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Somatic therapy

Reviewed by Robert Bogenberger, PhD

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What is somatic therapy?

Somatic therapy is a holistic treatment approach that addresses both the mind and the body. It prioritizes the mind-body connection, exploring the effect of our physical health on our mental health and vice versa.

People go to therapy to address, change, or better understand their thoughts, emotions, behaviors, relationships, and physical sensations. Some approaches, like cognitive behavioral therapy (CBT), address thoughts in order to affect feelings and behaviors. These therapies work from the “top down,” trying to enact change by engaging with our cognitive processes first.

Somatic therapy, on the other hand, works from the “bottom up.” This means it addresses your physical sensations and symptoms to help you explore how stress or trauma may be affecting you. This groundwork can lead to physical, emotional, and even spiritual healing.

How the body responds to trauma

When we’re confronted with a dangerous or life-threatening situation, our bodies prepare us to survive the perceived threat with a host of physical changes. Our heart rate speeds up, our lung capacity increases, our muscles tense, and adrenaline flows through our bodies. These changes represent our “fight-or-flight” response in action.

But “fight” and “flight” aren’t the only two possible responses to danger. Other options include “freezing” or “fawning.” When we freeze, we may stay still, avoid making decisions, or feel as if we’re outside our own bodies. When we fawn, we try to please the person threatening us in order to avoid or reduce harm or conflict.

When we fight back or flee in response to a threat, our bodies use up the energy and resources that were released for our survival. But freezing and fawning don’t engage the body in the same way. The energy built up from a stress response lingers in the body, unused and unprocessed. As a result, we may be left in a perpetual state of hypervigilance, which can harm our health. Even if our physical trauma response slows down in the moment, it may resurface later through other physical symptoms.

What conditions can somatic therapy treat?

Somatic therapy is used to treat mental health concerns such as:

This type of therapy can be helpful for physical conditions, including chronic pain, insomnia, and sexual dysfunction.

Common types of somatic therapy

Somatic experiencing

Somatic experiencing (SE) allows your nervous system to process and resolve the physical effects of trauma.1 It’s meant to help you release energy that wasn’t used during your body’s trauma response. Techniques practiced by SE therapists include:

  • Resourcing: Drawing on positive memories to help you stay calm as you reprocess your trauma
  • Titration: Reprocessing your traumatic experience slowly, step by step, as a way to expand your “window of tolerance” for stressors and trauma triggers
  • Pendulation: Alternating back and forth between experiencing feelings of distress and calming your body to a relaxed state

Sensorimotor psychotherapy

Sensorimotor psychotherapy is similar to SE in that it guides the body through a trauma response.2 But the two methods have different foundations.

While SE tries to help you release unused energy from a trauma response, sensorimotor psychotherapy operates under the belief that your body’s trauma response is unfinished. The idea isn’t that your leftover energy needs to be discharged, but rather that your body’s trauma response needs to be completed for healing to begin.

Sensorimotor psychotherapy follows a three-step process:

  1. Stabilization and symptom reduction: Your therapist will help you feel safe and relaxed before engaging in sensorimotor psychotherapy.
  2. Processing: Your therapist will lead you through your traumatic experience and help you notice and regulate your physical and emotional responses.
  3. Integration: To complete the trauma response, your therapist will help you avoid freezing or fawning. Instead, you may say or do things you wish you’d done during the original trauma. For example, if you’re reprocessing a physical assault where you didn’t speak, you might say, “Stop!”

The Hakomi method

The Hakomi method is a mindfulness-based approach to somatic therapy. Its central idea is that each of us has what’s called our “core material.” This material is made up of thoughts, feelings, and beliefs, and it affects our personality even if we’re unaware it exists.

The Hakomi method allows people to become aware of their core material and accept, challenge, or transform it. This is accomplished through the method’s five core principles:3

  1. Mindfulness: Living in the present moment allows us to observe, meditate, and reflect on our beliefs from a place of compassion and nonjudgment.
  2. Nonviolence: It’s important to support (rather than try to overcome) a person’s defensive mechanisms in an effort to learn from them.
  3. Mind-body integration: The mind and the body both reveal our core material, and they work together to influence our behavior.
  4. Unity: Each person contains their own internal system of distinct parts while also operating as part of the larger system of the world.
  5. Organicity: The self is naturally bent toward healing, wisdom, and wholeness.

Is EMDR somatic therapy?

Eye movement desensitization and reprocessing (EMDR) is a helpful therapy often used to process trauma, but it’s not a somatic therapy. While a therapist may incorporate somatic interventions into EMDR treatment, they’re not a requirement.

Somatic therapy techniques

Across the various types of somatic therapy, there are a number of common techniques (called “interventions”) clients are often taught to use. These include:

  • Grounding: Using your senses to fully experience the present moment, which calms the nervous system
  • Mindfulness: Observing your thoughts, feelings, and behaviors in the moment, without judgment
  • Self-regulation: Noticing, managing, and adapting your emotions and behaviors to suit different situations
  • Movement and processing: Listening to your body in order to gain insight and solve problems

Certain forms of exercise, such as yoga, Pilates, and dance, can also be adapted to incorporate somatic interventions.

Is somatic therapy evidence-based?

The effectiveness of somatic therapy is a topic of ongoing research, but recent studies have shown promising results, especially for treatment of trauma and PTSD.4

Keep in mind that while somatic therapy can be helpful for some people, it may not be right for everyone. In particular, some somatic therapy interventions that use physical touch to release tension may not be suitable for people who’ve been sexually abused or assaulted.

Find treatment now

If you’re in crisis and need support right away, call or text the 988 Crisis Lifeline at 988 anytime.

To find out how the mind-body connection may be able to help your healing journey, browse our directory to connect with a somatic therapist near you.

About the author

The editorial team at therapist.com works with the world’s leading clinical experts to bring you accessible, insightful information about mental health topics and trends.

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