Latest / The Trauma Therapist / Episode 729: Healing Developmental Trauma using NARM with Laurence Heller, PhD

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Episode 729: Healing Developmental Trauma using NARM with Laurence Heller, PhD · The Trauma Therapist

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Or welcome back to the Trauma Therapist Podcast. My name is Gaming Person.
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My mission is to help trauma therapist be their incredible cells, to be human,
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to be real, not just a clinician. I'm a big believer in
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who we are is more important than what we know, and this requires cultivating
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authenticity, genuineness, and vulnerability, and that requires intention. Can learn more
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about my courses and workshops by going to the Trauma Therapist project dot com.
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That's the Trauma Therapist Project dot com. Let's get started, all right,
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So five four, three, two and one, our folks, welcome back
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to the podcast. I am honored to have back doctor Lawrence Heller. Lawrence,
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welcome back to the podcast. Nice to be here. Thank you so.
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Lawrence Heller hold a doctorate in clinical psychology. He was in private practice
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for forty years. He developed the neuro Effective Relational Model or NORM. His
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book Healing Developmental Trauma has been published in fourteen languages and his model has taught
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throughout the world. He's a founder director of the NORM Training Institute and teaches
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regularly in the US, US and Europe. His new book, written with
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Brad Camer previous guests on this podcast, is titled The Practical Guide for Healing
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Developmental Trauma using the neuro Effective Relational Model to address adverse childhood experiences and resolve
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complex trauma. Doctor Heller, welcome back. Yeah, thank you, You're
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welcome. So before we get going here, share where the listeners, where
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you're from originally, and where you are currently. Well. I was born
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in Denver, Colorado, third generation on one side, so I have deep
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proofs there in Colorado. But I'm I've been living in last for the last
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twenty years in Los Angeles, which I enjoy too, And as you mentioned,
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for a big part of my the last twenty years, I've been traveling
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like four times a year back and forth to Europe. So I also feel
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very at home in Europe. So I'm kind of all over the place in
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some ways. But so we're gonna we're gonna talk about your book today,
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but before we do, I want to just if we can give our listeners
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kind of a thumbnail sketch of how did you get into this field in the
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first place. Well, I really it was curiosity. It was obviously,
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like I think a lot of therapists, it was curiosity about what made me
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take curiosity about what made other people take just really a deep desire to understand
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the depths of human experience, you know, realizing that there was much more
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than the kind of day to day uh you know living that you know,
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I was experiencing that I saw many other people experiencing, and so I as
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soon as I started doing some of my first experiential work in the field of
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psychotherapy, I was hooked. I mean, I knew that. My very
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first actually exposure was I saw this guy doing a demonstration in gestalt therapy.
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This is year, many many years ago, and I was immediately fascinated and
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by what specifically, Yeah, I was fascinated by he was like as they
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did at the time, he was working with this person's streams, and by
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just the depth of the experience. It that that depth drew me. It
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wasn't so much until late I mean, it wasn't until later really that I
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realized it was also looking for depth and myself. It was just more this
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kind of instinctive interest in in depth and you know, about myself, about
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other people, about human beings in general, and so on. One thing
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led to another and here I am all these years later. So right,
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but I mean, you developed your own model, right, Not everyone does
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that. How did that come about? Well, I think it came about
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from both the successes and the failures that I experienced for me personally and then
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for other people. And then later even as a you know, as I
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got seriously into be you know, becoming a clinician, I just I started
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to see that there was there were so many things that were useful and so
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many things that were exciting, particularly back in the seventies, you know,
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when there was all this new energy for for different ways of trying to work
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with human beings. It wasn't just the traditional behaviorism or the traditional kind of
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psychoanalytic work, and there wasn't much else out there out there. I actually
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ended up starting the Gestalt Institute of Denver back clear many years ago, and
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at that time, the only there was just what I was saying, There
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was the analytic institutes. There was you know, there was a little bit
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of ta. They actually opened up about their institute in Denver. But at
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the same time that that I co founded the Gestalt Institute. And then there
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was this traditional behaviorism, which skinner and not not what we're talking about today,
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but but the real old fashioned behaviorism that we had at the time,
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you know, at the time, and that still used in certain contexts for
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you know, but so that that's kind of the sequence. And what about
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trauma, your introduction to trauma, how did that come into play here?
