Somatic Therapy: Healing Your Mind Through Your Body

While some of us who are therapists may think we know a thing or two about how to help people heal from traumatic experiences, for many of us, there is often an unexpected twist. Decades of research into the impact of trauma on individuals has shown that, in many ways, trauma is stored in the body. As Dr. Bessel van der Kolk so aptly put it, “the body keeps the score.” Most people are familiar with the “mental” replaying of memories and thoughts of the past that are characteristic of psychological trauma. What is less well-known is that similar replaying of a traumatic experience goes on in the body. Trauma can manifest as a chronic state of tension in a part of the body, a startle response, gastrointestinal issues, or other changes in the body such as heart rate. While talk therapy is commonly thought of as the answer to all psychological problems, there is growing recognition that trauma is different. Healing from Complex-Post-Traumatic Stress Disorder (C-PTSD) requires a distinct approach that incorporates work with the body.

Somatic therapy and treatment (from the Greek word “soma” meaning body) takes many forms. The hallmark that is shared by most of the different forms is that they include physical experience, movement, and body awareness in understanding and treating psychological problems. In contrast to many therapies that view thoughts, beliefs, and stories as reality and treat the body as a mere container for the mind, somatic therapies view physical experience of emotions and stress as valid and important information.

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Many body oriented therapies these days are influenced by our understanding of the Autonomic Nervous System. As long as we feel safe, our parasympathetic nervous system maintains a calm, relaxed and connected state. When we perceive a real threat, our Sympathetic nervous system activates the well known “fight or flight” stress response: our heart rate and breathing speed up, our muscles tense up in preparation to “fight” or “flee”, our attention narrows down to the perceived danger and we react in order to survive. For people with a history of trauma however their nervous system can be dysregulated and overactive most of the time. Or it can flash instantly into fight or flight in the safety of their therapist’s office at the slightest hint of trauma related stimuli. The body is still in the past, reacting to a present moment that feels safe to most people.

One of the many approaches and techniques to treat Trauma and Stressor-Related Disorders (TSRD) is Eye Movement Desensitization and Reprocessing (EMDR). However, EMDR stands out from the many somatic-oriented approaches and techniques in that it has the most research supporting its use. Developed by psychologist Francine Shapiro in the late 80’s, EMDR involves focusing on a memory of a traumatic event and tracking the therapist’s finger as it moves back and forth across the patient’s field of vision. Essentially, a brief period of bilateral eye movements are used to help process traumatic memories in a way that slowly desensitizes the memory, lessening its emotional impact. While the mechanism by which this works is not entirely clear, there is enough evidence to support its use in the treatment of post-traumatic stress disorder (PTSD), that it has been given approval by the World Health Organization and the psychiatric associations of almost every country around the world.

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Most therapy approaches to treating Post-Traumatic Stress Disorder (PTSD) are primarily psychological. Somatic Experiencing is different. Developed by Peter Levine, Somatic Experiencing is based on many years of studying the ways animals and humans respond to danger and life-threatening situations. Levine observed that many animals in the wild do not develop PTSD, unlike many humans who have experienced danger and threat. Levine has theorized that the reason for this is that animals complete their full response to danger and discharge any remaining activation from their survival mode. This discharge is typically accomplished through large movements of the body, such as shaking or vibrating. Most humans, however, do not complete their bodily response to a traumatic event because they are often unable to engage in the natural expression of their survival response. Instead, they learn to suppress or hide these bodily responses and behave in ways that are appropriate for the social situation. Somatic Experiencing is a therapeutic approach that helps the patient safely and gently expose themselves to reminders of the traumatic event, attend to their body’s responses, and complete the response that was not fully expressed when the original event occurred.

Sensorimotor Psychotherapy is a form of treatment that combines elements of Cognitive-Behavioral Therapies (CBT), Humanistic Therapies and Behavioral Therapies with a focus on processing body experience and mindful movement. Since much human behavior is expressed through physical posture and movement, paying attention to these natural human behaviors can provide a lot of insight into a person’s psychological and relational ways of being. Sometimes working with the body in this way can be a powerful addition to talk therapy. For example, a person who holds their body in a crouched posture with a collapsed chest and rounded shoulders may be holding a protective stance that originated in response to threats from early in life. Working with this posture somatically can also provide a unique opportunity for healing.

In my practice, using somatic therapy techniques, particularly when working with trauma clients, Grounding has been a crucial technique that I use to help my clients feel less overwhelmed and begin the process of healing from their pain. Grounding is a simple yet powerful technique. It connects the client to the present moment and focuses them on their physical experience. By engaging in techniques such as focusing on the feeling of their feet on the floor, the feeling of their body in their chair, grounding chair, the sounds around them, and even the temperature of the air, the client can calm down their nervous system, activating the client’s parasympathetic nervous system (rest and digest vs. fight or flight). What’s perhaps most important about this technique is that it’s a skill that the client can use outside of sessions giving them a sense of empowerment and control of their nervous system – something that many trauma survivors have never felt before.

There has been an explosion of research on the somatic therapies in the last few years as clinicians and researchers are discovering the effectiveness of these powerful healing modalities on a wide variety of symptoms and diagnoses including PTSD, complex trauma, anxiety and other emotional regulation issues, and chronic pain that may be trauma related. One of the issues in the research base is the difficulty of blinding participants to whether they are receiving a somatic intervention or a control intervention. Also, there is a great deal of variation among practitioners who identify themselves as “somatic.” However, what is consistent in the majority of the studies is that the inclusion of somatic interventions in psychological treatments is more effective than traditional talk therapies focused on cognition for a variety of diagnoses. This is especially true for individuals with a history of severe or complex trauma.

There is an increasing trend in some somatic (mind-body) approaches being standardised for the treatment of trauma. This shift in how we understand psychological trauma reflects broader changes in the way Western medicine is beginning to understand human experience. The idea that there is a hard and fast distinction between mind and body is no longer as fixed as it once was. Neuroscientific research continues to uncover the complex inter-connections between body and brain in emotional experience. For the millions of people world-wide suffering from trauma, the one difference that makes all the difference may be paying attention to our most natural of messengers: the body.