What is Somatic Therapy and How is it Different than “Talk Therapy”?


After finishing a recent training in Somatic Therapy, it makes sense to share the late 20th– and early 21st-century move into the healing capacities available to people seeking to return to the wisdom of the body after years of looking to intellectual insight alone to find mental wellness.

What is Somatic Therapy and How is it different than “Talk Therapy”?

Somatic psychotherapy uses the body as a template for experience vs. rational-emotive or insight-based dialogue between therapy and client. Somatic is the opposite of a “heady” or “top-down” approach to emotional health. Cognitive Behavioral Therapy (CBT) is a classic example of an intellectual mode of therapy, working with cognitions and the “thinking brain” to create change. The nervous system may be explored intellectually but one’s experience is not accessed through the senses.

Somatic psychotherapy works from the “bottom-up”– reducing stress and anxiety physiologically, through changing the autonomic nervous system and discharging trauma.

Just as there are multiple modalities of talk therapy, there are multiple approaches to somatic therapies as well. Some of the most common modalities that a psychotherapist can be trained in include Somatic Experiencing™, Sensorimotor Psychotherapy, and the Hakomi Method.

For brevity, let’s explore Somatic Experiencing™ which is a form of therapy aimed at relieving the symptoms of post-traumatic stress disorder (PTSD) and other mental and physical trauma-related health problems by focusing on the client’s perceived body sensations (or somatic experiences). It was developed by trauma therapist Peter A. Levine (1989).

A practitioner may not ask you to tell a story about “what traumatic experience you’ve had” but rather invite you to track the sensations of your body as you recall such an experience(s). The most important underlying theory in somatic approaches to therapy is that the body’s memory of the trauma is more important than the cognitive memory.

When the body holds the memory of the trauma, people can get stuck in chronic fight, flight, freeze, or fawn responses in the body which cause a variety of physical, mental, and relational issues to occur. People often come to therapy when their bodily responses have become intolerable, i.e., sleeplessness, irritability, low impulse control, trouble breathing, etc. Others may show up to therapy for the behavioral symptoms of trauma under or overdoing work, substance use, spending, counter dependence, affairs, erectile dysfunction, etc. Their autonomic nervous system (ANS) is too often overwhelmed and needs relief. But treating symptoms is not enough.

In general, when your ANS is stimulated, your body releases adrenaline and cortisol, the stress hormone. These hormones are released very quickly, which can affect your:

  • Heart rate. Your heart beats faster to bring oxygen to your major muscles. During freezing, your heart rate might increase or decrease.
  • Lungs. Your breathing speeds up to deliver more oxygen to your blood. In the freeze response, you might hold your breath or restrict breathing.
  • Eyes. Your peripheral vision increases so you can notice your surroundings. Your pupils dilate and let in more light, which helps you see better.
  • Ears. Your ears “perk up” and your hearing becomes sharper.
  • Blood. Blood thickens, which increases clotting factors. This prepares your body for injury.
  • Skin. Your skin might produce more sweat or get cold. You may look pale or have goosebumps.
  • Hands and feet. As blood flow increases to your major muscles, your hands and feet might get cold.
  • Pain perception. Fight-or-flight temporarily reduces your perception of pain.

In “talk therapy” we might hear what a client is feeling (sad, glad, angry, or afraid) as they recollect a story but often they do not know how to access or find expression for what they feel. Returning to a restful state or place of neutrality might feel impossible. Accessing a sense of greater ease can be approached through hearing what our bodies feel as well as what they need to say. The body can be a weather vein that lets us know more about what we want more of and less of in life.

Renowned trauma Therapist Bessel Van Der Kolk describes the experience as follows: “Traumatized people chronically feel unsafe inside their bodies: The past is alive in the form of gnawing interior discomfort. Their bodies are constantly bombarded by visceral warning signs, and, in an attempt to control these processes, they often become expert at ignoring their gut feelings and in numbing awareness of what is played out inside. They learn to hide from themselves.”

This is why somatic psychotherapy has great potential to help traumatized individuals more than a cognitive approach. By starting to listen to the signals their body gives them and slowly beginning to create a sense of internal safety, clients can heal internally from their trauma.

Even exposure to long-term stress can negatively impact multiple systems (nervous, hormonal, neurotransmitter, attachment systems, etc.) in the body. By learning to direct our attention to internal sensations and develop new experiences of self-care and emotional regulation, healing from a variety of both psychological and physiological wounds is possible.

Many practitioners are able to combine both “talk therapy” and “sensory or somatic” approaches to best help clients achieve their goals. I find one need not have been a survivor of trauma to benefit from cultivating body wisdom, after all, it’s where we live as long as we’re alive.

Resources:

https://www.goodtherapy.org/blog/psychotherapy-for-your-body-role-of-somatic-psychology-today-0605174 https://www.ciis.edu/academics/graduate-programs/somatic-psychology

New York: Viking. Van der Kolk, Bessel A. The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma. New York: Viking, 2014.

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.

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