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Well, I was working with it before we we used the word and we
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have to remember how much this word has shifted and how much how it really
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didn't exist in the way that we use it now even fifty years ago.
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So trauma, if you said trauma, particularly to a physician, they were
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always they were always thinking medical or physical trauma. And then we of course
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with Vietnam War, and we started to you know, begin to understand what
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was traditionally called a shell shock or there were different words, but they started
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calling it, you know, PTSD. That became a diagnosis. Again,
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over I'm conflating what had took place over many years. And so the word
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trauma at that point was specifically being used for what I differentiate now as shock
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trauma versus developmental trauma. Shock trauma being more single incident kinds of trauma or
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not related specifically to the family, relational trauma to developmental trauma. And so
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I did I was very involved in working with with PTSD for for a number
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of years. But I saw that the models for PTSD that were developing and
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that we're out there really didn't deal with the more emotional and developmental kind of
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trauma that I had already been working with, but we didn't use the name
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trauma at the time. So I started, I began, you know,
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and I had been doing that work even consistently from the very beginning of my
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you know, my career of addressing what we're now calling trauma. But then
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UH started to understand more of the role of the body and the nervous system
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and other kinds of other elements through some of my exposure to different shock trauma
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methods, and I just felt that there was a big gap between u shock
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trauma and working you know, the self regulation models that were developing and that
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I was a part of myself in the earlier years and what we needed to
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address in terms of human development and you know, what we now call complex
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PTSD or developmental trauma, and there were other tools that were needed. People
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were actually being missed. And then I also saw the you know, an
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experience because I tried many different things in a serious way, not just dabbling.
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You know, I experienced that other techniques like there was a lot and
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I consider myself psychoanalytically and psychodynamically informed, but there was a lot that was
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being missed in that process, particularly in the early years, the relationship of
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the body. In all of this, there was no there was very little
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talk about the body, except maybe in terms of conversion reactions or you know,
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the languaging that we used at the time, but not realizing what I
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talk about in arm as the functional unity between the psychological and the physiological and
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I and that seemed to me to be an important distinction. There were some
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elements of that in the body oriented psychotherapies that I was exposed to, like
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in the seventies, right, different kinds of Riiching traditions and bioenergetics and many
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other bodyworks were being developed. I was, you know, very much involved
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in the early years of rolfing, not as a role from myself, but
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as as somebody who had their body word done many times by and found that
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all of this together made a more effective approach to working with people than just
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focusing on you know, ideas or beliefs, or just focusing bottom up trying
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to regulate nervous systems that these were used full elements, but they didn't cover
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the whole spectrum of what we need to address with developmental trauma. And then
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of course in the nineties we had the ACES study that came out and that
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gave a language and a name for things that many of us as clinicians had
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already understood, but it created a different awareness in the in the public over
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time, it took a little while for it to gain traction. Strange thing
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just to mention, because I do spend so much time in Europe, is
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that the Europeans have not talked very much about ACES, and in many experienced
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clinicians are not even aware of it. It's different in different countries depending on
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where you are, but still it's such a common reference point for clinicians in
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the US and not so much yet in Europe, which I found intriguing.
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But that was all part of the development that you know, that was both
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personal in terms of my own personal awareness as well as my work that I
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was doing with other people, but it was also a general understanding in the
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field that was developing that there was something else that is needed. Then,
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you know, with Aline Lapierre back in well it's been about fourteen or fifteen
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years ago. Together I had started a book and worked with a professional writer,
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and you know, was trying to put together a book on developmental trauma
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and then never was able to quite get it together in terms of the way
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I wanted it to be. And then Alene helped me to really finish and
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round out that that book. And the interesting thing was that there was on
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that and that book that I talked about the importance of how trauma and then
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I was mean at that point, developmental trauma affects on anomic and emotional regulation,
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how it affects what we now call it talk about as self image and
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as we talk about and it affects a person's capacity for relationship. So years
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after that, when you know, when they when CPTSD became part of the
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international you know, became an official diagnosis internationally, those were the three points,
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um, the same three points that they used to make a distinction between
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developmental trauma and shock trauma. And so really, you know, and I
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said too that you know, I learned from a lot of mistakes in like
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in the in the seventies, there were a lot of cathartic the sematic psychotherapies
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were exciting and thrilling and emotional and dramatic and uh, not always helpful.
