What is NARM and what does it mean to be a NARM Therapist?

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NARM (the NeuroAffective Relational Model) is a therapeutic approach specifically designed to address complex trauma and the internal patterns that affect quality of life that often emerges alongside it. These patterns usually began as adaptations to early adversity, but can become automatic and unhelpful when responding to a source of stress that is no longer present.

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Learn more information about Complex Trauma

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Being a NARM Master Therapist means I have completed the full formal training in the NeuroAffective Relational Model and remain connected with those trained in the model to remain competent in providing it. I integrate NARM principles and skills into almost every session I offer.

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NARM Process 

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Please note that the information written on my website is blended with my personal and clinical experience applying the model, and may differ from how other NARM therapists apply and integrate the model into their sessions.

 

One of the factors I appreciate most about NARM is how well it translates to online therapy. As long as you are in a private space where you can comfortably turn inward, we can do this work together from anywhere.

 

Many therapy approaches focus on recounting past challenging events, often stopping at awareness and/or moving forward with advice giving on concrete behavioral steps towards a goal, with little room for intuition or a client's inner knowing.

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For example, someone may process a difficult situation at work/with family/with friends, and then are given coping skills to reduce stress or on how to communicate effectively. The skills can appear both general, one size fits all, and highly detailed like a complicated dance that requires very specific conditions.

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NARM therapy differs in that the work invites connection with the present experience which involves how you relate to your own thoughts, sensations, and emotions as they organically arise. This is from the awareness that our relationship with ourselves is a comprehensive and intuitive guide to refer to outside of a session.

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This process looks like a NARM therapist inviting you to listen for what you are wanting in the present with what you are sharing. For the person processing a difficult situation at work/with family/with friends, it may bring them awareness that there is an unmet inner need based on how they are relating to themselves triggered by the external conflict. They may realize that they want to reduce stress and improve communication with others, but this is may be through increasing capacity for more authenticity with themselves and others which may include flexibility and tolerance for uncertainty and being misunderstood, not specific words or steps to further manage or control the situation.

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NARM is trauma-informed, depth-oriented, experiential and somatic. It recognizes the impact of unprocessed past adversity on our minds and our bodies, specifically with our nervous system in patterned ways that subconsciously shapes our lives.

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Within a NARM session, there are four distinct interventions:

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Clarifying the Therapeutic Contract – Getting clarity and listening for what you want on a deeper level for yourself, often present within and outside of therapy.

Asking Exploratory Questions – Inviting curiosity on what supports and also gets in the way of this internally. We relate to ourselves and others subjectively and in patterned ways in the present based on impactful past events. We explore this and what else may be possible, but not familiar.

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Reinforcing Agency – With awareness of what we want on a deeper level, our present patterns and what's outside of this, there is reconnection to agency or choice that is supported in therapy. The shift from should to want, pressure to desire is reinforced, and also space for complexity to move more freely.

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Reflecting Psychobiological Shifts – Since impactful events that created patterns affect us on a nervous system level, reflecting on physical signals as they arise from shifts outside of patterns and when agency is accessed are supported.

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How NARM views complex trauma

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NARM considers patterns developed early in life as a means to survive called, "survival styles".

 

As young children our survival relied on maintaining our relationship with primary caregivers and our primary group. When this is unavailable to us during times of adversity, we adapt and form these survival styles that we subonciounsly utilize as adults during times of extreme stress.

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This may be experienced as anxiety, trauma being activated, or retraumatization.

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Since modern social structures that prioritize economic demands over basic health and well-being of individuals, families, and communities, it is common to have survival styles to some degree, and activated often. Making it helpful to be aware of when systems have yet to change.​​​​
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Connection Survival Style

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Core dilemma that is difficult to balance: connection and disconnection with the present experience

The connection survival style may be recognized through a tendency to disengage or disconnect with our body and with others in a felt sense, and instead connect with bigger picture ideas or experiences that may be difficult to ground or share fully in the present moment. This may be experienced as a tendency to become highly intellectual or spiritual in a more obscure, inaccessible way while trying to connect.

 

When struggling with the connection survival style there may be a consistent struggle to feel ourselves as part of a shared social space and find comfort in retreating into our minds and inner worlds. Further enabled by choices in socializing which may be online even when there is the equal opportunity to meet in person.

 

The safety with this began as a way to prevent the pain that comes from awareness of physical needs that were unmet at the earliest point and period of life.

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This can be someone who had a mother who experienced significant distress or complications in their pregnancy, was born prematurely, was part of a traumatic birth or was unwanted by their caregivers, primary group, had health complications as a baby, and/or had physically, emotionally preoccupied caregivers. Increasingly, can also involve more absent caregiving through screen time.

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Those with this as their dominant survival style may experience themselves as neurodivergent or inherently as outliers across most contexts.

 

Since earlier and more severe trauma does have a neurological and biological effect, neurobiological differences such as ADHD, autism, and also what is considered giftedness may co-occur with this survival style. Deep differences may lead to more misunderstandings, conflict, and trauma in relationships that can contribute to later survival styles.​​

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Attunement Survival Style

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​Core dilemma that is difficult to balance: attunement to our needs and the needs of others

The attunement survival style may be recognized through a tendency to disregard our personal needs in the service of attuning to others (e.g. sleeping, eating, self-care), and on the flipside, may also disregard the personal needs of those closest to us in service of attuning to ourselves (e.g. prioritizing self-care trips when it affects functioning at home). There is a sense of "it's never enough" to feel satisfied in how we show up for others, and  perhaps more visible from the outside, how we show up for ourselves.

