What is NARM Therapy?
The NeuroAffective Relational Model (NARM)
NARM therapy is a process that helps you connect to what you most want for yourself, explore what gets in the way, and gently release those inner obstacles.
It sounds simple — and in some ways, it is. Yet even that first step, naming what we want, can feel surprisingly scary. Most of us have had good reasons to disconnect from our desires and authenticity. Namely: survival.
Staying connected to our caregivers, by whatever means necessary, is a matter of survival for children. The strategies we developed to ensure connection served us beautifully then — but eventually, they outlive their purpose and begin to limit our capacity for the life and relationships we long for.
Healing begins with deep compassion for these strategies, not rejection of them. Through appreciation and understanding, we open to new experiences and ways of being.
All of this unfolds through the relationship between client and practitioner — in conversation marked by attunement, curiosity, acceptance, gentle challenge, and the honoring of agency.
These qualities invite us to slow everything way down, so we can notice the subtle shifts in the body and emotions that happen when something important is acknowledged.
Clients often describe moments of profound reorganization or rewiring — experiences they hadn’t even imagined possible. They may feel lighter, more spacious, or deeply at ease.
Sometimes the shift is a deeper breath. Sometimes it’s a release of long-held tension. Other times it’s a newfound solidity — a sense of trust in oneself that allows for rest, ease, and presence.
As a practitioner, it’s truly a gift to witness this process of reconnection and transformation.
What follows below is an in-depth look at the NARM therapeutic model.
If you’re simply exploring or seeking support, you might start with a consultation call. It isn’t necessary to understand every detail of how NARM works — and for many, reading too much theory too soon can feel overwhelming.
The following sections provide a detailed overview of the NARM model — its origins, principles, and key therapeutic concepts. I offer this to support practitioners and curious readers who wish to understand the model more deeply.
Explore More About NARM
The NeuroAffective Relational Model (NARM) is a somatically oriented therapy designed to heal the lasting impacts of complex trauma (C-PTSD). It was developed by Laurence Heller, a renowned practitioner and contributor to the field of psychotherapy. NARM has its roots in psychodynamic therapies (Neo-Reichian), gestalt, and cognitive and somatic therapies as well as attachment theory and polyvagal theory. Most of the information that follows is derived from the two NARM books and deep study and practice of the NARM clinical model. The two NARM books are Healing Developmental Trauma: How Early Trauma Affects Self-Regulation, Self-Image, and the Capacity for Relationship (2012) by Laurence Heller and Aline LaPierre, and The Practical Guide for Healing Developmental Trauma: Using the NeuroAffective Relational Model to Address Adverse Childhood Experiences and Resolve Complex Trauma (2022) by Brad Kammer and Laurence Heller.
NARM Foundational Assumptions
NARM operates on a set of foundational assumptions. These assumptions are baked into every aspect and intervention of the model.
Top-down and Bottom-up
NARM assumes a functional unity between the psyche (thoughts, emotions, beliefs) and the nuanced physiological states that coincide. It utilizes both bottom-up (information flowing from the body into awareness) and top-down (using the mind and meaning making to integrate somatic information) perspectives and interventions. Integrating these processes is essential to the NARM model and sets it apart both from the ubiquitous cognitive behavioral therapy (CBT) and other somatic therapies. Using only a top-down orientation, we neglect the body and the emotions. When we work only with the body, the sensory and emotional experience can be confusing and overwhelming without using our adult cognitive capacities to form a useful framework for making sense of it. This integration is the key to the holistic and embodied shifts that are characteristic of NARM therapy.
Healing Happens in Relationships
That which is wounded in relationship is healed in relationship. Modeling and supporting connection in the therapeutic relationship is at the center of the NeuroAffective Relational Model. As clinicians, this modeling is an invitation for us to deepen into connection with ourselves and our own subjectivity (see NARM and Countertransference below). We use the term “heartfulness” to describe this bi-directional attunement.
