What is somatic therapy?
More and more, somatic therapy is being integrated into therapeutic techniques. But what is somatic therapy? And where does it come from? In this blog entry I will attempt to give an overview of what somatic therapy means, and how to approach a therapist about integrating somatics if you are interested.
As always, we start with context: all the way back in the 1600’s (yes really) there was a French philosopher named Rene Descartes who was quite taken with examining the relationship between the human mind and body. Since his work as a philosopher was pondering things, he began to think about the process of thinking itself, which he believed took place in the mind. He theorized that the mind and body were separate organisms, and that the mind had dominion over the body. This theory was known as Cartesian dualism, or sometimes mind-body dualism.
Though there were always people that opposed Cartesian dualism, when what we now know as Western medicine began to form and institutionalize, it carried the legacy of Cartesian dualism with it. Treatment of bodily ailments and treatment of mind ailments developed as distinct disciplines. We don’t know if this is what Descartes intended, and can’t say for sure how he would react if he were alive to comment on it, but it unfolded this way anyway.
For generations, psychology has had the task of treating what western medicine firmly categorized as ailments that are located within the container of the mind, and therefore should be treated in that location, using the vehicle of thoughts to transfer a cure from the psychologist to the patient. The most famous of these is “the talking cure” developed by Sigmund Freud. In this approach, the psychologist would aggressively analyze the patients every word, which is 1. Deeply unethical and 2. Super annoying.
I’m getting to the somatic stuff, I promise.
Let’s jump forward. For decades now, some doctors, therapists and clients have questioned the utility of Cartesian dualism to truly address the complexity of mental and physical health conditions, and have been developing treatments that integrate both mind and body. Soma means body. Somatic therapy means incorporating some dimension of work with the body into treatment for ailments that used to be considered to be solely of the mind: depression, anxiety, post traumatic stress disorder, and more.
There are many traditions of what is called collectively somatic therapy- Sensorimotor Therapy, Somatic Attachment Therapy, Somatic Internal Family Systems, and more. There is no singular type that is agreed upon as the best approach. Therapists that integrate somatic therapy into their practices are trained in and draw inspiration from traditions designed by many different healers, and that is a good thing. Just like every other type of therapy, there is no one size fits all. In addition, there are many, many traditional healing methods practiced across the world that include some type of body work, to which western somatic therapy traditions owe great honor.
The tradition I myself am mainly trained in is called Somatic Experiencing- I am not certified but simply studying it. Somatic Experiencing was developed to treat PTSD, or what is now mostly called simply trauma. The thesis behind Somatic Experiencing is that trauma can cause wear and tear on the autonomic nervous system, and so, trauma treatment should include the autonomic nervous system. The autonomic nervous system is a component of the peripheral nervous system that regulates involuntary physiologic processes including heart rate, blood pressure, respiration, digestion, and sexual arousal. It contains three anatomically distinct divisions: sympathetic, parasympathetic, and enteric. The autonomic nervous system lets us be relaxed, spontaneous, and socially engaged in a safe environment, or prepares us to fight, flee, or freeze in response to a threatening one.
Our human brains have evolved with add-ons to other species' brains, but we didn’t lose anything from them. Basically, we have new apps but not a very different operating system. As such, we have instincts to respond to harm or perceived harm in ways similar to other species. Somatic Experiencing considers humans, aka homo sapiens, part of an evolutionary lineage that shares bodily features (such as an autonomic nervous system) and bodily instincts (such as fight, flight, or freeze) in common with other animal species that are evolutionarily older than us, and honors the innate intelligence of those similarities. In a threatening situation, animals either run to get away, fight off the threat, or if those don’t work, play dead (freeze) to appear unappetizing to a predator until it wanders away.
As animals, if an instinctual survival response sets off an alarm in our autonomic nervous system telling us to fight, flee, or freeze, it is important that that protective response is allowed to fully play out in service of its goal: to get to safety. If that response is prevented or constricted, the unresolved instinct can remain trapped in the nervous system as a chronic trauma response, or PTSD. That can mean someone can feel trapped by the instinct to constantly fight, flee, or freeze, even if they aren’t in an unsafe situation anymore. That is because even though our mind can cognitively register when a threatening situation is no longer happening, at the level of the organism (or body) there is no real proof of that, because all the nervous system knows is that it couldn’t do what it needed to in order to protect itself. The nervous system doesn’t know time.
If that response were allowed to play out to its natural conclusion, our nervous system settles back into its baseline state, which is a proper flow in real time and proportional to what’s currently happening around us- not stuck in a chronic response. We'll start in therapy by creating a safe container, building skills to cope with overwhelming emotions, thoughts, or body sensations. Then, when you're feeling ready, we may slowly approach your traumatic narrative, attending to body sensations along the way and supporting the discharge of trapped fight/flight/freeze energy.
One thing I love about Somatic Experiencing, and all types of somatic therapy, is that they acknowledge that human beings have evolved capacity for abstract thought, but otherwise are not fundamentally different from other animals per se. Somatic therapy acknowledges the intelligence and healing instincts of other parts of our bodies besides just our minds. Our bodies have instinctive reactions to what’s going on around us- and that means involving the body in therapy can have profound positive impacts on our sense of not only ourselves, but the world. And who wouldn’t benefit from more wholeness and integration?
Most of our therapists at Riverbank incorporate somatic traditions into their treatment approaches. If you’d like to schedule a free 20 minute consultation with one of our therapists in-person in Seattle, or online for residents of Washington state, click here to fill out our contact form!