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Those who tend towards the attunement survival style may find themselves more susceptible to codependent relationships. Either as the selfless caregiver or as the insatiable receiver or both a caregiver in their friendships, but as a dependent in their romantic relationship. This leads to a struggle with sustainability, and shorter relationships because of the rigid role we may find ourselves stuck in without the end of the relationship or a major conflict.​

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Trust Survival Style

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Core dilemma: continue to trust self or trust the process in a relationship or a situation.

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The trust survival style may be recognized through a tendency to distrust that others can be reliable in an important way that we need, and on the flipside, can be about being overly trusting of others, and not trust ourselves to be capable in getting our own needs met.

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There is a sense of feeling larger than life, "special" in a dominant way, or feeling small, "especially bad" in comparison to others.​​ The trust survival style is a nonpatholagizing way, and more hopeful representation of narcissistic traits, overt and covert that can become a disorder with those who lack awareness and agency over these traits.

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The tendency towards the trust survival style may have formed due to lack of attunement with our capabilities that led to harm, can be emotional or physical abuse from a caregiver or primary group, neglect where basic needs can't be met. For those familiar with the concept of family roles, both the golden child and the scapegoat may relate with this style.

 

Subconsciously, as a way to prevent this harm, we overestimate or underestimate ourselves for the attention needed for care.

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Autonomy Surival Style

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Core dilemma: continue to meet expectations through performance or implement flexibility through authenticity in the relationship

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The autonomy survival style can be recognized through a tendency to act in a way that can meet the expectations of others of what's "right" or "good" even when it can lead to a sense of inauthenticity within ourselves, or a tendency to disappoint others that we don't want to from an authentic, but often subconscious need that feels too threatening to voice.

 

This is visible when we have a difficult time saying no or setting boundaries with ourselves or with others. We can name it as "self-sabotage" and/or "people pleasing". It is difficult to find win-win situations because it would require revealing that a situation doesn't actually work well for us to be able to collaborate with the other person on this. This kind of communication can take an extraordinary amount of energy and checking for the right words, right timing, right etc for those who have been significantly harmed in the past from expressing themselves directly and simply.

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The autonomy survival style can be experienced from someone when they are smiling, but we can feel tension, frustration, or anger underneath that the person may not be aware of in themselves or are proactively hiding. There may be a sense of confusion in leaving the exchange, and lack of follow through despite decisions or promises we thought they made.

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And on the inside, this survival style can feel like anxiety or shame because we may not be ready to be honest with ourselves about our feelings of disagreement, frustration, anger. Certainly not enough to express it with the other person. We may tend to "kill others with kindness", and find it difficult to be "vulnerable" or express authentic thoughts and feelings because we anticipate that the other person would reject these when they may have more to do with projections from the past.

 

It is possible that the other person would be upset by expressing our authenticity, similar to others from the past, but there is always a difference, and this complexity is something we can work with in the present.​

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Love-Sexuality Survival Style

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Core dilemma: be open to the complexity and nuance of love and sexuality or simplify or limit this

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​The love-sexuality survival style can be recognized through a tendency to prioritize performance and appearance of love or sexual attractiveness rather than the genuine, felt experience of love and sexual, physical intimacy. This can be present in all sexual orientations and expressions including spectrums of asexuality, and may actually be more prevelant in those who experienced trauma due to their difference in inherent sexual and romantic patterns and needs.

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For example, someone who is gay or queer likely experienced harm in their childhood for their sexual orientation due to most cultures being heteronormative where it became a need to assimilate and blend into environments that can also be spaces to meet romantic and sexual partners, cutting them off from connecting and exploring authentic and healthy experiences of love and sexuality that is complex and unique to them. Experiences and expressions of love and sexuality can become more extreme and one dimensional.

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This can also be the case for those whose appearances or personalities were reduced as negative in a romantic context by family, friends, potential romantic connections regardless of their sexual orientation.

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The extreme expressions from love-sexuality autonomy style may include when we idealize someone or ourselves as the perfect partner or the other person or label someone as being "out of" ours or someone's league even in a nonromantic or sexual way. When partnership or genuine connection seems impossible because of believing we are not attractive enough, successful enough without being able to define who we aren't enough for.

 

There is a reduction of complexity and nuance of who we or the other person is, and this may serve to make quick decisions to protect ourselves from rejection in place of allowing space for relationships to unfold in their own unique way through time which can include disappointments and spontaneous points of connection.

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Within therapy sessions, clients are supported to be aware of when internal dilemmas or pressure is present as a way to practice awareness of when survival styles are occuring without needing to name them. The specific survival style doesn't need to be named for it to be recognized and felt in a session and worked with in real time. It can even get in the way of the healing process from within, felt in our bodies, to approach ourselves through intellectual observation and with language we are not familiar with or connect with on a deeper level.

 

The goal is also not to eliminate survival styles or to erase trauma, and this is not realistic anyway as it isn't realistic to erase lived experience and predisposition, but to improve awareness and agency over them for balance and more sustainable relationships with others and with ourselves. This is the place where recovery, times of inner security, and posttraumatic growth can occur.

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I provide more information on NARM in therapy sessions, based on each person's unique ways of surviving and desire to thrive to improve their quality of life beyond survival mode.

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