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The “NARM” therapy explanation can be a game changer in treating complex trauma. “NARM,” or “NeuroAffective Relational Model,” is a new treatment approach offering promise in healing complex trauma and complex PTSD.
Yet, for those seeking the best trauma-informed care for themselves or loved ones, the NARM therapy explanation must be clear, concise, and understandable. What is NARM, and how can it help heal complex trauma?
NeuroAffective Relational Model Overview: What Is NARM?
The NeuroAffective Relational Model, or NARM, is a clinical therapeutic approach to addressing and treating complex trauma. Developed by Dr. Lawrence Heller, it focuses on revolving developmental trauma and early childhood attachment trauma. The NARM therapeutic model aims to help individuals establish self-regulation and healthy relationships. It works with the mind and body to help individuals see how their past traumatic experiences affect their present behaviors and emotions.
Complex Trauma
What is complex trauma? These are traumatic events and adverse childhood experiences involving several interpersonal threats. Ongoing abuse of young children and adolescents is an example. According to data, most cases of complex trauma start in early childhood or adolescence.
Research shows that cognitive impairment, psychopathology, and pre-existing vulnerabilities are inextricably linked with complex trauma. Furthermore, their severity has been underestimated, thus affecting treatment approaches and effectiveness.
Complex trauma causes include:
- Severe childhood bullying
- Repetitive child abuse
- Seeing neighborhood violence
- Domestic violence
- Sex trafficking
- Torture
- Imprisonment
- Exposure to long-term conflict
Individuals experiencing complex trauma are more likely to have a major depressive disorder, anxiety disorder, eating disorders, addiction, dual diagnosis, nicotine or cannabis dependence, PTSD, and conduct disorder than those experiencing non-complex trauma.
NeuroAffective Relational Model Overview: Principles and Components
A thorough NARM therapy explanation describes the model’s core principles, developmental themes, and associated survival styles.
Four Principles of NARM
Any NARM therapy explanation begins with understanding its four key foundational principles:
- Relational and Developmental Approach. NARM therapy emphasizes the significant role of early relational and attachment patterns in shaping a person’s identity and ability to regulate emotions.
- Somatic Awareness. NARM acknowledges the effect and impact trauma has on the mind-body connection. The therapeutic process involves integrating somatic awareness and regulation.
- Shame and Self-Regulation Work. NARM therapy explanation recognizes how pervasive the influence of shame is in those with developmental trauma experience. NARM therapy focuses on promoting self-regulation and developing healthy connections and relationships.
- Attachment Patterns and Identity. Understanding a person’s attachment patterns and their influence on identity formation is central to NARM therapy. This means NARM helps individuals regain their sense of authenticity and agency.
Five Developmental Themes (and Survival Style Structures)
NARM is the spontaneous movement toward connection, aliveness, and health. The basic life force issue is moving toward health and continuing behaviors that improve it. People often come to NARM therapy with a compromised capacity to realize life fully. NARM helps them by addressing the five developmental life themes and associated survival attachment style structures.
Connection
The need for connection is primary. Individuals come to therapy with profound boundary ruptures. These stem from developmental trauma sustained from pre-birth through adolescence or a history of adverse events.
They want but are afraid of connection. Their primary coping mechanism is disassociation.
Attunement
This is the capacity to know what you need, to express that need without undue grief, and to tolerate the expansion of abundance. An attunement deficit develops around an abrupt rupture or nonexistence, a loss between mother and child.
The child’s needs aren’t met. They learn early on to dial back needs. They long for fulfillment but can’t tolerate it. Their primary coping mechanism is depression.
Trust
Humans inherently trust themselves and others. When they feel safe, they can have a healthy interdependence. When trust needs aren’t met, they tend to act out their aggression into the environment.
Autonomy
Autonomy is the capacity to set limitations and say no, to establish and maintain boundaries, and to express your thoughts without fear or guilt. Unable to deal with their internal autonomy, individuals abhor confrontation and may sabotage efforts to help them.
Love/Sexuality
The core dual needs of love and sexuality involve the capacity to live fully with an open heart and integrate loving relationships with sexuality, which is vital. Deficits in core needs may result in the individual shutting down their heart but having sex with others or shutting down sexuality but not their heart.
