Somatic Experiencing
Somatic experiencing is a holistic, body-focused treatment modality that helps resolve both physical and psychological trauma symptoms.
Traumatic experiences can take a heavy toll on those involved. Symptoms of post-traumatic stress disorder (PTSD) or complex PTSD (CPTSD) can last for weeks, months, and even years following a traumatic event.
You may already be familiar with the psychological symptoms of PTSD and CPTSD, such as flashbacks and nightmares. Trauma and other mental health concerns, like anxiety and depression, cause physical symptoms in the body.
That's where somatic experiencing therapy comes in. Somatic means "of the body" and prioritizes mind-to-body connection in treatment. Unlike other approaches, this therapy addresses both physical and psychological symptoms.
What is Somatic Experiencing Therapy?
Somatic Experiencing (SE) is an alternative therapy geared toward trauma-based care. Peter Levine, Ph.D., the creator of SE, understood that trauma could become "trapped" in the body as shown by symptoms of PTSD. Through his method, mental health professionals work on releasing trauma stressors from their patients' bodies.
Somatic means "of the body" and prioritizes mind-to-body connection in treatment.
Many people who have experienced physical trauma can dissociate and disconnect from their bodies. SE helps increase awareness of internal experiences through interoceptive, proprioceptive, and kinesthetic sensations.
Trauma and the Freeze Response
Any trauma held within the body can lead to emotional dysregulation. One aspect of this is known as the freeze response. It is our body's most primitive defense against danger.
The freeze response is unlike the "fight or flight" response which causes increased heart rate, breathing, and focus in response to an acute threat. Instead, the "freeze" response can cause the opposite, similar to an animal "playing dead."
Trauma forces us to react in ways we have no control over. Somatic experiencing helps us gain back that control.
Sometimes, the body doesn't distinguish between physical and mental trauma. When danger is life-threatening, a person can typically "shake off" the fear once the trigger no longer persists. With emotional trauma, the brain can become trapped in a loop, believing it is still in danger.
The freeze response manifests in both cognitive and physical symptoms. These symptoms include:
- Confusion
- Detachment
- Difficulty moving or concentrating
- Lowered heart rate
- Slowed breath
The freeze response doesn’t get talked about as often as fight or flight, and causes some people to think they reacted wrong or are “broken.” Of course, this isn’t the case. Trauma forces us to react in ways we have no control over. Somatic experiencing helps us gain back that control.
Polyvagal Theory
Polyvagal theory was first suggested by Stephen Porges. He hypothesized a more nuanced approach to how our nervous system serves us when stimulated.
Historically, our autonomic nervous system—which controls automatic physiological functions such as heart rate and stress responses—was pictured as two parts:
- Sympathetic—the active nervous system. This controls your fight or flight response.
- Parasympathetic—the “calm” nervous system. This controls your freeze response
The parasympathetic nervous system is dictated by signals of the vagus nerve. It keeps these automatic activities functioning normally.
The Social Engagement System
Porges suggested another division of the autonomic nervous system called the social engagement system. It’s also controlled by your vagus nerve. Essentially, the social engagement system is more or less the go-between of sympathetic and parasympathetic responses.
Sympathetic responses, flight or fight, are intense. Your body is heavily stimulated to defend itself. An overactive sympathetic response feels like constant and intense anxiety. However, an overactive parasympathetic response can make a person feel shutdown.
Trauma takes away a person’s feeling of safety. But in a safe environment, a person is still stimulated, but in a very different way than fight or flight. They might feel playful, motivated, and energized. When the vagus nerve works to stop the fight or flight response, that time is when the social engagement system is engaged.
Somatic experiencing helps people who have experienced trauma level their responses, and find that safe space between the extremes.
SIBAM: The Somatic Experiencing Framework
Typically, most psychotherapy sessions use cognitive skills to access trauma memories via "top-down" methods. Unlike these traditional methods, somatic experiencing uses a "bottom-up" approach. It begins with bodily sensations before the recall of painful memories and thoughts.
Somatic experiencing practitioners use a therapeutic framework called SIBAM, which helps patients process trauma by incorporating their bodies into the healing process. SIBAM stands for:
Sensation
The patient will begin a session by noting what they feel in the body to link physical sensations to emotions.
Imagery
The patient shares what arises through the imagination of a scene or guided imagery.
Behavior
The practitioner observes the patient's behavioral responses, such as body language or posture.
Affect
The client learns to display emotions through word choices, tone, and speed.
Meaning
The patient can self-reflect on their perceptions and experiences.
Is Somatic Experiencing Therapy Effective?
Because somatic experiencing is still relatively new, researchers have published little on the topic. However, available studies look promising. One randomized, controlled trial showed that 44% of participants lost the diagnosis of PTSD after completing SE treatment.
Another study, which followed the 2004 tsunami in India, examined the efficacy of somatic experiencing interventions. Of the 150 participants, 90% reported reduced or no symptoms following a 75-minute session.
Lastly, a non-controlled intervention study followed 53 participants receiving 1-2 monthly treatment sessions following a tsunami. Following the first session, 67% of participants reported total or partial symptom reduction. When evaluated a year later, 90% had sustained improvement.
One randomized, controlled trial showed that 44% of participants lost the diagnosis of PTSD after completing SE treatment.
What Can Somatic Experiencing Therapy Treat?
Somatic experiencing therapy has helped treat symptoms of:
- Anxiety
- Chronic pain
- Grief
- PTSD
- Substance Use Disorders
- Trauma
Somatic experiencing targets the physicality of stored trauma, but trauma isn't the only thing that affects the body. Other mental health disorders or long-term concerns affect more than just the mind.
What Should I Expect in Somatic Experiencing Therapy?
Don't worry. Unlike other trauma therapies, somatic experiencing treatment does not require a complete retelling and processing of past trauma. However, it will bring up some painful memories and may make you feel "activated." This high level of energetic arousal in your body is also known as feeling triggered.
Triggers can feel uncomfortable, but that is the point of therapy. Your therapist will provide you with "resourcing" tools before reaching this state. Resourcing identifies tools to self-soothe emotional overload so that you can handle bad memories when they come up in therapy.
Find a Therapist
Many therapists call themselves somatic therapists but have no credentials. Somatic experiencing is a specific method developed by Dr. Peter Levine. The team at Sequoia Behavioral Health are certified in somatic experiencing therapy by Dr. Levine’s organization.
Pre-Interview
First, the mental health provider will perform a pre-interview. The interview helps assess your trauma and overall health history. They will ask how your body responds to stress and answer any questions about your expectations.
Be prepared for the SE practitioner to ask about your trauma history. We understand that sharing any degree of trauma can be uncomfortable. A good practitioner will recognize and respect that the topic may be challenging to discuss. They will help you feel safe enough to disclose more.
Therapeutic Process
The therapeutic process facilitates trauma triggers, states of arousal, and sensations of safety. This back-and-forth process is called pendulation. Because trauma interferes with the ability to recognize internal states, pendulation helps to reconnect emotions and physical feelings.
Practice during therapy helps you become familiar with these sensations to learn to down-regulate. Because our bodies hold and express trauma primitively, your therapist may see small movements that indicate your body is moving into freeze, flight, or fight modes. They will help you learn to ride these somatic experiences as you heal safely.
Schedule a Somatic Experience Session with us Today!
Living a life free from the burdens of past trauma is possible with SE therapy. Our licensed team at Sequoia Behavioral Health is uniquely qualified to assist you on your healing journey. Let’s take the next steps together.