Developmentally-Informed
Our psychological and emotional capacities develop in phases throughout childhood and adolescence. When the needs/project of a phase are not met, these capacities are compromised. The Adaptive Survival Styles represent clusters of strategies we develop in response to these “environmental failures”. These compromised capacities can be cumulative, just like the ACEs that drive them. If our earliest needs are not met, it will be more difficult to meet the challenges of the next phase. If the environment persists in failing to meet the child’s developmental needs, the harm is compounded.
Working with the Lifeforce
NARM assumes that we all naturally move toward health, connection and aliveness when the obstacles are removed. These obstacles are the strategies we used to survive and how we dampen or disconnect from our lifeforce energy. The concept of lifeforce has its roots in Bioenergetics, developed by Alexander Lowen who was a student of Wilhelm Reich. The Adaptive Survival Styles also correspond to Reich’s and Lowen’s character structures. Survival strategies/styles are distortions of the lifeforce.
NARM Organizing Principles
These principles function as a compass points guiding the therapeutic process.
Supporting Connection and Organization
Connection is the state of being in contact with self, others, the world (and beyond if you subscribe to such things). Especially with the very earliest disruptions of attachment, our capacity for connection is compromised. As practitioners, we track movements toward and away from connection and support the client to titrate the intensity of reconnection. Organization is the coherence of all of our systems and parts. As therapists, we can track organization (and conversely fragmentation) through the intelligibility of the the clients narrative (or meaning making) in the relational space. Connection and Organization are the fruits of a good enough upbringing and/or the healing process.
Exploring Identity
Identity is who we believe ourselves to be. We come to see our strategies and adaptations as who we really are. The whole nervous system and identity form around the environmental failures we were subjected to as young ones. We internalize those failures and make ourselves bad as a result. We use guilt, shame, and self-hatred to maintain this orientation to self. NARM supports us to disidentify from those failures and reconnect with the truth of our dynamic, authentic selves.
Working in Present Time
Foundational to the NARM process is working in the present time. While we do access material from past, it is only that which comes up for the client through present time exploration. This intentionally eschews regression. Instead, the client can begin to relate to what happened in the past from our present embodied adult consciousness rather than AS the child.
Regulating the Nervous System
In NARM, we don’t impose shifts in the body or nervous system. Rather, all interventions support the natural movement toward regulation that occurs when we disidentify from old patterns. This allows us to live in a flow of responsiveness or a dynamic co-creation with our environment. So much of the suffering involved in complex trauma is around the complex ways we override what’s happening in the nervous system.
The Four Pillars of NARM
The four pillars represent the methodology of the NARM process. These are neither linear nor sequential but a contract is required to ask deepening or process oriented questions.
Pillar One: Clarifying the Contract
The practitioner and client establish an agreement about what they are doing together. This starts with some version of the question, “What do you most want for yourself?” The practitioner is careful to contract around desired states rather than goals or external outcomes. Orienting to goals and outcomes tends to reinforce old patterns. Sometimes grappling with this question is as far as we get in a session. One reason contracting is so important is consent. Those of us who have experienced developmental trauma often have an early history of having to endure things that weren’t ok or having things “done to” us without permission. This can include all kinds of physical and psychological experiences of violation or dismissal. Contracting also serves to diminish the imbalance of power inherent in the client/practitioner relationship by returning the client to the driver’s seat and owning the process. Some of us may have a strong reaction to the implication that the practitioner knows more about what we need or want than we do. Others of us might feel most comfortable letting someone else tell us what we need/what to do and never connect to our own authentic desires or agency. Contracting is the antidote to these tendencies.
Pillar Two: Asking Exploratory Questions
The practitioner inquires about what is getting in the way of the client having the experience they want. Staying grounded in the present moment, we explore present day examples of experiences related to the desire. We might discover what aspects of the past we are bringing forward. Deconstruction of that experience, and drilling down to the heart of the matter are two ways we explore.
Pillar Three: Reinforcing Agency
When we learned as young ones that we were powerless to change things and get our needs met, we might continue to deny our own agency as adults. Part of what gets in the way of seeing our full range of possibilities is black and white thinking. When we split off or disown parts of ourselves (in order to protect the attachment relationships), we may mistakenly believe that we only have two choices, and neither of them are good. Self-shaming, -pressuring, and -judgment are the means by which we keep the gray area at bay.
