Book Review-Healing Developmental Trauma: How Early Trauma Affects Self-Regulation, Self-Image, and the Capacity for Relationship
What does it mean to have our development interrupted by trauma – and what do we do about it now? These are the questions that Healing Developmental Trauma: How Early Trauma Affects Self-Regulation, Self-Image, and the Capacity for Relationship answers.
NeuroAffective Relational Model (NARM)
The book is focused on a model called the NeuroAffective Relational Model (NARM). The model is concerned with how our development may or may not lead to dysregulations, disruptions, and distortions. These lead to difficulties in living our lives and ultimately reduce our ability to thrive.
The model suggests that we have five biologically-based core needs:
- Connection – The need to connect with others. (See The Dance of Connection.)
- Attunement – The need to connect with our emotions, thoughts, and reality. (See Personality Types and Start with Why.)
- Trust – The need to trust others. (See Understanding Trust and Betrayal and Trust => Vulnerability => Intimacy, Revisited.)
- Autonomy – The need to be in control of our own destiny. (See Why We Do What We Do and How to Be an Adult in Relationships.)
- Love-Sexuality – The need for love and sexuality. (See Anatomy of Love.)
The model further suggests that if these needs aren’t met, they will need to be addressed, because they will create barriers to a fulfilling life.
Our bodies are amazing machines that allow us to achieve wide ranges of self-regulation. From the mundane regulation of temperature, oxygen status, states of arousal, and the rest to the more complicated regulation of our emotions, we’re wired to achieve stability. Of course, there are limits. You can’t keep cool when you’re in intense heat. However, overall, our systems are widely effective at the process of keeping us in states of homeostasis – relative balance.
When these systems are impaired, we experience it as a barrier. Commonly, people who have been exposed to trauma have difficulty regulating emotions. To be clear, as Jonathan Haidt explains in The Happiness Hypothesis, emotions are really in charge. (See also Switch.) Our ability to regulate our emotions is just an attempt to understand them and shape our responses. Haidt’s model of a rational rider on an emotional elephant makes it clear that the elephant always wins when it wants to.
I prefer to position the work of regulating emotions as the perspective of the relationship between the elephant and the rider. The degree to which our emotions are responsive to the requests and influence of reason can be harmed by early developmental trauma. While Healing Developmental Trauma describes managing our emotions, I believe that this is too strong of a statement based on what we know about neurobiology.
NARM calls for mindfulness as a technique. However, as they use it here, mindfulness is a catch-all term for a variety of approaches including more formal meditation techniques. (See Altered Traits). One of the specific approaches recommended is Somatic Experiencing (SE). Somatic Experiencing is an approach developed by Peter Levine. Healing Development Trauma and the NARM approach pulls key techniques from this work, including grounding, orienting, titration, pendulation, and discharge. (See In an Unspoken Voice for more.)
Another component that is included in NARM is gestalt, which is a therapeutic approach developed by Fritz Perls, MD. It’s focused on being aware of the current state – particularly, the current state of the body and what sensations are being felt. This, too, is a part of the broader family of mindfulness.
“Cognitive Behavior Therapy (CBT) does not address the nervous system imbalances that drive cognitive distortions.” It’s a problematic statement for me, because it’s not well supported in the rest of the text, and it’s not precisely true. CBT does have some aspects of reality grounding in the overall suite of tools. But the more challenging aspect of the statement is should it? Cognitive distortions are just a separation of our perception from reality. Some of these distortions are adaptive. For instance, we know that depressed people have a more accurate – and negative – view of the world and their capability to impact it than non-depressed individuals. Thus, non-depressed individuals see the world more positively than they should – but it’s adaptive. (See How We Know What Isn’t So for more.)
Some cognitive distortions allow people to maximize their capacity for hope and self-agency. (See The Psychology of Hope for more about hope.) We shouldn’t limit those cognitive distortions. We should be concerned about those distortions and those adaptations that are no longer working.
For Another Time
Each of us picks up a series of quirks about the way that we interact with the world. They are adaptations and accommodations that we make either because a human in our life requires it from us or because the way that we see the world requires us to adjust. We see this in the stereotypical differences between men and women in the way that they interact. (See Radical Candor and No Ego for more.)
These adaptations and accommodations can be positive for the time that we adopt them. It can be that they’re incredibly effective at helping us navigate the world. However, over time, these may get progressively less effective or even become harmful. They can begin to limit our growth as adults and our ability to navigate in the world of today. That’s why we need to be aware of these adaptations and evaluate whether they’re still appropriate.
Sometimes those adaptations deprive children of their childhood. Chaotic lives and parents who fail to plan sometimes find children creating the structure, organization, and planning that is necessary for the children to get what they need – like food and shelter. (For some examples, see The Years That Matter Most.) The problem this causes is that the child doesn’t feel safe allowing others to be themselves and often results in over controlling in their adult lives, because to not do so is too dangerous and scary.
Too frequently, we believe that if we share our entire selves with someone else, they’ll stop loving us – or they’ll leave us. Too often, we hear about people who believe that others don’t know who they are and wouldn’t like them if they did. (See How to Be Yourself for more.) It’s one thing to do that with others – to deny a part of ourselves – but it’s a different thing when we do it to ourselves – hiding or limiting parts of who we are to become acceptable to others and to ourselves.
In No Bad Parts, we learned about the Internal Family Systems model, which explains that we have exiles (parts of ourselves that we deny) and protectors (parts of ourselves that are over expressed to protect us from harm). In trauma, we find dissociation, which can cause the creation of the exiles and the protectors.
Degrees of Dissociation
In my reviews of The Body Keeps the Score and In an Unspoken Voice, I spoke of dissociation, but Healing Developmental Trauma identifies the gradations of dissociation. Specifically, they use the analogy of a switch. Some people dissociate with a dimmer switch, turning up their degree of numbing or muting their experience. Others have a breaker switch, where they shut everything off completely and often experience the situation as if they’re outside their body.
So, the trick when working with people who have had trauma is to look not just for the complete dissociation but also the self-numbing that may be maladaptive.
NARM proposes that “emotions are experienced and contained.” I’d call it a holding space. (See more in my review for Alone Together.) A holding space is an environment that is capable of holding the emotion. The goal is to create a space that is sufficiently safe, calming, and reassuring that the person is able to gradually experience the emotion without becoming overwhelmed. You can see how I recommend this for small groups in my post, Small Group Safety Rules – Before, During, and After.
The key – as with Peter Levine’s approach in Somatic Experiencing – is to allow people to move into the experience and emotion to the degree that they’re capable of doing it and feeling safe. (See In an Unspoken Voice for more.)
Unleash the Kraken
For some, the process of creating a holding space and offering a place for them to express their emotion is like asking them to unleash the kraken. They fear that they’ll never be able to put their emotions back in a box. They’ve been taught that emotions aren’t safe, and they’re not sure how to dance with experiencing emotions without being overwhelmed. However, that’s what the holding space is for – to make it safe enough to experience the emotions and to learn that they don’t have to be overwhelming.
If you’re ready to help others – or yourself – work through your trauma and move forward with it in the past, start the process by reading Healing Developmental Trauma.