NARM Study-Practice Group

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1 NARM Study-Practice Group Highlighting the R in NARM: Working with the Relational Process Brad Kammer, MFT, LPCC & Laurence Heller, PhD

2 NARM Relational Process We recognize that the therapeutic process is a multi-dimensional process, the complexity of which cannot easily be reduced Ø Often in the therapeutic process (even whole therapeutic approaches), therapists go immediately into fix-it mode: trying to figure out, solve and fix their client s problems Our engagement is based in curiosity & mindfulness Ø While we hold compassion and consideration for our clients distress, we do not seek quick solutions or fixes We identify the client s symptoms and presenting problems as messages from split-off aspects of the self that can guide us in the therapeutic exploration We hold trust in our client s capacity to learn new ways of relating to themselves through this process that will support greater connection, health and fulfillment

3 NARM Relational Process What is coming to the foreground that is most getting in the client s way? Ø We work with what is emerging in the present moment Even-handedness/neutrality allows for greater acuity Ø Recognizing our therapeutic role in the relational process, and the ways we support, enhance and inhibit the process How do we support our clients capacity for connection/attachment AND separation/individuation How do we use our therapeutic engagement to support agency/autonomy AND interactive regulation Learning NARM relational skills, which can and do exist simultaneously (slides that follow)

4 NARM Relational Process & Skills Attunement Curiosity & Presence Acceptance Self-Inquiry Reflection & Exploration Mindful Interventions CAUTION: DO NOT ATTEMPT TO FIX Integration

5 NARM Relational Skills Skill CURIOSITY & PRESENCE ATTUNEMENT ACCEPTANCE SELF-INQUIRY REFLECTION & EXPLORATION MINDFUL INTERVENTIONS INTEGRATION Description Cultivating the capacity to be present with interest and inquiry Paying attention to what is emerging - cognitively, emotionally, somatically, relationally - within the client and within ourselves as therapists Attending to client without judgment, and with openheartedness and the willingness to learn Attending to our own inner process with openness, discernment, containment and self-regulation Gently holding a working hypothesis beginning the process of identifying how clients organize their life experience internally (i.e., identifications/survival styles) Using specific NARM skills & other relevant interventions to support the capacity for increasing depth of experience Providing the space, time and support for settling, reorganization & transformation on all levels of experience

6 NARM Relational Skills: CURIOSITY & PRESENCE Accepting that we truly don t know what our client s experience is or how to solve their problems but we can set the intention to be there to learn, and to support their process of connection, greater health & aliveness Ø Phenomenological approach Ø Focusing on the here & now Ø Adult to Adult relationship (supporting adult consciousness ) Engaged in inquiry process together Recognizing that the roles and power differential can perpetuate old disempowered dynamics ( child consciousness ) Understanding that therapeutic change rests with the client Trust in the client s capacity

7 NARM Relational Skills: Dual awareness: using our receptive presence to pay attention to our clients (and our own) inner experience & observable behaviors, the implicit & explicit ways clients express their inner reality Ø Our clients are more than their history: Recognizing that our clients stories are only part of the picture, we track all levels of experience: cognitive, emotional, somatic, relational, spiritual Ø Using relational-psychobiological attunement skills: Client s self-report Observational tracking ATTUNEMENT Our own resonance & countertransference Ø This is an ongoing, moment by moment process of staying present and attending to the complex therapeutic dynamics

8 NARM Relational Skills: Recognizing and respecting the complexity of who our clients are and not reducing this complexity Ø Some of the key ingredients in this acceptance process: Open-heartedness ACCEPTANCE Non-judgmental: understanding our clients are doing the best they can with what they know Welcoming all parts of oneself, particularly the parts they have rejected Being open to not knowing, but to learning & sharing Change comes from accepting the various parts of yourself as they are. (Dr. Laurence Heller)

9 NARM Relational Skills: SELF-INQUIRY Paying attention to our own internal experience & using our capacity for self-regulation within the therapeutic relationship what are we becoming aware of inside us as we are engaging with this client? Ø Willingness to learn & be affected in the therapeutic relationship Ø Identifying Countertransference Little C: Resonance, what we are picking up through attunement & tracking from our clients internal experience Big C: What is being evoked in us from our own unresolved patterns Ø Self-Regulation: Recognizing and accepting our own feelings & responses, and sharing them when therapeutically appropriate Noticing specifically our reactions of helplessness and any impulses to fix or solve

10 Working Hypothesis is based on the assumption that everyone is being influenced by their Core Dilemma which is the basic conflict between the life force and the adaptations (identifications & survival styles) we had to make to survive and that this internal conflict shapes our development and life experience Ø Reflection: We are curious about the core dilemma that is influencing them in this moment and how it is being expressed in their current lives NARM Relational Skills: REFLECTION & EXPLORATION Gathering more information Supporting increasing depth of curiosity, understanding and connection to one s inner world Supporting increasing capacity to hold complexity

11 Ø Exploration: The working hypothesis gives us a direction for the questions we ask Subject to continuous revision as more information emerges Using the NARM skills to help guide this process: NARM Relational Skills: REFLECTION & EXPLORATION Clarifying the Therapeutic Contract Asking Exploratory Questions (Inquiry) Clarification Drilling Down Tracking Mirroring Somatic Mindfulness

12 NARM Relational Skills: MINDFUL INTERVENTIONS Using NARM skills and bottom-up techniques to provide clients a solid platform with which to deal with the complexity of their internal experience Ø Framing the therapeutic process through 4 NARM Pillars Grounding and resourcing help clients tolerate increasing complexity, charge, affect, conflict Psychoeducation Ø Evaluating why you are using a specific tool/technique & how this fits with your working hypothesis of the core dilemma Be willing to re-evaluate Not pushing for outcome, but explore what gets in the way Ø Sharing our own personal experience when therapeutically appropriate

13 NARM Relational Skills: INTEGRATION Creating the conditions that support the possibility for re-organization & transformation - the emergence of the organismic impulse moving toward connection, health & aliveness Ø Before moving on to something else, providing the permission and support for our clients to be with their present experience tracking all levels of experience: cognitive, emotional, somatic, relational, spiritual Embodiment: Anchoring the integration in the body Supporting the sensations of re-organization, including not just positive feelings like expansion, but also the perceived negative feelings like disorientation, confusion, dizziness, etc., that can come with expansion Not needing to neatly tie up all loose ends, but trusting the organismic capacity for integration and self-regulation

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