Somatic therapy

somatic therapy

Click below to listen to this article:

somatic therapy

This article introduces somatic therapy, explains its history, concepts, applications and strengths and weaknesses.

somatic therapy is a form of psychotherapy that focuses on the mind-body connection and how it affects our wellbeing. According to Baker (2023), “somatic therapies posit that our body holds and expresses experiences and emotions, and traumatic events or unresolved emotional issues can become ‘trapped’ inside” (p. 12).

somatic therapy aims to release this trapped energy and restore balance and harmony in the body and mind. It can use various techniques, such as movement, breathing, relaxation, mindfulness, and talk therapy, to help clients access and process their emotions and sensations (Psychology Today, 2022).

somatic therapy can be beneficial for people who suffer from stress, anxiety, depression, post-traumatic stress disorder (PTSD), and other mental health conditions that are influenced by the body’s response to trauma (Forbes Health, 2023). For example, a person who experienced a car accident may have chronic pain, muscle tension, flashbacks, and fear of driving. somatic therapy can help them to release the physical and emotional impact of the trauma and regain a sense of safety and control.

History

somatic therapy dates back to physical education movements of the 19th century, and included many practices, such as yoga, Pilates, and judo (Psychology Today, 2022). Among the most prominent schools of somatics is that created by Thomas Hanna, who, in the 1970s, introduced and named the concept of “Somatics” (Psychology Today, 2022). Hanna defined somatics as “the field of study dealing with somatic phenomena, i.e., the human being as experienced by himself (or herself) from the inside” (Hanna, 1986, p. 4).

One of the major breakthroughs in somatic therapy was the development of somatic experiencing by Peter Levine in the 1970s. Levine observed that animals in the wild can recover from life-threatening situations by physically releasing the excess energy they accumulate during the fight-or-flight response (Levine, 2010).

Peter Levine applied this insight to humans who suffer from trauma and proposed that by becoming aware of and expressing the bodily sensations associated with traumatic events, they can heal from their psychological wounds (Levine, 2010). Levine’s approach has been widely used and researched in various settings and populations, such as war veterans, survivors of sexual abuse, refugees, and natural disasters (Van der Kolk et al., 2015).

Applications of somatic therapy

somatic therapy can help people who struggle with various mental and emotional health issues, such as anxiety, depression, chronic pain, addiction, and relationship problems (Verywell Mind, 2021). By working with a trained therapist, clients can learn to access and regulate their emotions, sensations, and impulses through techniques such as breathing exercises, movement, touch, mindfulness, and body awareness (Verywell Health, 2021). somatic therapy can also help clients develop a positive sense of self and a greater capacity for resilience and joy (Coach Foundation, 2023).

somatic therapy in practice

An example of somatic therapy in practice is the case of Jane, a woman who experienced a car accident that left her with chronic neck pain and flashbacks. Jane’s therapist helped her to notice how her body reacted when she recalled the accident and guided her to release the tension in her muscles through gentle shaking and stretching.

Jane also learned to use grounding exercises to calm her nervous system and to reconnect with positive memories and sensations. Over time, Jane reported feeling less pain, fear, and anger, and more confidence, peace, and happiness (Harvard Health Publishing, 2020).

somatic techniques

somatic therapy uses various techniques to help clients release the physical and emotional tension that results from traumatic experiences, and to restore a sense of balance and wellbeing. Some of the common techniques used in somatic therapy include:

Developing more awareness of the body and its sensations: This technique helps clients to notice how their body reacts to different situations, emotions, thoughts, and memories, and to identify any signs of stress or discomfort. By becoming more aware of their bodily sensations, clients can also access their inner resources and strengths that can help them cope with challenges (Verywell Mind, 2023).

The parasympathetic nervous system (PSNS) is a branch of the autonomic nervous system (ANS) that regulates bodily functions at rest and during non-stressful situations. It is often referred to as the “rest and digest” system, as it counterbalances the sympathetic nervous system’s (SNS) “fight or flight” response (Sreenivasulu, 2023).

The PSNS slows down the heart rate, decreases blood pressure, and promotes digestion. It is responsible for conserving energy, relaxing muscles, and enhancing processes like digestion, salivation, and urination (Healthline, 2023). Activation of this system helps the body recover and maintain equilibrium after stress or physical activity (Simply Psychology, 2023).

