“Before there are words, there is the wordless communication of the body.”

— Michael Changaris, Psy.D

Somatic therapy, also known as somatic experiencing therapy, treats mental and emotional health problems, including trauma, through the connection of mind and body. This embodied approach releases stress, tension, and trauma from the body.

Unlike many other treatments for mental health issues, such as cognitive behavioral (CBT) and dialectical therapies, somatic therapy integrates body-focused techniques and modalities such as meditation, dance, grounding, and breathwork into talk-therapy sessions. 

Bessel van der Kolk, a leading researcher in somatic experiencing therapy, posits that there is no “one size fits all” approach to addressing physical responses to trauma.

Views in Somatic Theory 

Somatic therapy is based on the theory that experiences are stored not only in your mind but also in the body. Focusing on the physical sensations experienced by a person while discussing problems in their life is a dualistic approach to therapy. People who practice somatic therapy believe that a person’s inner feelings impact their physical experience and therefore use mind-body exercises to release trauma that has become trapped in the body,. 

Dr. Peter Levine developed Somatic Experiencing therapy by observing how animals recover from traumatic experiences, such as attacks from predators. He noted that when the threat was gone, the animals would have a physical release such as shaking, running, or trembling. He observed that after this release, they quickly returned to their natural state. These observations contributed to Dr. Levine’s belief that, “the key to healing traumatic symptoms in humans is physiology.”

In somatic therapy, therapists use a range of techniques to help release certain bodily sensations that are causing disruption in order to heal trauma from both the inside and outside.

How Somatic Therapy Works 

Somatic experiencing therapy helps people uncover bodily sensations linked to a traumatic event as well as feelings associated with the trauma. During a therapy session, a person may be asked to describe the physical sensations that were felt during the traumatic event. Therapists may also invite the person to move their body in a way that activates negative feelings associated with the trauma. There are a number of different approaches and techniques used in somatic therapy. Unlike other therapeutic approaches, such as cognitive behavioral therapy, there is generally no set structure for moving through the counseling process. It is individualized so that each client receives the right treatment approach for their needs.

Recognizing Bodily Sensations

A fundamental aim of somatic experiencing is to learn about one’s body and the way that it processes stress and trauma. Therapy generally begins with clients learning more about their autonomic nervous system (ANS) and its role in the trauma response. Psychoeducation is a powerful tool because it helps clients gain a better understanding of themselves. Often, as a result, people become less afraid and less distrusting of their bodies and are able to rationalize and make sense of the responses and sensations that arise. This knowledge helps many people who feel confused about their response during a traumatic event or believe they should have reacted differently. After this has been discussed, the therapist will help clients increase their awareness of physical symptoms and bodily sensations. 

Resourcing

Resources are the tools that help clients access their innate strength and resilience. They are actions that can be drawn upon in times of need, such as when a negative bodily sensation surfaces due to triggers or stressful situations. Resources help clients maintain a sense of self and a feeling of strength and competency, regardless of what is happening in their immediate environment.

Resourcing means drawing on tools in moments of distress.  There is a vast range of resources available besides somatic, including psychological, spiritual, artistic, intellectual, and relational. Somatic resources aim to support the body as a principal vehicle for the therapeutic process.

Grounding techniques enable people to experience themselves as fully embodied in a moment. This often involves focusing on the five senses, feeling your feet on the ground, and regulating breathing. The ultimate aim is to calm the nervous system, regain a sense of safety, and interrupt disassociation or derealization.

Boundary Development

Boundaries are important in somatic therapy. Trauma is often associated with a loss of autonomy and control, and regaining the confidence to set and maintain boundaries can be incredibly difficult, particularly for those who have experienced abuse or assault.

In somatic therapy, boundary development includes sensing what it feels like to express boundaries using movement as well as verbal and nonverbal cues. Setting and maintaining boundaries are powerful tools for regaining a sense of safety and comfort in daily interactions in addition to in more stressful or testing situations. In somatic therapy, boundary development includes drawing on grounding techniques to stay focused on the present moment, noticing and responding to your changing needs, and expressing clear boundaries. 

Somatic therapy can involve touch, as it is a body-oriented modality. Somatic therapists are trained in how to use therapeutic touch effectively and ethically. However, if you are uncomfortable with the use of touch, you are encouraged to share this with your therapist.

Boundaries play a vital role in the therapeutic use of touch, and you will never be touched without consent.

Titration

Titration will generally be introduced after resourcing. It involves beginning to revisit the trauma or discomfort and exploring the related sensations. The gradual process of titration allows clients to come to terms with each aspect of the event. The therapist will attentively observe your response during titration and track the body sensations that arise, such as changes to breathing and clenching of fists. They may also ask you to share whether you experience:

• Hot or cold sensations
• Dizziness
• Feeling of weightiness
• Numbness
• Shaking
• Shivering

In somatic therapy, these are all seen as sensations associated with a release of the energy trapped in your body.

Pendulation

This refers to the swing from a state of distress in response to memories and sensations related to the trauma back to a state of relaxation.

The therapist will support you as you process and release trauma by using resourcing and grounding, including breathing techniques. 

What Somatic Therapy can Help With

Somatic therapy is used to address a wide range of mental and physical health issues.

Mental health issues that somatic therapy is used for include:

• Post-traumatic stress disorder (PTSD)
• Substance use disorder (SUD)
• Anxiety
• Stress
• Grief
• Depression

Physical issues that somatic therapy may assist with include:

• Chronic pain
• Digestive disorders
• Sexual dysfunction

Somatic therapy can benefit people who have not found success with traditional treatment methods after a traumatic experience. Using somatic techniques allows for the resolution and alleviation of physical symptoms associated with the trauma, making it easier to access and address the psychological effects of trauma.