Traumatic experiences often result in a wide variety of symptoms. Trauma also often has comorbidities with mental health conditions such as depression, anxiety, dissociation, and psychosis. However, one element of trauma that is in many ways more pervasive than any other is how it affects the body. How might this be addressed through therapeutic method and practice?
Somatic experiencing for trauma
Many will likely recognise the phrase ‘The Body Keeps The Score’, the title of Bessel Van Der Kolk’s seminal book on trauma, post-traumatic stress disorder (PTSD) and complex trauma. The key, is in the word, ‘body’.
Somatic, derived from the word ‘soma’, means ‘of the body’. Somatic therapies, therefore, are focused on how the body and bodily experiences can be utilised to aid the processing of and recovery from trauma.
Somatic experiencing (SE), is the most common therapy within this field, but you can also find somatic psychotherapies, such as biodynamic psychotherapy. SE was developed by Dr. Peter Levine, a renowned trauma therapist.
SE is based around the principles of the automatic, sympathetic nervous response when we experience trauma. This response is typically thought of as the ‘fight or flight’ response. However, in recent years, it has been added to with the addition of: freeze, flop and fawn.
SE focuses on what happens when we get stuck in the ‘freeze’ response. In the freeze response we might:
- feel tense or rigid
- feel our breathing rate increase
- feel our heart rate increase
- feel nauseous from hormones such as noradrenaline flooding our body
- feel dissociated or ‘spaced out’ from what is happening
When we feel vulnerable, especially if we are young, the freeze response often feels like the only way to survive what is happening to us. The problem comes when we revert to that freeze response long after the initial trauma has passed.
This is often because all the energy that built up during that initial freeze response has been internalised, or repressed, meaning the trauma is unprocessed, resulting in residual somatic effects.
Somatic experiencing as a trauma ‘reset’
SE involves work with a certified Somatic Experiencing Practitioner (SEP) that helps a patient or client to address areas of the body where trauma has lingered, resulting in strain, chronic pain or discomfort. Once these areas are identified, you can work through any emotions or psychological symptoms that are related to those areas of pain or discomfort, such as:
The idea is to address trauma through a ‘body first’ method so that the person experiencing the affects of trauma, PTSD, or complex PTSD is in a more regulated place physically before then going on to address emotions. All of this allows a person to process that initial trauma and better participate in the psychological aspects of therapy.
How does somatic experiencing work in practice?
At the beginning of somatic experiencing therapy, you might work with your therapist to increase bodily awareness, and increase feeling present in your body.
This can look like tapping or lightly pressing on different areas of the body and either internally naming that body part, or naming it out loud. A SE practitioner might also begin working on bodily awareness with you by asking you to start a session by explaining specific sensations in the body, e.g: “I feel a tightness in my shoulders”. In SE, starting off a session like this instead of focusing on how a patient or client is feeling emotionally, is part of the body first methodology that differs SE to other traditional therapies.
- See also: 'Could physical trauma be a predictor of depression and PTSD?'
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To manage the traumatic feelings or memories that might resurface by focusing on these sensations and physical symptoms, an SEP might work with you to identify some safe spaces, which can be a place, or memory with a person, or envisaging doing something you love. This safe space can then be used as a resource to ground and sooth if the body work becomes triggering.
What happens once the grounding work is done?
Once the work to create the safe spaces has been done with a therapist, you might be asked to start revisiting remembered sensations in the body, from a traumatic event. In somatic experiencing this is called ‘titration’.
Titration is done very gradually, to ensure that sensations do not overwhelm or retraumatise a client or patient – this is why it is essential to only incorporate SE into your therapeutic practice once you have completed certified SE training. Similarly, as a service user looking out for practitioners who have evidence of specific somatic experiencing training is a good way to safeguard yourself.
During titration, a therapist might ask you to track any bodily sensations that revisiting a specific trauma brings up. They might also ask you to verbalise anything they can’t physically see, such as changes in body temperature, or feeling numb in certain body parts.
During titration you might experience outlets, or releases of emotion or physical energy, through crying, shaking, or shivering. This is considered to be beneficial and part of this ‘reset’ that can happen through somatic experiencing.
Importantly, your SEP will use the resources developed in grounding to bring you out of this state, which is referred to as ‘swinging back’ to feeling calmer, or sometimes called ‘pendulation’.
Somatic experiencing isn’t for everyone: deciding if it’s right for you
From the service user perspective: some people, especially those who have experienced body orientated trauma such as physical or sexual abuse, somatic therapy might never feel right for them. This isn’t to say no one with trauma relating to these things can benefit from somatic therapies such as SE, but that it is important to be very careful when considering whether or not the therapy is for you. As such it might be beneficial to incorporate elements of SE into traditional talking therapies.
SE can sometimes involve touch, but it doesn’t have to. An SEP who has received official certified training will know when it is and isn’t right to use touch and will also respect the clients right to say no to it contextually or entirely.
For practitioners: if you already have an interest in trauma therapy, and practice trauma specific psychotherapy or other therapies such as EMDR, somatic experiencing can be a really valuable tool to add to your therapy ‘toolkit’.
The body first method in somatic experiencing, as mentioned previously is an affective way to ensure a client or patient is physically more regulated, instead of living in a state of arousal, before attempting to introduce more psychological methods into your practice with that client/patient.