The NeuroAffective Relational Model (NARM) is a method of psychotherapy specifically aimed at treating attachment, relational and developmental trauma, otherwise referred to as “Complex Trauma” (Complex-PTSD or C-PTSD). This developmentally-oriented, neuroscientifically-informed model emerged out of earlier psychotherapeutic orientations including Psychodynamic Psychotherapy, Attachment Theory, Gestalt Therapy, and diverse Somatic Psychotherapy approaches. Integrating top-down psychotherapy with
bottom-up somatic approaches within a relational context.
Developed by Dr. Laurence Heller over the course of his 45 year clinical career, it was first introduced in his widely selling book Healing Developmental Trauma: How Early Trauma Affects Self-Regulation, Self-Image and the Capacity for Relationship. Currently available in over ten languages.
The NARM model is a powerful approach to addressing adverse childhood experiences and its long-term consequences, as highlighted in the ACEs study. This approach was introduced in the influential book by NARM founder Dr. Laurence Heller, Healing Developmental Trauma: How Early Trauma Affects Self-Regulation, Self-Image and the Capacity for Relationship.
NARM holds that while what happened in the past is significant, it is not what happened in the past that creates the symptoms that people experience as adults. It is the persistence of survival styles appropriate to the past that distorts present experience and creates symptoms. These survival patterns, having outlived their usefulness, create ongoing disconnection from our authentic self and from others. For example, dissociation and isolation are the primary coping mechanisms for dealing with the earliest trauma. While dissociation and isolation have literally saved people’s lives, as this pattern continues into adulthood, it creates endless symptoms.
It is also the distortions of identity that develop in response to early trauma which create ongoing suffering. For example, children always experience environmental failure as their own failure. A simple example: if a child grows up with unloving parents, he or she is unable to see that this is their parents’ failure. Children tend to develop the sense of self that they are unlovable. A core element in the NARM model is working with the child’s and then the adult’s unconscious need to protect the attachment relationship. They do this in a process called splitting, which protects the image of the caregiver at the expense of their own positive sense of self. This has profound repercussions for all of us on a psychobiological level.
The NARM Clinical model has precise and effective techniques for working with the core themes of identity distortion and physiological dysregulation. In the NARM approach, we work simultaneously with the
psychology and the physiology of individuals who have experienced developmental trauma, and focus on the interplay between issues of identity and the capacity for connection and regulation.
Core Principles
The NeuroAffective Relational Model™ focuses on the fundamental tasks and functional unity of psychological and biological development. It is non-regressive, non-cathartic, and non-pathologizing
The Four Pillars below provide an outline for the clinical therapeutic process.
Another central clinical process is focus on the interpersonal, therapeutic relationship which serves as an agent of change. The NARM Relational Model provides an organized 6-step process for working with countertransference, empathy, helplessness and supporting therapeutic engagement.
NARM uses five primary organizing principles:
- Supporting connection and organization
- Exploring identity
- Supporting emotional completion
- Working in present time
- Supporting re-regulation of all systems of the body.
Organizing Developmental Themes
There are five developmental life themes and associated core capacities that are essential to a healthy sense of self, capacity for intimacy,and capacity for emotional and biological regulation.
- Connection. We feel that we belong in the world. We are in touch with our body and our emotions and capable of consistent connection with others.
- Attunement. Our ability to know what we need and to recognize, reach out for, and take in the abundance that life offers.
- Trust. We have an inherent trust in ourselves and others. We feel safe enough to allow a healthy interdependence with others.
- Autonomy. We are able to say no and set limits with others. We speak our mind without guilt or fear.
- Love-Sexuality. Our heart is open and we are able to integrate a loving relationship with a vital sexuality.
To the degree that these five basic needs are met, we experience ourselves as authentic and develop the capacity for human connection. We feel safe and trusting of our environment, fluid and connected to ourselves and others. We experience a sense of regulation and expansion. To the degree that these basic needs are not met, we become symptomatic and develop survival styles to try to manage the disconnection, distortion of identity, and physiological dysregulation which drive the symptoms.
A Fundamental Shift
Whereas much of psychodynamic psychotherapy has been oriented toward identifying pathology and focusing on problems, NARM is a model for therapy and growth that emphasizes working with strengths as well as with symptoms. It orients towards resources, both internal and external, in order to support the development of an increased capacity for self regulation.
At the heart of what may seem like a wide range of physical and emotional symptoms, most psychological and many of physiological problems can be traced to a disturbance in one or more of the five organizing developmental themes related to the survival styles.
Initially, survival styles are adaptive, representing success, not pathology. However, because the brain uses the past to predict the future, these survival patterns remain fixed in our nervous system and create an adaptive but inauthentic identity.
The Metaprocess
Each therapeutic tradition has an implicit metaprocess. The metaprocess teaches clients to pay attention to certain elements of their experience and to ignore others. When therapies focus on deficiency, pain, and dysfunction, clients become skilled at orienting toward deficiency, pain, and dysfunction. Focusing on the difficulties of the past does not sufficiently reduce dysfunction nor necessarily support a more authentic identity.
The metaprocess for the NARM model is the mindful awareness of self in the present moment. The client is invited into a fundamental process of inquiry:
“What are the patterns that are preventing me from being present to myself and others at this moment and in my life?”
We explore this question on the following levels of experience: cognitive, emotional, felt sense, and physiological. NARM explores personal history to the degree that patterns from the past interfere with being present and in contact with self and others in the here-and-now. It brings an active process of inquiry to clients’ relational and survival styles, building on their strengths and helping them to experience a sense of agency in the difficulties of their current life.
The NARM metaprocess involves two aspects of mindfulness:
- Somatic mindfulness
- Mindful awareness of the organizing principles of one’s adaptive survival styles
Using a dual awareness that is anchored in the present moment, a person becomes mindful of cognitive, emotional, and physiological patterns that began in the past while not falling into the trap of making the past more important than the present. Working with the NARM approach progressively reinforces the connection to self in the present moment. Tracking the process of connection/disconnection, regulation/dysregulation in present time helps clients connect with their sense of agency and feel less like victims of their childhood.
Using resource-oriented techniques that work with subtle shifts in the nervous system adds significant effectiveness. Working with the nervous system is fundamental in disrupting the predictive tendencies of the brain. It is connection to our body and to other people that brings healing re-regulation. Using techniques that support increased connection with self and others is instrumental in supporting effective re-regulation.
Working with the Life Force
The spontaneous movement in all of us is toward connection and health. No matter how withdrawn and isolating we have become, or how serious the trauma we have experienced, on the deepest level, just as a plant spontaneously moves towards the sun, there is in each of us an impulse moving toward connection. This organismic impulse is the fuel of The NeuroAffective Relational Model™. Click here to see the Distortions of the Life Force Chart.