Presentation in the electronic magazine Psychographima
Meet Training in the Neuromathy Relationship Model - NARM Approach to Developmental Trauma Therapy
What exactly do we mean when we talk about developmental trauma?
Ever since John Bowlby developed the theory of Bonding, the correlation between insecure attachment and psychopathology has been extensively researched. Talking about trauma [Complex Post-Traumatic Stress Disorder / C-PTSD / ICD-11 2018 / Complex Post-Traumatic Stress Disorder / Developmental Trauma] when in the early stages of development the child is exposed to a lack of a stable bond, and to prolonged and repeated neglect or abuse by his caregivers. This does not only mean the extreme events but also the latent experiences of absence, lack of harmonized attention, violation of personal boundaries, manipulative or aggressive intervention, which often leave the child in his daily life in a state of helplessness. Lack of proper care can also be due to general adverse living conditions (illness, social problems), or even to a traumatic background and lack of mental health care providers themselves - this is the often intergenerational nature of mental trauma.
Particularly through the contribution of modern neuroscientific clinical research in recent decades, a more comprehensive and in-depth understanding of the neurobiological background of the traumatic experience. This is how we know today that post-traumatic stress is a psychophysiological response of the whole organism, as well as the traumatic experience, especially when it comes to issues traumatic attachment in childhood, affects the structure and function of the brain and the organization and balance of the autonomic nervous system, leaving traces of on the physical sensory basis of the developing self. However, along with the new data on trauma, there is an important body of new knowledge and research data on what promotes mental resilience.
Tell us a little about the Neurotic Relationship Model (NARM.). What is the philosophy of this approach and what is the purpose?
The NARM trauma approach is based on the assumption that children have five biologically grounded basic needs necessary for healthy development: the need to connect with themselves and others, the need for caregivers' coordinated attention to their needs and feelings, the need for healthy trust and dependence, the need for autonomy and the need to give and receive love through the relationship. When one or more of these basic needs are not adequately met, children experience a threat to their well-being and healthy development, resulting in a struggle to survive psycho-emotionally. Difficulties in self-regulation, self-esteem, and the ability to relate, which often remain in adulthood, then emerge in early development. Children manage inadequate response to their needs and consequent physiological dysfunction, emotional disconnection and social isolation by adopting one or more of five biological-behavioral strategies, referred to in the NARM approach as "adaptive survival standards".
When a child adopts one or more of these survival patterns and in order to protect themselves from the threat of losing the important bond with their caregivers, the authentic sense of self is hindered, which is based on his connection to his body, to his emotional and social needs and to his autonomous, personal thoughts.
In the NARM approach, these adaptive types of survival are not seen as pathological, but as necessary psychobiological adjustments that the child has had to make to ensure his or her survival. Every survival pattern is described both as a basic biological need and as an innate (creative) ability and resilience, which, however, has been hindered and needs to be restored. Survival patterns provide five basic principles of organization, a clear framework for the healing process, in terms of ongoing self-development, disrupted and disorganized by early developmental trauma. This structure gives a central orientation to the therapeutic treatment of the patient's discomfort and symptoms.
The therapeutic approach combines the psychoanalytic exploration of limiting beliefs and established identities with simultaneously interventions of physically oriented experienced sense and awareness, which help the patient to begin to cultivate the ability to connect and share his experience in the present.
As patients begin to recognize and process unresolved, disorganizing beliefs, feelings, and sensations from the past, a sense of better emotional regulation and balance gradually develops, and awareness of those established, defensive defenses increases. continue to function as a result of early trauma.
The NARM trauma therapy model, emphasizing the already existing potential of capacity, functionality and resilience of the patient, investigates the history of the trauma, bringing to consciousness how entrenched adaptive defense patterns intrude on a person's ability to connect with his or her body, emotions, self, and others in the present.
In this sense, the NARM approach supports the identification process and personal freedom from surviving defensive patterns and limiting beliefs, thereby increasing the capacity for more connection, intimacy, functionality, resilience, health and well-being - benchmarks that characterize complex trauma resolution.
How can one be trained in the NARM approach? Who is the training program aimed at?
The NARM θυ NeuroAffective Relational Model είναι is an internationally taught clinical professional training program (NARM Training Institute International). Many clinical psychologists have already been trained in the NARM approach in North America and Europe, while NARM training programs are expanding internationally at a rapid pace and in this context, we took the initiative to offer it to our colleagues in Greece. THE duration The training is 2 years and includes a 3-day introductory and four 5-day seminars, for a total of 120 hours. The training program will be conducted in English with successive translation in Greek.
It is an advanced clinical training for mental health professionals and is aimed at psychotherapists of all approaches who have comprehensive psychotherapeutic training and clinical experience, and to mental health professionals such as psychiatrists, social workers, psychologists, counselors. occupational therapists, etc. working with complex mental trauma.
