Exploring NARM Therapy: Healing Complex Trauma

In the realm of psychological healing, the NeuroAffective Relational Model (NARM) emerges as a beacon of hope for those grappling with the complexities of trauma. Developed by Dr. Lawrence Heller, this innovative therapeutic approach delves deep into the intricate connections between early childhood experiences and their profound impact on identity formation and emotional regulation in adulthood. NARM not only addresses the effects of complex trauma but also offers individuals a pathway to rediscover their sense of self and foster meaningful relationships with others. By integrating somatic awareness with cognitive understanding, NARM opens doors to holistic healing that empowers clients to reclaim their vitality and navigate life’s challenges.

As we explore NARM therapy further, it becomes clear that its principles resonate deeply within our collective human experience. The model emphasizes critical aspects such as attachment patterns, emotional regulation, and relational dynamics—elements often overlooked in traditional therapeutic frameworks. Through its unique blend of psychophysiological insights and compassionate engagement, NARM provides a comprehensive roadmap for recovery that acknowledges both the pain of past traumas and the potential for personal growth. Join us as we delve into the foundational concepts behind NARM therapy and uncover how this transformative approach can illuminate paths toward healing for individuals affected by complex trauma.

Origins of NARM

Dr. Lawrence Heller, a seasoned therapist and author, developed the NeuroAffective Relational Model based on his extensive experience working with individuals who have experienced early childhood trauma. NARM offers a comprehensive method for healing developmental trauma and its impact on individuals’ lives.

Like all modern therapies, NARM draws upon many theories and styles. These include:

• Psychoanalysis
• Gestalt Therapy
• Rogerian Therapy (Person Centered therapy)
• Somatic Therapies (Body Based Therapies)
• Attachment Theory
• Polyvagal Theory
• Other Eastern wisdom traditions

Key Principles of NARM

The NeuroAffective Relational Model (NARM) developed by Dr. Heller is a therapeutic approach designed to address complex trauma. NARM focuses on connections between early attachment patterns and the development of identity and emotional regulation. When childhood is marred with hurt and trauma, the child grows into an adult with broken connections to the self and others. Heller designed NARM therapy to help individuals heal from trauma, regain a sense of aliveness, and enjoy new connections to the self and others.

NARM is built on the foundation of several key principles:

• Relational and Developmental Approach: NARM emphasizes the significance of early attachment and relational patterns in shaping an individual’s identity and their capacity for emotional regulation.
• Somatic Awareness: The model acknowledges the impact of trauma on the mind-body connection, and integrates somatic awareness and regulation into the therapeutic process.
• Working with Shame and Self-Regulation: NARM recognizes the pervasive influence of shame in individuals who have experienced developmental trauma, and focuses on promoting self-regulation and healthy interpersonal connections.
• Attachment Patterns and Identity: Understanding one’s attachment patterns and their influence on identity formation is a central aspect of NARM, as it aims to empower individuals to re-establish a sense of agency and authenticity.

NARM integrates cognitive and somatic approaches to achieve these aims. Central to NARM is the concept of “working from the bottom up,” which entails addressing early developmental issues before processing more explicit traumatic events. By fostering a deep understanding of one’s internal experience and relational patterns, individuals can gradually process and integrate their traumatic experiences.

NARM also relies on a top-down approach, using the mind and meaning making to integrate somatic information.

The Core Theory of NeuroAffective Relational Model

Life Force

The basic concept of NARM is that organisms possess a life force that motivates development. Basically, we have a survival mechanism built in that guides the individual, helping them adapt to their environment. Heller’s concept of life force is closely tied to the nervous system. However, it also appears to include some of the early Freudian libido. Under most conditions, this life force directs appropriate action, leading to healthy development.

The healthy flow of life forces creates a sense of aliveness. Our nervous system, environments, and behaviors work together promoting a flourishing existence. Michael Eigen expands on this concept, explaining that the state of “being alive (is) supported with all its mixes of emotions, feelings, sensations—the whole natural flow.” He continues, explaing that “the body of primary normalcy is the lived body or body subject contributing to how it feels to be alive, how aliveness feels” (Eigen, 1999).

Five Basic Needs

NeuroAffective Relational Model identifies five basic needs. We develop in relation to these needs. Each person has an individual developmental style giving more or less weight to each style. The five basic needs are: connection, attunement, trust, autonomy, and love-sexuality.

• 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.

We develop in these five distinct areas. We also may discover that our environments does not support equal development in these primary areas. Heller also refers to these developmental styles. Each core need is associated with specific patterns of relating and coping. Heller theorizes that these are “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” (Heller, 2018).

These developmental styles in NARM provide a framework for understanding how early attachment dynamics and relational trauma can shape individuals’ ways of connecting with themselves and others.

