Somatic Therapy: What Is It and How Does It Work?

• Somatic therapy is a type of mental health treatment that focuses on the body.
• More research is needed to explore the potential benefits of somatic therapy.
• You can find a somatic therapist via Somatic Experiencing International.

Traumatic experiences like sexual assault, childhood abuse, and natural disasters cause extreme stress. Most of us experience trauma at some point in our lives and can recover with time and support. But about 7 in 100 people develop post-traumatic stress disorder (PTSD) from it, according to the National Institutes of Mental Health. Among other symptoms, PTSD can cause intrusive memories of what happened, poor sleep, and feelings of numbness and detachment. A study published in March 2020 in the European Journal of Psychotraumatology found that PTSD is often associated with depression, anxiety, and substance use disorder.

PTSD can be effectively treated with trauma-focused talk therapy, also known as psychotherapy. According to the U.S. Department of Veterans Affairs National Center for PTSD, some of the most research-backed treatments for PTSD are cognitive processing therapy (CPT), prolonged exposure (PE) therapy, and eye movement desensitization and reprocessing (EMDR). But these approaches do not work for everyone. That’s where alternative options like somatic therapy may come in.

Read on to learn everything you need to know about somatic therapy, like the theory behind how it may work, what the research shows about its potential effectiveness, and where to find a provider.

Somatic therapy, also known as somatic experiencing (SE) therapy, is a new form of psychotherapy developed by Peter Levine, PhD, a psychotherapist and founder of Somatic Experiencing International. Somatic approaches are focused primarily on the body rather than the mind.

Somatic experiencing therapy addresses problems like chronic and post-traumatic stress by focusing on body awareness rather than thoughts and emotions. SE is sometimes called a bottom-up approach to treating trauma-related conditions. While talk therapy discusses thoughts and feelings that occur in the “higher” parts of the brain, SE begins with exploring the more “primitive” parts of the brain.

SE follows the theory that trauma is stored inside your body and mind. After a frightening or overwhelming experience, some people may develop a dysfunctional stress response. In this case, the body’s alert system gets “stuck” in an excessively reactive state, as SE practitioners explain in an article published in Frontiers in Psychology.

Somatic experiencing practitioners believe that physical movement — like gentle shaking and changes in posture — can allow for a physical “release” that supports healing and recovery. Becoming aware of bodily sensations and talking through them may bring the nervous system back into balance.

Over time, identifying and processing feelings in the body related to safety, comfort, and trauma could help reduce symptoms of PTSD.

The somatic psychotherapy process involves specific therapeutic techniques, though the experience can vary depending on your provider. Below, we provide a walkthrough of some common techniques a somatic therapist may use:

• Building rapport: Somatic therapy, like all therapy, begins with your therapist getting to know you, according to an article published in the Journal of Traumatic Stress. This occurs over the first few sessions.
• Psychoeducation: In your initial session, your somatic therapist will also talk to you about SE therapy, trauma, and how to heal. They’ll explain key concepts like trauma vortices (emotional tailspins in which you’re overwhelmed by traumatic memories and cannot process them) and healing vortices (positive steps toward dialing down your stress response and feeling better).
• Resourcing: During the resourcing process, you learn how to calm yourself down by focusing on a safe and peaceful state within your body. For example, your somatic therapist may direct you to describe how you feel sitting across from them. You may answer by saying something like, “This couch feels comfortable, and my shoulders are relaxed.” When you’re distressed, you can return to those positive feelings and use them to help you relax.
• Pendulation: Just as a pendulum swings from side to side, pendulation describes what comes next. You gently move between resourcing (focusing on a peaceful bodily state) and remembering the traumatic incident. Your SE provider will guide you as you talk through these sensations. For example, after describing your safe place on the couch, you may briefly describe the beginning of your traumatic experience and how it felt in your body, such as chest tightness and shaky legs. Pendulation typically starts during the third or fourth SE therapy session.
• Titration: If you become overwhelmed during the pendulation process, your therapist will help guide you back to how safe and at peace you presently feel, called titration. This strategy allows you to gradually revisit and process traumatic memories.

As the traumatic memory becomes less physically overwhelming, you can begin to feel better and process what happened through talk therapy. During these sessions, your therapist may review your symptoms and inquire about how effectively you've been able to self-regulate your emotions since the last session.

Somatic experiencing therapy is a distinct type of body psychotherapy. But other similar therapeutic modalities may incorporate body-focused techniques or fall under the banner of somatic therapy.

Sensorimotor Psychotherapy

Sesorimotor psychotherapy is another form of body psychotherapy that incorporates practices like somatic therapy, attachment theory, and cognitive approaches, among other methods, according to the Sensorimotor Psychotherapy Institute.

EMDR

EMDR involves focusing on a back-and-forth movement or sound as you process a traumatic memory, according to the National Alliance on Mental Illness. It can be compared with somatic therapy, where you shift your focus between safe physical sensations and those related to traumatic memories. But EMDR is a form of talk therapy, while somatic therapy is a form of body psychotherapy.

Brainspotting

Brainspotting is also distinct from somatic therapy. It’s a form of psychotherapy that was inspired by EMDR. According to an article published in January 2022 in the International Journal of Environmental Research and Public Health, the approach promotes the idea that where you look may impact how you feel. Like somatic therapy, there are very few studies on this type of treatment.

Somatic therapy was designed to support people with trauma-related conditions such as PTSD. It may be a promising option if you’ve tried other PTSD treatments and are still experiencing symptoms or prefer therapy that focuses on physical sensation. But it’s important to note that somatic therapy is relatively new and has yet to be backed by strong clinical research.

While there have been some promising studies, more research is needed to investigate the effectiveness of somatic therapy. “The current evidence base is weak,” according to the first literature review on the topic published in July 2021 in the European Journal of Psychotraumatology.

Four out of five studies of somatic therapy for PTSD show significant reductions in symptoms, but there are limitations to these findings. For example, only two studies exclusively included people with a confirmed PTSD diagnosis. One of the studies did not use a control group.

Other studies suggest somatic therapy may address symptoms of depression, anxiety, and pain and improve the quality of life for people without PTSD. But very few studies have been done.

Overall, experts say higher-quality research is needed to explore the potential benefits of somatic therapy. It’s important to note that many research-backed treatment options for PTSD, depression, and anxiety may be more accessible.

Because somatic experiencing is a relatively new therapy, finding the right professional is key. SE International has a practitioner directory you can use to find a licensed therapist or psychologist with the relevant SE training and expertise, including:

• Licensed clinical social workers (LCSWs)
• Licensed mental health counselors (LMHCs)
• Licensed professional counselors (LPCs)
• Licensed marriage and family therapists (LMFTs)
• Psychologists (PhD, PsyD, EdD)

You can also learn more about how to find the right therapist for you with our guides to online therapy platforms and virtual treatment options for trauma, anxiety, and depression.

Somatic therapy is a relatively new form of body-focused psychotherapy. While initial studies are promising, higher-quality research is needed to further evaluate the potential benefits of this treatment.