Somatic Therapy: How Somatic Experiencing can Support your Healing Process
Somatic Therapy
Somatic therapy is a body-based mindfulness approach that highlights what the client is feeling internally in the present moment. This approach can seem different than talk therapy or cognitive therapy in the way that there is less emphasis on talking in the sessions. Somatic therapy is a ‘bottom up’ approach which means that it focuses on the cues and information received from the senses and body, then emotions and then thoughts and cognitions. No matter what somatic therapy modality you choose to work within you will likely hear about the polyvagal theory which serves as the foundation for somatic experiencing as well as other approaches.
Polyvagal Theory
Polyvagal theory teaches us about the role the nervous system (particularly the autonomic nervous system) plays in our sense of safety or in our detection of threat. Our body is always scanning for threat in the environment without us being aware of this—this is called ‘neuroception.’ When trauma happens, we often don’t feel safe anymore and our nervous system develops kind of like a heightened alarm system that is detecting threat more often and more intensely. How polyvagal theory informs somatic work, is that it helps us notice whether the body is in a more heightened ‘fight or flight’ state or whether it’s in a collapsed ‘freeze’ state or whether it’s in a safe/calm, social engagement state; it helps us sense if the nervous system is regulated or dysregulated. If our body feels safe, we have access to curiosity, connection, calmness and ability to feel present and able to socially engage. In the chart below, you can see how fight, flight, freeze and social engagement are different nervous system states that also directly effect the physiology of the body. This is also why it is important to track what state a person is in and help support them in getting back to a sense of safety.
Interoception
No matter what form of somatic work you are learning about, you may hear of this term ‘interoception’. Interoception is the sensing of what is going on internally in your body—this can be sensations, temperature, pain, movement and even emotions. Building awareness of what is going on within your body is at the core of all somatic work. In somatic therapy you will learn to ‘track’ what is happening internally in the present moment.
Somatic Experiencing
Somatic Experiencing is a type of somatic therapy that addresses trauma and was developed by Dr. Peter Levine. Levine, by observing animals in the wild, realized that the animals encounter a lot of danger and threat in their environments but do not seem to be traumatized. He noticed that these animals would ‘shake off’ the trauma when the predator was gone and they were safe again. This shaking off of the trauma was a instinctual bodily reaction that served to ‘discharge’ or release the survival energy and thus completing the survival response. Humans, on the other hand, tend to have a disrupted survival response because they have to just go back to work or get up and keep going—without shaking it off or even feeling the feelings that may have shown up during and after the trauma. Humans, because of our big brains and cognitive capacity, are able to override the instincts in the body and disrupt the body’s natural responses. After a trauma, the survival energy then can become stuck in the body and nervous system—when this happens we feel on edge, dissociated and dysregulated and often go into a chronic state of anxiety (or depression). Somatic Experiencing assists the client with completing the self-protective survival responses and releasing the stuck survival energy in the body.
Resourcing
An important concept in Somatic Experiencing is ‘resourcing’ which is an invitation for you to direct your attention to something that you associate with safety or pleasure. Resourcing could be orienting to something in your environment that helps you feel safe—a pet, a picture of a loved one, a soft blanket, a window that looks out at the trees or even a color that you find soothing. Resourcing could be you thinking of a memory of something that was positive. Resourcing could be engaging in self-care—taking a hot shower, drinking tea, doing grounding exercises, calling a friend or taking a walk. These things may sound basic to you but for someone that has experienced trauma or chronic negative experiences—this can be a challenging task because the nervous system has learned to only notice threats and negativity in the environment (which is an adaptation and it is completely natural for it to do this) so there is some re-training that can happen to help the nervous system be able to notice cues of comfort and safety in the environment.
What does a somatic experiencing session look like?
Feeling safe in therapy is a pre-requisite to being able to do any kind of trauma work—especially somatic work. It can take a while for a client to truly have a felt sense of safety with their therapist and in the space that therapy is conducted in. Somatic therapy can be done in a therapy office or in the comfort of a person’s own home. However, some people may not feel safe and comfortable in their own home and some people may not feel comfortable in their therapist’s office—together with your somatic therapist you can decide what is the most comfortable for you. Once a felt sense of safety and comfort feels established (and this can take a long time for some people—which is totally okay) then somatic work can begin. I like to start clients off with resourcing and grounding exercises that are oriented towards the external rather than the internal—this tends to be less activating for some people when they are just getting started with somatic work. The resourcing/grounding exercise may look like orienting to the space that the client is in and orienting to comfort by identifying items in the room that give the client a feeling of comfort when they look at them. If the client feels comfortable enough to go a step further, I may invite them to track what is happening in their body as we continue.
