Somatic Therapies

Mosaic’s in-house somatic experiencing trauma therapist expert Jenny Korotko ATR, LCPC, SEP writes about the reason somatic based therapies can be useful when processing emotional pain. In this blog post you will also find suggestions for books, a workbook, websites, research links, a ted talk link and other ideas of how you can learn more about this approach. Mosaic offers many types of therapies that incorporate somatic focuses such as creative arts therapies, dance movement therapy and mindfulness based therapies.  

What is body based therapy or Somatic therapy?

Somatic based therapy is also known as Somatic Experiencing Therapy and has several training options for clinicians to consider. For those curious about how it’s used and why let’s start with the definition. Somatic Experiencing Therapy is also known as both body based therapy or body psychotherapy. It is a therapeutic modality which emphasizes on the mind body connection.The focus is on what we experience in the body and the mind plus the possible connections between the two.The definition of Somatic by itself means “of or relating to the body”. The theory somatic therapy is based on is that the negative things that happen in one's life are stored not only in the brain but the body too or in some cases mostly the body. The way to healing is through a mind and body connection starting with the body. This is also considered bottom-up therapy which will be defined later in the blog.

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WHAT IS SOMATIC EXPERIENCING®?

According to SEI:

Somatic Experiencing (SE™) aims to resolve symptoms of stress, shock, and trauma that accumulate in our bodies. When we are stuck in patterns of fight, flight, or freeze, SE helps us release, recover, and become more resilient. It is a body-oriented therapeutic model applied in multiple professions and professional settings—psychotherapy, medicine, coaching, teaching, and physical therapy—for healing trauma and other stress disorders. It is based on a multidisciplinary intersection of physiology, psychology, ethology, biology, neuroscience, indigenous healing practices, and medical biophysics and has been clinically applied for more than four decades. It is the life’s work of Dr. Peter A. Levine.”

SEI, "What is Somatic Experiencing?” accessed March 3, 2024, https://traumahealing.org/se-101/.

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Common ailments somatic therapy is used for are:

• Addiction
• Anxiety
• Depression
• Trauma
• Stress
• Parenting Stress

Why somatic therapy is becoming so popular:

The book that kicked the high demand for somatic therapy off was The Body Keeps The Score by Bessel Van der Kolk. The Body Keeps the Score is a book about how a group of therapists and scientists worked together to apply body based modalities (somatic therapies) using recent research on brain science, attachment and body awareness to treat trauma survivors.  What they discover is that by focusing on the mind and body in therapy a deeper level of healing can occur.  The body can hold onto trauma and utilizing the body to heal what is stuck in the body often results in a gentler way through addressing trauma symptoms.  Bringing somatic therapy into session can assist clients with the struggles of the past that the body is holding onto.In many cases the client is often holding onto them subconsciously.  

When we invite more body awareness into session through somatic therapy we create new paths to healing. These new paths to healing can activate the brain’s natural neuroplasticity leading the client into more of a conscious awareness of their body’s reaction to the past negative experiences.  This awareness can create new paths and offer the client a way to feel more in control of their emotions just by bringing in more body awareness in session.

What do body based therapists do?

They help develop an awareness of bodily sensations so that clients begin to feel more in control, sometimes safer in their bodies as they experience emotions.  It can also serve as a way to release built up emotions in the body making more room for clients to experience other more positive feelings in the body.

There are multiple types of somatic based therapy modalities. Some are Yoga Therapy, Dance Movement Therapy, Somatic Experiencing Trauma Therapy, EMDR (Eye Movement Desensitization Reprocessing), Hakomi, Brainspotting, Focusing, Accelerated Experiential Dynamic Psychotherapy, Art Therapy, Drama Therapy, Play Therapy, Sand Tray Therapy, Equine-Assisted Psychotherapy and many more mindfulness based therapies.

Somatic therapy is under the “Bottom-Up Processing” umbrella of therapeutic approaches.

What is the Bottom-Up process?  Bottom-up process starts with the sensation and movements in the body or how the symptoms of the main complaint appear in the body. This method of bottom-up psychotherapy uses the wisdom of the body’s movements plus sensations to bring awareness to how the negative events are being held in our bodies.  It also allows the client to take a break from the narrative and just feel their story.  Many clients who have trauma struggle with remembering details of who, what, where when or how.  Bottom-up psychotherapy releases the stress of trying to remember and validates that something happened to cause the body to hold onto emotional pain.  Bottom-up processing then assists the client with releasing the stored memory without really needing to know the story.  

What we know now about trauma is that when a person is experiencing stress or trauma their prefrontal cortex goes offline so that the body can adjust to fight, flight or freeze for survival.  It’s the body that absorbs the stress or trauma, not the brain because the prefrontal cortex is not easily accessible during these times.  It is therefore the body that initiates a trauma response, not the brain. For example a trigger is first experienced in the body so what better way toward healing than working with the very part that the problem begins in, the body.  This is why somatic therapies are so helpful with high stress, anxiety, depression or trauma.  

