How Somatic Therapy Has Changed My Trauma Therapy Clinical Practice
Embracing a New Era in Psychotherapy: The Rise of Somatic Therapy
For years, Cognitive Behavioural Therapy (CBT) reigned as the go-to modality in psychotherapy. However, a new approach is gaining momentum: Somatic Therapy.
Hello readers! I’m Chelsea, a Registered Clinical Counsellor and the Executive Director at Vitality Collective. With nearly a decade of experience, I’ve worked extensively with clients grappling with trauma, especially those who’ve endured multiple or complex traumatic events, often from childhood. Early in my practice, I became intrigued—albeit skeptical—about Somatic Therapy. It was a word that was veiled in mystery to me - what did it mean and entail?
To better serve my clients, many of whom seemed stuck in their traumatic pasts, I embarked on a two-year, 160-hour post-Master's training in Sensorimotor Psychotherapy, developed by the esteemed Dr. Pat Ogden. Initially, I was more comfortable with cognitive existential “talk therapy,” and unsure of how the body, movement, and breath could profoundly impact healing. But this journey opened my eyes and transformed my clinical practice.
Understanding Trauma and the Nervous System
Contrary to popular belief, trauma isn’t just an event. Trauma is a physiological response that:
Occurs in the nervous system,
Affects both the body (soma) and psyche,
Is triggered by unexpected and distressing events that overwhelm one’s ability to cope.
Trauma significantly impacts our Window of Tolerance (WoT)—a concept developed by Dr. Dan Siegel, which refers to the optimal zone where an individual can function most effectively, both emotionally and cognitively. Past traumas and their present-day triggers often shrink our WoT, leading to symptoms of nervous system dysregulation, manifesting as:
Hyperarousal: Anxiety, tension, hypervigilance, panic, rage.
Hypoarousal: Low mood, depression, fatigue, numbness, dissociation.
Clients often struggle to articulate their traumatic experiences, particularly when their nervous system is easily triggered due to a narrowed WoT. In fact, discussing trauma under these conditions can exacerbate symptoms and lead to further dysregulation. Many clients may not even have the words to describe their experiences, or one’s mind “goes blank” when asked, and this is because the word-generating and verbal-processing part of the brain actually gets deprioritized at the time of the trauma so that blood and the body’s physical resources can be used elsewhere (ie. abdomen, arms, legs) in order to survive. It’s an amazing coping strategy that our brains can automatically do this, especially as children, in order to aid escape (ie. which can also look like placating, walking on eggshells around an chronically angry parent), but once the trauma is over the coping strategy often remains well into adulthood and no longer is useful (ie. this can look like fear of getting in trouble, conflict avoidance in work or relationships, or depression/fatigue/emotional numbness because emotional needs weren’t met as a child so the nervous system prefers to ‘sleep off’ it’s emotional pain rather than attune to it). So how do we deal with it and treat it now after the fact?
The Triphasic Model of Trauma Treatment in Somatic Therapy
Somatic therapy follows a structured approach to ensure traumatic material is addressed safely:
Safety & Stabilization: This phase involves assessing risk, establishing coping strategies, gathering history, setting trauma targets and goals, cultivating supportive relationships, and developing grounding techniques to prepare for trauma processing.
Trauma Processing: Techniques from trauma therapy modalities such as Sensorimotor Psychotherapy, Somatic Experiencing, EMDR, AEDP, or IFS are employed to address the traumatic material.
Integration: This final phase focuses on helping clients gain closure and move forward, connecting meaningfully with present-day activities and relationships.
Before diving into why somatic therapy is transformational for trauma healing, let’s differentiate between "Big T" and "Little t" traumas—terms used to describe the intensity and impact of traumatic experiences.
Understanding "Big T" and "Little t" Traumas
Big "T" Traumas are life-altering events that threaten physical safety or survival, such as physical or sexual abuse, witnessing domestic violence, surviving natural disasters, severe accidents, war, sudden loss, and serious medical illnesses.
Little "t" Traumas are less intense but can still have a profound impact, especially if they occur repeatedly or during critical developmental periods. Examples include emotional neglect or abuse, bullying, parental divorce, inconsistent parenting, frequent moves, chaotic environment, academic pressure, financial hardship, and chronic or mental illness in the family.
The Accumulation of Trauma in the Body and Mind
Over time, these traumas can lead to patterned nervous system survival responses, such as:
Fight
Flight
Freeze (hypo- and hyper-arousal)
Submit/Fawn
Cry for Help
Faint
Shutdown
A trained somatic therapist can recognize these responses that are evident in body language, coping strategies, and relational patterns. These traumas and developmental injuries also contribute to deeply ingrained negative core beliefs, like:
I am not good enough.
I am unlovable.
I am powerless.
I am a failure.
How Somatic Therapy Transforms Trauma
A skilled trauma therapist guides clients in regulating their nervous system through body-oriented techniques and trauma processing protocols. This work expands the client's WoT, enabling them to cope more effectively without becoming overwhelmed or shutting down.
In somatic therapy, clients are supported in completing actions their bodies couldn’t perform during the trauma (e.g., the desire to defend oneself but being unable to due to a freeze response). This process helps reprocess traumatic memories.
Inner child work is also used to address developmental traumas and injuries. This approach integrates and transforms old neural networks that formed in childhood to cope with negative experiences, bringing them into the present for healing.
The Pot-on-the-Stove Metaphor
Treating trauma can be likened to containing a pot of boiling water on the stove. Traditional talk therapies often focus on managing the symptoms of a "boil-over" by putting a lid on the pot—verbally processing, cognitively reframing, and managing symptoms. While these are crucial aspects of therapy, they don't address the root problem: the traumatic material stuck in the nervous system. Why does addressing the nervous system matter? Our nervous system connects our minds and our bodies.
Somatic therapy, on the other hand, not only utilizes verbal processing but also introduces interventions that target the underlying trauma. This approach "turns off the burner," allowing the trauma to remain in the past and opening the door to new healing experiences.
Common Somatic Therapy Modalities
Somatic therapy includes various modalities, each with its unique approach to integrating body awareness into therapy:
Somatic Experiencing (SE): Developed by Dr. Peter Levine, SE focuses on processing and releasing trauma by tuning into bodily sensations. Clients work through these sensations gradually, allowing the body to complete its natural trauma response.
Sensorimotor Psychotherapy: Created by Dr. Pat Ogden, this modality blends somatic therapy with inner child/parts-work techniques, providing the brain and body with missing developmental experiences, fostering real-time transformation.
EMDR (Eye Movement Desensitization and Reprocessing): While not solely a somatic therapy, EMDR incorporates body awareness in trauma treatment. Through guided eye movements, clients reprocess traumatic memories, reducing their emotional charge. EMDR practitioners may also focus on bodily sensations during the process.
Looking for a Trauma Therapist?
If you’re interested in finding a trauma therapist who practices somatic therapy, we can help you find the best match.
Meet our team of Registered Clinical Counsellors in Surrey, Vancouver, Chilliwack, or Online and get matched with a therapist today by filling out our New Client Inquiry form.