One key aspect of the NARM process is developing our capacity for discernment, especially around the distinction between internal and external obstacles. This discernment is the key to experiencing our own self-agency and embodied adult consciousness. When we allow ourselves to see all of the available possibilities for making meaning and taking action, there comes a kind of serenity. Just like the prayer, we develop the courage to change what we can, acceptance of what we can’t, and the wisdom to know the difference.
The practitioner offers opportunities for clients to experience their own agency. These interventions can be delicate to offer and uncomfortable to receive. One example of this is turning something like shame or judgement into reflexive verbs. Instead of “I feel shame” we might reflect, “oh, I see, so when you (insert anything authentic) you shame yourself. Again, this can be tricky. Clients often do not experience shame as volitional/self-inflicted and it takes some finesse to do this in a way that the client can take in. When this goes well, there can be profound psychobiological shifts.
Pillar Four: Reflecting Positive Psychobiological Shifts
When a client experiences their own agency, reconnects with a disowned emotion, and/or experiences some small part of what they are wanting, there are physiologic, emotional, and relational shifts. The practitioner highlights these shifts in order to anchor the experience in our attention. As we grow our capacity to hold our own life energy, the felt experience can vary widely. If we tend toward bracing and tension, we might feel a relaxation or spaciousness in particular areas and most significantly in our breathing. If we tend toward collapse, we might feel grounded and embodied in a new way, maybe have more energy in the body. We might feel strong or proud and sit up a little taller (this also impacts the breath). Observing and reflecting these shifts helps to draw attention to the desired state and anchor the experience in the body with the support of the therapeutic relationship. These physiological cues can be powerful sign posts for recognizing and shifting the patterns in real time, outside of the therapy room.
The NARM Adaptive Survival Styles
To review, our physiological, psychological, and emotional capacities develop in phases throughout childhood and adolescence. When the needs/project of a phase is not met, these capacities are compromised. The Adaptive Survival Styles are clusters of strategies we develop as adaptations to these environmental failures. The environment includes first the womb, the body we are born into, our relationship with attachment figures, the home situation, community and even geopolitical contexts. There is great variance in the severity of the disruption such that two people using the same style could have VERY different degrees of disorganization and capacity for connection. When there is early relational trauma, the success of the next phase is threatened, and so on throughout development. So, sometimes people identify strongly with one or two of these styles, and others see themselves in all of them.
The following sections are very brief descriptions. Look out for much more detailed exploration of the Adaptive Survival Styles in the coming months.
The Connection Survival Style
Connection Survival Style represents a disruption at the very earliest stage of development (in utero through the first few months of life). This very first phase sets the scene for all future development. It’s as if the child never fully landed in the body or were never properly welcomed. This experience is also referred to as the “unwanted” or “hated” child. All forms of connection to self and others feel threatening and may be experienced as a nameless dread. Freeze, dissociation, and fragmentation are characteristic of this style. There are two subtypes, intellectualizing and spiritualizing.
The Attunement Survival Style
The disruption for this style occurs between 6 months and 2 years. This can result from prolonged separation from the mother, a mother with her own developmental trauma, divorce or other household disturbance, the child’s serious or chronic health problems, and chronic misattunement to the child’s need. The little one manages these situations by disconnecting from their own needs. The adult using this adaptation will have difficulty feeing and expressing their own needs, challenges managing intense emotions, and be preoccupied with fear of attachment loss. They may fear and reject “neediness” and project their own needs on to others or have unrealistic expectations for their adult relationships. The subtypes are inhibited and unsatisfied. .
The Trust Survival Style
This style develops from 1.5- 4 years old. Vulnerability and dependence on caregivers was not safe and even used against the child. This can span a continuum from very subtle manipulation (using the child to illicit a response in the other parent) to profound abuse and chaos in the family. As adults, this pattern uses power, control, aggression, and bodily armoring to keep themselves impervious to others and stay on top. On the more disorganized side of this style, someone may create an elaborate and deceptive persona that is precisely the opposite what is happening internally (reaction formation) in order to manufacture a response from others. The two subtypes are seductive and overpowering.
