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Healing Developmental Trauma: How Early Trauma Affects Self-Regulation, Self-Image, and the Capacity for Relationship Paperback – September 25, 2012
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Although it may seem that people suffer from an endless number of emotional problems and challenges, Laurence Heller and Aline LaPierre maintain that most of these can be traced to five biologically based organizing principles: the need for connection, attunement, trust, autonomy, and love-sexuality. They describe how early trauma impairs the capacity for connection to self and others and how the ensuing diminished aliveness is the hidden dimension that underlies most psychological and many physiological problems.
Heller and LaPierre introduce the NeuroAffective Relational Model® (NARM), a method that integrates bottom-up and top-down approaches to regulate the nervous system and resolve distortions of identity such as low self-esteem, shame, and chronic self-judgment that are the outcome of developmental and relational trauma. While not ignoring a person’s past, NARM emphasizes working in the present moment to focus on clients’ strengths, resources, and resiliency in order to integrate the experience of connection that sustains our physiology, psychology, and capacity for relationship.
- Print length320 pages
- LanguageEnglish
- PublisherNorth Atlantic Books
- Publication dateSeptember 25, 2012
- Dimensions6 x 0.7 x 9 inches
- ISBN-101583944893
- ISBN-13978-1583944899
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Editorial Reviews
Review
—Peter A Levine, PhD, author of In an Unspoken Voice: How the Body Releases Trauma and Restores Goodness and Waking the Tiger: Healing Trauma
“Laurence Heller, PhD and Aline LaPierre, PsyD's Healing Developmental Trauma provides a method that blends bottom-up and top-down approaches to regulating the nervous system, and provides the NeuroAffective Relational Model which focuses on maximizing client strengths and resiliency to integrate physical and emotional connections in the body.”
—Midwest Book Review
About the Author
Aline LaPierre, PSYD, is founder and director of the NeuroAffective Touch® Institute and developer of NeuroAffective Touch® specializing in teaching the integration of therapeutic touch and psychotherapy. Dr. LaPierre is a graduate of Pacifica Graduate Institute, Santa Barbara, and The New Center for Psychoanalysis in Los Angeles, and is trained in many body-centered modalities, including Somatic Experiencing®, Continuum, Body-Mind Centering, acupressure, as well as craniosacral, deep tissue, and neuromuscular bodywork. Past faculty in the Somatic Doctoral Program at Santa Barbara Graduate Institute (2000–2010), she is deputy editor of the International Body Psychotherapy Journal and vice president of the United States Association for Body Psychotherapy (USABP). A clinician, author, artist, and teacher, she maintains a private practice in West Los Angeles. For further information on NeuroAffective Touch®, please visit www.NeuroAffectiveTouch.com.
Product details
- Publisher : North Atlantic Books; 1st edition (September 25, 2012)
- Language : English
- Paperback : 320 pages
- ISBN-10 : 1583944893
- ISBN-13 : 978-1583944899
- Item Weight : 1.09 pounds
- Dimensions : 6 x 0.7 x 9 inches
- Best Sellers Rank: #26,568 in Books (See Top 100 in Books)
- #43 in Popular Neuropsychology
- #75 in Post-traumatic Stress Disorder
- #129 in Popular Psychology Pathologies
- Customer Reviews:
About the author

Dr. Heller offers ongoing two year clinical trainings as well as occasional workshops on specific topics such as Shame and Guilt in the USA and through out Europe. For more information: http://www.DrLaurenceHeller.com
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The title suggests that the book is about developmental trauma. Yet it's not limited to people dealing with severe trauma. It provides insight in how most of us work and how our childhood affects our adult relationships.
The book identifies five different attachment styles: trust attachment, love/sexuality attachment, independence, etc. It suggests that during human development each attachment develops at a different point of growing up. For example at six months old, our connection with a parent is that they are holding us in their arms and looking at us. A couple years later, we may be developing trust with our parents. Can we trust them that our needs will be met.
If there are problems with one of the attachment styles, children will usually progress through a healthy range of calling attention to their needs - starting with "hey mommy, I'm hungry" to using healthy aggression. The concept of "health aggression" caught me eyes. The book is full of terms where simply hearing the term was a huge insight in and off itself. In this case, the idea that aggression can be healthy was intriguing. If that doesn't work, the child's sympathetic nervous system gets activated (fight/flight). If that doesn't work, the parasympathetic nervous system gets activated (e.g. shutting down).
Simply these ideas of the different nervous systems are a fascinating concept. The sympathetic and parasympathetic nervous system can be triggered at the same time (stepping on the gas and break at the same time). That's for example, when we panic and try to suppress the panic.
