How is somatic therapy different from traditional talk therapy?
Traditional psychotherapy uses dialogue, and focuses on the thoughts the client is having. The client talks about what is wrong so the therapist can help them find solutions. This model is fine, except it deals with the mind and often completely ignores the body! Most clients who seek healing through therapy are having some kind of somatic issue (somatic means “body”) that may not be fully addressed in talk therapy… such as chronic physical tension, pain, or tightness; sleep issues, digestion issues, anxiety; depression, lack of energy, mental fog. Addictive behaviors (for example overeating, shopping addiction, substance abuse, relationship and sex addiction) also fall into the somatic category because the behavior often originates in some suffering or tension that’s first felt in the body, which the mind interprets as a need for a “fix”.
Somatic therapy is not psychotherapy. It is a body-centered approach to healing that helps the client focus on sensations arising in the present moment, and connect those sensations to life stresses they may be experiencing. It works from the bottom up, (meaning it addresses phenomena in the body & nervous system first and the mind follows), rather than the top-down approach that many cognitive therapies offer (which focus on the mind and thoughts and hope that doing so will regulate somatic symptoms such as anxiety). Focusing our healing efforts on what’s happening in the body can actually help resolve long-standing tensions left over from trauma, stress, and addiction. The somatic approach also addresses the nervous system dysregulation that happens when the body senses a lack of human connection.
If you already see a talk-based psychotherapist and you are getting results, there’s no reason to stop going! Somatic work is a great supplement to CBT, EMDR, DBT, and other traditional approaches to mental health. It also complements many holistic therapies such as acupuncture, chiropractic, meditation, yoga, massage, hypnotherapy, naturopathic medicine, ayurveda, reiki, and more.
Kate Hartman, SEP, C-IAYT is not a psychotherapist. She uses Compassionate Inquiry and Phoenix Rising dialogue techniques to coach the client toward greater awareness of what is happening in the body, while offering gentle SE Touch to directly guide the nervous system toward greater regulation.
What does the nervous system have to do with somatic therapy?
The answer to this question is, basically, everything. The autonomic nervous system (as opposed to the sensory nervous system, central nervous system, or musculo-skeletal nervous system) operates almost totally unconsciously. It silently dictates the operation of every organ, muscle, and bone in the body. It’s responsible for digestion, heart rate, breathing, blood flow to the skin and organs, and many other functions in the body that happen every minute but which you don’t consciously think about. In trauma and stress, the autonomic nervous system can become dysregulated, causing a multitude of somatic symptoms in the short term, and in the long term, creating disease pathways in the body.
There are two main branches of the autonomic nervous system: the sympathetic and the parasympathetic. The sympathetic nervous system is the “fight or flight” branch — meaning it raises the heart and breath rate, slows digestion, dilates the pupils and intensifies the gaze, causes bracing in the shoulders and neck, and pulls blood flow away from the extremities. This is the system that operates when the body senses that we’re under duress or threat (which can happen just from thinking about a stressful event!). The parasympathetic nervous system is the “rest and digest” branch — it slows the heart and breath rate, activates digestion and peristalsis, sends bloodflow to the limbs warming the hands and feet, and softens the gaze. These two branches of the autonomic nervous system are like a symphony, working in harmony with one another constantly throughout the day. One system or the other may become dominant at certain times throughout the day, but neither is ever switched totally on or totally off, except in extreme circumstances.
When we experience stress or trauma and we don’t fully process the emotions and body sensations that came along with it, the traumatic energy can get stuck in the body, throwing off the natural harmony of the autonomic nervous system. This disconnect causes a wide range of symptoms. The symptoms can manifest differently in every person, but autonomic dysregulation often causes sleep and digestion issues, distractability, anxiety, depression, dissociation, procrastination, adrenal fatigue, PTSD, persistent tiredness or inability to relax, high reactivity or easily triggered causing relationship issues, addictive behaviors, and more.