The Autonomy Survival Style
This style also develops from 1.5 years to 4 years old under different circumstances and dynamics than the previous style. Autonomy, or increasing age appropriate self-determination, is not supported and even punished by caregivers. Highly anxious parents, or parents who view their children as extensions of themselves may be very controlling during this period. The child feels bound to choose between their authenticity and being in connection. As adults, this style feels paralyzed by self-doubt and inner conflict. They put enormous amounts of pressure on themselves for everything. They often place others in a role of authority to which they either must comply or defy, leaving them with no good choices. The subtypes are rebellious and submissive.
The Love/Sexuality Survival Style
This style develops in two separate phases, 4-6 years and 12-15. People who use this style may be highly successful and attractive. It can develop when parents reject emerging sexual curiosity and expression, or when love is conditional on performance and appearance. As adults, this pattern relies on external cues to guide them and may have a very distorted view of themselves. They have difficulty experiencing both love and sexuality simultaneously. There is an emphasis on doing to avoid their inner experience and vulnerability. Perfectionism and the “right” way reign, deferring to rules or established norms. The subtypes for this style are romantic and sexual.
More NARM Concepts
Primary vs. Default Emotions
The two emotions we are concerned with when working with complex/developmental trauma are grief and anger. Both grief and anger can be primary and default emotions.
Primary emotions are those which connect us to ourselves and the truth of our experience in the present moment. When we have experienced developmental trauma, we have to disconnect from primary emotions to manage the heartbreak and rage that comes with not having our needs met.
Default emotions are those we use to disconnect from our primary experience and serve to maintain the pattern that protects the attachment relationship.
It can be very tricky as we can experience one emotion (let’s say anger) in both default and primary ways in the same moment. Default grief can look like collapsing into unendurable grief AS the child who experienced it and denying our own authentic agency and protest. Primary grief connects us to our hearts and allow us to feel grief FOR the child we were, FROM our embodied adult consciousness. Default anger may come up to protect us from that profound heartbreak of childhood, while primary anger is communicating something about what is and is not ok.
The Emotional Completion Process
The emotional completion process is woven throughout Pillars 2, 3, and 4. As we reconnect with embodied adult self-agency, we often find the capacity to reconnect with primary emotions. Brad Kammer of the Complex Trauma Training Center (CTTC) and co-author of the Practical Guide to Healing Developmental Trauma likes to say that primary emotions ride the back of self-agency. Here’s how it works:
1. Identify the emotion.
2. Explore the intention of the emotion or what it’s communicating.
3. Support the transformation of the unresolved emotional conflict.
People can feel profound shifts in their psychobiological capacity when they experience this resolution. We come to recognized that the conflict (eg. I can’t feel my anger because…) is only relevant to maintaining the child’s attachment to their caregivers. We begin to grasp that we don’t need our parents or any other adult relationship like we needed our parents back then.
The process of reconnecting to these disconnected emotions can be quite intense, which is why we time it carefully to coincide with moments of increased agency and titrate (work with it bit by bit) according the client’s capacities. Also, though, there is a great deal of energy that is liberated when it is no longer bound up in holding these emotions at bay.
Containment vs. Catharsis
Some somatically oriented models focus on releasing the blocked energies of these disowned or split off emotions. This kind of release or catharsis may (or may not) feel great in the moment. We may feel that we are finally free of whatever was “wrong” with us, only to find that the same dynamics continue to painfully recur. Sounds demoralizing, right? Conversely, it may be experienced as overwhelming which is potentially re-traumatizing and reinforces the old patterns. Most importantly, though, we will not have built the capacity to hold the energies bound up in the pattern. It is only by being able to be with (contain) the emotions/states, that we can hear the messages they carry and allow them to inform our beliefs, sense of self, and actions.
NARM and Countertransference
Working with countertransference is central to the practice of NARM. The concept of countertransference has its roots in Freudian psychoanalysis and refers to how the work with the client impacts and informs us as practitioners. Some models reject any countertransference as a distraction and even harmful.
