SWISS MEDICAL EXPERTISE: ZURICH, MALLORCA, LONDON, NEW YORK

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Dr. Peter A. Levine, Ph.D. pioneered Somatic therapy after seeing how wild animals heal from recurrent traumatic encounters, such as predator attacks (for instance gazelles avoiding an attack of a cheetah). What he observed was that when a threat was removed, the animals physically released their fight-or-flight energy by trembling, shaking, and occasionally sprinting. He also observed that once the physical evacuation was complete, they swiftly recovered to their regular state.

Dr. Levine thought that people, like animals, had the power to release bodily energy in response to stress, but frequently sabotage this ability by holding it for a long time and ruminating the thought processes of the traumatic experience following trauma. We have all undoubtedly had firsthand experience with holding it all together during a trying time. For many of us, our capacity to override an inherent instinct for self-care is what creates the scene for PTSD. By interrupting this natural cycle of discharge, the energy becomes trapped, thereby keeping us in a condition of continual fight-or-flight and preventing us from returning to our relaxed, balanced state.

However, it was not until sometime later that he could be able to confirm his observations. It occurred during a session with a patient who was struggling with PTSD. His patient began strongly recalling a horrific childhood memory, and he got a flash of inspiration as he saw her distressed state. He urged her to defend herself by fleeing from the danger as if she were being pursued by a tiger. She started kicking her feet, imitating escape, and thus completed the natural discharge of traumatic energy that had been stored in her body for an extended period of time.

After this session, she received instant and sustained alleviation from her PTSD symptoms, and Dr. Levine witnessed for the first time a human’s capability to physically discharge trauma energy in the same way that animals do intuitively and routinely. Thus, Somatic Experiencing was introduced as a therapeutic modality.

Often referred to as somatic therapy or somatic experiencing, somatic therapy integrates the brain, spirit, and body into a therapeutic healing practice. Somatic therapy employs a body-centric approach to relieve the symptoms of PTSD and other mental health concerns by establishing a harmonious connection between the mind and body.

Humans frequently override the neurological system’s inherent mechanisms of fight-or-flight response with feelings of helplessness and obsessive thoughts, judgments, and phobias. Somatic Experiencing attempts to assist individuals in moving through a point of “frustration” in their processing of a traumatic incident.

The autonomic nervous system (ANS), which is comprised of the parasympathetic and sympathetic nervous system, and the enteric nervous system, is activated in response to physical and mental challenges and is responsible for the fight, flight, or freeze reflex. Although the ANS is supposed to self-regulate, it can become deregulated, especially when the full expression of one’s response to trauma is suppressed. As a result, the body continues to react as if threatened. According to somatic experience, undesired outcomes of trauma — such as fear, anger, hyper-vigilance, and shame result from the body being denied the opportunity to process the traumatic event appropriately.

While many people who have been through traumatic situations recover entirely, unaddressed trauma can result in more serious mental and physical health problems, such as posttraumatic stress disorder (PTSD), difficulty sleeping, mood changes, or immune system problems. Somatic Experiencing strives to reintroduce the body’s ability to self-regulate in order to attain integrity and balance.  

Unlike traditional mental health therapies such as Cognitive-behavioral psychotherapy, which is focused predominantly on the biochemical processes of the brain, somatic therapy utilizes body-oriented techniques such as dancing, breathing exercises, and meditation to assist patients on their rehabilitation journeys. Additionally, training in somatic experience therapy incorporates talk therapy and mind-body exercises.

Rather than settling difficulties vocally, this therapy tries to assist in releasing how the physical body holds on to tension, stress, and trauma.

Each session is unique, but there are certain practices that will almost always occur, although there is no specific routine for when they might occur. The details of each step, including what is addressed and when to go to the next, are fully set by the patient and their comfort level at each stage.

The initial important step is to establish a sense of confidence and trust in the therapy environment, both with the mental health professional and the physical space. Once the confidence and trust have been formed, the process of resolving and healing the trauma can begin.

Following that, the therapist may invite the patient to relive the time immediately preceding the traumatic experience, but not the incident itself. For instance, using the event of a vehicle crash as an analogy, the therapist can begin the process of reliving the trauma by inquiring about the climate on the day of the crash. This mild and indirect method of reviewing the trauma enables our bodies to develop the necessary resilience and gradually release trapped painful energy.

However, the rate of progress is dictated by the patient’s comfort level at each stage. The careful investigation continues until the patient develops sufficient resilience to integrate and release the trauma energy constructively and completely.

