Somatic experiencing therapy is a type of alternative therapy geared towards helping people find healing from trauma. Created by Peter Levine, PhD, 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).
At a Glance
Somatic experiencing therapy can help people by focusing on how stress and trauma affect the body. By increasing bodily awareness, developing ways to release trauma, and finding ways to relax the body, people can find relief. To learn more about how this works and whether it might be right for you, let's look more closely at the techniques it uses, what it can treat, and what the research says about its effectiveness.
What Is Trauma Therapy?
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.
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.
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.
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.
Affect
This is how you display your emotions to the outside world, such as through your word choices, tone, and speed.
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.
How to Find a Therapist
What Somatic Experiencing Therapy Can Help With
Somatic experiencing therapy may be helpful with aspects of:
- Trauma
- Anxiety
- Grief
- Substance use disorders
- PTSD
- Chronic pain
Trauma can have debilitating effects on the body. Somatic experiencing therapy can help by relieving the emotions, stress, and pain that have detrimental effects. For example, it can help relieve stress and pain associated with muscle tension.
PTSD Symptoms and Diagnosis
Benefits of Somatic Experiencing Therapy
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.
The freeze response in the human body is akin to an animal "playing dead."
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
Effectiveness of Somatic Experiencing Therapy
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.
One study looked at the efficacy of somatic experiencing interventions following a 2004 tsunami in India. While there was no control group, 90% of the 150 participants in one study reported either no symptoms or a reduction in symptoms at an eight-month follow-up interval following a single 75-minute session.
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.
Things to Consider
While somatic experiencing therapy does not involve a complete retelling and processing of your past trauma like some other trauma therapies might, you will be asked to bring up some of these painful memories. Doing so may result in you feeling "activated" or feeling a high level of energetic arousal in your body. This may also be known as feeling triggered.
This may feel uncomfortable, but that is the point. Before reaching this stage, your therapist will work with you on "resourcing," or finding tools that will help you self-soothe when you are feeling emotionally overloaded so that you can handle working with these memories when they come up in therapy.
Other Types of Therapy
It is also important to consider that somatic experiencing therapy may not be right for everyone. Where this form of therapy puts its main focus on the body, other types of therapy—such as cognitive behavioral therapy-work on the thoughts, emotions, and behaviors that are associated with trauma and stress. Other types of therapy that can also be helpful include trauma-informed therapy, eye movement desensitization and reprocessing (EMDR), and mindfulness-based stress reduction (MBSR).
How to Get Started With Somatic Experiencing Therapy
If you're interested in this type of therapy, below is actionable advice that you can use to begin your search for this kind of care.
How to Find a Therapist
There are many therapists who may call themselves somatic therapists, but somatic experiencing therapy is a particular method, developed by Dr. Peter Levine. His organization offers training in this particular approach. You can find a list of practitioners on their website.
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What to Expect
Be prepared for your practitioner to ask you about your trauma history. Remember, this is your therapy, so you can only answer as much as you feel comfortable with. A good practitioner should recognize and respect that and work with you to feel safe as you disclose more.
What Does a Session Look Like?
First, the practitioner or therapist will do a pre-interview to learn about your trauma and overall health history and answer any questions about your expectations. They will then ask questions centered around assessing how your body is responding to your trauma and stress.
The therapeutic process will involve facilitating states of arousal triggered by the trauma and sensations of safety and calm. This process of going back and forth between these states is called pendulation, and it focuses on recognizing these sensations. Trauma can interfere with our ability to recognize our internal state, and this technique helps us reconnect with ourselves and what’s going on in our bodies.
This is practiced in the safety of your therapy so that you become familiar with these sensations and once learned you will hopefully be able to down-regulate on your own. Because of how our bodies hold and express trauma primitively, your therapist may see small movements that indicate your body moving into flight mode. You will learn to safely ride these somatic experiences out as you begin to heal.
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