Instinctual Trauma Response and graphic narrative

Domain VIII · Creative & expressive arts therapies · Louis Tinnin, Linda Gantt · Morgantown, West Virginia, USA

What it is

The Instinctual Trauma Response (ITR) is two things. First, it is a model: a stereotyped sequence of survival responses that the founders say occurs in any overwhelming event. Second, it is a method: the client draws the trauma as a series of pictures that follow that sequence (the graphic…

Format

• Format (clinic version).
• Marathon intensive of about 7 hours a day, Monday to Friday, with 30–35 hours of individual therapy per week, for one or two weeks. Clients may return later for another course. Out-of-town clients stayed in a local hotel.

Who practises it, and how they are trained or regulated

• Version followed: the Individual Intensive Trauma Therapy (IITT) clinic protocol of Intensive Trauma Therapy, Inc., Morgantown, West Virginia (Louis Tinnin MD and Linda Gantt PhD, ATR-BC), as profiled by the California Evidence-Based Clearinghouse (research evidence review dated June 2015). It is supplemented by the current ITR Training Institute descriptions (2024–25), which add grounding, Safe Place, True Self and…
• ITR is a proprietary, trademarked method (ITR®) of the ITR Training Institute, whose co-founder is Linda Gantt and whose Training Director is Danni Davis LCSW. The institute offers ITR certification. Gantt is also co-founder of HelpForTrauma.com, and she closed her long-running intensive clinic to concentrate on training practitioners.
• The IITT training was Part I, a 4-day didactic and experiential course (30 h), then Part II, a 5-day practicum at the clinic following one client through a week of treatment (40 h). A programme manual existed. Clinic staff were Master's-level social workers, licensed professional counsellors and art therapists. Current training routes and fees may differ from this.

Questions to explore with your client

• What drew you to it, and what are you hoping it will change?
• Does it involve any substance, plant preparation, remedy or supplement? Has your doctor or prescriber been told, especially about any medication you take?
• Is it a group, retreat or community? How do they respond if someone wants to leave or raises a concern?
• How do you and the practitioner understand what is happening, in spiritual or cultural terms? Is that a source of comfort, worry, or both?
• Does it use a device, heat, cold, water or a physical procedure? Has a medical professional checked that it is safe for you?
• Who runs it, and what training or registration do they hold?
• What actually happens in a session or meeting, and how often?
• What does it cost, and is there pressure to commit to more?
• How do you feel afterwards, in the hours and days that follow?
• Does it fit with, or clash with, the work we do here?

What practitioners of it watch for

• fatigue across 7-hour days. Schedule breaks, food and grounding.
• if the targets are unmet, list the traumas still unprocessed rather than calling it failure.
• if the safe place turns unsafe (intrusive images), change it to a neutral or present-day place.
• the readiness signs are restored self-care, orientation, and a stable adult presence in sessions.
• do not invent or suggest early traumas to fill the 'foundation' slot. Use only events the client already knows or that are documented.

When to involve someone else

• New or worsening physical symptoms, or advice to stop or change prescribed medication: involve the client's doctor or prescriber.
• Signs of coercion, isolation from family and friends, escalating costs or secrecy: discuss openly and consider safeguarding.
• A crisis or thoughts of suicide: follow your crisis protocol. In the US, call or text 988; in the UK and Ireland, Samaritans on 116 123.

Drawn automatically from the guide's own sections. Stay curious: neither endorse nor dismiss what the client values, and check anything that matters against the full guide and its sources. Not medical advice.