The Imaginary Reworking and Reprocessing Therapy (TRIR)

April 8, 2024

One of the most powerful tools that people who go to psychological therapy have to improve their mental health is the imagination . Through this resource, psychotherapists can access together with the patient to their dysfunctional schemes, to memories of negative experiences that have generated a harmful emotional impact on their person.

In this article we are going to talk about one of the Imaginary Reworking Therapy and Reprocessing , which includes some of the most complex and experiential techniques within psychological therapy, which, when well used (requires improvisational skills and therapeutic skills), can help many people turn the page and adopt more adaptive points of view in relation to their past.

It should be noted that, unlike other experiential techniques little scientifically contrasted, this therapy has shown its effectiveness for Posttraumatic Stress Disorder. Specifically, it has been shown to be effective for those patients with high levels of anger, hostility and guilt in relation to the trauma experienced.

What is Imaginary Reworking Therapy and Reprocessing?

Imaginary reprocessing therapy and reprocessing (TRIR) was originally designed to treat adults who have been sexually abused in childhood. It was proposed by Smucker and Dancu (1999, 2005), although today there are different variants (see Arntz and Weertman, 1999 and Wild and Clark, 2011) to address various problems.

The TRIR gives prominence to the emotions, impulses and needs experienced by the patient when reliving the trauma in the imagination . The trauma is not denied: the patient corrects the situation in his imagination so that in this he is now able to express his feelings and act according to his needs, something that at the time was not possible (due to his vulnerability or helplessness, or simply, for being in shock).

It is a combination of imaginal exposure, domain imagination (in which the patient adopts a more active role-protagonist) and cognitive restructuring focused on trauma. The main objectives of the imaginal reprocessing and reprocessing are:

Reduce anxiety, images and repetitive memories of the trauma / emotionally negative situation.
Modifying maladaptive schemes related to the abuse (feeling of impotence, of dirt, of inherent evil).

Why is it recommended to use the TRIR?

The most effective therapies for treating traumatic memories have in common a component of imaginal exposure. Traumatic memories, especially childhood memories, are encoded primarily in the form of images of high emotional intensity, which are very difficult to access by purely linguistic means. It is necessary to activate the emotions to access them and be able to elaborate and process them in a more adaptive way. In short, imagination has a more powerful impact than verbal processing on negative and positive emotions .

In what cases can it be used?

In general, it has been used to a greater extent in those people who have suffered some trauma in their childhood (child sexual abuse, child abuse, bullying) and who, as a consequence, have developed Post Traumatic Stress Disorder.

But nevertheless, can be used in all those people who have experienced negative experiences in childhood / adolescence -not necessarily traumatic- that have had a negative impact on the development of their person. For example, situations of negligence (not being attended to properly), not having met their psychological needs in childhood (of affection, security, feeling important and understood, validated as a person ...).

It is also used in cases of Social Phobia, since these people usually present recurrent images linked to memories of traumatic social events (feeling of being humiliated, rejected or having made a fool of themselves), which occurred at the beginning of the disorder or during its worsening.

It is also used in people with Personality Disorders, such as Borderline Personality Disorder or Evasive Personality Disorder.

Variants and phases of this psychotherapeutic model

The two best-known variants of the TRIR are Smucker and Dancu (1999) and Arntz and Weertman (1999).

1. Variant of Smucker and Dancu (1999)

Imagination Exhibition Phase : consists in representing in the imagination, with closed eyes, the whole traumatic event, as it appears in reviviscences and nightmares. The client must verbalize loudly and in the present tense what he is experiencing: sensory details, feelings, thoughts, actions.
Imaginary Rework Phase : the client returns to visualize the beginning of the abuse scene, but now includes in the scene his "adult I" (of the present) that comes to help the child (that is his I of the past that suffered the abuse). The role of the "adult self" is to protect the child, expel the perpetrator and drive the child to a safe place. The patient must decide the strategies to use (that's why it's called domain imagination). The therapist guides him throughout the process, although in a non-directive way.
Imagination phase of "Nurturing" . Through questions, the adult is induced to interact directly in the imagination with the traumatized child and sustain it (through hugs, reassurance, promises to stay with him and take care of him). When it is considered that the client can be prepared to conclude the imagination of "nurturing", he is asked if he has anything else to say to the child before finishing the imagination.
Post-imagination reprocessing phase : it seeks to promote the linguistic processing of the work done in the imagination and reinforce the positive alternative representations (visual and verbal) created during the domain imagination.

2. Variant of Arntz and Weertman (1999)

This variant consists of 3 phases (very similar to those of Smucker and Dancu) but it differs from Smucker's in 2 things:

It is not necessary to imagine all the traumatic memory , but can only imagine until the patient understands that something terrible is going to happen (this is very important in the face of traumas related to child sexual abuse). Reworking can begin at this time and the patient does not have to remember the details of the trauma and related emotions.
In the third phase, the new course of events is seen from the perspective of the child instead of that of the adult , which allows new emotions to emerge from the evolutionary level in which the trauma occurred. In this way, patients come to understand the perspective of the child, who really little or nothing could do to avoid the situation of abuse. This third phase is very useful to work the feelings of guilt ("I could have stopped him", "I could have said he did not want"), in short, feel that something could have been done differently than what was done.