Somatic experiencing - Dr. Axe

The definition of somatic is “relating to or affecting the body.” Somatic experiencing (SE), one form of somatic therapy, is a therapeutic technique that can help people suffering from symptoms of post-traumatic stress disorder (PTSD), as well as anxiety symptoms and depression.

Unlike most forms of psychotherapy, SE focuses on physical responses that occur when someone experiences trauma.

What qualifies as trauma exactly? Trauma is considered anything that overwhelms someone’s nervous system.

Traumatic experiences are believed to lead to dysfunction in the nervous system when they aren’t fully processed. This dysfunction can prevent someone from living in the present and can contribute to a number of symptoms and unhealthy defense mechanisms.

SE can help people release pent-up energy, learn to better cope with difficult bodily sensations and suppressed emotions, and essentially can release someone from” living in the past.”

What Is Somatic Experiencing?

Somatic experiencing is a form of somatic therapy and a “body-centered” therapeutic approach. It’s most often used to help people overcome symptoms tied to trauma, since it may allow someone to become “unstuck” in the fight, flight or freeze response.

Another way to describe trauma is “incidents that make you believe you are in danger of being seriously injured or losing your life.” According to Harvard Health Publishing, examples of trauma can include:

  • physical abuse
  • sexual abuse
  • emotional abuse
  • physical neglect
  • emotional neglect
  • witnessing domestic violence
  • substance misuse within the household
  • mental illness within the household
  • parental separation or divorce
  • incarceration of a household member
  • a sudden death in the family
  • a stressful divorce
  • caring for someone with a chronic or debilitating illness

Here are some of the core principles behind somatic therapy/somatic experiencing:

  • The mind and body are connected, so whatever is felt in the mind is thought to also show up in the body.
  • SE involves a patient working on feeling physical sensations in the body that are tied to past traumatic events, rather than only thinking through the events and emotions that were felt. The purpose is to access the body memory of the event, not the story itself.
  • Repressed memories are thought to be capable of continuing to impact the body physically, even when memories are forgotten. Until a memory is fully felt and processed, it will continue to do damage.
  • The main goal therefore is to begin experiencing present moments again.

What does a somatic therapist do?

A somatic therapist (or coach) educates patients about how their autonomic nervous systems work and helps them increase their awareness of their own bodily sensations.

As a practitioner of “body psychotherapy,” the therapist talks to his/her patient about what exactly is being experienced and perceived in the body.

The therapist also acts as a trusted partner and calm presence during sessions, which can feel stressful and overwhelming for the patient at times. Overall the therapist’s goal is to help decrease the distress and symptoms that the patient is feeling so she/he can experience improved coping skills and quality of life.

What happens in a somatic experiencing session?

The goal of SE therapy sessions is to release traumatic activation through increased tolerance of bodily sensations and related emotions.

SE integrates body awareness into the psychotherapeutic process, which is what makes it unique. Sessions focus on creating awareness of inner physical sensations, which are seen as the carriers of the traumatic memory.

Unlike other approaches, such as exposure therapy, SE does not require reliving the traumatic events and discussing them in detail. Instead, patients learn to monitor their own arousal through body awareness and relaxation techniques.

SE therapists help their clients move between aroused states and calmer states. Sessions usually involve purposefully triggering low‐level autonomic nervous system activation, tracking bodily reactions and then working on dissipating the reactions.

Techniques and mechanisms that are used to help a patient self-regulate arousal include:

  • Titration, which helps keep arousal at a low level during the processing of traumatic triggers.
  • Pendulation, which describes balancing between regulated parts in the body and dysregulated parts.
  • Discharge, which involves dissipating arousal.
  • Relaxation techniques, including breathing exercises and visualization.

Who coined the term “somatic experiencing”?

SE therapy was created by Dr. Peter Levine, Ph.D., considered an industry leader in studying and treating trauma. Dr. Levine is the author of the best-selling book “Waking the Tiger: Healing Trauma.”

He helped develop SE therapy based on multidisciplinary studies of stress physiology, psychology, ethology, biology, neuroscience and indigenous healing practices.

One way he apparently came up with the somatic experiencing approach was by observing how animals handle stress. He realized that animals typically complete a full sequence of a response to danger, unlike most humans.

Animals usually notice danger, react by fighting or fleeing, and then recover, often with help from physical movement that releases energy. Humans, on the other hand, don’t always complete this cycle, which can lead to someone becoming “stuck” in the trauma.

Benefits/Uses

Below are some of the ways that somatic experiencing can help people dealing with anxiety, depression, a range of symptoms tied to stress and other problems:

1. Can Help Reduce Physical Sensations Tied to Trauma/Stress

With SE, the focus is on bodily sensations linked to past events and feelings, rather analyzing details of the events.

Experiencing trauma and chronic stress can trigger emotional and physical reactions that can stick with someone for years. These reactions, such as increased levels of stress hormones — including cortisol and adrenaline — can increase someone’s risk of experiencing a number of health conditions, including heart attack, stroke, obesity, diabetes and autoimmune diseases.

SE may help some people who are dealing with physical symptoms and conditions related to stress, anxiety and depression, such as:

  • increased inflammation
  • chronic pain
  • digestive issues like IBS, constipation and diarrhea
  • muscle tension and pain
  • insomnia and sleep problems
  • fatigue and low motivation
  • even susceptibility to infections and respiratory issues due to compromised immune function

2. Can Improve Someone’s Ability to Be Present

Rather than “numbing out” feelings, using unhealthy coping mechanisms, or engaging in risky behaviors or substance abuse to avoid feeling certain emotions, somatic experiencing is all about facing past traumas head on.

