What is somatic therapy?

by Bobbi Smith, LICSWA

More and more, somatic therapy is being integrated into therapeutic techniques.  But what is somatic therapy?  And where does it come from?  In this blog entry I will attempt to give an overview of what somatic therapy means, and how to approach a therapist about integrating somatics if you are interested.  

As always, we start with context:  all the way back in the 1600’s (yes really) there was a French philosopher named Rene Descartes who was quite taken with examining the relationship between the human mind and body.  Since his work as a philosopher was pondering things, he began to think about the process of thinking itself, which he believed took place in the mind.  He theorized that the mind and body were separate organisms, and that the mind had dominion over the body.  This theory was known as Cartesian dualism, or sometimes mind-body dualism.  

Though there were always people that opposed Cartesian dualism, when what we now know as Western medicine began to form and institutionalize, it carried the legacy of Cartesian dualism with it.  Treatment of bodily ailments and treatment of mind ailments developed as distinct disciplines.  We don’t know if this is what Descartes intended, and can’t say for sure how he would react if he were alive to comment on it, but it unfolded this way anyway.

For generations, psychology has had the task of treating what western medicine firmly categorized as ailments that are located within the container of the mind, and therefore should be treated in that location, using the vehicle of thoughts to transfer a cure from the psychologist to the patient.  The most famous of these is “the talking cure” developed by Sigmund Freud.  In this approach, the psychologist would aggressively analyze the patients every word, which is 1. Deeply unethical and 2. Super annoying.

I’m getting to the somatic stuff, I promise.  

Let’s jump forward.  For decades now, some doctors, therapists and clients have questioned the utility of Cartesian dualism to truly address the complexity of mental and physical health conditions, and have been developing treatments that integrate both mind and body.  Soma means body.  Somatic therapy means incorporating some dimension of work with the body into treatment for ailments that used to be considered to be solely of the mind:  depression, anxiety, post traumatic stress disorder, and more.  

There are many traditions of what is called collectively somatic therapy- Sensorimotor Therapy, Somatic Attachment Therapy, Somatic Internal Family Systems, and more. There is no singular type that is agreed upon as the best approach.  Therapists that integrate somatic therapy into their practices are trained in and draw inspiration from traditions designed by many different healers, and that is a good thing.  Just like every other type of therapy, there is no one size fits all.  In addition, there are many, many traditional healing methods practiced across the world that include some type of body work, to which western somatic therapy traditions owe great honor.

The tradition I myself am mainly trained in is called Somatic Experiencing- I am not certified but simply studying it.  Somatic Experiencing was developed to treat PTSD, or what is now mostly called simply trauma.  The thesis behind Somatic Experiencing is that trauma can cause wear and tear on the autonomic nervous system, and so, trauma treatment should include the autonomic nervous system.  The autonomic nervous system is a component of the peripheral nervous system that regulates involuntary physiologic processes including heart rate, blood pressure, respiration, digestion, and sexual arousal. It contains three anatomically distinct divisions: sympathetic, parasympathetic, and enteric.  The autonomic nervous system lets us be relaxed, spontaneous, and socially engaged in a safe environment, or prepares us to fight, flee, or freeze in response to a threatening one.

Our human brains have evolved with add-ons to other species' brains, but we didn’t lose anything from them.  Basically, we have new apps but not a very different operating system.  As such, we have instincts to respond to harm or perceived harm in ways similar to other species.  Somatic Experiencing considers humans, aka homo sapiens, part of an evolutionary lineage that shares bodily features (such as an autonomic nervous system) and bodily instincts (such as fight, flight, or freeze) in common with other animal species that are evolutionarily older than us, and honors the innate intelligence of those similarities. In a threatening situation, animals either run to get away, fight off the threat, or if those don’t work, play dead (freeze) to appear unappetizing to a predator until it wanders away.

