Doing TIR Online: Can I Really Treat my Trauma with Telehealth?
By Irene Ilachinski, LCSW, TIRF
You may be thinking that treating trauma with Traumatic Incident Reduction (TIR) is too intense to do with someone through a screen, and that it may not be doable. So you would rather wait till the pandemic is over, or just not do it.
Except that your life and your issues are happening now, regardless of what is going on in the outside world.
You really would rather see someone in person, in their office. This is understandable, and it’s ok to acknowledge that this is what you want. As with anything involving human connection, there are pros to doing TIR in person. You meet with your facilitator in their workspace, which is a contained environment away from your daily working and living space. You both share that physical space in the time that you are working through your distress.
But right now, there are still health risks to meeting in-person with someone outside of your home, so most practitioners and viewers are needing to prioritize safety and do sessions online. For many of us, that’s been a sudden and significant change in how we work together. I had always been an “old school” practitioner myself until COVID hit, and then I knew I had to adapt to this new reality. Was this going to work? I didn’t know.
One year out, I have some good news. Since March of 2020, I have been facilitating TIR sessions only online. People viewing with me have reported that through our work, they have been feeling relief, less stress, and being more present in their lives, even during the pandemic. Most of them have never met me “in person”, but they still work successfully with me. And there are pros to online sessions. One big pro is not having to take time or effort to travel to a physical office is a plus for many people right now. Also, people with mobility and/or chronic health issues can meet with facilitators with greater ease. So yes, you can work through your issues, even treating trauma, with online sessions. You just need to do a few things to prepare for this work.
Set up a comfortable, private, distraction-free place to do your work.
The environment you choose will not just be private, but distraction-free. So beyond just a door that closes and locks, if needed, think about what might be a distraction: A partner or other family member working in the office next door? Small children that could come knocking in the middle of your session? Construction going on in the apartment next door?
You do what you can, of course, but it is important to consider how your environment might affect your ability to open up and focus on the session. It can feel awkward to talk about conflicts and emotions you are having about your partner or other family members when they are in the room next door. They may not be snooping on purpose, but you may still be concerned about what they hear. And with trauma treatment, this focus is especially important. TIR sessions are often more intense and focused than “typical” talk therapy. These qualities help make it effective in relieving your symptoms, but they also make the need for a distraction-free environment more crucial.
So if this means putting a “white-noise” machine outside your door [such as a fan] or having someone else on “childcare duty” during your session, it may truly be worth it so that this cuts down on distractions. You may even feel more comfortable doing sessions from your car or a closet. That’s fine with me, and it is likely ok with your facilitator. The fewer distractions you have in your environment, the more you can engage and benefit from the session.
Make sure that you have a good internet connection.
I use a secure, encrypted portal for viewing. Avoid using social media platforms like apps related to Facebook, Instagram, and such because at the time of this writing, they are generally not private or secure. I do need to see your face, and you need to see mine. Even if you close your eyes during your session, your face and mine need to be in visual range.
Note: If you have visual impairment, it is still important that I can see you. A phone connection alone isn’t ideal. With TIR, a facilitator needs to be able to observe more than just your voice – they observe what is going on in your face and even your body. So please stay in visual range, at least with your face.
If something distracts you from your viewing, it’s not the end of the world. I have heard kids yell, family members knock on doors, and dogs barking. Just like with in-person sessions, a distraction may occur. You handle it as you need to and then continue the session.
Occasionally, you might lose the internet connection for whatever reason. Bad weather or a downed server can do this. When this happens with my viewers, we just reconnect and pick up where we left off. If the internet connection does not improve within a few minutes, it’s a good idea to reschedule the session for a later time or another day. The more stable your internet connection is (grounded, WiFi or cellular/smart phone), the fewer interruptions you will have. Also, I ask folks to kindly park their device, whether it is an iPad, iPhone or Laptop, on a stable surface, even if it is a book or a shelf. It’s far easier to focus on you and the session if I am not getting dizzy, after all.
So things may happen. The best approach is to prepare for things that could be an ongoing or frequent distraction from their viewing. Dogs barking in the background don’t bother me if they don’t bother you. A kid knocking on your door every five minutes, asking for you, is going to be more of a distraction that needs planning in the form of a sitter or responsible older person. It’s good self-care to build your session in as your time “away”, just as though you would for a work meeting. And please choose the helping person carefully. Someone you’ve been living with is preferable from a health standpoint, but if it needs to be someone outside your home, do what feels necessary for you and your co-habitating people to be safe these days.
Take a minute (or two, or five), to transition to your TIR space.
Once you step into your “therapeutic space”, close the door. Take a minute to just breathe deeply.
Find a good position, an easy chair, even your bed. Get a cushion if you need to. Avoid standing, because that can get uncomfortable and distract you from your viewing, especially if you experience an intense body response. Doing a session online often means your body and head are facing in one direction more than would be the case when you are meeting with someone in-person. If you have been meeting with colleagues and friends through Zoom this past year, you already know about the eye- and body-strain that can happen. Fortunately, with TIR, you don’t have to be quite so formal as to be sitting straight up in a desk chair and you can look anywhere you want to.
Try to designate one or two areas in your physical environment for your sessions. This can help you transition your mind and body into “TIR mode” more easily. You may even want to put up a soothing picture or object nearby to help ground you in this space.
Ok, I have my distraction-free environment. Now what?
You and your facilitator are ready for session. It usually only feels awkward in the first few minutes of the first few sessions, but that sensation will likely fade as you begin your viewing session. My viewers and I can usually get right into the sessions pretty smoothly.
Is it really worth doing all this? Why don’t I just wait till I can go in person?
You may be tempted to hold off on doing this. If you have a situation wherein having a private and distraction-free environment is impossible, yes, you may need to hold-off until you can see someone in person. If you are in an abusive or unsafe situation, or you don’t have a stable internet connection, online sessions may be a no-go. But only if that is truly the case, would I recommend that.
If it is difficult but doable, then you may want to go ahead with TIR. Because you have been living with this trauma and the effects that it has on you, and you don’t have to do that anymore. In fact, it’s part of self-care to do this work and get relief and resolution. No matter where you do this work, whether or not there is a pandemic, your life is happening now. When you can relieve the effects of traumatic incidents, you can live more fully in the present and participate in your life, and with the people who are important to you, in a better way than you do when you are carrying this burden around. That’s true whether you are home or out and about.
You may have heard that self-care is like filling your gas tank. If your gas tank is nearly empty, it’s hard to drive yourself where you need to go, much less anyone else. This work helps you fill your gas tank.
So the bottom line is, yes, Traumatic Incident Reduction works, and it even works online.
You can take this step for yourself and for people you care about, right now. So I wish you well as you start this process. May your benefits be excellent!
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