Dr. Peter A. Levine used the picture of the tiger in his first appointment with “Nancy,” a patient with a variety of symptoms resulting in the past potentially traumatic incident, and this interaction would later define and shape his career. Nancy froze, her pulse racing as she relived the events leading up to a painful childhood operation, which included being bound and numbed with ether. “I’m going to die!” she exclaims. She pleaded helplessly, “Please don’t let me die!” “Nancy, you’re being hunted by a tiger,” Dr. Levine was impelled to say amid the turmoil, prompted by a seemingly prophetic vision of a charging tiger. Run! “Run for the nearest tree!”. Nancy started kicking her feet like a prey of a tiger to prepare for an escape.  Dr. Levine first experienced the human animal’s intrinsic ability to heal from trauma and anxiety by completing the instinctive, self-protective behavior that had been swamped and locked into her body’s nerve system over 20 years earlier. Nancy started kicking her feet. This single session had a tremendous impact on Nancy’s life, involving the disappearance of her agoraphobia, the cessation of her migraines, and a revived, sustained enthusiasm in living as per her results in frequent follow-ups. The tiger has come to represent our vitality, our true nature.

Furthermore, in an interview with Psychotherapy Networker(PN), Dr. Peter A. Levine talked about his novel Somatic Experiencing Therapy. He mentioned that when we are overcome by trauma, talking therapy alone is not enough. We must listen to our bodies’ unspoken voice: one that does not rely on words to generate experiences that represent those of helplessness and fear. A Somatic Experiencing therapist may initiate contact with clients in a similar manner to a talk therapist: by inviting them to discuss the concerns or emotions that are troubling them. Rather than focusing on the subject of their distress, the therapist may say, “This may seem unusual to you, but stick with me.  I’m curious if you’d be able to identify the locations in your body where you experience those unpleasant emotions (or conflicts) and how they feel physically.”

As this study progresses, we hope to arouse their curiosity about the bodily experiences that underpin their feelings or emotions. Chronic negative feelings, in Peter’s experience, frequently do not shift until the underlying sensory patterns change. And this can only occur with increased body awareness.

Somatic experiencing therapy, as such, is the most common and practical form of somatic therapy. Patients describe their issues in this therapy, just as they do in other types of mental wellbeing therapies. Somatic therapists encourage patients to focus on their inherent physical sensations rather than just talking about them.  Meditation, breathwork, visualization, dance, massage, grounding,  and/or sensation awareness exercises are some of the mind-body practices that can be done after that.

Numerous subgroups use the framework of somatic therapy in unique ways, in addition to standard somatic therapy. These are some of them:

  • Sensorimotor psychotherapy is a type of therapy that employs the body as a resource of information as well as a target for intervention.
  • The Hakomi Method is a psychotherapy that focuses on four key concepts: softness, kindness, empathy, and self-awareness, and blends scientific, spiritual, and psychological sources.
  • The bioenergetic analysis is a type of body-psychotherapy that combines physical, analytic, and relational work based on energy.
  • Biodynamic psychotherapy is a blend of allopathic (medical) and holistic therapy approaches that include massage done by the therapy provider.
  • Brainspotting is a comprehensive therapy that combines mind and bodywork with eye positioning to help train emotional responses.

Somatic therapy is based on the premise that what happens in your life is stored in both your mind and your body. It is a thorough approach to therapy because it focuses on both physiological responses in your body and a conversation about your concerns. Techniques used in somatic therapy include:

Body awareness.  One of the first steps in learning to release body tension is to do this. The client learns to detect and identify regions of tension in the body, as well as thoughts and feelings that are calming.

Grounding. This is the act of making a deep connection with your body and the land. Being able to sense your body, feeling your feet firmly on the ground, and relaxing your nervous system are all part of grounding.

Pendulation. A therapist helps you from a relaxed state to one that feels comparable to your traumatic event with this technique. This can be repeated multiple times to help you release “stuck” energy. You can feel uneasy or nervous as the energy is discharged. You will be directed back to a relaxed condition each time. In time, you will develop the ability to relax on your own.

Titration. The therapist uses this method to take you through a traumatic memory. As you recall the traumatic experience, you will be asked to notice any changes in your body. If you have any bodily sensations, the therapist will assist you in dealing with them as they arise.

Sequencing. This entails paying close attention to the manner in which your body’s anxieties dissipate. For example, you might feel a tightness in your chest followed by a tightness in your throat. As the stress in your body dissipates, you may experience trembling.

Resourcing. This entails reflecting on the things in your life that make you feel safe, such as your relations, personality traits, or even a particular vacation place. It might be anything that helps you feel at ease. The good feelings and sensations linked with your resources, which operate as an emotional anchorage, are then recalled.