Colleagues interested in getting to know the approach NARM can participate in Introductory Seminar "Introduction to the NARM Neurotic Relationship Model ™" taking place in Athens on 8-10 November 2019. The seminar introduces the theoretical, methodological and experiential understanding of the NARM μοντέ model and provides the opportunity for a first, comprehensive experience on how to work in this approach.
What can one expect from education? What are the benefits for a mental health professional?
The NARM approach is a synthetic therapeutic model that derives its origin through the great tradition of anthropocentric psychotherapeutic directions (psychodynamic, cognitive, phenomenological, Gestalt, physical etc.). At the same time, - and this can be said, is the peculiarity of the NARM approach - it is a neurobiologically updated approach, based on the current findings of relational neuroscience in the field of evolutionary psychotraumatology, which describes on a neurobiological basis, on the one hand, post-traumatic developmental disorders and, on the other, their supportive therapeutic treatment.
As a method specifically designed to address the wider range of symptoms associated with complex, developmental-relational trauma, the approach focuses on therapeutic work with traumatic ligation patterns, the consequent long-term psychobiological symptoms, and interpersonal difficulties.
Its theoretical orientation and methodology are based on and aim at a more comprehensive understanding of biological and psychological development, that is, the psycho-physiology, as a functional unit, which is put and developmentally affected by exposure to mental trauma.
In this sense, the interested mental health professional can, through the NARM training program, expand and enrich the already existing theoretical and clinical-empirical range of his knowledge, adding to his quiver new cognitive tools and therapeutic techniques in indicative thematic areas such as:
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Psychism and neurophysiology: the role of the body and the nervous system in developmental trauma.
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Understanding and the therapeutic approach of the two-way relationship and interaction between the dysregulation of the autonomic nervous system and the psychological issues of identity.
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The five basic biological needs, the corresponding adaptive survival patterns and their developmental importance.
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Neurophysiology of attachment and the dynamics of detachment-crossing as survival strategies in early development.
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The involvement of the body in the therapeutic process: The therapeutic work in the present moment, the importance of the experienced sensation, the practice of physical consciousness and the activation of the "inner well-meaning observer" in the therapeutic context.
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The importance of psychoeducation on the symptoms of traumatic reactions and a consistent focus on support resources and resilience during the healing process.
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Therapeutic work with adult consciousness: encouraging the patient's ability to engage in emotions and personal development, enhancing the process of de-identification from victim distortions, supporting the developmental process of merging-separating, connecting and isolating and self-care.
What are the challenges when working with a trauma mental health professional?
Traumatic ligation, developmental trauma, as a concept and as a clinical object, has been at the center of the interest of Psychotherapy in recent years internationally. This is, I think, not because it is a new topic, but because the evolution of knowledge in this field has contributed to a deeper understanding of the multifaceted etiology of mental trauma and to the development of valid, holistic, synthetic psychotherapeutic approaches to its approach.
To cite an example, we now know that early mental trauma affects the subcortical (unconscious) areas of the brain, while the vague memory of the traumatic experience is not easily accessible through dialogue and discussion. Current findings clarify and document the body's involvement in the traumatic experience and it is understood that the effectiveness of a purely discussion-based cognitive therapy will be limited. Analytical verbal processing can also be re-traumatic, putting an extra strain on the already intense neurophysiological stimulation of anxiety or fear, especially if the therapeutic intervention is done quickly, before a sense of psycho-emotional security develops for the patient.
More generally, as exposure to trauma is associated with the experience of loss of a sense of security, control, and choice, maintaining a consciously gradual rate of healing, which can be described as "slow down," is a fundamental rule in psychotrauma understanding.
Therapeutic treatment - always within the safe context of the collaborative therapeutic relationship and through the various creative therapeutic interventions - needs to be addressed not only at the verbal level, but also in the secretive physical experienced sense, allowing the approach of the subjects in the organic rhythm that patients experience as safe and supportive.
As a creative challenge, for the specialist who works with mental trauma, I would also mention the cultivation of a, as we can call it, dual awareness in his therapeutic presence: the ability to relate both to his personal bodily sensation and to his inner experience in the present moment, as well as with the experience of his patients.
Also, in addition to self-monitoring of his work, it is necessary to activate and make use of his own support resources and stocks, that is, to cultivate and his own self-care.
Tell us a nice memory from the years you have been working on this approach.
In our work as psychotherapists, it is always a special joy and satisfaction, when in the course of a therapeutic course, the patients make an important for them "next step" in the issues that concern them. When, for example, through the new awareness and new remedial experiences they experience in the supportive context of the healing process and the consequent deeper understanding and acceptance of themselves, they can move from a position of often long-term, psycho-emotional dysfunction or psychosis. in a more flexible, empowered and optimistic outlook on their lives. I can say that working therapeutically with the NARM approach, I am grateful to remember such important "stations" experiences.
Zoe Paradomenaki Sillat, Dipl.-Psych.
Clinical Psychologist, Psychotherapist
Organization of NARM Education in GREECE