Listening to the Body: What Somatic Therapy Offers
Most of us were taught to work through hard things by thinking about them. We talk it out, we make sense of it, we try to understand why. That matters. But if you have ever said "I know I'm safe, so why does my body still feel like it's bracing," you already understand why somatic therapy exists.
Somatic therapy is an approach that includes the body in the healing process. Instead of focusing only on thoughts and stories, it pays attention to what is happening physically in the present moment: the tight chest, the held breath, the restless legs, the sudden heaviness. The word "somatic" simply means "of the body."
Here is what it looks like, what the research says so far, and who it might help.
Why the Body Belongs in the Room
When something overwhelming happens, our nervous system responds automatically. Heart rate climbs, muscles tense, attention narrows. That response is protective. The trouble comes when the body keeps responding long after the danger has passed.
This is part of why insight alone does not always bring relief. You can fully understand where a reaction comes from and still feel it take over. Somatic work meets that reaction where it lives, in the nervous system, and helps it learn something new.
What a Session Might Look Like
Somatic therapy is usually gentle and slow. A session might include:
Noticing sensation. Your therapist may ask what you notice in your body as you talk, and help you stay with that sensation with curiosity rather than judgment.
Building resources. Before approaching anything painful, you spend time finding what feels steadying: a memory, a place, a person, the feeling of your feet on the floor.
Pendulation. Moving attention back and forth between something uncomfortable and something settling, so your system learns it can feel difficulty and return to calm.
Breath and movement. Small, intentional movements or breathing practices that help complete a stress response or release held tension.
You stay in charge the whole time. Nothing about this work requires you to retell a painful story in detail before you are ready.
What the Research Says
Somatic approaches have been used by clinicians for decades, and the research has been catching up. The evidence is still growing, but what exists so far is encouraging.
Somatic Experiencing and PTSD. Somatic Experiencing (SE) is one of the best known somatic methods, developed by Peter Levine. In 2017, researchers in Israel published what they described as the first randomized controlled trial of SE for posttraumatic stress. The study included 63 adults who met full criteria for PTSD. Half received fifteen weekly SE sessions while the other half waited, and the results suggested SE may be an effective treatment for PTSD (Brom et al., 2017).
Trauma and chronic pain. Another 2017 trial, conducted at a large spine center in Denmark, looked at people living with both low back pain and trauma symptoms. Everyone received standard exercise based care, and some also received six to twelve sessions of Somatic Experiencing. Those who received SE in addition to usual care had a significantly greater reduction in PTSD symptoms, with a large effect size (Andersen et al., 2017). This matters because trauma and physical pain so often travel together and are rarely treated together.
A broader look. A 2021 review in the European Journal of Psychotraumatology gathered the available studies on Somatic Experiencing. The authors found preliminary evidence that SE helps with PTSD symptoms, and early signs that it may also improve mood, physical symptoms, and overall wellbeing, both for people with trauma histories and for people without them. Clients and practitioners pointed to two things that felt especially important: the focus on building resources, and the careful use of touch (Kuhfuß et al., 2021).
Yoga as a somatic practice. Somatic principles also show up on the mat. In a 2014 study led by Bessel van der Kolk, 64 women with chronic PTSD that had not improved with other treatment were assigned to either ten weeks of trauma sensitive yoga or a women's health education class. By the end, 52 percent of the yoga group no longer met criteria for PTSD, compared with 21 percent of the comparison group. Both groups improved early on, but the yoga group held on to those gains while the comparison group slipped back (van der Kolk et al., 2014).
An honest note. Body oriented therapies are still less studied than approaches like cognitive behavioral therapy. A 2021 meta-analysis of body psychotherapy concluded that the field needs larger, higher quality studies to fully establish how well it works (Rosendahl et al., 2021). Somatic therapy is promising, and it works best as part of thoughtful, individualized care rather than as a cure all.
Who Might Benefit
Somatic therapy can be a good fit if you:
Have experienced trauma, especially trauma that is hard to put into words
Feel stuck in patterns of anxiety, shutdown, or being on edge
Live with chronic pain or tension that seems connected to stress
Have done a lot of talk therapy and understand your story, but still feel it in your body
Want to feel more at home in yourself
It can also be helpful for people who simply want to feel more grounded, more aware of their own signals, and better able to settle after a hard day.
A Gentle Place to Start
You do not need to wait for a therapy session to begin practicing body awareness. Try this the next time you notice stress building:
Pause and feel your feet on the floor. Notice the weight of your body in the chair. Let your eyes slowly look around the room and land on something neutral or pleasant. Take one breath that is a little slower on the exhale than the inhale. Then simply notice what shifted, even if it is small.
That is somatic work in its simplest form. Paying attention, with kindness, to what your body is telling you.
Working With Us
At Big Oak Wellness, our approach is trauma conscious, and we believe healing involves the whole person: mind, body, and spirit. If you are curious whether a body centered approach might be right for you, we are glad to talk it through. Reach out through our website or email Emily directly: emily@bigoakwellness.com
References
Andersen, T. E., Lahav, Y., Ellegaard, H., & Manniche, C. (2017). A randomized controlled trial of brief Somatic Experiencing for chronic low back pain and comorbid post-traumatic stress disorder symptoms. European Journal of Psychotraumatology, 8(1), 1331108. https://doi.org/10.1080/20008198.2017.1331108
Brom, D., Stokar, Y., Lawi, C., Nuriel-Porat, V., Ziv, Y., Lerner, K., & Ross, G. (2017). Somatic Experiencing for posttraumatic stress disorder: A randomized controlled outcome study. Journal of Traumatic Stress, 30(3), 304–312. https://doi.org/10.1002/jts.22189
Kuhfuß, M., Maldei, T., Hetmanek, A., & Baumann, N. (2021). Somatic experiencing: Effectiveness and key factors of a body-oriented trauma therapy: A scoping literature review. European Journal of Psychotraumatology, 12(1), 1929023. https://doi.org/10.1080/20008198.2021.1929023
Rosendahl, S., Sattel, H., & Lahmann, C. (2021). Effectiveness of body psychotherapy: A systematic review and meta-analysis. Frontiers in Psychiatry, 12, 709798. https://doi.org/10.3389/fpsyt.2021.709798
van der Kolk, B. A., Stone, L., West, J., Rhodes, A., Emerson, D., Suvak, M., & Spinazzola, J. (2014). Yoga as an adjunctive treatment for posttraumatic stress disorder: A randomized controlled trial. Journal of Clinical Psychiatry, 75(6), e559–e565. https://doi.org/10.4088/JCP.13m08561