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Sometimes they were, but not always helpful. But I saw that regress of
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work was often very destructive to many people, and so I started seeing,
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yeah, and I didn't see the need for it, you know, like
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the deep breathing and hitting pillows and kicking and all of that didn't seem to
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help a lot of people in the way that it might have. So I
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started, you know, in as my my journey, just kind of picking
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and choosing what elements that I saw as the most helpful that we needed to
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pay attention to the body. My first my you know, my first exposure
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was to Gestalt, which was is was and is considered an existential psychotherapy.
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NORM itself is also existential, and that we work in the present moment.
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And then I saw this this really important element that is really a core piece
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of NORM, which is that, um, how to bridge that gap between
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what happened in the past to the symptoms that people experience in the present.
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Now. For some highly integrated people, just becoming aware of what happened in
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the past helps them change what's going on for them in the present. But
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that doesn't work for a lot of people. And so what I came to
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see is that it isn't so much about doing an archaeological expedition into the past.
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It's not so much what happened to us, but the various adaptations that
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we made in order to survive, and that develop into what I call a
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norm, the adaptive survival styles. It's these these adaptations that once saved our
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lives that now as adults, create the symptoms. And then I started looking
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even more deeply at this broader theme of psychotherapy, and like there was Anna
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Freud in her long list of defense mechanisms, which was very useful and part
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of the development of psychoanalytic understanding. But then I started to ask myself,
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what is the common denominator here between all of these so called defense mechanisms,
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And then I saw that really what we're talking about here is various aspects of
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disconnection. When life gets too painful, when emotions get overwhelming, when needs,
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basic psychobiological needs don't get met, then we use various kinds of strategies
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and mechanisms to disconnect. And I saw that connection and disconnection was a fundamental
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theme that I started to address more directly. And actually the original title of
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the very first book that I wrote was on shock trauma with Diane Poohheller,
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and then this second book with Alene Lapierre are on developmental trauma. Was seeing
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that the specifics of how the adaptations that we made, which one saved our
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lives now are as I mentioned a moment ago creating the symptoms. And what
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that then led me to see is that when we get goal oriented, when
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we're trying to create change for the client, were almost by definition going to
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miss them. And that's actually a profound paradigm shift when we really look into
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that. Can you give us an example there that's very interesting? Okay,
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Well, so, for example, many therapies, not just the traditional somatic
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psychotherapist, but some of the analytic psychodynamic therapies saw, for example, that
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the client had a lot of anger. They were caring, they were just
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dealing with a lot of anger that they weren't aware of that maybe was coming
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out and in the form of bodily symptoms or depression or anxiety, that it
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expressed itself in a variety of ways. And so they had this idea and
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many still do that. The idea then, is to get people into this
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anger and to feel it and to get it out. It's again that idea
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is a little less popular these days than it once was, but it's and
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I saw again that trying to get people, for example, into their anger
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was actually dangerous and disrespectful, because people disconnected from their anger, or their
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needs or what their bodies for a reason. And it's more important to explore
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the so called resistance, in other words, what's getting in the way of
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us being healthily connected to our anger and aggression and to our needs and to
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our bodies, And to explore the obstacles that we have, the learned obstacles
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that are now in the way of that kind of deeper connection that is the
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birthright for all of us. And so instead of trying to get somebody to
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be connected we ship, I shifted it to let's explore the various ways that
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a person you know has disconnected and feels that they need to continue disconnecting.