As animals, if an instinctual survival response sets off an alarm in our autonomic nervous system telling us to fight, flee, or freeze, it is important that that protective response is allowed to fully play out in service of its goal:  to get to safety.  If that response is prevented or constricted, the unresolved instinct can remain trapped in the nervous system as a chronic trauma response, or PTSD.  That can mean someone can feel trapped by the instinct to constantly fight, flee, or freeze, even if they aren’t in an unsafe situation anymore.  That is because even though our mind can cognitively register when a threatening situation is no longer happening, at the level of the organism (or body) there is no real proof of that, because all the nervous system knows is that it couldn’t do what it needed to in order to protect itself.  The nervous system doesn’t know time.

If that response were allowed to play out to its natural conclusion, our nervous system settles back into its baseline state, which is a proper flow in real time and proportional to what’s currently happening around us- not stuck in a chronic response.  We'll start in therapy by creating a safe container, building skills to cope with overwhelming emotions, thoughts, or body sensations. Then, when you're feeling ready, we may slowly approach your traumatic narrative, attending to body sensations along the way and supporting the discharge of trapped fight/flight/freeze energy.

One thing I love about Somatic Experiencing, and all types of somatic therapy, is that they acknowledge that human beings have evolved capacity for abstract thought, but otherwise are not fundamentally different from other animals per se.  Somatic therapy acknowledges the intelligence and healing instincts of other parts of our bodies besides just our minds.  Our bodies have instinctive reactions to what’s going on around us- and that means involving the body in therapy can have profound positive impacts on our sense of not only ourselves, but the world.  And who wouldn’t benefit from more wholeness and integration?

Most of our therapists at Riverbank incorporate somatic traditions into their treatment approaches. If you’d like to schedule a free 20 minute consultation with one of our therapists in-person in Seattle, or online for residents of Washington state, click here to fill out our contact form!

Connecting to Your Body

"How do you know what your body needs?? Sorry if that is a silly question."

I got asked this question recently, and needed to share that…This is not a silly question AT ALL. We are brought up to disconnect from our bodies. We are trained to ignore, silence or control our body's needs. Of course it's difficult to know what your body needs and how to give her that.

You're told to clear your plate, even though you're full.

You're told to dress a certain way, because your shoulders are "distracting" to the boys at school.

You're told to raise your hand in order to go oee.

You're told to stop crying.

You're told to sit still and be quiet, when you want to talk and move.

That's almost all of us. On top of that, you may have experienced trauma as a child and/or as an adult, and trauma-related survival reactions often lead to dissociation and disconnection from the body, furthering the disconnect.

I say all of this to remind you that connecting to your body can be extraordinarily difficult, and at times painful. We live in a society and many of us grew up in a family that does not value the information coming from your body, and sees her as another object to control and overcome. It's hard to listen for the needs of your body when you've been taught to ignore, silence or control them.

The process of reconnection is unlearning this training, and relearning how to be in connection with your whole self.

Questions to reconnect with your body's needs:

1) consistently (like, several times a day) ask yourself: "what am I feeling right now?" Look for emotions and body sensations.

—name what emotion(s) you're feeling. Check in with each part of your body (or start with one part if that feels more doable and safer): what sensations are in your feet? Legs? Low back? Chest? Upper back? Face? Check out this body sensations list. Name those sensations, which will help you connect emotional states to how they show up as sensation in your body, and will help lead to you what your body might need in that moment.

2) consistently (like, several times a day), as yourself: "what do I need right now?" Base your answers off of things like comfort, relieving pain, exploring stillness vs movement.

—Are you cold? grab a blanket and see what happens.

—Do you notice dryness in your mouth, or a grumbling in your belly? drink some water and/or eat a snack and notice how that changes things.

—Do you have some tension in your upper back? Get up and stretch or move a bit, and notice how that shifts the tension.

Take an experimental, curious attitude. Rather than "this sensation is horrible and uncomfortable", just notice "hmm, there's some tension in my shoulders, I wonder what happens if I move my arms around or change my posture."

Just noting the emotion, body sensations, and various actions that might shift your experience is part of how you begin to hone in on what your body needs and respond to those needs more consistently.

This takes time and practice. Please be patient and kind with yourself.