We use somatic therapy also known as bottom-up therapy because the body reacts first then the mind thinks. If we can bring more awareness to how the body is reacting we can feel more in control of how our mind thinks.  Many somatic based therapists feel that it is difficult to change thoughts without first noticing the feelings in the body that are triggering the thoughts.  When one has ongoing stress or significant difficulties from their past still affecting them they often have unconscious patterns stuck on when triggered.  With more body awareness in the therapy space we invite a direct connection with the limbic system, where high stress or trauma tends to be stored. A simple way of putting this all together is once the client starts to understand how they feel about things they can start to change the way that they think about them.  

Also, once things are brought into more awareness through the body based and somatic therapies we bring the unconscious to the conscious making it more possible for healing patterns to replace triggers.  

A quote from a somatic therapy client:

“It’s like you can all of a sudden notice that the unhealthy triggered part is in the driver's seat when you become more aware of your body in therapy.  You then gain enough knowledge of why the triggered part was driving for so long. You end up validating its need to be driving, which is usually because it was trying to keep you safe. Then you can gently replace the driver with a more aware, empowered, down to earth self. This can all be done just by slowing down and noticing how things are feeling in your body during therapy”

Some techniques somatic therapists use are:

• Pendulation: Noticing a relaxed state and emotions relating to the issues back to relaxed. This helps the client feel more of their whole body vs just the area it feels the emotions relating to the agitator.
• Resourcing: This technique involves finding internal and external resourcing memories or objects.  The therapist might encourage the client to look around the room and pick something that brings a settling feeling into the body.  The therapist might also ask the client to remember a time they felt confident and walk the therapist through the memory. As the client recalls this memory the client will be encouraged to notice how they feel as they are describing this memory of when they were confident.  This encourages awareness of how good things feel in the body and reminds the client that they can experience good too.  
• Titration: This technique is used to ease the client into the most agitating part of the story or the main event that occurred leaving the client in need of counseling services.  The therapist does not start right away with asking the client to tell them their biggest trauma. They titrate into the narrative often having the client check in with their body every step of the way.  
• Tracking: Overall most somatic therapies involve teaching the client how to notice their body, or track how emotions feel in their body, during session.  This helps the client get used to focusing on their body sensations and it can serve as a useful tool outside of the therapy space.  
• Many people in the medical field from the 1950s onward were interested in somatics in therapy. Dr. Peter Levine developed the coined somatic experiencing trauma therapy not long after observing how animals recover successfully from traumatic experiences and wondering why not all humans can do the same.  From his research many types of somatic interventions emerged and are still used to this day. ‍

Pros:

• Research shows us that somatic therapy can reduce anxiety, depression and symptoms experienced due to trauma
• Many clients report feeling they have more capacity for life’s stress after a few somatic therapy sessions. Some describe feeling more resilience in socially challenging settings such as work or school due to stress.  
• Due to learning more tools clients can use on the go many report feeling an overall sense of well-being.

Cons:

• It can be difficult to feel the benefits if the client has a very high stress life both at home and at school/work.
• Some experts suggest a need for more research for the variety of symptoms somatic therapists state they can help with
• Finding a therapist who is trained in somatic therapy techniques is often challenging and many have a long wait list

Research to refer to:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5518443/

Results of research highlighted: “The results presented in this study show a large effect size (Cohen's d > 0.8) both on PTSD symptoms and depression symptoms, even though the clinical results should be considered moderate (44.1% lost the diagnosis of PTSD).”

Books to consider:

The Body Keeps the Score‍

by Bessel van der Kolk

My Grandmother's Hands: Racialized Trauma and the Pathway to Mending Our Hearts and Bodies

by Resmaa Menakem (also an SEP)

Complex PTSD: From Surviving to Thriving

by Pete Walker

Focusing

by Eugene Gendlin

Healing Developmental Trauma

by Laurence Heller and Aline LaPierre

My Body Compass

by Albert wong

Unbroken: The Trauma Response Is Never Wrong: And Other Things You Need to Know to Take Back Your Life

by MaryCatherine McDonald

Workbook I highly recommend:

The Body Awareness Workbook for Trauma: Release Trauma from Your Body, Find Emotional Balance, and Connect with Your Inner Wisdom

by Julie Brown Yau PhD (Author), Lisa Genova PhD (Foreword)

Doing it ‘On your own’ body based interventions can include:

Yoga therapy, yoga, Tai Chi, Qigong, Reiki and other touch therapy healing modalities, walking meditations, guided meditation, and dance movement therapy.

Website to consider for more information: https://traumahealing.org/

Tedtalk to watch about Somatic Therapy: https://www.youtube.com/watch?v=UU7eSxcBhpMDoes Somatic Experiencing (SE) Work? SE practices for healing | Monica LeSage | TEDxWilmingtonWomen