Integrative · 2005
Narrative Exposure Therapy (NET)
Trauma is integrated when the fragmented story becomes a coherent life narrative.
Narrative Exposure Therapy (NET) is a therapeutic model developed for the treatment of complex and repeated trauma, especially in contexts of war, torture and displacement. It rests on the idea that trauma is stored as fragmented sensory memories ('hot' memory) disconnected from their autobiographical context ('cold' memory), which generates re-experiencing and narrative disorganisation. The intervention consists of reconstructing the patient's complete life story chronologically, integrating both traumatic and positive events, through detailed narrative exposure. The aim is to contextualise traumatic memories within a coherent narrative, allowing them to be integrated into autobiographical memory and reducing their activation as a present threat. It is a structured, brief approach, highly applicable in low-resource settings, with strong empirical support in populations exposed to multiple trauma.
Core ideas
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Trauma fragments memory into unintegrated systems
The model proposes that traumatic memories are stored as intense sensory and emotional components ('hot' memory) disconnected from their autobiographical context ('cold' memory), which facilitates their automatic reactivation as though they were happening in the present (Schauer, Neuner & Elbert, 2011).
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Re-experiencing is a problem of decontextualisation
PTSD symptoms are explained not only by emotional activation, but by the inability to situate traumatic memories in the past, which means they are lived as current rather than as events that have already ended (Schauer et al., 2011).
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Autobiographical narrative organises experience
Human beings integrate their experience in the form of a life story; when this narrative is broken by trauma, identity and temporal continuity are affected. Therapy seeks to restore this narrative organisation (Schauer et al., 2011).
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Exposure must be integrated into a complete narrative
Unlike other approaches, NET focuses not only on the isolated trauma, but on its integration within the patient's whole life story, combining exposure with narrative reconstruction (Schauer et al., 2011).
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Integration requires connecting emotion and context
Therapeutic change occurs by linking the intense emotional components of the trauma with contextual information (time, place, sequence), allowing the memory to be transformed into an integrated autobiographical memory (Schauer et al., 2011).
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Narrative repetition facilitates progressive integration
Repeated exposure to traumatic memories within the narrative makes it possible to reduce emotional activation and to consolidate their integration into autobiographical memory (Schauer et al., 2011).
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Trauma must be integrated into the story, not eliminated
The aim is neither to forget nor to suppress the trauma, but to incorporate it as part of a coherent life narrative, in which it loses its dominant and disorganising character (Schauer et al., 2011).
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Identity is rebuilt through narrative
By reorganising the life story, the patient recovers a sense of biographical continuity and identity that has been fragmented by the trauma (Schauer et al., 2011).
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The complete life context is essential in complex trauma
In cases of multiple or prolonged trauma, working with a single event is insufficient; all significant events must be integrated within an overall narrative in order to achieve stable change (Schauer et al., 2011).
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Testimony consolidates the integration of the trauma
Producing a complete account and formalising it as a written testimony reinforces narrative coherence, ownership of one's history and the closure of the therapeutic process (Schauer et al., 2011).
Influences
- Classical conditioning
- Information processing theory
- Theory of traumatic memory
- Exposure therapy
Key references
- Schauer, M., Neuner, F., & Elbert, T. (2011). Narrative Exposure Therapy: A Short-Term Treatment for Traumatic Stress Disorders.
- Neuner, F., Schauer, M., Klaschik, C., Karunakara, U., & Elbert, T. (2004). A comparison of narrative exposure therapy, supportive counseling, and psychoeducation.
- Elbert, T., Schauer, M., & Neuner, F. (2015). Narrative Exposure Therapy (NET): Reorganizing memories of traumatic stress.