Understanding NARM Therapy
In the NeuroAffective Relational Model overview, Dr. Heller describes it as “a model for human growth, therapy, and healing that, while not ignoring a person’s past, more strongly emphasizes a person’s strengths, capacities, and resiliency.”
NARM uses a top-down and bottom-up approach. The top-down approach identifies distortions in cognitions and emotions, while the bottom-up approach addresses nervous system dysregulation. Both are necessary to expand therapeutic options.
The therapy addresses unconscious early disconnection and patterns that affect a person’s emotions, identity, physiology, relationships, and behavior.
NARM can explain trauma’s impact on an individual, but recognizing what is wrong is significantly different than resolving core issues. In brief, if therapy concentrates on what’s wrong, it may reinforce it. For example, by focusing on pain and feeling deficient, the person will likely become better at feeling pain and deficiency.
Exploring NARM Applications in Clinical Practice
When individuals come to therapy broken and want the pain to end, they’re often consumed with thoughts of what is wrong. However, the more they focus on their deficiencies, the more that sense of wrongness becomes who they are. This stymies growth. They may not know what is wrong and cannot pinpoint the origin. They only know their life isn’t working and want help fixing it.
How Does NARM Promote Healing?
However, with NARM therapy, the focus isn’t on fixing what is wrong. Instead, therapists work with the individual to create an environment with healthy experiences. NARM therapists use a mix of cognitive and somatic techniques to promote complex trauma healing. These techniques include Gestalt exercises, affect regulation and somatic experiencing.
NARM integrates somatic experiences with psychodynamic and relational themes. It is mindful self-awareness in the present.
The concept of NARM is that you cannot force change. An explanation of NARM therapy shows that the more an individual allows themselves to experience who they are fully, the greater their possibility of change.
What Is the NARM Therapeutic Process?
For clinicians seeking a better understanding of NARM therapy, the NARM therapeutic process involves four foundational pillars.
- Contract. This identifies therapy’s overarching goal.
- Exploratory Questions. Therapists ask questions to gather information so the individual can begin self-reflection.
- Agency Reinforcement. Individuals in NARM therapy have a vital role in the therapeutic process. They bear responsibility and self-efficacy to help promote their change.
- Reflect Positive Shifts. When individuals enter NARM therapy, they often fixate on the past. NARM, however, helps them gradually shift to the present.
Case Examples Illustrating NARM Interventions and Outcomes
Each person’s situation is unique. NARM interventions are tailored to meet their specific needs.
Anxiety is a common symptom when an individual’s core needs aren’t met. However, anxiety cannot be effectively dealt with by resources alone. It’s necessary to manage and integrate feelings. In NARM, the body is used to help individuals have more capacity to deal with their conflicts. So, anxiety needs to be worked on, owned, and experienced without acting out.
For someone with attunement issues, NARM can help them resolve their basic trauma so they can tolerate more change, connection, and relationality.
For couples with autonomy issues, NARM works to help them begin to experience their autonomy.
- On the surface, individuals are polite, superficially pleasant, and placating.
- But underneath, they have deep-seated anger and resentment.
- They can’t express their autonomy openly.
- Their relationship dynamic is either that one makes the other so miserable they leave, or the individual disappears entirely.
- They don’t like confrontation and won’t stand up directly, only indirectly.
The therapist needs to hold the individual’s internal structure, reflect it to them, and do so without taking sides.
Understanding NARM Therapy Significance and Potential Benefits
The NARM therapy explanation may seem complicated at first. Yet, pared to its essence, the NeuroAffective Relational model overview reveals its promise to:
- Effectively address complex trauma.
- Support individuals in their goals to reclaim well-being and agency.
Key focus areas include helping individuals develop their capacity to be more attuned and balanced in regulating behaviors, body sensations, and emotions. NARM helps them explore and heal dysfunctional relational patterns, address attachment ruptures, and develop healthier connections.
Furthermore, NARM therapy benefits include helping individuals recognize and integrate parts of their identity, such as strengths, history, and cultural influences.
Finally, NARM helps with embodiment, the reconnection with the body, addressing trauma and other body experiences to promote the individual’s safety and vitality.
For those affected by complex trauma, NARM can help them become more mindful and self-aware, heal their relational trauma, use their strengths, and regulate their emotions.
