Somatic Experiencing® Therapy: An Introduction to Healing Trauma Through the Body

In the history of humankind, there have been many ways of treating those who have gone through mental health problems, be it by locking them up in asylums, performing brain surgeries, and later treating them with the introduction of talk therapy and medications. 

When you imagine going to a therapist for any problem you might be going through, what is the one thing you would almost always do in the session?

You would talk. You would talk about what is troubling you, talk about what is making you upset or angry, and yes, again talk about your thoughts and motivations.

The premise of most therapy sessions is talking. However, therapists and researchers in the early 1970s & 1980s saw that talk therapy was not helping a certain set of clients. These were clients who had undergone significant trauma in their lives.

Some examples of trauma include -

• Experiencing emotional or physical abuse in childhood
• Experiencing the death of a parent or a close adult in childhood
• Experiencing a parent being dependent on alcohol or other substances in growing years
• Experiences of being part of a natural calamity like Tsunami
• Experiences of being part of war

Trauma is an emotional or psychological response to an event or series of events that are deeply distressing or disturbing. It is an experience that often overwhelms an individual's ability to cope, leading to feelings of helplessness, terror, and intense emotional stress. Trauma can have lasting effects on a person's mental, emotional, and physical well-being, impacting their thoughts, behaviours, relationships, and overall quality of life.

Why would people who have gone through significant trauma not benefit from talk therapy?

Because the primary expectation in a therapy room would be that the person speaks about the events leading up to the trauma, and every time they would talk about their trauma, they would relive it creating more barriers in the healing journey. 

In the realm of mental health and therapy, traditional approaches often focus primarily on verbal communication and cognitive understanding. However, for individuals who have experienced trauma, healing extends beyond mere words.

The Somatic Experiencing® therapeutic approach recognizes the intricate connection between mind and body in processing trauma. Developed by Dr. Peter A. Levine, the Somatic Experiencing® approach offers a unique and holistic approach to trauma resolution by facilitating the release of stored tension and restoring the body's natural capacity for self-regulation.

The term ‘somatic’ means body. This article aims to explore the principles, techniques, and benefits of the Somatic Experiencing® therapeutic approach in the context of trauma therapy.

Understanding Somatic Experiencing® Therapeutic Approach:

At its core, the Somatic Experiencing® approach acknowledges that trauma is not solely a psychological phenomenon but also deeply embodied within the nervous system.

The nervous system is like the body's communication network, helping us sense the world around us and respond to it. It's made up of the brain, the spinal cord, and a vast network of nerves that run throughout our body like wires. 

Traumatic experiences often trigger a primal "fight, flight, or freeze" response, causing the body to become dysregulated and stuck in a state of heightened activity or diminished activity.

As an example, let’s say that a child witnessed their parents fighting and observed physical violence, which led to the eventual separation between the parents, leading to the child growing up with a single parent. In the instances of arguments between the parents, the child might go through a series of responses such as -

•  Wanting to come in between their parents to stop them (fight response) 
•  Wanting to lock themselves in a room and not go back outside (flight response)
•  Stress eating every time any indication of a fight would start to numb their emotions (freeze response). 

Over a period of time, this child may grow up having a dysregulated nervous system. This means they might over or under-perceive threats in their environment as an adult.

When your nervous system is in a constant state of shock for a consistent period or experiences sudden trauma, the body ends up storing it because often as children we are never taught a way of processing such difficult experiences.

Over time it can manifest as mental or physical ailments such as chronic pain, anxiety, depression, irritable bowel syndrome, and other auto-immune disorders.

Animal- Human Connection 

Animals in the wild typically respond to threats or trauma through instinctual reactions such as fight, flight, or freeze. After the threat has passed, they discharge any residual energy from these responses through shaking or trembling, returning to a state of calm and equilibrium.

Humans also have instinctual survival responses but may become stuck in these responses due to various factors, leading to unresolved trauma. The therapeutic approach addresses trauma by gently guiding individuals to reconnect with their nervous system and instinctual responses in a safe and supportive environment. Through this process, clients learn to adjust to their experiences, gradually accessing and discharging the energy bound in the nervous system without becoming overwhelmed. You can read more about the animal-human connection.