The PSNS begins in the brain and branches out via long fibres, leading to connecting neurons near the organs they intend to act upon, enabling quick responses (Simply Psychology, 2023). It also controls functions such as constriction of pupils, constriction of bronchial muscles, increased production of saliva and mucus, and increased urine output (Wikipedia, 2023). The PSNS is composed of cranial nerves and sacral spinal nerves that originate from specific regions of the brainstem and the sacral spinal cord (Kenhub, 2023). The main nerve of the PSNS is the vagus nerve, which innervates most of the thoracic and abdominal organs (Britannica, 2023).

An example of PSNS activation is when a person finishes a meal and feels relaxed and sleepy. The PSNS stimulates the secretion of digestive enzymes and hormones, increases blood flow to the gastrointestinal tract, and reduces the heart rate and blood pressure. Another example is when a person cries and experiences nasal congestion and watery eyes. The PSNS triggers the lacrimal glands to produce tears and the nasal mucosa to secrete mucus.

Calling upon emotional resources: This technique involves helping clients to recall positive emotions or experiences that can counteract the negative ones. For example, a client who feels anxious or fearful may be asked to remember a time when they felt safe or confident, and to imagine how their body felt in that moment. This can help them to activate their parasympathetic nervous system, which is responsible for relaxation and recovery (First Session, 2023).

Grounding: This technique helps clients to anchor themselves in the present moment and to feel more connected to their surroundings. It can be done by focusing on the breath, the sensations of the feet on the floor, the sounds or smells in the environment, or any other aspect of reality that can bring attention to the here and now. Grounding can help clients to calm down, to reduce dissociation, and to regain a sense of control (Positive Psychology, 2023).

Encouraging detailed descriptions: This technique involves asking clients to describe their bodily sensations, emotions, thoughts, or memories in as much detail as possible. This can help them to process their experiences more fully, to understand their meaning and impact, and to integrate them into their narrative. By describing their experiences in detail, clients can also reduce their emotional charge and increase their tolerance for distress (Psych Central, 2023).

Movement: This technique involves using physical activities such as dance, exercise, yoga, vocal work, or bodywork to help clients express themselves, release tension, and heal trauma. Movement can help clients to access emotions that may be difficult to verbalize, to regulate their nervous system, to increase their self-esteem and confidence, and to enhance their creativity and joy (Psych Central, 2023).

somatic therapy is based on the idea that “the body remembers everything” (Levine & Frederick, 1997), and that by working with the body, clients can heal from trauma and improve their mental health.

Example therapy session

A hypothetical somatic therapy session for a PTSD sufferer might look something like this:

• The therapist begins by creating a safe and supportive environment for the client, explaining the goals and methods of somatic therapy, and obtaining informed consent.
• The therapist then invites the client to notice their breathing, posture, and any sensations or feelings in their body.
• The therapist guides the client to bring awareness to any areas of tension, pain, or numbness, and to gently explore them with curiosity and compassion.
• The therapist may also use touch, movement, or sound to help the client connect with their body and express their emotions (Rothschild, 2000).
• The therapist then helps the client to identify and work with a specific traumatic memory or trigger that is causing them distress.
• The therapist encourages the client to stay present and grounded in their body, and to notice how the memory or trigger affects their bodily sensations and reactions.
• The therapist supports the client to regulate their arousal level, using techniques such as breathing, grounding, orienting, or resourcing.
• The therapist also helps the client to access and mobilize their innate coping and survival responses, such as fight, flight, or freeze, and to complete any unfinished actions or impulses that were interrupted or suppressed during the trauma (Ogden et al., 2006).
• The therapist then assists the client to integrate and process the traumatic experience, using cognitive, emotional, or narrative approaches.
• The therapist helps the client to make sense of what happened, how it affected them, and how they can cope and heal from it.
• The therapist also helps the client to reframe any negative beliefs or emotions that resulted from the trauma, such as shame, guilt, or self-blame, and to replace them with more positive and empowering ones.
• The therapist validates the client’s feelings and experiences, and reinforces their strengths and resilience (van der Kolk et al., 2014).
• The therapist then ends the session by reviewing what was accomplished, addressing any questions or concerns, and providing homework or suggestions for further practice.
• The therapist also ensures that the client is calm, stable, and comfortable before leaving.
• The therapist may also offer some resources or referrals for additional support if needed (Courtois & Ford, 2013).

