Narrative Exposure Therapy Lifeline: Stones and Flowers Along a Rope

Lay out a life along a rope: flowers for good times, stones for hard ones, candles for losses. Short labels only. Then step back and see it whole.

AdultsKidsGrief & lossTrauma-focused
20–40 minutesIn person and on videoFor clinicians
Free interactive tool
Designed by Michael Thompson, MSc
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Even the overview can stir up trauma memories.

More

Use it in session with a trained clinician, keep labels to a word or an age, and do the full narration only within a trauma-focused treatment.

For clinicians

Use the lifeline with a client in session as part of trauma-focused work. Keep labels short and save the narration for later sessions.

How to play

  1. Pick Flower (a good time), Stone (a hard time) or Candle (a loss), then tap Lay it (Light it for a candle).
  2. Drag each one along the rope to the right point in life.
  3. Add a word or an age, nothing more. Under More: make it bigger, or move it earlier or later.
  4. Tap Step back and see my lifeline to see the whole rope. What kept you going?
  5. Copy or print the lifeline for the next sessions.

About the technique

The lifeline comes from Narrative Exposure Therapy, developed by Maggie Schauer, Frank Neuner and Thomas Elbert at the University of Konstanz for people who have lived through many traumatic events, such as refugees and survivors of organized violence. Laid out as a rope or line, the client places flowers for good events and stones for frightening or painful ones, in order from birth to the present, to build an overview of their whole life before narration begins (Schauer et al., 2011).

The rationale is that trauma memories are often fragmented and cut off from their time and place. Placing them on a single timeline, alongside resources and positive memories, sets up the later sessions in which the therapist and client narrate the life in order and process each stone in detail. The evidence for NET as a full treatment is moderate to good: a meta-analysis of 16 randomized trials with 947 participants found large reductions in PTSD symptoms, with NET outperforming inactive and non-trauma-focused comparisons but not active comparison treatments as a group (Lely et al., 2019). The lifeline on its own is a preparation and overview step, not the treatment.

Even the overview can stir up memories. Use it in session with a clinician trained in trauma work, keep labels on stones to a word or an age, and do not narrate stones in detail outside a structured trauma-focused treatment. Watch for dissociation, and close by returning attention to the flowers and to the present. With children, know your reporting duties: a stone may mark abuse not yet disclosed.

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For therapists: how to run it

Goal

See your life story in one view, with the good times placed alongside the hard ones, as a starting map for therapy.

In session

  1. Explain first: “We'll just lay things down and name them with a word. We'll talk about the hard ones later, one at a time.”
  2. In person, hand over the tablet, or use a real rope alongside it. On video, send the link so the client lays the items, and you guide.
  3. Pace it: if a stone brings up a lot, pause, ground, and leave the label blank. You can hide all labels in the picture.
  4. Finish by stepping back together: notice the flowers, ask what kept them going, and print the lifeline for the narration sessions.

As homework

Not given as self-guided homework. Use it together in session.

Mandated reporting

Exercises like this can lead to disclosures of abuse, neglect or risk. Know your reporting duties before you start, and pause if one comes up.

Good to know

In Narrative Exposure Therapy (NET) the client lays a rope for their life and places flowers for good events and stones for traumatic ones, in order, naming each one only briefly. The full story of each stone is told later, one at a time, with the therapist. This tool covers the lifeline overview only. It is not the exposure itself. Store a printed lifeline like a clinical record. With children, any activity can lead to a disclosure of abuse or neglect. Know your mandated-reporting duty before you start, and pause the activity if one comes up.

Worksheets that pair with this tool

Trauma Timeline Worksheet

Trauma Timeline Worksheet

A two-page grid for mapping events, dates and the emotional and physical reactions that followed.Adults and teensAnxietyEmotionsTrauma and PTSDCBTNarrative+3Free PDF 2 pagesStrengths List Worksheet

Strengths List Worksheet

A word-bank list for clients who go blank, and an open reflection sheet on strengths and qualities.Adults and teensDepressionSelf esteemCBTPositive psychologySolution focused+32 worksheets 1 page eachThe Tasks of Mourning Worksheet

The Tasks of Mourning Worksheet

The four tasks of mourning, the three phases of grief, and a five-stage inventory clients order themselves.Adults and teensGriefIPTPsychoeducational+13 worksheets 7 pages in total

Sources & credibility

Method
Narrative Exposure Therapy lifeline (stones and flowers)
Developed by
Maggie Schauer, Frank Neuner and Thomas Elbert (University of Konstanz)
First described
2005; 2nd edition 2011
Approach
Narrative Exposure Therapy (trauma-focused)
Evidence
Supported by studiesNET has support from many randomized trials, especially with refugees and people with many traumas, and appears in trauma guidelines. The lifeline is one step of the protocol; on its own it is an overview, not a treatment.

References

  1. Schauer, M., Neuner, F. & Elbert, T. (2011). Narrative Exposure Therapy: A Short-Term Treatment for Traumatic Stress Disorders (2nd ed.). Hogrefe.
  2. ISTSS Clinician's Corner: “I want to hear your story”, the identity of Narrative Exposure Therapy (Frank Neuner). Source
  3. Lely, J. C. G., Smid, G. E., Jongedijk, R. A., Knipscheer, J. W. & Kleber, R. J. (2019). The effectiveness of narrative exposure therapy: a review, meta-analysis and meta-regression analysis. European Journal of Psychotraumatology, 10(1), 1550344. Source

How it was made

Built by the Mentalyc team from the original method and the published sources listed here. Nothing you enter is stored.

Questions people ask

What is narrative exposure therapy?

Narrative exposure therapy (NET) is a brief, trauma-focused therapy, often used with people who have lived through many traumatic events. The client builds a chronological life story with the therapist, including detailed processing of the hardest events.

What is the NET lifeline?

In NET, the lifeline is a rope laid out to represent life, with flowers for good events, stones for traumatic ones and often candles for losses. It gives an overview before the detailed narration begins.

Is narrative exposure therapy a form of CBT?

NET draws on exposure principles shared with trauma-focused CBT, together with testimony therapy. It is usually listed as its own evidence-based trauma treatment and should be delivered by a trained clinician.

How does the lifeline exercise work in narrative exposure therapy?

Early in NET, the client lays a rope across the floor for their life and places flowers for good events and stones for traumatic ones, naming each briefly. Detailed narration of the stones comes later, in order, in sessions with a trained clinician.

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Your game designer
Michael Thompson

Michael Thompson, MSc

Michael's background combines doctoral training in clinical psychology with research on motivation, learning, and emotional regulation.

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Table Of Contents
  1. About the technique
  2. For therapists: how to run it
  3. Worksheets that pair with this tool
  4. Sources & credibility
  5. Questions people ask
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