One of the main goals of SE is helping people notice their bodily sensations in the present moment. Paying attention to how your body feels is one way of practicing mindfulness.

3. Can Help Someone Prepare for Future Stressful Events

As one Psychology Today article explains, “healing” is able to take place when people are able to “restore their nervous system’s normal cycling between alertness and rest.”

  • Alertness and excitation happen when someone is stimulated. This can result from a traumatic or dangerous event that takes place. (Excitation can also happen following a pleasurable event, however SE usually doesn’t focus on this.)
  • Settling happens when someone is able to recover and return to homeostasis. This usually requires a quiet, relaxing period in which the personal can “rest and digest” and recover. Settling is important for building up energy so we are ready to respond to the next stimulating event.

By healing past traumas, someone is better able to move forward, recharge and handle future problems.

As somatic coach Rachel Grant describes the process:
trauma disrupts the nervous system and causes it to be dysregulated, usually through over-stimulation. When we become over-stimulated, we can be flooded with intense emotions, such as fear, panic, and rage. This overwhelm compromises the body’s ability to react to the danger, and we get stuck in one of two patterns: either a very high level of arousal (panic, anxiety) or feeling shut down, numb, and frozen.

By “resetting” your nervous system, you’re better able to cope with everyday stress and withstand problems that arise in life.

How to Do It

SE is a practice that emphasizes staying present and in your body, so you do it by paying attention to sensations that lie underneath your feelings. It’s best to practice with a trained therapist, although you can use certain SE concepts on your own as well.

Overall, the goal is to learn how to better shift from feeling aroused/anxious to feeling calmer. Here are some tips and techniques to help you get started:

  • When thinking about traumatic events that have happened in the past, pay close attention to how your body feels (including pulsing, temperature, heart rate, etc.). Notice all of the ways you body moves through feelings, including via contraction/expansion, pleasure/pain, warmth/cold.
  • If you start to feel distressed, think about past, positive memories/experiences to control your reaction. Bring to mind pleasant sensations, and try to feel them coursing through your body. Use this technique to counter the reaction you have to stressful memories.
  • Eventually you’ll hopefully develop a greater capacity to handle stress and stay in the present moment. Every time you work on SE, use whichever stress-relieving practices (like breathing exercises, meditation, visualization, affirmations and prayer) help you to control your body’s arousal. Don’t be scared to physically feel anxious/aroused, since with practice you’ll become more confident and comfortable with your ability to handle these feelings.

Does It Work? (Plus Potential Downsides)

Does somatic experiencing really work? Healing from trauma can be a complicated process, and not every therapeutic approach will work for every person.

That said, there is some evidence, including at least several controlled studies, suggesting that SE can help people heal from trauma.

One study conducted in 2009 that examined a group of social service workers who were given somatic experiencing/trauma resiliency treatments following trauma involving Hurricane Katrina found that it helped decrease participants’ PTSD symptoms and psychological distress. However, it didn’t necessarily help all participants deal with physical symptoms.

A 2017 study published in the Wiley Journal of Traumatic Stress demonstrated that 15 weekly SE sessions among 63 adults with PTSD resulted in significant effects for post-traumatic symptoms severity and depression.

In another 2008 study, in which participants with a history of trauma partook in one 75‐minute SE session, 90 percent of participants reported significant improvements or being completely free of symptoms of intrusion, arousal and avoidance during four-week and eight-month follow-ups.

Finding a Therapist

To get the most benefit from SE, it’s important to work with a therapist or coach, such as a certified somatic experiencing practitioner (SEP), who is specifically trained in this approach. Training in SE typically involves completion of course work and hands-on practice with patients, so it’s best to seek out someone with these qualifications when choosing a practitioner.

Keep in mind that some SEPs use “healing touch” to help guide their patients. If you’re not comfortable with a therapist touching you in any way, be sure to discuss this beforehand, or consider trying another form of therapy instead.

For many more helpful resources, including help finding a SE therapist, check out the Somatic Experiencing Trauma Institute website.

Other Ways to Cope with Trauma

SE is just one way to work on healing your mind-body connection. Other approaches that have been shown to be beneficial for people dealing with trauma and chronic emotional distress include:
  • Physical touch, including massage therapy, chiropractic care and so on
  • Exercise
  • Yoga, which has been found to be a powerful way to work through stress, grief and depression
  • Writing in a journal
  • Meditation
  • Music and art therapy
  • Prayer
  • Other traditional forms of therapy, such as cognitive behavioral therapy

Working with a trained therapist can help you reframe what happened to you in the past so you can move past it.

Is EMDR a Somatic Therapy?

Eye movement desensitization and reprocessing (EMDR) therapy is one healing method available for people with PTSD. It involves processing traumatic memories and their associated beliefs, emotions and sensations.

EMDR and somatic experiencing are now being integrated more in therapeutic settings, since their effectiveness seems to be stronger when used together.

Conclusion

  • The meaning of “somatic” is “relating to or affecting the mind.” Somatic therapy/somatic experiencing (is a form of psychotherapy that focuses on the connections between the brain, mind and behavior (or the mind-body connection).
  • With help from a therapist, and also by practicing on your own, SE techniques may help reduce symptoms tied to past traumas, chronic stress, anxiety, depression and grief.
  • Something that makes SE unique is that it’s body-centered. SE involves a patient working on feeling physical sensations in the body that are tied to past traumatic events, rather than only thinking through the events and emotions that were felt. The purpose is to access the body memory of the event, not the story itself.