As a senior faculty member who teaches throughout Europe and the U.S., I have noticed a few universal themes with which SE® students and practitioners have difficulty. Today's blog addresses how to adapt Somatic Experiencing® to working with developmental and relational/attachment trauma as opposed to shock trauma. But first, some background.
I have been working with what we are now calling developmental trauma for over 30 years. In the '70s, my interest in humanistic psychology led me to co-found the Gestalt Institute of Denver. In those early years of teaching, much somatic psychological work focused on inducing regressive cathartic discharge. In short, this meant clients would repeatedly relive early painful experiences. We thought it was useful to feel our “pain.”
Following the trend of those times, I was working from a pathology perspective with what we called character structures. It soon became clear to me that regressive cathartic work, because it primarily focused on a client's resistances and weaknesses, was often not effective— in some cases even hurtful. As a result, I gave up working with regression and catharsis as therapeutic tools. I began a process of de-pathologizing my approach to focus on the strengths and resources of each patient.
I initially had met Dr. Peter Levine in the mid '70s. We reconnected in the '80s and I discovered that his work with shock trauma, which he called Somatic Experiencing, was moving in a similar direction to my own work with developmental trauma. I quickly resonated with the non-regressive, non-cathartic, and gentle approach of SE. Adding the more subtle and effective nervous system interventions of SE was just what was needed to round out my own therapeutic approach.
Differences between Shock Trauma and Developmental Trauma
As opposed to many shock traumas, there usually is no single traumatizing event in cases of developmental/relational trauma. When children experience ongoing misattunement (a lack of connection between caregiver and child), neglect, or abuse, they are trapped in an impossible situation. Caregivers are supposed to protect and keep children safe; children cannot run from, or fight, the parents upon whom they are completely dependent.
To manage this bind, children develop survival strategies which I call adaptive survival styles (formerly known as character structures). When adaptive survival styles persist beyond their usefulness and are still active in adult life, they create significant psychobiological challenges that cannot be handled on a nervous system level alone. This is because they have permeated a person's very sense of identity— typically in the form of chronic shame and low self esteem. While the physiological responses in developmental trauma are in many ways similar to those of shock trauma, SE therapists also need to understand how to address the complicating psychodynamic and relational elements of these survival strategies.
A Developmental Distress Cycle
Developmental trauma creates a distress cycle that is different from what is called the trauma vortex in SE. To understand how this distress cycle is set in motion, it is important first to take into account how continuous loops of information travel both bottom-up from the body to the brain and top-down from the brain to the body. The bottom-up therapeutic approach of classic SE focuses on the body, the felt-sense, and the instinctive responses as they are mediated through the brain stem and move upward to affect the limbic and cortical areas of the brain.
Top-down psychodynamic and cognitive approaches address our thoughts, judgments, and identifications without explicitly addressing their impact on the body and nervous system. Whereas with shock trauma we can focus primarily on bottom-up dynamics, to work effectively with developmental trauma we need to work both top-down and bottom-up.
In my new book, co-authored with Dr. Aline LaPierre, Healing Developmental Trauma: How Early Trauma Affects Self-Regulation, Self-Image, and the Capacity for Relationship, we introduce the NeuroAffective Relational Model™ (NARM) . This approach uses SE to re-regulate the nervous system while drawing on psychodynamic, cognitive, and spiritual traditions to resolve developmentally driven distortions of identity such as low self-esteem, shame, and chronic self-judgment. For excerpts from the forthcoming book, please click here. Here are some kind words about the book from the founder of SE:
“Seasoned clinicians Larry Heller and Aline LaPierre weave a rich and coherent synthesis of childhood development in the pioneering tradition of Wilhelm Reich, Erik Erikson, and Alexander Lowen. They provide easy-to-understand tools for all of us who are seeking a better understanding of our fundamental conflicts. Healing Developmental Trauma is a vital and accessible map supporting emotional maturity and psycho-spiritual growth.” – Peter A. Levine, PhD
New NARM Post-Advanced Trainings: Working with Developmental Trauma
The first 2-year NARM post-advanced clinical training in working with developmental trauma began in Germany earlier this year. It demonstrated that SE students and practitioners have a great interest in building their SE skillset by learning how to work with developmental/relational trauma. Additional trainings are soon starting in Switzerland, Denmark, the Netherlands, and Los Angeles. For information and enrollment please visit The Insight Center. In all trainings, participants will learn:
- The diverging skills needed to work with developmental versus shock trauma
- How to help clients attune to all levels of their experience: cognitive, emotional, and physiological in a mindful, progressive process of disidentification from their survival styles
- When to work bottom-up, when to work top-down, and how to work with both simultaneously to meet the special challenges of developmental trauma
- How to integrate nervous system regulation skills into a developmental trauma framework
- When shock trauma interventions are contraindicated in working with developmental trauma
- How to address the complex interplay between identity distortions and nervous system dysregulation
Our new book and the NARM trainings are oriented toward building bridges between different disciplines. In attachment and psychodynamic processes, the role of the body has traditionally been secondary or ignored; but SE has effectively brought the body into the therapeutic narrative. Mindfulness and spiritual traditions, although they bring a rich knowledge of being, stillness, and flow, have not understood the role of nervous system regulation. In the book and trainings, we weave threads from these many disciplines to create an integrated model.
Laurence Heller, PhD, is the originator of the NeuroAffective Relational Model™ (NARM), an integrated system to work with developmental, attachment, and shock trauma. He was the co-founder of the Gestalt Institute of Denver, has been on the faculty of several universities, and is a senior faculty member for the Somatic Experiencing Training Institute. Dr. Heller is the co-author with Dr. Aline LaPierre of Healing Developmental Trauma, as well as the co-author with Dr. Diane Poole Heller of Crash Course, a book about healing auto accident trauma published in four languages. He currently teaches NARM and SE in the United States and throughout Europe.