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And ultimately I came to the understanding that so much of this, so much
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of what is driving the fear of connection that we all want. Ultimately,
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in the variety of the variety of ways that we experience the connection to ourselves,
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connection and intimate relationship to some for some people, for something greater than
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themselves. Is that what's you know, what's driving all of the this is
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fear, is that if the ideas is that if we give up these so
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called defense mechanisms, these adaptive survival style mechanisms as I call them, that
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something worse will happen. And what really, what I came to understand is
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that there's what in ourm I talk about as the core dilemma, where the
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child will actually give up what's most authentic and most real, most alive in
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themselves in order to protect the attachment relationship with the parents. And that's an
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essential aspect of developmental trauma. And as a child, it made sense,
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of course to give that up. But we continue in these patterns, foreclosing
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aspects of ourselves and even ending up hating aspects of ourselves as part of that
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foreclosure, which is ultimately a way of trying to protect the attachment or lave
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relationship with the parents, even if the parents are long dead, I mean,
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the fantasy continues. And so I started putting all of these elements together,
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and step by step out of that came now I mean, it's it's
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incredible to hear you talk about this your process, because it's I mean by
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hearing you correctly in saying, because it seems to be like a subtle difference
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we're talking about. You're talking about the anger. There's this need for some
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people to get a client to express their anger. But you're saying, rather
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than that, find out what's inhibiting that expression in the first place. When
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when people are, for example, having symptoms of unintegrated anger, which can
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be of a whole variety of different things, Yes, then I'm saying it's
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more important to explore the fear of the anger. And then then when when
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the fear of the anger, which is always coming from a child consciousness place
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what I call in child consciousness, you know, unless people have really you
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know, acted out, if they have impulse control, and the other issues
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come into play. But for the most part, what I'm saying is that,
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yeah, as people explore the fear of the anger and the confusion that
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many people have between anger, the emotion and anger and anger the behavior or
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the behaviors of anger, then then what is needed, what is unresolved that
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the anger is trying to communicate, can come to the surface be communicated,
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but not through a cathartic method, not through biting and kicking and screaming and
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you know, all the kinds of things that we did in the seventies,
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but in an embodied, integrated way. At the same time, normans both
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top down and bottom up, so not only just to feel the emotions,
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but to understand what they have been trying to communicate to the environment, because
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emotions are basically communications were and that's the way infants and children, even before
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there's language, communicate needs and distress and other things to their parents. So
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the capacity to be able to feel and to integrate made such a huge difference
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in people's lives. But we're not trying to get them to feel that's our
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natural state. We're helping them explore the obstacles in the way to feeling more,
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to feeling their feelings, to feeling their bodies, and as they do
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that, they see I don't need to do that anymore. I can allow
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myself to feel like I don't have to keep running from myself. Because that's
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really a big part part of what the strategy that we've all used in terms
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of trying to deal or not deal with the various elements of whatever kind of
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developmental trauma we experienced, is that we then end up running away from ourselves,
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running away from our bodies, running away from our emotions, running away
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from intimate relationships. But again, we don't know what it is really why
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we're so afraid, and so NARM is and part of the exploration in ARM
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is exploring. And that's the way that the very first pillar in ARM we
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call it the contracting pillar, which can be confusing because it's not like we're
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actually signing a contract, nor are we guaranteeing results because the psychotherapists we can't
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guarantee results. But what we do in ARM is it's very important for the
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client to communicate what it is, what their intention, what it is that
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they're most wanting. And the more they're able to communicate what it is they're
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most wanting on an emotional level rather than on a behavioral level, the more
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effective that initial contract is, and then the agreement between the therapist and the
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client is I'll be glad. Let's say they want to have more capacity for
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intimate relationship. We can't promise that they're going to end up in an intimate
24:23
relationship as therapists. But what we can promise is that I'll explore what's getting
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in the way of you having the capacity that you're wanting for intimate relationships or
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whatever it is. I just use that as an example. So your second
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book, The Practical Guide're Healing Developmental Trauma? How did that come about?
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Why do you write that? Who's it for? Well? It was written
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with Brad the Camera, who's my partner at the NORM Training Institute and the
24:56
director of training there, and we had been creating literally hundreds of webinars over
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We've been together the institute now for about six years, and we saw that
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these webinars on a variety of different topics could we're already the framework of a
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very what we thought could be a very useful book where we could drill down
25:23
more into the clinical techniques and the clinical understanding in NORM in a way that
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I didn't have the time or the opportunity to do in the same depth.