10 Tips for Soothing Anxiety With a Mask On

Wearing a mask is mandatory in Washington state as of last Friday. Most of us have been wearing them before this anyway, and if you haven't, get on that now. While you're at it, make a few calls to demand the arrest of the officers that killed Breonna Taylor.

Masks reduce the possibility of the spread of COVID massively. They are also hard to breathe in.

I often use my breath as a primary tool to soothe myself when I get anxious. And anxiety abounds these days. You know, anxiety, like...when you walk into a grocery store trying to get through it as fast as you can and a bunch of other people with masks reminding you that you live in 2020 and you're trying not to touch anything or touch your face or get too close or wonder is that box going to give me the virus and also systemic oppression and murder of Black people by police and am I doing enough and my personal mental health concerns and...you know. There's ANXIETY.

Anyway. What I'm trying to say is that a deep breath would usually help, but not right now. (Taking action about the things we care about helps) and also you may need to use other skills to soothe the anxiety that you're holding in your body.

Other skills that might help soothe anxiety with a mask on:

• Feel the movement of your legs

• Notice the crinkles of a smile at the edges of people's eyes

• Hug yourself

• Tap your fingers in a rhythm

• Squeeze and release your hands

• Press your feet into the ground

• Roll your neck and/or shoulders

• Place your hand on your chest and feel your heartbeat

• Hold something cold in your hands

• Alternate tapping your feet

What helps you soothe when the breath doesn't?

Why and How To Reconnect With Your Body

Why get in touch with your body?

What is the point of becoming embodied?

For those of us who tend to live in our heads and feel more comfortable in thinking, connecting with your body might feel pointless. For those of us who have a history of trauma and feel safer disconnected, connecting with your body might feel scary. For those of us who have been doing this disconnection for a long time, it might feel impossible (more on this tomorrow).

So why is it so important? Why are somatic therapies and connection to the body something you see on every other post these days?

It's because it helps (in short).

In long:

Becoming embodied allows deeper communication with yourself. It helps you align with your values, live with intention, and cultivate empathy for others. 

Your body is wise AF. It has data and information that you need to take care of yourself and be taken care of.

When you're disconnected from your body, it has to start screaming for you to pay attention and take care. But when you are more connected, more embodied, you can begin to hear the whispers.

You can hear the quiet conversation inside and respond so it doesn't escalate to screaming. You can get your needs met needs more effectively, because you hear them before they become desperate to get met. You can drink water when you're a little thirsty rather than chug when you're parched. You can soothe anxiety when it's just a trickle, before it becomes a flood of panic.

Meeting your needs builds trust in yourself. You show up for yourself, because you're listening to your whole self.

Not saying this is easy, or comes automatically. Just that it's important, and takes practice.

How do you practice this?

Are you struggling to reconnect with your body?

Do you ask "what am I feeling in my body" and come up with nothing?

You're not alone. This disconnection makes sense. Often, living in our heads and outside of our bodies helps create safety, especially if you have been through a trauma. It makes sense that you don't feel much when you try to sense what is there. You've been protecting yourself from what you might find. Two reminders: 1) You don't have to try this. 2) If you feel ready to, or feel safe enough to create more connection with your body but are struggling, you might try this:

-ask yourself, when/how did/does it serve you to live in your mind? Explore your relationship with your body and what protection the disconnection has given you. Rather than directly trying to feel what's happening in your body, maybe start with thinking about your relationship to your body to build a little more safety with the process.  

-break it down into smaller parts. Notice a specific part of your body rather than asking the question as a whole. "What do I feel in my right shoulder?" rather than "What sensation is in my body?" This can feel less overwhelming.

-create sensation to feel. Squeeze gently up and down your arm, and notice the change after you stop. Do a few jumping jacks, and notice what happens. Pet your dog, drink some water, put on a heating pad, hold an ice cube, and notice what sensations show up there.

Be kind to yourself as you do this. Know that it is a practice, and that connection will ebb and flow. If you begin to feel unsafe, move to something else.

What else helps you connect?