Satisfying Needs

We react to the environment to satisfy needs and protect against harm. Heller explains, “a primary need emerges and is satisfied. It recedes into the background, and another need emerges; and so, the cycle continues” (Heller, 2012). The continuous process of the arising of needs, our responsive reaction, and the subsiding of the need becomes a pattern of existence. We identify with these patterns, creating a sense of self within our environments. We experience a sense of mastery and self-efficacy as we smoothly interact with affective reaction to external cues.

Diana Fosha explains that when we have a “handle on…affective-relational patterns” we respond “spontaneously from an increasingly affect-laden place” (Fosha, 2000). Our life force effectively helps us navigate life. Healthy development within the NARM system refers to utilizing emotions to motivate healthy action in building relationships with others, experiencing a positive sense of self, and regulating emotions.

Developmental and Complex Trauma

Childhood trauma interrupts the normal development of a child. NARM therapist Melissa Knight Taylor suggests that developmental trauma “can result from any dynamic in your childhood that did not support your development” (Taylor, 2023). Trauma is embedded in our psyche impacting us in the present. The impact of trauma is expressed in three primary areas:

• Self-Image (Self-Esteem)
• Self-Regulation
• Capacity for Satisfying Meaningful Relationships

Basically, trauma interferes with the natural flow of the life force, creating “internal roadblocks that keep us from experiencing the connection and aliveness we year for.” Heller continues, explaining “these roadblocks develop in reaction to developmental and shock trauma and the related nervous system dysregulation, disruptions in attachment, and distortions in identity” (Heller, 2012).

See Complex Trauma for more on this topic

An Example of Failed Need Fulfillment

A common example of failed need fulfillment is found in common caregiver-infant interactions. When an infant is hungry, cold, or ill, they cry. Basically, this is the infants request for help to satisfy a need. When a caregiver does not appropriately respond, the infant escalates demands, “ramping up the sympathetic branch of the autonomic nervous system, protesting the lack of response, and finally erupts into anger” (Heller, 2012).

John Bowlby identified this process as well. He wrote, “the sequence of responses seen in young children during temporary separation from mother as those of protest, despair, and detachment” (Bowlby, 1988). No parent can satisfy every child’s need. However, when dismissing of needs is chronic, the child’s anger is left unresolved. Much like the stress response. Stress arises, behaviors satisfy the demands, and the body returns to a homeostatic balance. Toxic stress is when this cycle of arousal and satisfaction is broken, leaving the individual in a habitual state of stress.

Heller explains that “when aggression, anger, and other forms of protest are ineffective, not possible, or dangerous, children adapt.” He continues, “at a certain point, if the lack of attunement persists, the chronic sympathetic arousal overloads the nervous system; children adapt through resignation, shutting down the angry protest as well as the need itself, and move into the parasympathetically dominant freeze response” (Heller, 2012).

Survival Styles

When an avenue for resolving internal discomfort is ineffective, we adapt through finding new ways to soothe the disruption. In psychology, we refer to these as defense mechanisms. Heller theorizes that the young child develops survival styles. He describes five different styles built around the five primary needs (connection, attunement, trust, autonomy, and love-sexuality). Accordingly, a therapist can identify these styles in a client through exploratory question in the therapeutic process.

See Adaptive Survival Styles for more on this topic

The Therapeutic Process

The NARM therapeutic process is built on four pillars.

• A clarifying therapeutic contract. This pillar is about identifying the overarching goal of therapy.
• Exploratory question to invite self reflection. This is a process of gathering information so the client can focus on their own internal processes.
• Reinforcing agency. This pillar suggests that adult clients have responsibility and self-efficacy to assist change. The client plays a key role in the overall process.
• Reflecting positive shifts. Clients with a traumatic history tend to focus on the past. The NARM approach progressively works towards a shift to the present moment.

Key Areas of Focus

In the Neuroaffective Relational Model (NARM), the key areas of focus in the therapeutic process:

• Regulation: This involves developing the capacity to regulate emotions, behaviors, and bodily sensations in a balanced and attuned manner.
• Relationality: This area of focus revolves around exploring and healing relational patterns, including addressing attachment ruptures and developing healthy connections with others.
• Identity: This area of focus requires recognizing and integrating the various aspects of one’s identity, including personal history, cultural influences, and individual strengths.
• Embodiment: Embodiment involves reconnecting with the body and addressing bodily experiences, including trauma, in order to foster a sense of safety and vitality.

Techniques for Addressing the Key Areas of Focus

While NARM explains the impact of trauma, Heller recognizes understanding what is wrong is much different than resolving the issues. He explains, “we now know that when we focus on dysfunction, we risk reinforcing that dysfunction: if we focus on deficiency and pain, we are likely to get better at feeling deficiency and pain.”

