Somatic Therapy & Trauma

Woman considering anorexia recovery

Treating the impacts of trauma must be done very carefully, as revealing and exploring these experiences long after they have passed can cause retraumatization and increase the individual’s struggle.

Some professionals believe in a “top-down” treatment approach to trauma, which involves focusing on cognitions and the “thinking brain [1].” Cognitive Behavioral Therapy, CBT, is an evidence-based treatment approach considered to be “top-down.”

Others believe that trauma must be treated using a “bottom-up” approach, which emphasizes the body and the nervous system as it relates to trauma and trauma responses. Somatic Therapy is one such “bottom-up” approach that has numerous modalities and can be beneficial.

Trauma & the Body

Somatic treatment approaches stem from the understanding that “the body’s memory of the trauma is more important than the cognitive memory [1].”

Basil van der Kolk is a renowned trauma therapist in this area and wrote the book “The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma,” which is considered to be one of the foremost books on the somatic impact of trauma.

Van der Kolk describes that “Traumatized people chronically feel unsafe inside their bodies: The past is alive in the form of gnawing interior discomfort. Visceral warning signs constantly bombard their bodies.

In an attempt to control these processes, they often become experts at ignoring their gut feelings and in numbing awareness of what is played out inside. They learn to hide from themselves [1].”

College student using somatic therapy to help her recover from traumaThe body has what is referred to as a Core Response Network (CRN), which is comprised of the autonomic nervous system and limbic system and is “responsible for organizing and generating an immediate response to challenges presented by a person’s environment, such as the well-known “fight, flight, or freeze” response to stressors and perceived dangers [2].”

The CRN releases stimulant chemicals such as adrenaline and cortisol to engage in the “fight, flight, or freeze” response. For humans, when the danger is gone, these chemicals do not simply disappear but linger in the body and “may result in conditions including posttraumatic stress (PTSD), depression, phobias, muscle aches and pains, irritable bowel syndrome and other digestive issues, insomnia, and autoimmune disorders [2].”

In essence, trauma does not only live within one’s mind, memories, and beliefs, but also lives within the body itself, impacting those cognitions while also impacting the physical body unconsciously.

Somatic Treatments

Somatic Therapies focus on how and where trauma is being expressed in the body, with treatment professionals helping individuals find effective ways to “discharge” this trauma-related energy.

One popular somatic treatment is Somatic Experiencing, developed by Peter A. Levine. This method focuses on three core strategies – resourcing, titration, and pendulation [3].

Resourcing is the process by which individuals identify ways they can feel safe and secure while attempting to resolve the trauma and might involve individuals finding a safe or comforting memory or valued object. Titration involves gradual exposure to trauma-related distress so that the individual can build up a tolerance to this memory over time.

Finally, pendulation is the process of switching back-and-forth between resourcing and titration so that an individual can navigate moving “between a state of arousal triggered by a traumatic event and a state of calm,” allowing them to reach homeostasis and experience balance in the body’s systems [2].

Eye Movement Desensitization and Reprocessing (EMDR) is also a somatic treatment wherein individuals are asked to follow an object or light on a light bar with their eyes as they recall a traumatic event. It is believed that focusing the eyes on a moving object allows the individual to be exposed and slowly desensitized to the traumatic impact of the distressing memory.

Somatic treatments are becoming more popular and show promising efficacy in the treatment of trauma. As mentioned above, trauma must be treated carefully. Therefore, it is important to engage in these treatments with a certified professional.


Resources:

[1] Unknown (2019). Understanding CBT vs. somatic psychotherapy. NC Center for Resiliency. Retrieved from https://nccenterforresiliency.com/what-is-cbt-vs-somatic-therapy/.

[2] Walling, C. (2017). Psychotherapy for your body: the role of somatic psychology today. Good Therapy. Retrieved from https://www.goodtherapy.org/blog/psychotherapy-for-your-body-role-of-somatic-psychology-today-0605174.

[3] Unknown (2020). What is somatic experiencing? Somatic Experiencing Trauma Institute. Retrieved from https://traumahealing.org/about-us/.


About the Author:

Image of Margot Rittenhouse.Margot Rittenhouse, MS, PLPC, NCC is a therapist who is passionate about providing mental health support to all in need and has worked with clients with substance abuse issues, eating disorders, domestic violence victims, and offenders, and severely mentally ill youth.

As a freelance writer for Eating Disorder Hope and Addiction Hope and a mentor with MentorConnect, Margot is a passionate eating disorder advocate, committed to de-stigmatizing these illnesses while showing support for those struggling through mentoring, writing, and volunteering. Margot has a Master’s of Science in Clinical Mental Health Counseling from Johns Hopkins University.


The opinions and views of our guest contributors are shared to provide a broad perspective on eating disorders. These are not necessarily the views of Eating Disorder Hope, but an effort to offer a discussion of various issues by different concerned individuals.

We at Eating Disorder Hope understand that eating disorders result from a combination of environmental and genetic factors. If you or a loved one are suffering from an eating disorder, please know that there is hope for you, and seek immediate professional help.

Published January 28, 2021, on EatingDisorderHope.com
Reviewed & Approved on January 28, 2021, by Jacquelyn Ekern MS, LPC

About Baxter Ekern

Baxter is the Vice President of Ekern Enterprises, Inc. He is responsible for the operations of Eating Disorder Hope and ensuring that the website is functioning smoothly.