The books proposed remedy is to pay attention to what we are feeling in our bodies because that's how we find out about our needs. In the ideal world that the book paints, we can freely express our needs in our relationships and (as adults) also deal with when people don't necessarily tend to our needs. (E.g., because I'm a hungry adult doesn't mean the other person has to feed me. They could be full and not interested in going to a restaurant with me. Yet, that I am aware of my hunger and can express it appropriately - without fear, panic or not at all -, that's the goal.)
Most people I know are functioning adults, yet I often find that what the book describes affects me. Often when I'm with people, I'm very focused on making sure that they feel entertained and comfortable. (That might be a good host's job.) Yet the book's idea is that I should scan my body to realize what's going on with me and express my needs, e.g. "I feel a bit bored, let's check out the other pool." The book shifted my thought of what a good relationship looks like: Both people should feel comfortable to express their needs and the other person responds to that. (And needs don't have to be monumental things like needing help to move, but a need for comfort at the end of a tiring hike, a need for play in a conversation that turned dry, etc.)
The book opens up many interesting topics. For example, it suggests that based on unmet childhood needs, people may develop pride. E.g., if they were ignored as a child, they may pride themselves as easy going. The book suggests that for each pride, there is usually an opposite shame. That example person may have shame around being too needy. That concept alone is very interesting. Now when I hear people making prideful statements, I wonder if there is an opposite shame in place as well. (The pride essentially is trying to make us feel good about a place where we are hurting.)
I've written many quotes from the book into my notebook. It was a real page turner because each page offered so many intriguing insights to how life works.
Here are a few examples. They say those w/ developmental trauma don't really benefit from "top down" cognitive approaches because those who have experienced early developmental trauma experienced trauma when "their prefrontal cortex was not yet fully developed" (pg,.25) To that I would say, "Clients with developmental trauma aren't brain dead!!" Many clients I've seen w/ developmental trauma have greatly benefited from insight oriented therapy and cognitive therapy where they try to make sense of their thinking and challenge their unhelpful thoughts.
They also write, "It is our experience that, for many clients, catharsis is not helpful and can even impair the capacity to self-regulate. The more traumatized and disorganized a person's nervous system, the more likely catharsis can be re-traumatizing." (p.25) In my many years of clinical practice, I've never seen a client actually get "traumatized" by a new cathartic insight. There may be some uncomfortable feelings that come w/ new insights but overall my clients tend to delight in these new epiphanies where things finally make sense and the puzzle pieces are getting put together. Thus, cathartic experiences tend to be much more organizing, than disorganizing. So, once again these 2 psychologists make trauma patients sound much more fragile than they actually are. Side note: Feeling some distress in therapy is actually a good thing it's a sign you're growing and working hard. One of the most effective ways to build greater affect tolerance and affect regulation is to experience some distress (dysregulation) and survive it and come out the other side. Hence the saying, "You gotta feel it to heal it."
And then when it comes to discussing Somatic Experiencing they make the truth claim that "traditionally SE does not focus on attachment, emotional, or relational issues as part of its therapeutic scope." (p.24) Seriously?! Check out Pat Ogden's trauma work, she's totally emotion and attachment focused, she teaches how particular body postures can be linked to past attachment figures.
And then when it comes to their perspective on psychodynamic therapy...they say psychodynamic therapies "ignore the body and the present moment." (p.24) No they don't! From the very beginning Freud was interested in the body and the present moment (what was transpiring between the patient and therapist). Winnicott also said you can't separate mind from body we're "psyche soma units." It's a constant feedback loop: our body and physical sensations can impact our thoughts and feelings and our thoughts and feelings can impact our bodies. And then, over and over again, these writers warn against focusing too much on a patient's past because you run the risk of "reinforcing that dysfunction" and "making an individual's past more important than present experience" (pg.2) Psychiatrist Dan Siegel who writes and speaks a lot about developmental trauma says the exact opposite. "History is not destiny, the greatest predictor of having a secure attachment with your child is based on how well you have made sense of your own childhood experiences." By understanding our past we don't have to keep repeating it. Understanding and making peace with our past frees us to become the people we want to be in the present.
What was so frustrating about this book is that the writers DO NOT cite ONE academic reference to support the NARM model and their many truth claims. They do provide a recommended reading list in the back like Dan Siegel's book "Parenting From the Inside Out." but it doesn't sound like these psychologists have done their research.
If they could write another book that has more academic references and doesn't bash the other theories and is truly integrative and "a unified systemic model" that they claim NARM is but keep contradicting themselves, I'd be very interested to read that book. But so far I'm not impressed. I’m tired of reading dualistic psychologies which pressure you to pick a side (e.g., valuing the client's present over their past or their past over their present).