The client is never pushed to do anything that they are uncomfortable with!
Many people with trauma have learned to disconnect from their body and do not feel safe noticing what is happening in their body—if this is the case, more time will be needed building a sense of safety. It is okay and totally normal if you need more time building a sense of safety in your body! Even if it takes a long time—that is fine and do not push yourself or force yourself to do exercises in therapy that make you feel uncomfortable—this will have a backfiring effect. Slow and steady wins the race with somatic work. I often invite the client to slow down, not only because this is how the client can track what is going on internally but it also prevents the flooding that often happens with trauma work. Going too fast can be counterproductive.
Mindfulness
Another reason I may stay with resourcing and grounding exercises for a while or re-introduce them often, is because sometimes it takes time for clients to learn mindfulness. Mindfulness is a key component to doing somatic work—everything about somatic work is tracking what is going on internally and noticing how things in the environment, thoughts, feelings, images, memories are effecting a client internally in the present moment. Clients will learn to build a vocabulary around describing how they are feeling emotionally and physically and then they will learn to use mindfulness to track these feelings as they are happening. It takes a while for most people to build the mindfulness muscle and to truly be able to track and notice these tiny, sometimes microscopic, shifts that are happening internally.
Once the client feels safe, comfortable and has a enough internal awareness—we may start doing full somatic experiencing sessions. This looks like me inviting the client to slow down, enter a mindfulness state and be present with what is happening internally. Then, we follow whatever the body brings up—trusting that the body will bring up what needs to come up. If all goes well and if the client is in therapy for trauma work, we may start the work of ‘re-negotiating the trauma.’
Re-negotiating the Trauma
Re-negotiating the trauma means that we may touch into elements of the trauma that the client had experienced. We do not want to go straight into the peak most traumatic moment that the client remembers. For example, if the client had a medical trauma, we may not bring up or focus on the most intense memories around this event but may focus on something a little less activating such as ‘What was it like for you the day before the surgery? How does your body feel when thinking about that day? Did you receive the support from your loved ones that you felt like you needed that day? What was something you needed that day that you didn’t receive?’ The therapist may slowly ask these types of questions while the client is tracking what is going on internally. What I am looking for while the client is tracking and answering these questions are:
Self-protective survival responses that were repressed at that time but could be given an opportunity to be expressed now.
Emotions that the client had to repress at that time but could be expressed now.
Whether or not the client experienced the support they needed to get through the trauma at that time and to see if there is a way for them to get that support now—in order to do some reparative work.
Clients often don’t need to recall or do work around the most intense moments of their trauma in order to see that there body and nervous system are becoming regulated and calming down. If the client feels comfortable doing this work and wants to proceed into more emotionally charged memories around their trauma—I am happy to support them in doing this work and we will move forward cautiously and at their pace. What I am hoping for from doing re-negotiating the trauma work is that a client can discharge the fight/flight survival energy from their body by letting these instinctual processes play out in therapy— resulting in the nervous system becoming more regulated and this becoming their new baseline.
People that might not benefit from Somatic Experiencing:
Most people can benefit from somatic work but for some, it may not be as helpful. People that are in crisis or experiencing the trauma currently may not benefit from somatic work because somatic work can only be done when there is enough of a sense of safety in one’s environment and in one’s body. Once the client is safe enough and not in a crisis state—they can begin this work. Otherwise, the best course of action for this client is to seek assistance with crisis stabilization. Examples of these types of situations are people currently experiencing domestic violence, living in a war zone, homelessness, severe poverty, severe suicidal ideation, unmanaged eating disorders, unmanaged addictions—if you are experiencing these types of issues seek help from your local crisis center and crisisline. If a client has recently experienced sexual or physical assault but are in a safe enough environment now—they can benefit from some resourcing, grounding and somatic work.
Some others that may not be a good fit for somatic work are those that are experiencing psychosis. Somatic work requires a sense of being able to feel present, regulated and grounded enough.
Can I do somatic work if I am on medication?
Yes you can! Some clients feel an emotional blunting effect or not as connected to their body from medication but that is okay we can work with that. There is no need for you to quit or reduce your meds to do this work.
If you have more questions about somatic therapy or Somatic Experiencing reach out! CONTACT
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