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What is Somatic Experiencing Therapy?
Somatic experiencing therapy is a type of alternative therapy geared towards helping people find healing from trauma. Created by Peter Levine, Ph.D., this therapy works on the principle that trauma gets trapped in the body, leading to some of the symptoms people with PTSD or people who have experienced trauma might experience. Through this method, practitioners work on releasing this stress from the body.
Many people who have experienced trauma, especially those who have experienced physical trauma such as domestic violence or sexual assault, can dissociate or disconnect from their bodies. Somatic experiencing helps them increase awareness of their internal experience (interoceptive, proprioceptive, and kinesthetic sensations).
What Does a Somatic Therapist Do?
A somatic therapist helps an individual develop an awareness of their bodily sensations, teaching them to feel safe in their bodies while recalling certain thoughts, experiences, and emotions. Somatic therapists help individuals release certain emotions that are built up within the body using a variety of techniques including breathwork, hypnosis, or acupressure, among others.
How Does Somatic Experiencing Therapy Work?
The trauma that is held within the body may lead to emotional dysregulation. It is believed that somatic experiencing therapy works by releasing the trauma that becomes "trapped" in the body. One aspect of this dysregulation is the freeze response, our body’s primitive defense against danger. This response would activate if someone were being chased by a tiger.
Unlike the "fight or flight" response that takes place in response to an acute threat, which causes the sympathetic nervous system to increase heart rate, breathing, and focus, the "freeze" response can cause the opposite.
It is said that the body doesn’t know how to distinguish physical trauma from mental trauma. If the danger is life-threatening, like that tiger, you may be able to physically shake off that fear once the tiger is no longer around. With emotional trauma, however, the brain can get stuck believing that you are still in a state of danger.
The freeze response may manifest in both cognitive and physical symptoms such as:
Cognitive Symptoms
- Confusion
- Detachment
- Difficulty concentrating
Physical Symptoms
- Difficulty moving
- Slowed breath
- Lower heart rate
Is Somatic Experiencing Therapy Effective?
While not much research has been published on somatic experiencing, one study, a randomized controlled trial, showed that 44% of the participants no longer met the criteria for a diagnosis of PTSD after treatment.
A 2018 study looked at the effects of somatic experiencing therapy to build resilience in health professionals at risk of vicarious trauma. The results indicated that a three-year somatic experiencing training course significantly improved quality of life and psychological symptoms.
A 2021 scoping literature review found that the current research on somatic experiencing therapy shows promise. However, more research using randomized controlled trials is needed further to assess its effectiveness and use for mental health conditions.
Is Somatic Experiencing the Same as EMDR?
Eye Movement Desensitization and Reprocessing, or EMDR, is a method of therapy for dealing with unresolved trauma and distressing life events that often produce more rapid results than traditional talk therapy.
Somatic Experiencing works by bypassing the higher cognitive centers of the brain and working with sensations that are associated with the primitive part of the brain by way of the Autonomic Nervous System. It works directly with the trauma brain reactions, using body awareness and body sensations to gently and gradually release the emotion and energy from those body memories.
Unlike EMDR, which may target the worst part of the trauma first, Somatic Experiencing works from the outside edges inward to the core of the trauma. While the pace may be slower than with EMDR, the discharge and release of the traumatic activation from your nervous system can be very powerful. With this release your nervous system can return to a healthier range of resiliency and healing can take place.
How Do You Know if You Need Somatic Experiencing Therapy?
A person should seek help from a doctor or mental health professional if they have:
1. mental or physical symptoms affecting their well-being
2. flashbacks, nightmares, or intrusive thoughts
3. symptoms that are interfering with work or relationships
They will be able to offer advice and, potentially, a diagnosis.
If a person is considering trying SE, they should ideally look for a practitioner with experience working as a psychotherapist. Other things to look for include:
1. positive, unbiased reviews
2. accreditation from a professional medical association
3. transparency about their methods and approach
If a person is undergoing SE and they are not sure it is helping, or they think it could be making things worse, they should speak with another mental health professional for a second opinion.
Does a Somatic Therapist Touch You?
As with any form of therapy, it's essential to be in an emotional and mental place where you have the time and energy to process complex feelings. If you're doing somatic therapy in person, touch is often involved. Because of that, it's wise to ensure you don't mind being touched by another person. Boundaries and consent play vital roles in touch, and you will never be touched without consent.
What Does Somatic Release Feel Like?