3 Key Principles of Somatic Experiencing® Therapeutic Approach

1. Tracking Sensations

Tracking sensations means paying attention to how your body feels, like noticing if you're tense, warm, or shaky. These physical feelings can help unlock and deal with past traumas.

Example: If someone experiences a car accident, they might notice that they feel tense and shaky whenever they hear loud noises, like car horns. By tracking these sensations, they can start to understand how their body reacts to triggers from the accident. This awareness can then help them work through their trauma and feel more in control.

There are 3 types of sensations that practitioners of the Somatic ExperiencingⓇ method focus on:

1. Interoceptive Sensations:  

Interoceptive sensations refer to the internal sensations of the body, such as heartbeat, breathing, muscle tension, and visceral sensations (e.g., stomach butterflies).

In the Somatic Experiencing® approach, the practitioners help clients develop awareness of interoceptive sensations as a way to connect with and regulate their nervous system. By tuning into these internal cues, individuals can better understand how their body responds to stress and trauma. This awareness is crucial for identifying triggers and building resilience.

2. Kinesthetic Awareness: 

This term typically refers to the sensory experience and the perception of bodily movements and sensations. It encompasses a broad range of sensory feedback related to bodily motion, such as muscle tension, joint position, and the feeling of movement.

3. Proprioceptive Sensations: 

Proprioceptive sensations refer to the sense of the body's position and movement in space or the spatial awareness of the body. It includes sensations such as joint position, muscle tension, and balance in relationship to the space our body occupies in the environment. By focusing on proprioceptive cues, clients can ground themselves in the present moment, reduce shutting out of the environment, and restore a sense of safety and agency.

2. Pendulation

Pendulation means shifting back and forth between feeling safe and feeling uncomfortable. This helps people get better at handling tough situations and becoming stronger.

Example: Imagine someone with social anxiety who wants to become more comfortable in social situations. They might start by attending a small social gathering with close friends where they feel safe. Then, they might challenge themselves by attending a slightly larger gathering with acquaintances, where they feel a bit more uncomfortable. After that, they might return to another small gathering with friends to regain a sense of safety and reassurance. Following this, they might try attending a medium-sized event where they feel a bit more anxious. They continue this cycle of pushing their comfort zone while also returning to familiar, safe situations to ground themselves and regain confidence. This back-and-forth movement between feeling safe and uncomfortable characterizes the pendulation process. 

3. Completing Incomplete Responses 

Completing Incomplete Responses means going back to moments where you felt frozen or unable to react and finding ways to finish what you couldn't do then. More often than not in stressful situations, especially the sudden unpredictable ones, our nervous system instructs the body to shut down, just like a deer may pretend to be dead in front of a cheetah in order to protect oneself.

Example: Let's say someone was bullied at school but didn't stand up for themselves at the time. By revisiting that experience with the help of a therapist, they might practice speaking up for themselves or setting boundaries. This allows them to release the pent-up emotions from the past and feel more confident and in control in similar situations now.

Techniques Used in Somatic Experiencing® Therapeutic Approach

1. Grounding Exercises 

Grounding exercises are activities that help people feel safe and calm by focusing on what's happening right now in the present and the things around them.

Example: One grounding exercise could be naming five things you can see, four things you can touch, three things you can hear, two things you can smell, and one thing you can taste from your current environment. These activities bring attention to the present moment, as traumatic memories or flashbacks often take us into the past making us relive the moment and feel out of control. 

2. Somatic Resourcing

Somatic resourcing means finding and using tools inside and outside of the body experiences that can help feel relaxed, strong, and calm.

Example: An internal resource might be remembering a time when you felt really confident or loved. An external resource could be holding a comforting object like a soft blanket or listening to soothing music. These resources can be used during times of stress to help you feel better and more in control.

3. Slow Titration 

Slow titration means taking trauma processing slowly and carefully, making sure it doesn't overwhelm you and cause more distress. The term "titration" is borrowed from chemistry to describe a similar gradual and controlled process.

