Somatic Experiencing: A Body-Centered Approach to Treating PTSD
By: Adam Grafa
“Trauma is a fact of life. It does not, however, have to be a life sentence.”
–Dr. Peter A. Levine
Somatic Experiencing is a body-centered approach to treating PTSD (post-traumatic stress disorder) that, rather than focusing only on thoughts or emotions associated with a traumatic event, expands to include the natural bodily (somatic) responses. It was first conceptualized by trauma therapist Dr. Peter Levine in the 1970s and in the years since it has come to be considered a leading-edge therapy for PTSD, with over 12,000 healing professionals trained.
Trauma vs. PTSD
Before taking a deeper look at Somatic Experiencing (SE), it’s essential to understand the interrelationship of trauma and PTSD. Very simply, a traumatic event, either experienced or witnessed, will happen before PTSD can set in. In other words, PTSD doesn’t happen without a traumatic event to trigger it, but at the same time, just because someone experiences trauma isn’t a guarantee that they will also experience PTSD.
Whether or not they do will depend on the individual because we all respond differently to trauma. Some of us have greater innate resilience to it than others. The good news is that for those of us born without it, Somatic Experiencing is a way to develop that resilience.
Common Forms of PTSD treatment
To better understand Somatic Experiencing, it is helpful to contrast it with some of the other common therapeutic approaches used to treat PTSD:
Exposure therapy – As explained by the American Psychological Association (APA), Exposure therapy entails having a client confront the trauma directly in a safe environment to reduce fear. It has been shown scientifically to reduce fear and avoidance.
Cognitive Therapy – This method has its origins in Cognitive Behavioral Therapy and according to the APA: entails modifying the pessimistic evaluations and memories of trauma to interrupt the behavioral and/or thought patterns that have been interfering in the person’s day to day life.
Eye movement desensitization and reprocessing (EMDR) – Rather than focusing on changing thoughts, emotions, and responses associated with a traumatic event, EMDR focuses on specific memories and how they are stored in the brain. Initially this was accomplished with rapid left-right eye movement while focusing on a particular memory, but other forms of bilateral stimulation, like alternating tones or taps, have proven to be equally effective.
While one of these modes of treatment can be successful at eliminating or diminishing the effects of PTSD, they aren’t always for everyone. For some, because these methods engage trauma more directly, the treatments themselves can become another source of trauma.
How is Somatic Experiencing (SE) different?
Merriam-Webster defines somatic as “of, relating to, or affecting the body…” so, by its name alone, Somatic Experiencing telegraphs its difference from other therapeutic models. SE expands the focus of therapy to include the bodily energy created by trauma and seeks to repair and complete the natural cycle our bodies possess to release it. It also follows a less direct and more incremental approach to revisiting trauma, especially in comparison to Exposure Therapy.
According to Kate Pabst, a Certified Somatic Experiencing Practitioner at Lyn-Lake Psychotherapy and Wellness, SE helps people “build awareness, coherence and self-regulation. The result is a deeper understanding of the body/mind connection with improved ability to release and regulate emotions. It also helps manage stress, resolve issues related to trauma, heal from and navigate life transitions, relationships and build resilience.”
Origins of Somatic Experiencing
Dr. Peter Levine developed Somatic Experiencing from his observations of how wild animals recover from repeated traumatic experiences like attacks by predators (imagine gazelles eluding a cheetah). What he noticed was, after a threat was gone, the animals experienced a physical release of their fight-or-flight energy by shaking, trembling, or sometimes running. He also saw that with completion of the physical release, they quickly returned to their normal state.
Dr. Levine believed that humans also possess the same ability to release physical energy from stress but often thwart it by “keeping it together” following trauma. We all probably have direct experience “keeping it together” through a difficult experience. Our ability to override what is an innate mechanism for self-care is for many of us what sets the stage for PTSD. By stopping this natural cycle of release, the energy becomes stuck, in effect keeping us in a perpetual state of fight-or-flight so that we are unable to return to our relaxed, balanced state.
It wasn’t until sometime later after his initial observations, however, that he was able to validate his thinking.It happened while he was in session with a client suffering from PTSD. His client began vividly reliving a traumatic childhood experience, and as he observed her agitated state, he had a flash of inspiration. He encouraged her to protect herself by running away from the threat, as if she was being chased by a tiger. She began kicking her feet, simulating escape, and with that action completed the natural release of traumatic energy that had been long trapped in her body.
Following this session, she experienced immediate and lasting relief from her PTSD symptoms, and Dr. Levine saw for the first time a human’s ability to enact the same physical release of trauma energy that animals do instinctively and regularly. With that, Somatic Experiencing as a therapy began.
What are Somatic Experiencing sessions like?
No two sessions are alike, but there is a set of activities that will typically happen, although no set schedule for when they should occur. The specifics of each step, what is discussed, when to move from one step to the next, are determined entirely by the client and their comfort level at each step.
The first step is getting comfortable in the therapy environment, both with the therapist and the physical space, to have a sense of trust. Only after that, when trust is established, will the process of addressing the trauma begin.
After that, it might start by the therapist asking a client to revisit the time around the traumatic event, but not the event directly. For example. Using the experience of a car crash as an example, instead of immediately exploring the trauma, the therapist might begin the process of revisiting it by asking what the weather was like the day of the crash before it happened. This gentle and indirect approach to revisiting the trauma allows our bodies to build the resilience needed and slowly release stuck traumatic energy, a bit at a time.
The pace of progress, though, is determined by the client’s comfort level at each step along the way. The gentle exploration continues until the client builds enough resilience to productively and completely engage and release the trauma energy.
Kate likens Somatic Experiencing sessions to dancing, “It is fluid, and there is some improvisation that happens too… the goal is to get to that “flow” state that people talk about, like when you’re dancing and your movements are completely in sync with the music, and you’re no longer consciously thinking about what you’re doing.”
Resources
https://www.webmd.com/mental-health/what-are-treatments-for-posttraumatic-stress-disorder#1
https://www.frontiersin.org/articles/10.3389/fpsyg.2015.00093/full
https://www.goodtherapy.org/learn-about-therapy/types/somatic-experiencing
https://traumahealing.org/about-us/#about
https://www.psychologytoday.com/us/blog/the-intelligent-divorce/201503/somatic-experiencing