You may cry as a way of letting go of the emotions and sadness that you’ve been holding. You may take a deep sigh and notice the ability to breathe easily, or you may feel like you’ve dropped a huge brick from your heart. Clients often express a lighter feeling after their body has properly sequenced through an event or emotional experience.
How Can I Tell if a Somatic Therapist is a Good Match for me?
Many research studies show that the biggest factor in a successful therapy experience is the relationship between the therapist and the patient. So, making sure you’re comfortable with your therapist is important. Two things come to mind in trying to sort out the rightness of fit:
1. When you talk to this person, do they make you feel comfortable? Do you feel seen and listened to? Are they talking to you or past you?
2. Does their style and approach match what you want? Some people want, more than anything, to be listened to and supported. Others want to be challenged or given concrete tasks to work on. Think about what you want and ask your therapist how their style compares to your goals.
How Long is a Session of SE Therapy?
Most typical sessions will last approximately the proverbial 50 minutes - an hour (50 minutes of one-to-one counseling and 10 minutes of administration time). The number of sessions required to experience significant symptom relief may vary considerably from person to person and from situation to situation. The practitioner will discuss this with you on an ongoing basis. Part of the therapeutic contract is that you can opt out or stop at any time.
How Often Should You Have SE Sessions?
The frequency of Somatic Experiencing (SE) sessions depends on you. It depends on what your presenting circumstances are, what your presenting symptoms are, what events have occurred in your life, and how long has it been that you’ve been dealing with all of this. Sessions are typically spaced a week apart. Sometimes in rare circumstances, we might wanna work more often than that, and at other times, every other week or even once a month.
Is Somatic Therapy Covered by Insurance?
Unfortunately, the answer varies quite widely. One important caveat to keep in mind is that using insurance to pay for therapy requires you to receive a mental health diagnosis. That information is passed along to your insurance company. Some people are not comfortable with this and decide not to seek reimbursement from their insurance companies. To find out if this is a viable option for you, we suggest you call your insurance company and ask the following questions: Do I have out-of-network benefits for psychotherapy? Do I have a deductible? How much is it? What percentage of my bill will be covered after my deductible is met? What is the insurance company’s usual and customary fee for CPT code 90834?
Origins of Somatic Experiencing
Dr. Peter Levine developed Somatic Experiencing from his observations of how wild animals recover from repeated traumatic experiences like attacks by predators (imagine gazelles eluding a cheetah). What he noticed was, that after a threat was gone, the animals experienced a physical release of their fight-or-flight energy by shaking, trembling, or sometimes running. He also saw that with the completion of the physical release, they quickly returned to their normal state.
Dr. Levine believed that humans also possess the same ability to release physical energy from stress but often thwart it by “keeping it together” following trauma. We all probably have direct experience “keeping it together” through a difficult experience. Our ability to override what is an innate mechanism for self-care is for many of us what sets the stage for PTSD. By stopping this natural cycle of release, the energy becomes stuck, in effect keeping us in a perpetual state of fight-or-flight so that we are unable to return to our relaxed, balanced state.
It wasn’t until sometime later after his initial observations, however, that he was able to validate his thinking. It happened while he was in session with a client suffering from PTSD. His client began vividly reliving a traumatic childhood experience, and as he observed her agitated state, he had a flash of inspiration. He encouraged her to protect herself by running away from the threat as if she was being chased by a tiger. She began kicking her feet, simulating escape, and with that action completed the natural release of traumatic energy that had been long trapped in her body.
Following this session, she experienced immediate and lasting relief from her PTSD symptoms, and Dr. Levine saw for the first time a human’s ability to enact the same physical release of trauma energy that animals do instinctively and regularly. With that, Somatic Experiencing as a therapy began.
Who can Benefit from Somatic Trauma Therapy?
Since disturbing feelings often show up in the body in debilitating ways, somatic therapy aims to drain those emotions of their power, relieving pain and other manifestations of stress, such as disrupted sleep or an inability to concentrate. These types of emotions can stem from a variety of conditions and circumstances that somatic therapy may potentially help alleviate. They include
- post-traumatic stress disorder (PTSD)
- complicated grief
- depression
- anxiety
- trust and intimacy issues
- self-esteem problems.
Types of Somatic Therapy
Below are some of the most common forms of somatic therapy.
1. Somatic experiencing
Somatic experiencing treats the body’s reactions to trauma. Some somatic therapists may ask you to discuss your traumatic experiences, while others only ask you to describe the physical sensations you felt during the traumatic event. You may be asked to move your body in a way that activates negative feelings. The therapist will teach you to release the built-up energy safely, so you can gradually get rid of the trigger.
