Somatic therapy: How working with the body can heal the imprints of trauma

Before we’re knee-deep together in the world of thought, I’d like you to notice what’s going on in your body.

What can you feel in your face? Your neck? Your shoulders and arms? Maybe there’s tingling or fizzing, some warmth or cold. What does the air feel like against your skin? Some areas may be tense, while others are more relaxed. There might be a complete absence of sensation in other places.

Now tune into what emotions are coming up for you. Are you excited? Sluggish, tired? Anxious and ready for this exercise to be over? (If that’s the case, I won’t hold it against you.) Where do those feelings show up in your body? They might be in your chest, your throat or your stomach.

This act of drawing attention to our bodies is the foundation of our newsletter today. Ana, 44, of Fullerton wrote: “I understand that the body holds memories and information, and it can be a starting point for practicing holistic wellbeing. Beyond talk therapy, can you describe other types of therapy that focus on the body, or incorporate it into therapy sessions?”

Somatic therapies

Psychotherapies that heavily involve the body are referred to as “somatic,” which just means “of, relating to or affecting the body.”

There are many different kinds of somatic therapies. Before I describe a few of them, it’s important to understand why a growing number of mental health practitioners believe that the key to healing trauma and other stress disorders is through body work.

Most mental health treatment in the U.S. today is based on “top-down,” cognitive-based approaches, which encourage people to become conscious of their thoughts and then work to change those thoughts. Top-down approaches zero in on the topmost areas of the brain used for thinking and speaking.

This approach is helpful for a lot of people in alleviating symptoms of depression and anxiety. But in many cases, especially when mental health challenges are rooted in childhood neglect or traumatic experiences, these therapies aren’t enough.

That’s because trauma leaves our bodies bracing (quite literally) to be hurt again. Certain conversation topics, places, people, smells, sounds or stressful life events might activate the more primal parts of the brain that regulate emotions and trigger our fight-flight-freeze response — even when there’s no actual threat to our safety. And when our survival brain takes over, our thinking brain goes offline, said Los Angeles-based somatic therapist Aline LaPierre.

Through somatic (or “bottom-up”) approaches, people begin to develop a bodily awareness that helps them feel safe in the present and puts the danger in the past.

Psychotherapist Robyn E. Brickel writes that therapists use somatic therapy to help their patients explore their trauma after helping them first feel safe and secure in their bodies — a different approach than traditional therapy takes.

“Safety and stability allows a person to have one foot in feelings (right side of the brain or the bottom) and one foot in the logic, the here and now, the present, the frontal lobe (left side or top),” Brickel writes. “Using both sensation and thinking to process trauma helps a person realize that the danger they are responding to is actually old.”

If we don’t become acquainted with our body’s memories and how they show up in our present lives, there’s a “part of ourselves that can be arrested in time,” said somatics teacher and political organizer Prentis Hemphill.

“This interrupts our ability to be present and have the kind of relationships we want to have,” they told me. “It makes it possible for all kinds of exploitative things to happen to our bodies.”

Types of somatic therapy

Here are just a few kinds of psychotherapies that seek to work with all that we hold in our bodies. I’d be happy to dive into more of them if you all have follow-up questions.

Somatic therapists may draw from some or all of these approaches:

Hakomi was developed by psychologist Ron Kurtz in the late 1970s and early 1980s and integrates Western psychology principles with those of the East, such as empathy, presence, nonviolence and mindfulness (the ability to notice the present moment without judgment, including what is happening in the body).

Practitioners help clients notice the ongoing interactions between their bodies and minds, and how those interactions influence how the person views others and their world. Hakomi sometimes involves consensual touch from the therapist when painful or traumatic memories come up. For example, the therapist might softly touch the client’s shoulder as a way to comfort and encourage the person to stay with the experience.

Somatic Experiencing focuses on the body, first to address symptoms, with the idea that healing the felt experience of trauma can also help heal the emotional experience.

Psychologist Peter Levine developed Somatic Experiencing after observing that prey animals, who routinely face danger in the wild, recover by physically releasing the energy that builds up in their bodies during stressful events. Humans, on the other hand, often override these natural ways of regulating the nervous system with feelings of shame, judgment and fear. This approach aims to help people gradually move past the place where they’re stuck in processing their trauma.

Some Somatic Experiencing therapists might ask you to discuss your traumatic experiences; others will only have you describe what you felt in your body during the traumatic event. You may be asked to move your body in a way that brings up negative feelings so that they can be processed.