somatic therapy can benefit PTSD sufferers in various ways. Some of the benefits are:

• somatic therapy can help PTSD sufferers to release the trauma that is stored in their body, reducing symptoms such as chronic pain, muscle tension, headaches, digestive problems, or insomnia (Levine, 2010).
• It can help PTSD sufferers to regulate their nervous system, restoring a balance between arousal and relaxation, and enhancing their ability to cope with stress and emotions (Ogden et al., 2006).
• somatic therapy can help PTSD sufferers to reclaim their sense of agency and control over their body and life, increasing their confidence and self-esteem (Rothschild, 2000).
• It can help PTSD sufferers to reconnect with their body as a source of pleasure, joy, and vitality, improving their quality of life and wellbeing (van der Kolk et al., 2014).

somatic therapy is a promising and effective approach for treating PTSD. By working with the body as well as the mind, somatic therapy can help PTSD sufferers to heal from trauma on a deeper level.

How does somatic therapy work?

One of the main principles of somatic therapy is that the body has an innate capacity to heal itself, if given the right conditions and support. As Baker (2023) states, “somatic therapies posit that our body holds and expresses experiences and emotions, and traumatic events or unresolved emotional issues can become ‘trapped’ inside.” (p. 1).

By accessing these trapped emotions through the body, somatic therapy can facilitate the process of healing and integration. For example, a person who experienced a car accident may have developed chronic neck pain and fear of driving.

A somatic therapist may help them to notice how their neck muscles tighten when they think about the accident, and guide them to relax those muscles through gentle touch or movement. This may help them to release some of the fear and pain associated with the trauma, and regain a sense of safety and control.

somatic therapy can be used with other forms of therapy, such as cognitive-behavioural therapy (CBT) or psychodynamic therapy. It can also be tailored to suit the needs and preferences of each individual client. Some of the common techniques used in somatic therapy include:

• somatic experiencing: A method developed by Peter Levine that involves tracking the sensations and movements of the body as a way of accessing and resolving trauma.
• Hakomi: A method developed by Ron Kurtz that combines mindfulness, non-violence, and organicity to create a safe and respectful environment for self-discovery and healing.
• Sensorimotor psychotherapy: A method developed by Pat Ogden that integrates cognitive and emotional processing with body awareness and movement interventions.
• Bodynamics: A method developed by Lisbeth Marcher that uses developmental psychology and muscle testing to identify and address psychological issues related to different stages of life.

somatic therapy is based on scientific evidence that supports the link between the mind and body in health and disease. Research has shown that somatic therapy can improve psychological outcomes such as self-esteem, mood, coping skills, and quality of life (Price et al., 2017). somatic therapy can also reduce physiological symptoms such as blood pressure, heart rate, cortisol levels, inflammation, and pain (Payne et al., 2015).

Mental health as a cause of physical illness

According to somatic therapy, physical illness can be caused by mental health conditions, especially trauma, stress, anxiety, and depression. This is because these conditions can affect the nervous system and create chronic tension, pain, inflammation, and disease in the body (Sandstone care, 2023). somatic therapy aims to help people release the trauma and stress from their body by using techniques such as touch, movement, breathing, mindfulness, and emotional expression (Verywell Health, 2022).

One of the pioneers of somatic therapy is Peter Levine, who developed the somatic experiencing method based on his observation of how animals cope with life-threatening situations. He proposed that trauma is not caused by the event itself, but by the inability of the body to complete its natural response to the threat and return to a state of balance (Levine, 2010). He also suggested that trauma can be healed by activating the body’s innate capacity to self-regulate and restore equilibrium (Levine & Kline, 2007).

Another influential figure in somatic therapy is Bessel van der Kolk, who has researched the effects of trauma on the brain and body for decades. He has shown that trauma can alter the structure and function of the brain, impairing memory, cognition, emotion regulation, and interpersonal relationships (van der Kolk, 2014).

van der Kolk has also demonstrated that trauma can increase the risk of developing chronic diseases such as cancer, diabetes, heart disease, and autoimmune disorders (van der Kolk et al., 2007). He has advocated for the use of somatic therapies such as EMDR, yoga, neurofeedback, and sensory integration to help trauma survivors heal their mind and body (van der Kolk et al., 2016).