2. EMDR
In EMDR therapy, the client remembers traumatic experiences in short doses while simultaneously focusing on an external stimulus — the most common being sideways eye movements. Other focal points might include hand tapping or listening to a particular sound.
3. Hakomi
Hakomi is a type of somatic therapy centered on mindfulness — the ability to notice the present moment without judgment. First, the practitioner establishes an atmosphere of gentle acceptance and then helps the client identify body indicators of unconscious beliefs. The client accesses unconscious material quickly and works with the therapist to safely release it.
4. Sensorimotor psychotherapy
Sensorimotor psychotherapy combines principles from psychotherapy, somatic therapy, attachment theory, and neuroscience, and techniques from the Hakomi method. This therapy helps the client safely re-experience a traumatic event and then carry out any unfinished actions (such as being unable to fight off an attacker) from the initial event. This is done to achieve a feeling of completion and closure.
5. Neurosomatic therapy
Neurosomatic therapy helps clients whose symptoms exist closer to the physical end of the mind-body continuum. NST identifies the hidden sources of tension and physical pain in the nervous system, skeletal system, and soft tissues. The main techniques used in this approach include massage, posture work, and exercises to correct imbalances.
Techniques in Somatic Experiencing Therapy
Somatic experiencing practitioners use a framework known as SIBAM (Sensation, Imagery, Behavior, Affect, and Meaning) to help clients incorporate their bodies in processing trauma.
Typically, most therapy uses our cognitive skills to access our memories or traumas via "top-down" methods. However, somatic experiencing uses a "bottom-up" approach, which starts with bodily sensations before returning to our thoughts.
1. Sensation
You may not be used to sitting with the sensations that are constantly coursing through your body, or you may not have previously realized how they were linked with your emotions. You will begin with simply noting what you are feeling in your body.
2. Imagery
This part of the framework uses guided imagery (where the practitioner leads you through imagining a scene while you listen) or interactive guided imagery. The latter is an ongoing conversation between you and the practitioner where you share what’s coming up as you are being led through this exercise.
3. Behavior
While much of this therapy consists of you reporting your internal experiences, the behavior part of Levine's model involves the therapist observing your behavioral responses, such as your body language or posture.
4. Affect
This is how you display your emotions to the outside world, such as through your word choices, tone, and speed.
5. Meaning
Finally, this part of the model looks at how you perceive the therapy and what your experiences mean to you.
Other Techniques
Some of the main techniques used in sensory experiencing therapy include:
- Bodily awareness: This involves learning more about how the body's nervous system responds to stress and trauma. People then work to recognize the physical sensations they experience when they encounter stress or trauma.
- Resourcing: This technique involves drawing on feelings of inner strength and resiliency to cope with problems.
- Titration: In this technique, a therapist helps a person work through the traumatic memory, including the feelings and sensations they experienced at the time.
- Pendulation: This process involves using relaxation techniques to swing the body from an aroused, anxious state to one that is calmer and more relaxed. With practice, people can achieve this more readily when they feel themselves experiencing a stress response.
15 Benefits of Somatic Experiencing
Some of the benefits that can be drawn from these studies and literature are:
1. Reduced physical and psychological discomfort
2. Decreased strain and pain
3. Decreased stress
4. Decreased negative affect
5. Reduced irritability and/or aggression
6. Improved concentration
7. Higher sense of oneself
8. Increased positive affect
9. Improved confidence
10. Increased hope
11. Increased resiliency
12. Heightened physical wellbeing
13. Improved relationships
14. Improved sleeping
15. Heightened interest in activities
5 Trauma Release Exercises
Trauma Release Exercises, developed by David Berceli, Ph.D., are physical exercises that help assist your body in releasing deep muscular patterns of stress, tension, anxiety, and trauma. These exercises do this by safely activating a natural reflex mechanism in your body, a shaking or vibration sensation that helps to release muscular tension. By releasing muscle tension, your nervous system calms down, and your body can return to a more balanced state.
Practicing Trauma Release Exercises, or TREs can help you relax deeply and reduce your overall stress levels. You will likely experience increased energy levels, improved sleep quality, reduced muscle and back pain, increased flexibility, and many more health benefits from trying these exercises. They are simple movements that you can use throughout your life to have better mental and physical health and control over your stress and anxiety.
Trauma Release Exercises are effective for victims of accidents, or violence, people suffering from PTSD, anxiety, and depression, as well as athletes, parents, spouses, and anyone at all. If you are reading this, you can benefit from TREs! Below you can find some step-by-step instructions on how to practice some simple TREs on your own:
Exercise 1: Helps to stimulate your nervous system, starting in your feet and traveling up your body.