Eye Movement Desensitization and Reprocessing was first developed by psychologist Francine Shapiro in 1987 after she noticed that rapid eye movements seemed to make her own difficult memories less disturbing.

During EMDR, you’re asked to briefly focus on a traumatic memory while the therapist stimulates both sides of your brain. This can look like the therapist directing your eye movements from left to right with their finger, or tapping each of your knees or shoulders, back and forth. In a virtual EMDR session, it could be a ball moving at various speeds back and forth across your screen, timed by your therapist. If successful, the approach allows people to remember traumatic events without becoming overwhelmed by the physical and emotional manifestations of post-traumatic stress.

Experts aren’t exactly sure why or how EMDR works, but it’s thought that it helps the feeling and thinking parts of our brains communicate with each other.

Sensorimotor psychotherapy combines somatic therapies, attachment theory, neuroscience and techniques from the Hakomi method. It helps clients develop resources within themselves to move out of the fight-flight-freeze response and into a state where they can think clearly and access their emotions in a way that feels safe (otherwise known as self-regulating).

This example given by psychotherapist Susan Lucas in a Psychology Today interview helped me understand how this works: “If a client wants to speak about a traumatic incident, for example witnessing a fight between two older siblings, a therapist would ask the client to recall up to a few moments before the actual incident.

“The therapist would then help the client get into a mindful state by asking them to notice certain things: If they are upset, what is it in their body that tells them they are upset? Is it a tightening in the stomach? Or a dark feeling in the chest? Then the therapist asks the client to focus on those sensations, and by observing the client’s gestures and postures, find out what movement the client would have liked to have made, but couldn’t.”

Beyond trauma

We can all benefit from a greater connection with our bodies, regardless of how much stress and trauma we carry. In the words of Prentis Hemphill, when you tap into the experience of your body, “the world opens.”

“As a Black Southerner, the body was more present in the culture I grew up in,” they told me. “At the same time, I was taught that the Black body was wrong or nasty or wrong. All these stories get heaped onto our bodies. I was trying to be the person who could just exist in my head. But when I encountered somatics, it was an invitation to trust what I knew from the wisdom of my body.”

Hemphill noted that many somatic approaches prize being calm and still. But for Hemphill, embodiment — “the awareness of our body’s sensations, habits and the beliefs that inform them” — is about embracing the full range of emotions, even those that have been disavowed in our culture, such as rage and ecstatic joy, Hemphill said.

“The body is the site through which we experience life, where we take action from,” Hemphill went on. “When we try to circumvent the body by only working through talk or thought, we end up losing out on a lot of information: understanding our reactivity, what we really long for, the opportunity to do things that maybe we haven’t done that would allow us to feel.”

There are so many ways to bring awareness to our bodies: deep breathing, yoga, dance. Or simply just slowing down and allowing ourselves to be curious about how we feel when we’re happy, upset — or any of the (87!) human emotions.

Embodiment is also about being present to hugs, laughter with someone you love, being in nature and feeling part of something larger than yourself. “That’s just as valid a practice of somatics as anything else,” Hemphill said.

I would love to hear from you all about how you practice embodiment and/or your experiences with somatic therapy. And if you have any more questions about somatics, send those too.

Until next week,

Laura

If what you learned today from these experts spoke to you or you’d like to tell us about your own experiences, please email us and let us know if it is OK to share your thoughts with the larger Group Therapy community. The email GroupTherapy@latimes.com gets right to our team. As always, find us on Instagram at @latimesforyourmind, where we’ll continue this conversation.

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More perspectives on today’s topic & other resources

Not long ago, EMDR was considered an experimental form of trauma treatment. Now it’s used by thousands of therapists across the world. Here’s how it works.

In this podcast episode of “For The Wild,” Prentis Hemphill shares how embodiment is a resource that allows us to connect with the planet, recognize grief and heal relationships.

“The Wisdom of Your Body: Finding Healing, Wholeness, and Connection Through Embodied Living,” by psychologist and researcher Hillary McBride, explores the broken and unhealthy ideas we have inherited about our bodies, and why we should reconnect with them — all the while weaving in her own experiences with an eating disorder and chronic pain.

“When the Body Says No: Exploring the Stress-Disease Connection,” by addiction expert and physician Gabor Maté, details how emotion and psychological stress play a powerful role in the onset of chronic illness, cancer and many other serious illnesses.

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