NeuroAffective Relational Model is “a model for human growth, therapy, and healing that, while not ignoring a person’s past, more strongly emphasizes a person’s strengths, capacities, resources, and resiliency” (Heller, 2012). NARM therapy accomplishes this through a mix of somatic and cognitive techniques. Therapists incorporate somatic techniques of somatic experiencing, Gestalt exercises, and affect regulation to accomplish this aim.

NARM therapy subscribes to the Rogerian concept of change. Basically, we can’t force change. Carl Rogers’s stated that “if I can provide a certain type of relationship, the other will discover within himself the capacity to use that relationship for growth and change and personal development will occur” (Rogers, 2012). Similarly, NARM does not focus on fixing what is wrong but creating the experiences and environment that opens the flow of life energy.

The more we focus on what is wrong the more what is wrong becomes a part of who we are. Heller explains that “the more we allow ourselves to fully experience who we are, the greater the possibility of change” (Heller, 2012). Accordingly, NARM therapy does not spend endless hours delving into the past, exploring every aspect of the trauma.

The Impact of NARM

The NeuroAffective Relational Model has shown promise in effectively addressing complex trauma and supporting individuals in reclaiming a sense of well-being and agency in their lives. Through its holistic and relational approach, NARM offers a unique framework for therapists and individuals to navigate the complexities of developmental trauma and its lasting effects on one’s life.

Associated Concepts

• Acute Stress Disorder: This disorder is a precursor to PTSD. This diagnoses allows professionals to begin early treatment on individuals suffering from a traumatic event before they meet the time criteria necessary for a PTSD diagnosis.
• Adaptive Survival Styles: These are defensive styles that Dr. Lawrence Heller identified methods that children adopt to adapt to harsh early environments.
• Adverse Childhood Experiences (ACEs): This refers to childhood events that lead to cognitive struggles later in life.
• Post-Traumatic Stress Disorder (PTSD): This is a mental health condition triggered by a terrifying event, either by experiencing it or witnessing it. Symptoms may include flashbacks, nightmares, severe anxiety, and uncontrollable thoughts about the event.
• Cognitive Processing Therapy: This therapy is a empirically tested style of therapy used by Veterans Health Administration (VA) to treat PTSD.
• Eye Movement Desensitization and Reprocessing Therapy (EMDR): This is a common therapy style used to treat trauma.
• Trauma Resiliency Model: This approach focuses on building resilience and promoting healing in individuals who have experienced trauma. It emphasizes the natural and innate capacity of individuals to heal from trauma when provided with the right support and resources.

A Few Words by Psychology Fanatic

In conclusion, the NeuroAffective Relational Model (NARM) offers a profound and integrative approach to understanding and healing complex trauma. By focusing on the interplay between biological, psychological, and relational aspects of human experience, NARM provides a comprehensive framework for addressing the deep-seated patterns that often underlie trauma-related symptoms.

NARM’s emphasis on fostering connection, both within oneself and with others, highlights the importance of relational healing in the recovery process. This model not only helps individuals reconnect with their authentic selves but also empowers them to build healthier, more fulfilling relationships. Through its unique blend of somatic awareness and cognitive restructuring, NARM facilitates a deeper integration of body and mind, promoting holistic healing and personal growth.

As we continue to explore and apply the principles of NARM, it becomes evident that this approach holds significant promise for transforming the lives of those affected by complex trauma. By embracing the core tenets of NARM, therapists and clients alike can embark on a journey of healing that honors the complexity of human experience and fosters lasting change.

Last Update: July 29, 2025

References:

Bowlby, John (1988). A Secure Base. Basic Books; Reprint edition. (Return to Article)

Eigen, Michael (1999). Toxic Nourishment. Routledge; 1st edition. (Return to Article)

Fosha, Diana (2000). The Transforming Power Of Affect: A Model For Accelerated Change. Basic Books. (Return to Article)

Heller, Lawrence (2018). Introduction to the NeuroAffective Relational Model (NARM). Published: 12-26-2018; Accessed: 12-6-2022. (Return to Article)

​​Heller, Lawrence; LaPierre, Aline (2012). Healing Developmental Trauma: How Early Trauma Affects Self-Regulation, Self-Image, and the Capacity for Relationship. North Atlantic Books; 1st edition. (Return to Article)

Rogers, Carl R. (2012) On Becoming a Person: A Therapist’s View of Psychotherapy. Mariner Books; 2nd Edition. (Return to Article)

Taylor, Melissa Knight (2023). What is NARM? Accessed: 2-7-2024; Published: 8-30-2023. (Return to Article)