Somatic Therapy

Unlike traditional talk therapies like cognitive-behavioral therapy (CBT), which often engages the mind, somatic therapy focuses on working with the body to help individuals become more aware of sensations like tension, relaxation, pain, and comfort. They may start to use these sensations as a pathway to healing and emotional regulation. 

Somatic psychotherapy focuses on the connection between the body and mind, also known as the mind-body connection or mind-body psychotherapy. Somatic therapy utilizes bodily sensations and movement to address underlying emotional issues. In contrast, the core elements of cognitive behavioral therapy (CBT) target maladaptive thought patterns and behaviors to promote change through talk therapy. Unlike CBT's cognitive restructuring techniques, somatic therapy often involves somatic experiencing therapy exercises aimed at accessing and processing emotions stored in the body.

Because somatic therapy works under the principle that trauma and intense emotions can become caught in the body, this modality utilizes techniques designed to recognize and release those difficult emotions. Below are examples of techniques and modalities used to perform somatic therapy. 

Resourcing

The resourcing technique involves working with clients to identify and develop internal and external resources that can support their healing process. These resources might include bringing up positive memories, images, sensations, or other tools that help them become more grounded and regulated. 

Tracking sensations

In the tracking technique, clients are guided to observe and describe bodily sensations without judgment. This process may help individuals reconnect with their bodies and recognize how emotions manifest physically.

Titration

The titration principle involves breaking down overwhelming experiences into more manageable parts. Clients explore sensations related to trauma or stress gradually, allowing the body to process the emotions without becoming overwhelmed or retraumatized.

Pendulation

In pendulation techniques, clients learn to move between areas of tension and relaxation, regulating their nervous system and better tolerating difficult emotions.

Completing defensive responses

Somatic therapists often support clients in revisiting and completing defensive responses that may have been interrupted during a traumatic event. This process can allow the body to complete actions thwarted during the traumatic experience, facilitating a sense of closure. There are numerous methods of somatic therapy mental health professionals may use, including, but not limited to, the following. 

Brainspotting

Using brainspotting, therapists help clients identify points (brain spots) within their field of vision that may be associated with trauma recollection. Once identified, the client may focus on that point while drawing out the traumatic memory and process it by focusing on the emotional relationship to the physical sensation. 

Eye-movement desensitization and reprocessing (EMDR)

EMDR⁴ is a therapeutic modality involving tactile, visual, or audio bilateral brain stimulation techniques while recalling a traumatic memory to change how it's stored in the brain and diminish its intensity. 

Hakomi

In the Hopi language, Hakomi roughly translates as "How do you stand in relation to these many realms?" This technique involves mindfulness engagement between the client and therapist. Mental health practitioners using this method may focus their attention on the client’s posture, body language, and gestures as they recount traumatic memories while staying mindful of how their own conscious experience manifests within the body. 

Mindfulness and movement techniques

Several mindfulness techniques are taught to therapists in somatic therapy to connect the mind and body. The therapist may guide these exercises within sessions or, with time, encourage patients to practice them between sessions. Clients often engage in guided, mindful breathing exercises to promote body awareness by drawing attention to the sensation of the breath. 

Yoga

A yoga practice allows individuals to concentrate on the body's internal experience by engaging in external movement. Following the same principle, some professionals use tai chi or dance therapy to support clients. 

Somatic acupoint stimulation (SAS)

Current research suggests that SAS techniques like acupressure and acupuncture may manage or relieve somatic symptoms. 

Individuals undergoing somatic therapy may expect a preliminary session with their psychologist to share information about their past traumas or mental health challenges as well as current emotional experiences, thoughts, and behavioral concerns. During this first assessment, the therapist may ask about physical symptoms or bodily reactions the client may have to stress, as well as a family history of physical or mental illness. 

Because of the sensitive nature of some traumatic experiences, clients are not expected to discuss any information they don't feel comfortable sharing immediately. A safe, supportive environment can facilitate the healing process, and it may take time for a client to know they are secure enough to talk about difficult, complex subjects. 