In this context, it refers to the gradual exposure to distressing or traumatic experiences in a manner that ensures the individual remains within their "window of tolerance" the range of emotional and body arousal they can manage without becoming overwhelmed or retraumatized. By titrating the exposure, therapists can help clients process their experiences safely and effectively, without triggering excessive distress.

Example: If someone experienced a car accident, they might start by talking about what happened briefly, then take breaks to relax and calm down. They would gradually increase the time spent discussing the event as they feel ready, making sure not to rush or push themselves too hard. This approach helps prevent them from feeling retraumatized and keeps them within their comfort zone.

5 Benefits of Somatic Experiencing® Therapeutic Approach 

1. The Somatic Experiencing® method is a bottom-up approach. A bottom-up approach involves starting with bodily sensations in therapy and regulating the nervous system's response to trauma, gradually addressing higher-level cognitive and emotional processes for healing and resilience. This method prioritizes the fundamental elements of body experiences to guide therapeutic interventions which we now know is one of the most important approaches in treating trauma. 
2. Preliminary evidence suggests that the Somatic Experiencing® approach shows positive effects on Post Traumatic Stress Disorder (PTSD) symptoms. Additionally, it may improve both emotional and physical symptoms, as well as overall well-being, in both traumatized and non-traumatized individuals
3. By addressing trauma at both the physiological and psychological levels, this modality promotes holistic and sustainable healing. 
4. Through the cultivation of body awareness and self-regulatory skills, individuals gain greater autonomy over their emotional and physiological responses.  
5. Many clients report a reduction in symptoms associated with trauma, such as anxiety, depression, chronic pain, and relational difficulties, leading to enhanced well-being and vitality.

4 Cons of Somatic Experiencing® Therapeutic Approach

1. Despite positive findings, the evidence base for the therapeutic modality is still evolving, with relatively fewer large-scale studies compared to other therapeutic modalities. More unbiased randomized controlled trials (RCTs), a clinical goal standard in assessing if a therapeutic technique works or not, are needed to confirm the effectiveness and explore its specific mechanisms further. 
2. Somatic Experiencing® therapy typically requires multiple sessions over an extended period, which can be time-consuming and costly for people. 
3. Effective implementation of Somatic Experiencing® therapy requires highly trained and experienced practitioners, which may not be readily available. 
4. Exploring traumatic experiences and bodily sensations in therapy can sometimes lead to temporary increases in emotional distress or discomfort for some.

Conclusion:

The Somatic Experiencing® therapeutic approach offers a profound and transformative path to healing for individuals who have experienced trauma. By honoring the body's innate wisdom and resilience, it facilitates the gentle release of stored tension and supports individuals in reclaiming their sense of safety, vitality, and wholeness. As awareness of the mind-body connection continues to grow within the field of mental health it stands as a beacon of hope and possibility for those seeking profound and lasting healing from trauma. 

Disclaimer: The views expressed in the article represent those of the organization and are not affiliated with the Somatic Experiencing Trauma Institute.

References:

Kuhfuß M, Maldei T, Hetmanek A, Baumann N. Somatic experiencing - effectiveness and key factors of a body-oriented trauma therapy: a scoping literature review. Eur J Psychotraumatol. 2021 Jul 12;12(1):1929023. doi: 10.1080/20008198.2021.1929023. PMID: 34290845; PMCID: PMC8276649.

Payne P, Levine PA, Crane-Godreau MA. Somatic experiencing: using interoception and proprioception as core elements of trauma therapy. Front Psychol. 2015 Feb 4;6:93. doi: 10.3389/fpsyg.2015.00093. Erratum in: Front Psychol. 2015;6:423. PMID: 25699005; PMCID: PMC4316402.

Positive Psychology. (2020). Somatic Experiencing. Positive Psychology

Winblad NE, Changaris M, Stein PK. Effect of Somatic Experiencing Resiliency-Based Trauma Treatment Training on Quality of Life and Psychological Health as Potential Markers of Resilience in Treating Professionals. Front Neurosci. 2018 Feb 16;12:70. doi: 10.3389/fnins.2018.00070. PMID: 29503607; PMCID: PMC5820455.