Some examples of how somatic therapy can help people with physical illness caused by mental health conditions are:

• A woman who was sexually abused as a child developed breast cancer as an adult. She underwent somatic experiencing therapy and was able to process her traumatic memories and release the emotions that were trapped in her body. She also learned to reconnect with her body and feel more empowered and confident. Her cancer went into remission after six months of therapy (Levine & Kline, 2007).
• A man who suffered from chronic pain and fatigue due to fibromyalgia found relief through somatic therapy. He discovered that his pain was linked to his childhood trauma of being neglected and abandoned by his parents. He learned to regulate his nervous system and calm his stress response through breathing exercises and mindfulness. He also expressed his anger and grief through movement and sound. His pain decreased significantly, and his energy increased after three months of therapy (Heller & LaPierre, 2012).
• A woman who had diabetes and hypertension due to her anxiety and depression improved her health through somatic therapy. She realized that her anxiety and depression were related to her abusive relationship with her husband. She learned to set boundaries and assert her needs through role-playing and body language. She also practised self-care and relaxation techniques such as massage and meditation. Her blood sugar and blood pressure normalized after four months of therapy (Rothschild, 2000).

Strengths and weaknesses

One of the strengths of somatic therapy is that it can help clients who have difficulty accessing or expressing their emotions verbally. By using techniques such as touch, movement, breathing, or imagery, somatic therapists can help clients become more aware of their bodily sensations and what they mean. For example, a client who feels numb or disconnected from their emotions may be guided to notice how their chest feels tight, or their stomach feels queasy when they recall a traumatic event. This can help them reconnect with their feelings and release them in a safe and supportive environment.

Another strength of somatic therapy is that it can help clients build resilience and coping skills for dealing with stress and negative emotions. somatic therapy can teach clients how to regulate their nervous system, which is often dysregulated by trauma or chronic stress. By learning how to calm themselves down or energize themselves up, clients can gain more control over their emotional states and reactions. For example, a client who suffers from anxiety may be taught how to use deep breathing or grounding exercises to reduce their panic symptoms and feel more relaxed.

However, somatic therapy also has some limitations and challenges. One of them is that it may not be suitable for everyone, especially those who have severe physical or mental health conditions, such as psychosis, dissociative disorders, or chronic pain. somatic therapy may trigger or worsen these conditions by activating the body’s memories of trauma or distress. Therefore, somatic therapists need to screen their clients carefully and work collaboratively with other health professionals to ensure their safety and wellbeing.

Another limitation of somatic therapy is that it may not address the cognitive or behavioural aspects of emotional problems. somatic therapy focuses mainly on the body’s sensations and responses, but it may not help clients change their negative thoughts or maladaptive behaviours that contribute to their psychological issues. Therefore, somatic therapists may need to integrate other therapeutic approaches, such as cognitive-behavioural therapy (CBT) or dialectical behaviour therapy (DBT), to provide a more comprehensive and effective treatment for their clients.

somatic therapy is a promising and innovative way to treat trauma and emotional problems through the mind-body connection. It has many benefits for clients who struggle with verbalizing or regulating their emotions, but it also has some drawbacks and limitations that need to be considered. As one somatic therapist put it, “somatic therapy is not a magic bullet, but it is a powerful tool that can complement other forms of therapy” (Levine & Kline, 2007, p. 15).

References

Baker, J. (2023). What is somatic therapy? Harvard Health. https://www.health.harvard.edu/blog/what-is-somatic-therapy-202307072951

Britannica. (2023). Parasympathetic nervous system | Definition & Function. Retrieved from https://www.britannica.com/science/parasympathetic-nervous-system

Coach Foundation. (2023). somatic Therapy: The Definitive Guide. Retrieved from https://coachfoundation.com/blog/somatic-therapy/

Courtois, C. A., & Ford, J. D. (Eds.). (2013). Treating complex traumatic stress disorders in adults: Scientific foundations and therapeutic models. Guilford Press.