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And the first book, the first book presents the developmental model, some overview
25:42
and some and some detail about the various survival styles, and then an end
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at the end of each chapter on each one of the survival styles, some
25:55
clinical orientation, about how we helped these individuals or individuals or dealing with these
26:00
dynamics move towards resolution. So the book with Brad is really the next step
26:07
where we the whole focus was on how do we help all of these dynamics
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and help people move to resolution, whatever that might mean in their their individual
26:19
life, Helping them, you know, finish and what is unfinished from their
26:27
history and become aware of the adaptations that they made that they don't you know,
26:33
to difficult situations in early life that they don't need to make as adults,
26:38
that they have to help clients see that they have many more options than
26:42
they realized when they're viewing the world through a child's eyes, which we all
26:48
do to a certain degree. And so you know, in terms of that
26:52
whole piece of norm not being regressive, it's my experience that we're all regressed
26:59
in off and that you know that we're all stuck in different degrees in different
27:04
ways, in various kinds of developmental dynamics. So there is actually we deal
27:11
with what I talk about as child consciousness, but I don't talk about the
27:15
inner child because I don't want to make that a thing there, you know,
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that's just a metaphor. It's a construct, a way of understanding,
27:26
and as those you know as clinicians get further into normally see that in general,
27:33
I tend to avoid nouns in ARMS, so I don't talk about I
27:37
mean, of course people will come in, they'll be complaining about burnout,
27:41
but I will then at some point, when the timing is right, I'll
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say, well, let's I'll be glad to explore with you how you burned
27:49
yourself out on the on your last job, let's say. And so that's
27:56
beginning to address then the language of agency, which is also a very important
28:03
piece in ARM in terms of how we've we've all internalized the environmental failure that
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we experienced as children and then carry it forward and repeat it in a variety
28:18
of different ways and a variety of different strategies as adults. But that was
28:22
a long winded answer to your question about who's the score. So we've written
28:29
it obviously more for clinicians, but just like with the with the first book,
28:34
which did very well and you know, far beyond the population of clinicians,
28:41
where this book is also for people who want more specific information about their
28:45
own healing and who are you know, probably have had some experience in different
28:52
psychotherapies, finding some things that help, some things that different didn't work as
28:56
well. And so it's really for various kinds of clinicians and other helping professionals
29:02
who want to integrate a norminformed trauma informed understanding to their work, but also
29:08
to the general public who are just interested in personal growth and personal development,
29:12
and we're leaving some of the suffering that they've experienced. So specifically we're talking
29:21
about complex trauma here right in the book, can you give us, as
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best you can kind of an example of what a case might look like how
29:34
you deal with it in the book kind of a snippet. Well, generally
29:38
people come into the therapeutic process because they're symptomatic. They're feeling, you know,
29:44
it could be very specific symptoms, or it could be generalized symptoms.
29:48
It could be anxiety or depression, it could be the breakup of a really
29:52
recent relationship, and there they're suffering, you know, in the aftermath of
29:56
that. So we start with with addressing that what is it that's going on
30:03
that's bringing here and what would you most want for yourself? That's the first
30:07
pillar, Like, what is it that they're oh, you know, and
30:10
ideally getting something more than just symptom relief. So we'll start with where they
30:17
are struggling in their lives right now, and then we begin to explore,
30:23
you know, what the details of that struggle are. And the interesting thing,
30:27
and what I think distinguishes NORM from other therapies is that by staying so
30:36
precisely in that phenomenological here and now kind of addressing their direct experience in the
30:42
moment, that whatever has been unfinished from the past, instead of having to
30:48
go look for it, it spontaneously emerges. Seriously, I mean, you
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have to see this and I've seen at hundreds of times now to see how
30:57
spontaneous that is. It. Let's put it this way. We're constantly working
31:04
with this connection disconnection dynamic in the here and now with clients, and we're
31:10
just reflecting to them both when they're more connected and when they disconnect. And
31:15
so there's a growing mindfulness or somatic mindfulness or increasing awareness of this connection disconnection
31:22
process. As soon as people starts to become more aware of that and start
31:29
to feel more connected than what they've been disconnecting from tends to surface and that
31:34
tends to be often certain childhood memories or childhood experiences. The other thing that
31:41
I think is important to remember about this general field of complex trauma is that
31:45
we're not generally talking about specific incidents, although there may be some that are
31:51
very important to address, but in general, what characterizes complex trauma is the
31:56
chronicity of the process. That it's often, you know, when we're talking
32:01
about neglect, abuse, chronic miss tuna, we're talking about dynamics that take
32:06
place over years and years and years, and so there's this chronicity piece.
