NARM Study-Practice Group

Highlighting the “R” in NARM:Working with the Relational Process

NARM Study/Practice Group Brad Kammer, MFT, LPCC & Laurence Heller, PhD

We recognize that the therapeutic process is a multi-dimensional process, the complexity of which cannot easily be reducedØ 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

NARM Relational Process

NARM Study/Practice Group Kammer & Heller

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)

NARM Relational Process

NARM Study/Practice Group Kammer & Heller

NARM Relational Process & Skills

Cur

iosi

ty&

Pre

senc

e

Attunement

Acceptance

Self-Inquiry

Reflection & Exploration

Mindful Interventions

IntegrationNARM Study/Practice Group

CAUTION: DO NOT ATTEMPT

TO FIX

Kammer & Heller

NARM Relational SkillsSkill Description

CURIOSITY & PRESENCE

Cultivating the capacity to be present with interest andinquiry

ATTUNEMENT Paying attention to what is emerging - cognitively, emotionally, somatically, relationally - within the client and within ourselves as therapists

ACCEPTANCE Attending to client without judgment, and with open-heartedness and the willingness to learn

SELF-INQUIRY Attending to our own inner process with openness, discernment, containment and self-regulation

REFLECTION & EXPLORATION

Gently holding a “working hypothesis” – beginning the process of identifying how clients’ organize their life experience internally (i.e., identifications/survival styles)

MINDFUL INTERVENTIONS

Using specific NARM skills & other relevant interventionsto support the capacity for increasing depth of experience

INTEGRATION Providing the space, time and support for settling, re-organization & transformation on all levels of experience

Kammer & Heller NARM Study/Practice Group

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 & alivenessØ Phenomenological approachØ Focusing on the here & nowØ 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

NARM Relational Skills: CURIOSITY & PRESENCE

NARM Study/Practice Group Kammer & Heller

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 realityØ 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 § Our own resonance & countertransference

Ø This is an ongoing, moment by moment process of staying present and attending to the complex therapeutic dynamics

NARM Relational Skills: ATTUNEMENT

NARM Study/Practice Group Kammer & Heller

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§ 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

NARM Relational Skills: ACCEPTANCE

NARM Study/Practice Group Kammer & Heller

“Change comes from accepting the various parts of yourself as they are.”(Dr. Laurence Heller)

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

NARM Relational Skills: SELF-INQUIRY

NARM Study/Practice Group Kammer & Heller

“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 experienceØ 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§ Gathering more information§ Supporting increasing depth of curiosity, understanding

and connection to one’s inner world§ Supporting increasing capacity to hold complexity

NARM Relational Skills: REFLECTION & EXPLORATION

NARM Study/Practice Group Kammer & Heller

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:

§ Clarifying the Therapeutic Contract§ Asking Exploratory Questions (Inquiry)§ Clarification§ Drilling Down§ Tracking§ Mirroring§ Somatic Mindfulness

NARM Relational Skills: REFLECTION & EXPLORATION

NARM Study/Practice Group Kammer & Heller

Using NARM skills and bottom-up techniques to provide clients a solid platform with which to deal with the complexity of their internal experienceØ Framing the therapeutic process through “4 NARM Pillars”

§ Grounding and resourcing help clients tolerate increasing complexity, charge, affect, conflict

§ PsychoeducationØ 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

NARM Relational Skills: MINDFUL INTERVENTIONS

NARM Study/Practice Group Kammer & Heller

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

NARM Relational Skills: INTEGRATION

NARM Study/Practice Group Kammer & Heller