- Stand with your feet comfortably shoulder-width apart.
- Gently lean your weight to one side of your body. Balance on the outer edge of the foot on the side you are leaning toward, and on the inner side of the foot on the side you’re leaning away from.
- Take 2-3 slow, deep breaths.
- Repeat leaning toward the other side of your body.
- Repeat on each side 2-3 times.
- Stretch/shake it out.
Exercise 2: Helps to fatigue your calf muscles
- If it helps, you can use a yoga block nearby and use a wall for support.
- Bring your weight onto one foot, and bend your opposite knee.
- Rise onto your tiptoes, hold for a few seconds, and then slowly lower your heel back to the floor.
- Repeat until you feel about 70% fatigued.
- Repeat with the other foot.
- Stretch/shake it out.
Exercise 3: Helps to fatigue your quads and your glutes
- Bring yourself into a simple chair pose. If it helps, you can use the wall for support or modify as needed.
- Bring your weight to your heels.
- Remain in this position until you feel about 70% fatigued.
- Stretch/shake it out.
Exercise 4: Helps to stretch your inner thighs.
- Stand with your feet comfortably wider than shoulder-width apart.
- Fold your body forward, hinging at the hips, and let your head hang down. You can bend your knees here.
- While hanging, take 3 full, deep breaths with your head in the center of your body.
- Shift your weight to one side of your body, aligning your head with your knee. Take 3 more full, deep breaths.
- Repeat on the other side.
- Repeat, once more, in the center, and then slowly come back to standing.
- Stretch/shake it out.
Exercise 5: Helps to fatigue the upper thighs
- Sit up against a wall, make sure you can see your toes.
- Dip your hips down low enough to start to feel a burn, and hold that position until you feel about 70% fatigued.
- Stretch/shake it out.
What to Expect in a Somatic Therapy Session
For those who have attended talking therapies before, you’ll be aware that you might sit opposite your therapist, a few meters away, and be invited to talk through any issues that you may be having. The therapist may offer insights, a different perspective, or challenge unhealthy thinking.
It is a very collaborative space that is designed to help you better understand yourself and your reactions/responses to events in your life. When SE is added to a psychotherapeutic approach simply adds another dimension to the therapy.
In the first session, you may be introduced to how your therapist works, as we all work slightly differently and integrate our modalities in different ways. In the first session with me, I would explain the importance of attending both to the mind and the body. A short tour of the nervous system and nervous system responses would follow because it’s important to understand what is happening inside your body when you experience a stress response to past trauma. In many ways, it takes the fear and shame out of the process if you start to realize that these reactions are biological responses that are currently out of your direct control.
As the therapist starts to add body awareness to the sessions, you may be asked to shift your attention momentarily to the sensations in your body. Perhaps you notice a tightness in your chest and that your breathing is getting a little more labored.
Asking you, at this point, to make sense of your somatic reaction will engage the cognitive part of your brain where long-held defensive and adaptive strategies may keep you from fully resolving issues. Instead, we may stay with the sensation of the tightness of the chest to see how it feels when you do. Most often, giving the body the gift of your attention will help start to regulate the nervous system and I would guide you in how to track it as it down-regulates.
You may then start to feel the tightness at ease and as you follow those sensations you may become aware that your shoulders drop a little and your heart rate starts to normalize. On occasion, placing awareness on the area may intensify it and this too is important information. In these cases, the therapist invites you to draw your attention to a part of your body that feels less intense or relatively relaxed. This sends signals to the rest of the nervous system that it can begin to stand down from alert.
As you move from awareness of stress to awareness of calm, the body starts to unravel the stuckness that is a hallmark of PTSD. Over time, this may allow images or emotions to start to come to the surface, beginning the process of trauma resolution.
How to Find a Somatic Experiencing Therapist Near Me
The first step to starting somatic therapy is to find a therapist in your area. Depending if you want to see someone in person or virtually, you may need to look for someone doing telehealth. If you're looking for an in-person experience so that you also receive the benefits of touch-oriented treatments, add your location into a search engine field along with your query.
Somatic therapy is common enough that you should be able to find one in most major cities. If you're looking for a virtual therapist, check online to make sure that your potential therapist has positive reviews.
It's important to note that most somatic therapists do not work directly with health insurance companies because somatic therapy is considered an alternative form of therapy. Many are licensed marriage and family therapists (MFTs), psychologists, or other licensed therapists and may be able to provide you with a superbill to submit to your insurance company for reimbursement.
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