First Session. (2023). somatic therapy exercises and techniques. Retrieved from https://www.firstsession.com/resources/somatic-therapy-exercises-techniques

Forbes Health. (2023). What is somatic therapy? https://www.forbes.com/health/mind/somatic-therapy/

Hanna, T. (1986). What is Somatics? Somatics: Magazine-Journal of the Bodily Arts & Sciences. Retrieved from https://somatics.org/library/ht-whatissomatics

Harvard Health Publishing. (2020). What is somatic therapy? Retrieved from https://www.health.harvard.edu/blog/what-is-somatic-therapy-202307072951

Health.com. (2023). somatic Therapy: What It Is, Benefits, and Uses. https://www.health.com/somatic-therapy-7643892

Healthline. (2023). The parasympathetic nervous system Explained. Retrieved from https://www.healthline.com/health/parasympathetic-nervous-system

Heller, L., & LaPierre, A. (2012). Healing developmental trauma: How early trauma affects self-regulation, self-image, and the capacity for relationship. North Atlantic Books.

Kenhub. (2023). parasympathetic nervous system: Anatomy and functions. Retrieved from https://www.kenhub.com/en/library/anatomy/the-parasympathetic-nervous-system

Levine, P. A. (2010). In an unspoken voice: How the body releases trauma and restores goodness. Berkeley: North Atlantic Books.

Levine, P., & Frederick, A. (1997). Waking the tiger: Healing trauma. Berkeley: North Atlantic Books.

Levine, P. A., & Kline, M. (2007). trauma through a child’s eyes: Awakening the ordinary miracle of healing. North Atlantic Books.

Ogden, P., Minton, K., & pain, C. (2006). trauma and the body: A sensorimotor approach to psychotherapy. W.W. Norton & Company.

Payne, P., Levine, P. A., & Crane-Godreau, M. A. (2015). somatic experiencing: using interoception and proprioception as core elements of trauma therapy. Frontiers in psychology, 6(93), 1-18.

Price, C., Wells, E., Donovan-Hall, M., & Mehta, V. (2017). Mindfulness-based cognitive therapy reduces pain catastrophizing in women with chronic pelvic pain. pain Medicine, 18(9), 1708-1716.

Psychology Today. (2022). somatic Therapy. Retrieved from https://www.psychologytoday.com/us/therapy-types/somatic-therapy

Rothschild, B. (2000). The body remembers: The psychophysiology of trauma and trauma treatment. W.W. Norton & Company.

Sandstone care. (2023). somatic therapy: Understanding the mind-body connection. Retrieved from https://www.sandstonecare.com/blog/somatic-therapy/

Simply Psychology. (2023). What Does The parasympathetic nervous system Do? Retrieved from https://www.simplypsychology.org/parasympathetic-nervous-system.html

Sreenivasulu, H. (2023). What is the parasympathetic nervous system and what does it do? Retrieved from https://microsoftstart.msn.com/en-us/health/ask-professionals/expert-answers-on-parasympatheticnervoussystem/hp-parasympatheticnervoussystem?questionid=s8qlvln2&type=condition&source=bingmainline_conditionqna

Therapy mantra. (n.d.). somatic Therapy: Types, Benefits, Limitations & Alternatives. https://therapymantra.co/therapy-types/somatic-therapy/

Van der Kolk B., Stone L., West J., Rhodes A., Emerson D., Suvak M., & Spinazzola J. (2015). Yoga as an adjunctive treatment for post-traumatic stress disorder: A randomized controlled trial. Journal of Clinical Psychiatry; 75(6): e559–e565.

van der Kolk, B. A., Roth, S., Pelcovitz, D., Sunday, S., & Spinazzola J. (2007). Disorders of extreme stress: The empirical foundation of a complex adaptation to trauma.

van der Kolk, B. A. (2014). The body keeps the score: Brain, mind, and body in the healing of trauma. Viking.

Verywell Health. (2021). What Is somatic trauma Therapy? Retrieved from https://www.verywellhealth.com/somatic-trauma-therapy-5218970

Verywell Health. (2022). somatic Therapy: Uses, Benefits, Techniques, Results. https://www.verywellhealth.com/somatic-therapy-5216537

Verywell Mind. (2021). What Is somatic Therapy? Retrieved from https://www.verywellmind.com/what-is-somatic-therapy-5190064

Wikipedia. (2023). parasympathetic nervous system. Retrieved from https://en.wikipedia.org/wiki/Parasympathetic_nervous_system