In NARM, we distinguish between “Big C” and “little c” countertransference.
“Little c” would include any clinically significant information we receive from how working with client is impacting us. This can include feeling anger about a situation when the client may not have access to very appropriate anger. Another example would be a mirror neuron response to what’s happening in the client’s body (eg. feeling tension in the shoulders that isn’t usually there). We can use this information to feel into the client’s experience and shape our interventions without taking it on as our own.
“Big C” refers to the ways our patterns and strategies collude with or react to what’s happening for the client. It is only through compassionate awareness of our own patterns that we can see them in action and choose not to enact these reactions in the therapeutic process. One example of this would be rushing in to fix something when a client feels hopeless because we can’t tolerate feeling helpless. Or, maybe we don’t challenge a client because we haven’t integrated our own anger and are afraid of their reaction.
We use the concept of the 50/50 to hold this complexity. It refers to the ideal balance of attention: 50% on the client and 50% on ourselves (how the relationship and the work is impacting us). It takes ongoing support, practice and discernment to tell the difference between these two kinds of countertransference.
For us, as practitioners, this can take on the significance of a spiritual practice. As we continue to deepen into connection with ourselves, we are able to connect with others and particularly clients as unique and dynamic subjects (as opposed to objects to act upon). This is a huge part of what makes NARM so powerful.
FAQ
NARM is used for treating and healing developmental trauma. Developmental trauma refers to conditions in childhood and adolescence that compromised the normal development of capacities. The model emphasizes the relationship between client and therapist, fostering agency, supporting self-regulation, and cultivating capacity for connection.
NARM stands for the NeuroAffective Relational Model®. It’s a therapeutic approach designed to support healing from the lasting effects of complex and developmental trauma. “Neuro” reflects how trauma impacts the nervous system, “Affective” refers to our emotions, and “Relational” highlights the healing potential within safe, attuned connection.
While most mainstream talk therapy focuses on insight and storytelling, NARM gently invites us to stay connected to the present moment — to what’s happening right now in our body, emotions, and thoughts. Rather than analyzing the past, we explore how old survival patterns are still shaping our current experience and relationships. This shift helps the nervous system reorganize around greater connection and vitality.
A NARM session is a collaborative conversation where you’re invited to slow down and notice subtle shifts in your body and emotions as we talk. There’s no pressure to “go deep” or relive painful memories, . The focus is on curiosity and compassion — exploring what you most want for yourself and what gets in the way. As awareness grows, new possibilities for regulation, ease, and connection naturally emerge.
EMDR (Eye Movement Desensitization and Reprocessing) is an evidence-based technique used to desensitize us to traumatic memories and reprocess how they are stored in our memory. It involves a very standardized protocol using eye movements from left to right while accessing the traumatic memory. Some people with developmental trauma find EMDR too overwhelming. NARM, by contrast is much more about the therapeutic relationship and gently being present to what’s happening in the moment.
If you’ve done personal growth work before but still feel stuck in old emotional or relational patterns, NARM can be a powerful next step. It’s especially helpful for people who want to feel more connected to themselves and others, but find that old defenses or survival strategies keep getting in the way.
Not necessarily. In NARM, you don’t have to retell your trauma story to heal. Instead, we pay attention to how early experiences may still live in your body and patterns of relating today. The healing happens through connection — not through rehashing painful details.
Yes. Many difficulties that show up as anxiety, depression, or challenges in relationships can stem from unresolved developmental trauma. NARM works by addressing the patterns underneath those symptoms — helping you build capacity for connection, choice, and emotional regulation.
That depends on your goals and needs. Some people notice meaningful shifts after just a few sessions, while others benefit from a longer-term process. The pace is always collaborative and guided by what feels right for you.
In Closing...
The NeuroAffective Relational Model (NARM) is a powerful, complex, and nuanced process that offers a way to heal from developmental trauma and live into the life we love. If you are interested in trying it out for yourself, schedule a call below. I’d love to hear from you.
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