Monday, December 5, 2016

Book Report

I have been reading and listening to Healing Developmental Trauma by Drs. Heller and LaPierre that is mostly about the Neuro Affective Relational Model (NARM) of working with people (adults) who have experienced early trauma. What is interesting about it is that it is about more than "shock trauma" which is what most of us think of - child abuse, neglect, a severe accident. They define Developmental Trauma as much more encompassing, even pre-natal insults like a surgery, or a depressed mother. I thought right away, if that is the case then we all have some kind of trauma, and a lot of it makes us different from one another. I used to think that "bad things" happening (and subsequent survival) make us just that more interesting as people. Most of us go on from there, to survive and thrive.
Obviously, my focus in my work is on the adults (and kids) who experience the shock trauma. But as simply as I can explain NARM, here it goes. Our bodies are regulated by our mothers, at first, through gestation, and then through the bonding period. Our parents hold us, feed us, sleep by us and we learn to feel safe and calm and "regulated" neurologically. We become organized and our brain and endocrine systems function optimally. We enjoy good nutrition, health and connected relationships to others assuming that love continues throughout our childhoods.
When that bonding and meeting of needs is disrupted, both early on and throughout our development, our bodies become disorganized and dis-regulated. We learn adaptations to survive the abuse or neglect. Humans (and animals) have three autonomic responses to danger: Fight, Flight, or Freeze. An infant can only do one of these things: Freeze. They will stop crying and disassociate from the body to ignore hunger, a wet diaper, pain. Babies and children will cease to recognize needs and have needs to preserve the minimal bit of relationship with the parent that they can get. As they get older they continue to protect the parent relationship by appearing compliant and good. They are not however, connected to themselves or others, they are not developing their own identity or knowing what they need from the environment. They do not recognize that the failure was in the environment. Instead they just know they "feel bad" and later they simply "are bad."
I wanted to cry listening to and reading this, for the babies out there who are enraged when they even have to "cry it out" as some professionals propose. There are many people who are now adults who experienced this, and just this lack of responding can create lifelong effects. Frequent disassociation, anxiety, panic attacks, health problems, relationship issues. I feel vindicated as I recall my own parenting - I held them, responded to them, bonded to them and I still strive to meet their needs as they grow.
There are five adaptive styles/organizing principles that can become survival mechanisms that go on into adulthood. I can list them but going into all of the traits and treatment here is way beyond my blog scope: Connection, Attunement, Trust, Autonomy and Love/Sexuality. Surviving as a baby or child is one thing, the problem arises as adults because we're not babies anymore. We were abandoned, but no longer. We were harmed, but no longer. Yet people are going through life as if the trauma is still happening and they often can't even put their finger on WHY they still feel bad. NARM does not focus on repeating the past traumas, it focuses on helping people remember without re-experience of it through connecting back to the body and learning to regulate their own biological systems. Developing identity and the ability to deeply connect to another person.
The use of this model in treatment is complex and requires a lot of study, practice and supervision. One of my goals is to do the 12-18 month program. For now I have to say that just having this understanding of the brain's development has made a difference in my practice. I do have a fair number of clients (in person and online) who seem to have one of the Adaptive Survival Styles and trying to do this kind of work online while completely DIS-Connected to them is potentially disastrous. I am ambivalent about continuing as an online therapist for this reason. After all, connection and relationship is what therapy is about, and then sending clients back into the world to try to connect and build relationships with others. It is important to continue learning, be humble, genuine, self aware, regulated and Connected.