Somatic therapy has been around for a long time but only in recent years has it been recognized as an effective and critical part of psychotherapy for trauma and related mental health conditions.
Somatic therapy is a form of trauma therapy that combines traditional approaches with mind-body exercises. For many years, mental health has been biased towards addressing what happens in the mind over what is experienced in the body. This has limited the effectiveness of therapy for trauma survivors. After all, trauma is held in the body through implicit memories associated with what has happened in the past—not in a narrative memory of the event itself. Insight and cognitive restructuring are not enough to stop the somatic, defensive responses that are commonly experienced from trauma survivors. Somatic therapy changes the neural pathways that hold these implicit memories and lay the groundwork for a new way of being beyond trauma.
The Goal of Somatic Therapy
The goal of somatic therapy is to teach the brain and the body to feel safe and learn to regulate a range of feelings in daily life. Trauma survivors spend much of their energy in a state of hypervigilance, trying to discern what is safe or not. This is exhausting and overwhelming, leaving people with limited emotional resources left to experience joy, ease, and connection in life. Somatic Therapy trains the nervous system to work from the “bottom up,” teaching the body to feel calm and more connected with others.
How Does It Work?
So how does Somatic Therapy work in practice? There are many different methods, including Sensorimotor Psychotherapy, Somatic Experiencing, and EMDR, among others. It can be hard to navigate all the different approaches and decide which one best fits your needs. While practitioners may identify with specific modalities, there are some common elements that can help you understand how it works to bring lasting relief to trauma symptoms.
1. Awareness of the Body
Most of our lives we spend disconnected from or hyper aware of our bodies. This is often even more true for people who suffer from PTSD. The first step of Somatic Therapy is to invite you to bring conscious awareness to how you are feeling in the present moment. In doing so, you may notice uncomfortable feelings of tension, agitation, even pain. You learn to first be interested and curious about what is happening without resisting or trying to make it go away. Your therapist will help you cultivate this awareness in a safe way.
2. Connecting to Breath
The breath is a natural somatic resource that we can work with to regulate our nervous system to feel more calm or activated. In Somatic Therapy you will learn different methods to attend to the breath in order to manage anxiety and difficult emotions. Breath practices start with mindful awareness of the breath as it is. They can also include directed practices such as box breathing that balance the autonomic nervous system through heart rate variability training.
Grounding practices are particularly important when people are feeling triggered by internal or external events. When we have gone into survival mode we need quick, simple practices that bring us right into the body and come back into a zone of safety. You can learn some of these somatic strategies in therapy to use in daily life. A trained somatic therapist is skilled in using directed grounding practices any time you are feeling overwhelmed in the session.
4. Mindfulness of Present Moment Experience
Mindfulness of present moment experience helps us to shift from talking about life events to being with the thoughts, feelings and body sensations that arise as a result of difficult and satisfying experiences. This is a skill that can be cultivated through directed mindful awareness with your therapist in session as well as guided mindfulness meditation practices to try outside of sessions.
When we process implicit traumatic memories in therapy we want to do so in a way that does not feel overwhelming. We achieve that balance by “titrating” the amount of sensation one can tolerate, especially if unpleasant experiences arise. Trauma therapy is not about excavating the most difficult experiences and bringing them to light in therapy. It is about titrating the amount of somatic memory one can bring to awareness and allow one to let it go when it feels like too much to bear. This process teaches you that recollection is a choice, which may be a new experience for trauma survivors.
6. Self Compassion
Self compassion is an essential ingredient in any kind of therapy but even more so with somatic therapy. Your therapist will invite you to practice somatic resources that help you cultivate a felt sense of kindness and open heartedness towards yourself. This can be experienced with simple practices like holding an open palm on the heart centre. It is not unusual for trauma survivors to have resistance to self compassion. We can explore how the body holds these defenses in the body and how to gradually soften them when no longer needed.
Some people may feel uncomfortable being directed to paying attention to somatic experiences in therapy. If this is the case, a good starting place is to learn about the science and rationale behind Somatic Therapies. To learn about trauma and the body, I often recommend reading Bessel Van der Kolk’s book The Body Keeps the Score or learning about Stephen Porges’ work on the polyvagal theory.
How to Get Started with Somatic Therapy
Many people come to Somatic Therapies after finding that talk therapy was not enough. It is essential that you feel safe with your therapist when working from the experience in the body. Take some time to interview a few therapists to learn more about how they work from a somatic approach and what modality they use. Many somatic therapists come to the work from their own therapeutic experiences and mindful awareness practices. At the end of the day, you want to work with someone who is engaged and committed to helping you be more present and safe in your body.