Somatic therapy works directly to balance the autonomic nervous system, creating relief from ongoing somatic symptoms. To learn how, let’s talk a little about Polyvagal theory.
What is Polyvagal Theory?
Polyvagal theory, developed by Stephen Porges, underpins the majority of the work I do with clients. It is the science of connection. It maintains that the “rest and digest” branch of the autonomic nervous system, which is controlled mainly by the Vagus nerve, has two branches within itself. The first, and oldest in terms of evolution, is the dorsal-vagal response. This is responsible for total shutdown of body symptoms, or the freeze response. The second is the ventral-vagal system, which is mediated by social engagement.
This means that, in scientific terms, we are “wired for love.” Our bodies are tuned in to the connections and relationships we have with those around us, and when these relationships feel sturdy, attuned, safe, and connected, the ventral-vagal branch of the parasympathetic nervous system signals the body’s alarm systems to relax. If the relationships around us (especially during early childhood) contain some type of mis-attunement, the body’s alert systems are quietly told to turn on. We evolved in tribes and connected family systems. Nature’s way of taking care of us (or you could say God’s way, as we are our brother’s keeper) was to put us in groups. The group takes care of us. In modern times, of course, we no longer live in tribes, and the extended family has been reduced to the nuclear family.
This ventral-vagal system is highly sophisticated. It can sense minute changes in speech, tone, eye contact, breath rate, and overall tension of the people around us. It is always searching for a secure attachment with someone in the environment. When we are engaged in a secure connection with another human, bloodflow to the skin increases, digestion can continue, our heart rate becomes more variable which indicates health, and we can breathe more deeply leading to increased oxygenation throughout the body. (As for how important oxygenation in the body is… well, recent research shows that cancer and chronic disease thrive in a de-oxygenated environment!)
The ventral vagal system also tracks mis-attunements in the immediate environment. If it senses that someone we’re connected to is mis-attuned, neglectful, or abusive, the alert system of the body turns on, activating the sympathetic nervous system. Distress and frustration are meant to cause us to seek out more secure attachment, especially in early childhood. In the long term, mis-attunements can cause what the industry refers to as “little-t trauma” which causes the same amount of nervous system dysregulation as a single “big-T trauma” also referred to as incident trauma or shock trauma.
The takeaway? Our relationship to other humans is of highest importance to our autonomic nervous system. We are hurt in relationship, and we heal in relationship. The goal of somatic therapy is to create a healing relationship, in which the therapist is highly attuned to the client, witnessing and holding space without judgment for everything that arises within the client’s body-mind. Positive regard is held for the client, which the nervous system picks up on energetically. Within this safe and contained healing space, magic can happen.
The magic of somatic work
Within the context of a therapeutic relationship, our first goal is establishing safety and trust. This starts with an empathic, nonjudgmental, and respectful container. I work hard at creating this with every client. If that connection is not there, the body feels stressed and the sympathetic nervous system will activate in order to protect the person. The focus through the whole session is to help the body feel supported and relaxed, and to connect you with yourself. This way the sympathetic nervous system can step back from its dominating position, and work in harmony with the parasympathetic nervous system. We know this is happening when the body starts to relax, the breath and heart rate synchronize, and the muscles can let go into the Earth’s gravity.
Many studies have shown that simply activating the relaxation of the parasympathetic nervous system actually allows the body to heal on a cellular level — furthermore, when that relaxation happens in the context of a supportive and attuned relationship, polyvagal theory shows that healing increases exponentially because our earliest instincts for connection are satisfied. In other words, growth, healing and insight happen naturally when we feel safe enough to be vulnerable, yet connected with a trusted other.
It is not about re-living or talking through the story of trauma. Rather it is a present-moment process that invites the body, mind and soul to find a new, more synchronized rhythm.
Talk therapy might help someone discover the truth on the level of the mind. Somatic therapy goes a step further by helping us connect the mind, heart, and gut. Then, the truth can be felt on all levels and the client can experience their authentic self as a whole, and live more freely with joy.