Once this preliminary interview is concluded, the therapist can compare their findings with diagnostic criteria from the Diagnostic and Statistical Manual of Mental Health Disorders, Fifth Edition (DSM-V) to create a treatment plan according to the client’s unique needs, circumstances, and symptoms. This step may be crucial because co-morbidity with panic disorder, generalized anxiety disorder, and major depressive disorder are common in individuals with somatic symptoms and may require different or additional treatment approaches.

In addition to applying somatic therapy techniques, treatment may include psychotherapeutic methods, medications, or, in some more treatment-resistant cases, electroshock therapy (ECT). Therapists may integrate several treatment modalities to address all aspects of an individual's healing. 

It is important to consult with a doctor or medical professional before beginning or changing any medication plan. The information provided in this article is not intended as medical advice; please consult a qualified healthcare professional for personalized guidance.

Some mental health conditions result in challenging emotions that may emerge in the body in painful ways. Somatic therapy can be an effective treatment for neutralizing hurtful feelings and relieving bodily manifestations of stress in a wide range of disorders and challenges, including but not limited to the following: 

• Post-traumatic stress disorder (PTSD)
• Depressive disorders
• Anxiety 
• Acute grief
• Substance use disorders
• Eating disorders
• Trust and intimacy issues
• Self-esteem issues

Somatic therapy may not be suitable for some individuals, and risks may include re-traumatization, misconstruing of touch, and regression. Somatic treatment should be conducted by qualified and licensed mental health professionals trained in this approach. 

If you are struggling with substance use, contact the SAMHSA National Helpline at (800) 662-4357 to receive support and resources.

While more studies, randomized controlled trials, and scoping literature reviews are recommended to determine the full potential of somatic therapy, there is a growing body of research on what makes it effective and how it may be used in different treatment capacities.

For example, a 2018 review and case study published in the Journal of Behavioral Addictions explored the efficacy of somatically-driven therapeutic techniques to help people with compulsive sexual behavior. While not listed in the DSM-5 as a diagnosable condition, compulsive sexual behavior may be diagnosed in connection to another condition, such as a behavioral addiction or impulse control disorder. In some cases, it can create significant problems in daily life and is sometimes co-occurrent with conditions such as depression, anxiety, and trauma. 

The study's findings suggest that therapeutic methods focused on establishing a mind-body relationship (similar to the Hakomi Method) can help individuals with compulsive sexual behavior cultivate improved sexual and emotional health in a supportive, non-judgmental way. 

According to another 2021 systematic review published in Frontiers in Psychology, EMDR was found to be effective in treating certain conditions other than post-traumatic stress disorder (PTSD), such as mood disorders, anxiety disorders, substance use disorders, eating disorders, and obsessive-compulsive disorder (OCD). While there were some study limitations, overall, the review concluded that EMDR could be used beyond the treatment of PTSD, including in non-pathological and intense crises.

There are several resources to help individuals find a therapist with experience in using methods of somatic therapy, including but not limited to the following: 

• The National Alliance on Mental Illness (NAMI) offers a helpline for individuals seeking support and a directory of mental health professionals to help them find a therapist. Its website also provides educational resources and advocacy information. 
• The National Institute of Mental Health (NIMH) website also has a directory of psychologists, resources, and information on how to get involved in research or participate in clinical trials. 
• The US Department of Veterans Affairs (VA) is highly involved in supporting individuals with PTSD. It offers resources and information on how to get help, types of PTSD treatments, and psychoeducational materials for people caring for individuals with PTSD. 

In addition, there are options for individuals interested in learning somatic self-care techniques to use at home. While some consult with a traditional therapist in the office, some prefer telehealth sessions through an online platform like BetterHelp because of its convenience and accessibility. Clients can choose between phone, video, or live chat sessions and access resources like worksheets, support groups, and goal-setting.