Somatic Experiencing

Somatic Experiencing, a brief, body-centered approach to relieving the negative effects of trauma, is based on the idea that trauma-related symptoms occur when the body’s natural response to threat is interrupted, creating an imbalance in the nervous system. In Somatic Experiencing, individuals are helped to complete survival reactions thwarted at the time of the trauma so that balance can be restored. The process is gradual rather than cathartic and always proceeds at the pace of the client.

What Is Somatic Experiencing?

Developed by psychologist Peter A. Levine, this approach is based on repeated observations of how wild animals respond to stressful situations. Levine recognized that animals in the wild routinely face threatening situations but are rarely traumatized because they rely on their body’s innate ability to self-regulate. When approached by a predator, for example, the animal’s autonomic nervous system (ANS) instantly prepares it for the “fight, flight, or freeze” response. The sympathetic branch of the ANS causes large amounts of energy to be released in the body, which the animal can then use to either fight off or flee from an attacker. Once the threat has been eliminated or avoided, the parasympathetic branch of the ANS helps the body relax and get rid of excess energy.

When an animal can see no way out of its situation, it reacts by freezing. Once the threat passes, the animal emerges from its immobilized state and spontaneously discharges the energy accumulated in its body by, for example, shivering or twitching vigorously and running away. Regardless of which survival response the animal chooses—fight, flight or freeze—the end result is always the same. The flood of energy released during the body’s stress response is discharged, allowing the animal to return to a normal, unaroused state.

When faced with traumatic events, the ANS in humans is capable of functioning in the same way it does in animals. However, cognitive processes, emotions, a lack of time, and other psychosocial factors can undermine the natural self-regulating responses of the ANS. For example, we might suppress the urge to cry in order to avoid embarrassment, or we might not have enough time to swerve before a vehicle collision. In situations such as these, energy that should have been directed toward survival responses becomes trapped within the body, creating instability in the nervous system. Instead of the two branches of the ANS working together harmoniously, the system becomes jammed, resulting in over-activation of one branch or the other. The individual may then experience a prolonged state of either hyperarousal or complete shutdown or fluctuate erratically between the two. This dysregulation in the ANS manifests itself in the symptoms commonly associated with trauma.

The aim of this treatment is to correct the instability within the nervous system by facilitating the release of trapped energy. This is often accomplished by helping individuals become more aware of bodily reactions associated with trauma and empowering them to complete survival reactions. As these natural responses unfold in the context of a safe, supportive environment, energy trapped inside the body is gradually discharged, restoring the nervous system to a state of balance.

The focus on internal awareness that is key in Somatic Experiencing can be traced to meditative approaches such as yoga and tai chi. This method also shares some similarities with the Alexander technique and the Feldenkrais method, two other approaches that place focus on awareness of the inner self.

What Happens in a Somatic Experiencing Session?

On the surface, Somatic Experiencing may seem like a typical psychotherapeutic approach, with therapist and client sitting across from each other. However, the main emphasis is on the body rather than on thoughts and emotions, and those receiving treatment will not have to talk at length about the traumatic experience or try to process what happened verbally.

After ensuring the person is grounded and comfortable in their surroundings, the therapist will gently guide them through the following processes with the aim of restoring balance to the nervous system:

• Focusing. Clients are encouraged to focus attention on bodily sensations, pleasant or unpleasant, without trying to interpret or explain what is happening. Concentrating on bodily sensations helps to intensify them so an individual can become more aware of what is really being felt and experienced in the moment. The therapist will take note of bodily reactions, including changes in posture, facial expression, muscle tone and breath, and address these so they can be more deeply sensed.
• Resourcing. In the initial stages of Somatic Experiencing, the therapist will likely place an emphasis on pleasant, non-threatening sensations to help the client feel safe and comfortable. They may be encouraged to think about a time or place when they felt safe or strong or an individual or object that makes them feel secure and to focus deeply on the pleasant sensations experienced when thinking about these resources. As negative somatic experiences related to the trauma are dealt with, individuals may be better able to draw upon these resources for strength and comfort.
• Titration. As the session progresses, the client’s attention will gradually be directed toward aspects of the traumatic experience and linked sensations. Therapists will take care to proceed at a manageable pace in order to avoid re-traumatization. Instead of going straight to the heart of the trauma, individuals will be exposed to traumatic material a little at a time so the resulting activation is not overwhelming but can be easily managed and discharged.
• Pendulation. Therapists help clients gently shift their attention between sensations related to the trauma and those linked to established resources, much like a pendulum swings between two opposing sides. Each time clients connect with positive inner feelings of strength and comfort, they may will feel more empowered to face unpleasant sensations related to the trauma. If the negative sensations start becoming too intense, the therapist will shift the focus back to pleasant memories.
• Discharge. As individuals cycle between states of arousal and relaxation—between regulation and dysregulation—energy trapped in the body will gradually be released. With the support of the therapist and an increasing sense of empowerment, it often becomes possible for clients to complete survival reactions that were interrupted or suppressed at the time of the trauma— crying, sweating, trembling, sighing, heavy breathing and even laughing. Therapists encourage clients to stay with these reactions and allow the body to go where it wants to go. If the level of activation is becoming unmanageable, the therapist will interrupt the process, guiding the client back to a”safe” place. With each successive discharge, the tension experienced will decrease as the nervous system tends toward a state of balance.

Physical touch is sometimes incorporated into Somatic Experiencing, though it is not required for healing to occur. Touch in this type of treatment might involve the therapist placing one or both hands on an area of the body to help the client focus more deeply on sensations in that region. The therapist’s hands may also be used to support a part of the body as a means of facilitating relaxation in that area. Touch is usually applied with the client fully clothed, in a seated position or lying face up on a massage table.

Benefits of Somatic Experiencing

One of the main benefits of Somatic Experiencing is its use in the relief of physical and emotional symptoms of posttraumatic stress (PTSD), such as anxiety, depression, hypervigilance, flashbacks, sleep disturbances, eating problems, numbness, and chronic pain. Although empirical support is limited, a few studies have demonstrated the efficacy of this approach in treating PTSD symptoms among survivors of natural disasters. Somatic Experiencing has also been applied with success to the treatment of various forms of addiction.

Clients who receive this form of treatment often report less tension, irritability, and anger, as well as a greater sense of ease and balance. Since improvements are said to be possible in just one session, this treatment can be particularly useful in situations where a brief form of treatment is needed, such as in emergency situations. Somatic Experiencing is also considered a safe method of treatment since the individual is not re-traumatized during the process. Although traumatic memories are triggered, they are approached indirectly and gradually so arousal remains at a manageable level.

An additional advantage of Somatic Experiencing is the way it can help individuals develop their capacity to self-regulate. Many people find it possible to learn, through somatic experiencing, how to shift quickly and easily out of negative emotional states and how to calm themselves when faced with stressful situations. Anyone wishing to increase their sense of resilience and empowerment may find this mode of treatment to be beneficial.

References: 

1. Decker, J. (2011). Somatic experiencing. Retrieved from http://somaticstress.com/somatic-experiencing
2. Heller, D. P., & Heller, L. (2004). Somatic experiencing in the treatment of automobile accident trauma. Retrieved from http://boazfeldman.com/EN/Links_files/HELLER%20-%20Somatic-Experiencing-with-Auto-Accident-Diane-Poole-Heller%E2%80%A6.pdf
3. Kelloway, R. (2016, May 5). What is SE touch? Retrieved from http://life-care-wellness.com/what-is-se-touch
4. Lahad, M., & Doron, M. (2010). Protocol for treatment of post traumatic stress disorder. Istanbul, Turkey: IOS Press.
5. Leitch, M. L., Vanslyke, J., & Allen, M. (2009). Somatic experiencing treatment with social service workers following hurricanes Katrina and Rita. Social Work, 54(1), 9-18.
6. Levine, P. A. (1997). Waking the tiger: Healing trauma. Berkeley, CA: North Atlantic Books.
7. Olssen, M. C. (2013). Mental health practitioners’ views on why somatic experiencing works for treating trauma. Retrieved from http://sophia.stkate.edu/msw_papers/244
8. Payne, P., Levine, P.A., & Crane-Godreau, M. A. (2015). Somatic experiencing: Using interoception and proprioception as core elements of trauma therapy. Frontiers in Psychology, 6(93), 1-18. Retrieved from http://journal.frontiersin.org/article/10.3389/fpsyg.2015.00093/full