These techniques help with healing in the following aspects:

  • Gaining a better understanding of your body and its characteristics
  • Invoking emotional resources
  • Advising on how to make a mental map of your past undesired experiences
  • Harmonious escape from your undesirable feelings and unwanted sensations 
  • Developing self-calming techniques
  • Emotional boundaries are being strengthened.
  • Changing your focus from something stressful to something non-stressful can help you relax.
  • Developing the skill to replace old situational memories with new ones
  • Emotional liberation

Somatic therapy has been demonstrated to be an effective treatment modality for a variety of psychiatric and physical disorders.Post-Traumatic Stress Disorder is a condition that occurs following a traumatic event.  Treatment of PTSD with somatic therapy has been shown to be significant as it has been shown to reduce the time required to heal after a traumatic incident.

Initial research on somatic therapy discovered that it is an effective treatment for PTSD, noting that “mixed model linear regression analysis revealed significant effects of the intervention for symptoms severity of  depression(Cohen’s d = 0.7 to 1.08 and PTSD (Cohen’s d = 0.94 to 1.26) both pre-and post-intervention.” In other words, somatic therapy may be a useful treatment strategy for PTSD, although additional research is needed to determine which patients would benefit the most from this approach.

When tsunami victims were studied, the findings said, “90% of individuals reported considerable improvement or full absence of intrusion, arousal, and avoidance symptoms. The findings substantiate the efficacy and reliability of Somatic Experiencing Therapy in the treatment of trauma responses.”

The term “trauma,” like PTSD, is employed differently in different settings. A traumatic event is described as an incident that creates long-term disruption in the autonomic and core extrapyramidal nervous systems in Somatic experiencing (Levine, 1977, 1997). The rationale of somatic experiencing therapy is based on the assumption is that trauma is located in the nervous system and body, and not in the event itself; an event that is traumatic to one person may not be traumatic to another, as people differ greatly in their ability to cope with a variety of difficult situations due to differences in their early environmental challenges, genetic makeup, and specific trauma and history of attachment to people.

This perspective indicates a stress continuum, with chronic but mild sympathetic activation on one end and chronic severe activation of both sympathetic and parasympathetic (or, more precisely, ergotropic and trophotropic) systems on the other. The pattern of extreme co-activation of sympathetic and parasympathetic systems in life-threatening circumstances (demonstrated in cats by Gellhorn, 1964a) offers an interesting model for the freeze, collapse, and dissociation frequently observed in PTSD (Nijenhuis et al., 1998b; Halvorsen, 2014)

A Somatic experiencing therapist is a licensed and skilled mental health professional with an appropriate educational background who has received supervised, advanced, hands-on training in somatic therapy techniques.

The qualification for a somatic experiencing therapist vary around the globe. For instance, in the US and Canada it could be a three stage qualification. The first involves becoming a psychotherapist. This would require a Master’s degree in Psychology and a registration with a professional association or college. The second stage is to train specifically in somatic psychology. After MA, there is three years of additional training in somatic experiencing. The third stage is to extend your skill and understanding. 

Learning at workshops and in a university will only take you so far. Practicing your craft, experiencing therapy as a client, and consulting with more experienced therapists are all ways to deepen your knowledge.

Healing from trauma can be approached in a variety of ways. Somatic therapy is a body-centered approach that can be especially beneficial if you have suffered from trauma. It was initially intended as a complement to previous trauma-focused therapies, which, while effective in certain cases, did not work for everyone.

You may be able to revisit trauma through somatic experiencing without recalling specific events or emotions.  When you execute these body-focused activities, you concentrate on physical sensations rather than emotions and thoughts, as you might in talk therapy or exposure therapy. According to Valerie Candela Brower, a qualified professional counselor and trained somatic experience practitioner, trauma occurs when “too much happens too soon for the nervous system to handle.”

Candela Brower adds, “It’s like eating a big dinner and not fully digesting it, then eating another big meal, and then another. Instead of digesting what has occurred, the body stuffs our sensations, numbs out, or denies reality.” According to Candela Brower, talking about trauma without proper support or with a therapist who isn’t trained in trauma might retraumatize you. “Somatic work gives the body the time and space it needs to finish whatever it wasn’t able to achieve at the time it wasn’t able to.”

Somatic experience also aids in identifying whether you’ve been “stuck” in the fight, flight, or freeze reaction. In addition to trauma-related symptoms, this could lead to chronic stress symptoms. One of the primary aim of somatic experiencing is to improve your ability to control your emotions and build a body/mind connection. This may assist you in coping with some of your most troubling symptoms.

Somatic treatment appears to be useful for persons who have undergone trauma, according to new research: Somatic experience was reported to help reduce symptoms of PTSD and despair in 63 people in a 2017 study. Another 2017 study of 91 patients with lower back pain and PTSD found that a short somatic experience (in combination with other therapies) may help to alleviate backache and PTSD symptoms.

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