32:09
It's not like being hit by a car, which is a single incident chakram
32:15
as terrible as it is, it's different. And there's another piece, which
32:20
is that it tends to be relational. And then R in arm stands for
32:23
relational. It tends to be relational in the fact that often the perpetrators were
32:30
members of the family immediate or extended, often the parents or step parents,
32:37
so, you know, and this relational piece brings up the whole conflict that
32:44
comes up for children that to be angry at the person upon whom they're one
32:49
hundred percent dependent and with whom they have a love relationship. It's it's hard
32:57
to feel the protests, the anger and even the age that comes up when
33:00
you've been mistreated or abused or neglected in some significant ways, and that dynamic
33:08
doesn't automatically come up in shock trauma. So it's an important one of the
33:13
important distinctions that it's important for all of us has clinicians to understand well as
33:21
we kind of wind down here, So I'm assuming the best way from able
33:29
to get in touch with you as your website. There's the Yeah, there's
33:32
an ARM Training Institute website which is the major website. I have my own
33:37
website which is more oriented towards the European teaching, but people can for the
33:44
general US and all of the online stuff that's on the ARM Training Institute website.
33:51
Yes, okay. My guess is people are going to be listening to
33:54
this and just the way you're able to articulate how NORM addresses a relational trauma
34:06
is fascinating. I guess as people are going to want to learn how they
34:10
can learn about NORM UM. So looking at the website, now you have
34:15
trainings, you have seminars. These seminars listed all over Europe. My gosh,
34:22
you know we do UM. So do you have online things people can
34:29
access. Yeah, we have a Yeah, we Actually it's only in the
34:34
last number of months that we've gotten more back into in person trainings. We
34:37
started off like nineties percent in person and then of course COVID came and like
34:45
so many other people, we had to adapt and so then at this point
34:49
we've still got a significant presence online. We've got this subscription program where people
34:52
can get webinars and see demos, you know, and they have regular access
34:58
and new new material is coming on every month. So there's there's that,
35:02
and um, that's the call that's called the Inner Circle training. Maybe I
35:07
may may have I may have mistated. But then we've also got an online
35:12
training program for people who are not the psychother licensed psychotherapists, so we call
35:16
that our OBT or Online Basics training. That's open to all helping professionals who
35:22
want just more norm based trauma informed understanding for their own work, whatever that
35:30
might be. So there's all different well, helping profession professionals are welcome in
35:37
that. And then we've got our what we call our Level two, which
35:42
is for licensed psychotherapists, and there we have they get significant exposure to the
35:49
basic techniques and overall understanding in our Then we've got a third year, which
35:55
has to do with working with what traditional described as personality disorders. And then
36:00
I teach this kind of ongoing webinar this is online called the Postmasters where for
36:07
those people, and we get a lot of people who want to stay with
36:10
us through the process, who can really take the want to take the time
36:15
to go into a great deal of depth about the more difficult and areas of
36:22
human experience. And I call that that fourth year of training the primitive edge
36:28
of experience, because I'm really helping people learn how to work with very complex
36:32
PTSD, work with personality disorders and other kinds of major sources of trauma.
36:42
We'll have everything linked appear at the show notes page at the Trauma Dippers podcast
36:45
dot com. Doctor Heller's book again is called The Practical Guide for Healing Developmental
36:51
Trauma using the New Effective Relational Model to address adverse childhood experiences and resolve complex
36:58
trauma and Heller, I'm assuming that can be purchased anywhere. Yeah, we'll
37:04
have that length up here again. Doctor Heller. It's been a while since
37:07
we've talked initially, but man, you're you're amazing. I mean you're so
37:12
you can feel your experience and the depth of your experience and your ability to
37:17
articulate the work you do is really super inspiring. So anything you want to
37:22
come back here, you're welcome. Okay, I'd love to take care.
37:27
Okay. Good