I whole heartedly believe therapists who treat traumatized patients need to resist these urges to split and become better containers who can effectively hold BOTH so that our clients’ experiences can become more integrated, and maybe then our clients will begin to feel more whole inside and more fully alive, which is the stated goal of the two authors who write this book. As Dan Siegel says, healing trauma is all about INTEGRATION: of one's thoughts, feelings, and their body. We're bodies, not just minds on sticks. Trauma impacts the whole person mind AND body. So we need whole person approaches to effectively treat trauma. And every trauma patient is unique so there is not "one size fits all." Different theories work for different patients so we need to value ALL the theories that help.
Top reviews from other countries

Stupendously readable, a book hard to put down - successfully merges the worlds of psychotherapy, neuroscience, NLP (my insight) and somatic awareness into a truly innovative 21st century healing science which describes early developmental trauma to a great extent; a subject closely affiliated to Complex-PTSD: “a psychological disorder through prolonged, repeated experience of interpersonal trauma in a context of little or no chance of escape (entrapment) resulting in a pervasive disorganised-type attachment insecurity and distortion of one’s core identity.”
C-PTSD is currently not included in the latest Diagnostic and Statistical Manual of Mental Disorders and for a number of years experts in the field of childhood trauma have suggested it may not be a useful category for diagnosis and treatment of children. Instead it is proposed Developmental Trauma Disorder (DTD: van der Kolk) becomes a diagnosis for “early life developmentally adverse interpersonal trauma as a result of a significant disruption or betrayal in the relationships with primary caregivers.”
The ‘R’ in the NARM method stands for ‘relational’ which points to the fact “that the most important information for the development of the brain is conveyed by the social rather than physical environment.” The dominant symptoms of traumatised children can therefore be best understood, as efforts to minimise objective threat and regulate emotional distress; and “reenactments of oppositional, rebellious, unmotivated or antisocial behaviours in adulthood” can thus be viewed through the prism of ‘trauma-related triggers’ rooted in past behaviours once meant to ensure survival and minimise attachment loss, i.e. fear of abandonment. This is charted in NARM through the concept of the ‘distress cycle’: the caregiver misattunes - child protests - child senses self as bad - misattunement continues - disconnection continues - loss of capacity to self-regulate - pride based counter-identifications develop - leading to morbid nervous system dysregulation of high arousal.
NARM ultimately has been designed to help those diagnosed with developmental trauma acquire the skills of coping by mastering new connections between their experiences, emotions and physical sensations to reprogram the damage done in early childhood when a distortion of ‘proception’ - the development of experience in order to anticipate social responses - created a confused internal schemata of the affective and cognitive characteristics of primary relationships.
The main tools in NARM’s locker appear to be derived from Gestalt therapy’s in-the-moment framework and the principle “that the mind forms a global whole with self-organising tendencies.” A set of five powerful neuro-affective techniques are offered consisting of containment, grounding, orienting, titration and pendulation. These can be easily recognised as having parallels in other therapeutic approaches that repair the capacity for a healthy differentiation of self and connection to others. However, it is the sub-cellular (quantum array network) bottom-up processing interventions based on the work of Levine (Somatic Experiencing) which is the game changer and creates the conditions for discharging shock states through increasing contact with the body; and successfully integrates the neuroaxonal top-down processing of enquiry into issues of shame-based identification and the uncovering of core needs and capacities.
The only other book I have yet read on the same topic is Steven Kessler’s 5 Personality Patterns (see review) which also delves into the bioenergetics of Lowen (1975) - ‘The Revolutionary Therapy That Uses the Language of the Body to Heal Problems of the Mind’. I found Heller’s approach more easily comprehensible in half the word count partly due to its overtly expressed clinical underpinnings in a technical format I happen to prefer, and in its supporting diagrams. In fact it is my truest contention the Neuro Affective Relational Touch Model could be marketed for the best seller list, possibly something akin to the once phenomenal popularity of The Roadless Traveled (1978) - such is the potential of this book “to anyone on a path of self-discovery seeking new tools for self-awareness, growth, and healing.”
Finally, it must be the saddest truth of all that unless we have been vastly fortunate not to have suffered some kind of early trauma - “when in a world the vast majority of those responsible for child maltreatment are the children’s own parents” - then the tendency for many of us to grow up and repeat the sins of our perpetrators is a hidden statistic that is waiting to be acted upon, and would account for so much social disruption in literally ‘all’ walks of life.


Just reading it made me relax and I have started to review my whole approach to healing and mindfullness.
Combined with Peter Levines book" In An Unspoken Voice" it has been such a joy and deep satifsaction to read and learn the content of Heller an LaPierres book. Now I am reading it again to have an even deeper integration and learning of it.
If you are into restoring your own or your clients nervous system back to wellbeing and goodness then this is a book for you.
Grahi - Zen Therapist and Organisational Coach &Consult

