected by PTSD is growing as violence and sexual abuse increase in society as a whole (Ursano & Fullerton, 1990). There is a lack of empirical research on the traumatic effects of interpersonal violence (e.g. robbery, rape, incest, physical assault). Since inmates are typically victims of interpersonal violence (Gabel, Johnston, Baker, & Cannon, 1993), the inmate population studied was particularly suitable for TIR. For more information on TIR, see www.TIR.org

ÿ?Traumatic Incident Reduction (TIR) and Primary Resolution of the Post-Traumatic Stress Disorder? provides a brief discussion illuminating the concept of PTSD: how it arises, what maintains it, how it progresses to increasingly constrain a person?s life. PTSD also involves faulty thinking, but focus on such present-time reactions is ineffective without addressing the original trauma. PTSD is the consequence of attempts to avoid re-experiencing. Traumatic Incident Reduction (TIR) is a technique for overcoming this tendency, allowing the sufferer to experience the traumatic incident in a special, safe way. In the case of multiple traumas, this can be complex, needing to deal with each. It is necessary to find the original trauma, which invariably has led to more recent ones, and fully resolve it in one sitting. This provides complete relief from the burden of the past trauma. An individual session, designed to handles a single incident, may take between 20 minutes and 3 hours (average 1.5 hours). The primary incident may be obvious to the sufferer, or hidden. People with anxiety problems but no flashbacks may find forgotten traumas, the resolution of which through ?Thematic TIR? can eliminate current symptoms. Currently occurring emotional and somatic symptoms are traced back in time until a root incident is found. Emotion and thinking are intertwined: correcting one will correct the other. TIR focuses on the emotion. Once the trauma is fully processed, the person is able to think rationally about it. ?Dr Moore?s monograph will guide you in deciding whether you will benefit from TIR, and may inspire you to train to become a ?facilitator? who can help others with this powerful family of techniques.? --Bob Rich, PhD, www.anxiety-and-depressionhelp.comÿ

This manual for clinicians presents a ground-breaking, accessible and unifying new model for understanding functional neurological disorder (FND) that bridges the gap between theoretical FND-specific models and the more practical, but non-FND-specific Cognitive Behavioural Therapy (CBT) models. Grounded in psychology, the Pressure Cooker Model provides a clear metaphor for FND, focusing on intra-individual and inter-individual cognitive, emotional and behavioural processes. Developed based on years of clinical experience in the field, it is applicable to the assessment and treatment of every type of FND. Viewed as a systemic condition with unique psychosocial features, the book will describe the rationale for radically transforming FND recovery by providing a treatment model that aims to resolve emotion dysregulation processes and repair relationships between the person and the system. It uses a unifying framework to guide the steps of intervention and can be adapted for work in a multidisciplinary team context to facilitate communication between disciplines. Enriched with case studies and research data, the book also highlights a plethora of clinical tools and strategies based on the Pressure Cooker Model, as well as contextualising its position alongside CBT models. This manual is instrumental in educating and treating people with FND. It offers essential guidance for neuropsychologists, neuropsychiatrists and other health professionals, as well as students in these fields.

Healing Sexually Betrayed Men and Boys: Treatment for Sexual Abuse, Assault, and Trauma is the new authoritative source for treatment of sexually victimized men and boys. Male victims and survivors of sexual trauma lived in shadow until the turn of the 21st century, when scandal after scandal about the sexual abuse of boys and men shed light on their suffering. These men and boys require different treatment roadmaps than their female counterparts. Yet there is little in the professional literature to help a clinician work with sexually traumatized boys and men. Richard B. Gartner is a seasoned psychologist/psychoanalyst who has worked therapeutically with sexually abused men for over three decades. He is a clinician, advocate, teacher, lecturer, and nationally and internationally recognized expert on the subject. Dr. Gartner’s classic book, Betrayed as Boys: Psychodynamic Treatment of Sexually Abused Men, is one of the few written to guide clinicians. Now, nearly two decades after writing that groundbreaking volume, he follows up on his earlier work. Healing Sexually Abused Men and Boys, together with its companion volume, Understanding the Sexual Betrayal of Boys and Men, is a thorough, comprehensive guide to learning about and healing male victims and survivors. Dr. Gartner has invited a group of experts to write about specific problems faced by these boys and men. Specialists from the psychoanalytic, psychodynamic, trauma, and legal worlds fill in the details about a wide range of interconnected subjects related to the complex reverberations of male sexual trauma. Healing Sexually Betrayed Men and Boys covers such diverse topics as: therapy with young sexually traumatized boys; the aftermath for men who were raped as adults ; covert seduction of boys and its aftereffects; treatment for substance addictions and sexual compulsions; couples work with male survivors and their partners or spouses; bodywork with male survivors; treatment for male veterans who suffered sexual trauma in the military; profiling sexual predators and working with survivors who have also been sexual predators. This book is a valuable resource for clinicians at every level of training. With strategies for how survivors can build support networks and descriptions of clinical, familial, and community-based treatments, Healing Sexually Betrayed Men and Boys is essential reading for clinicians of all theoretical persuasions who work with male sexual abuse survivors. Filling in gaps in the relatively scant literature on the subject, it will also help sexually abused or assaulted men themselves understand what is available to them.

This article briefly reflects the extent to which substance dependency and traumatic events, which may lead to a diagnosis of a post-traumatic stress disorder, are becoming a feature of life all over South Africa. Many social workers are familiar with current evidence-based approaches and are skilled at adapting them to local cultural and contextual conditions. Exploring and continuing learning various evidence-based approaches to render more effective services are an important aim of social work practice. Metapsychology and Traumatic Incident Reduction (TIR), an Applied Metapsychology technique, are introduced to challenge social workers to render more integrated and effective services. The prevalence and comorbidity of substance dependency and PTSD Looking at statistics about substance dependency, as well as the high tendency of being a victim of trauma in South Africa, is it evident that social workers are confronted and challenged on a daily basis to improve their knowledge and skills in this regard. In South Africa, drug consumption is twice the world norm (CDA-2011) and 15% of South Africa's population has a drug problem (CDA-2011). Over 30% of the South African population have an alcohol problem or are at risk of having one and alcohol affects 17.5 million of South Africans. Studies show that people who start drinking before the age of 15 are four times more likely to become alcoholics than people starting to drink later in their life. The recently-released United Nations World Drug Report had named South Africa as one of the drug capitals of the world. When it comes to the abuse of alcohol and usage of dagga, this country is rated to be one of the top ten narcotics and alcohol abusers in the world (Addiction Drug Alcohol Statistics, S.A. 2012 About the Author Elca Erlank, Ph. D. became a TIR trainer in 2012. She has trained with both Gerald French and Yvonne Retief. Elca is a social worker, in South Africa with 22 years experience in various related fields of social work services. She had specialized in the field of substance dependence and received her doctorate degree in 2003. From the Metapsychology Monographs Series at www.TIRBook.com.