Somatic Therapy: Healing Trauma Through the Body, Not Just the Mind

Why the Body Holds Trauma: Van der Kolk's Research

In 1994, psychiatrist Bessel van der Kolk published research that would eventually reshape how the mental health field understood trauma. Using brain imaging technology, he demonstrated something that clinicians had suspected but could not previously prove: that traumatic memories are processed and stored differently from ordinary memories, and that the body plays a central role in this storage.

Van der Kolk's landmark 2014 book, The Body Keeps the Score, synthesised decades of research to make a case that has since become foundational in trauma treatment: trauma doesn't simply leave emotional or cognitive traces — it reorganises the brain, changes the nervous system's baseline, and creates physical patterns of tension, arousal, and shutdown that persist long after the traumatic event is over.

This matters enormously for treatment. If trauma is stored in the body — in the way the diaphragm tightens when someone raises their voice, in the way the shoulders brace at sudden sounds, in the way the gut clenches in certain social situations — then talking about it, no matter how insightfully, can only go so far. Insight does not automatically regulate the nervous system. Understanding why you freeze does not necessarily prevent you from freezing. The body needs to be part of the healing.

This is the fundamental premise of somatic therapy: to work with trauma at the level where it lives, which is the body as much as the mind.

Somatic Experiencing (SE) vs Talk Therapy

Somatic Experiencing (SE) is one of the most widely practised and researched somatic approaches. Developed by Peter Levine, a biophysicist and psychologist who spent decades studying trauma and the stress responses of animals in the wild, SE is grounded in a specific observation: animals in the wild routinely survive extreme threat — being chased by predators, for example — without developing the equivalent of PTSD.

Levine observed that animals complete their threat response physiologically. A gazelle chased by a cheetah, if it escapes, will often be seen shaking and trembling after the chase. This shaking is not distress — it is the nervous system discharging the intense activation mobilised for survival. Once the discharge is complete, the animal returns to baseline and resumes normal behaviour as if nothing happened.

Humans, by contrast, often interrupt this discharge process. Social norms, cognitive interference, and the uniquely human capacity to think about our own suffering mean that we frequently suppress the physical completion of the threat response — the trembling, the shaking, the urge to collapse or to run. When this happens, the charge remains trapped in the nervous system, continuing to dysregulate it long after the threat is gone.

SE works by helping people safely complete these incomplete physiological responses, releasing the trapped activation and restoring the nervous system to its natural baseline. Unlike conventional talk therapy, which primarily works through language and narrative, SE works primarily through body sensation — noticing what is happening in the body, tracking sensation moment to moment, and supporting the natural processes of self-regulation that the body wants to perform but has been prevented from completing.

Polyvagal Theory in Plain Language

To understand somatic approaches fully, it helps to understand polyvagal theory — developed by neuroscientist Stephen Porges — which provides the neurobiological framework for much of somatic trauma work.

The vagus nerve is the longest nerve in the body, running from the brainstem to the abdomen and innervating most of the organs of the chest and belly. Polyvagal theory proposes that the vagus nerve (and the broader autonomic nervous system it regulates) has three primary states, each associated with a different pattern of behaviour, physiology, and social engagement.

The ventral vagal state is the state of social engagement — safety, connection, curiosity, play. When we are in this state, the muscles of the face are relaxed and responsive, the voice is prosodic, we can hear human speech easily and filter out background noise, our heart rate is variable and regulated. This is the state in which learning, healing, and genuine connection occur.

The sympathetic state is mobilisation — fight or flight. When the nervous system perceives threat, it mobilises energy for action: heart rate increases, muscles tension, digestion pauses, attention narrows. This is adaptive in the face of genuine danger. It becomes problematic when it activates in the absence of real threat, or when it becomes chronic — as happens in trauma.

The dorsal vagal state is immobilisation — freeze, collapse, dissociation. This is an even more ancient defensive response, activated when the nervous system assesses that fight or flight is impossible. The body becomes still, energy drops, the person may feel numb, spacey, or disconnected from themselves. Dorsal vagal responses are common in trauma, particularly in situations where someone was unable to escape or resist.

Somatic therapy, informed by polyvagal theory, aims to help people access and expand their ventral vagal capacity — their window of resilience, the range of activation within which the nervous system can remain regulated. This requires not just cognitive insight but actual physical experiences of safety, connection, and regulation.

What a Somatic Session Looks Like

A somatic therapy session looks quite different from conventional psychotherapy. While there may be some verbal narrative, much of the work happens at the level of sensation and movement rather than story.

Two key concepts in somatic work are titration and pendulation.

Titration refers to approaching traumatic material in very small doses — like adding drops of acid to water rather than the reverse. Rather than diving into the full traumatic narrative, the somatic therapist helps the client touch the edge of the traumatic experience just enough to activate some of the associated body sensations, then draws back. This prevents retraumatisation and works with the nervous system's capacity rather than overwhelming it.

Pendulation refers to the movement between activation and settling — between touching something difficult and returning to resource. A somatic session will typically move back and forth between moments of activation (when traumatic material is touched) and moments of resource (returning attention to something stable, safe, and settling in the body). This back-and-forth movement gradually expands the nervous system's capacity to tolerate activation without becoming overwhelmed.

During a session, the therapist might ask: "What do you notice in your body as you think about that?" or "Where do you feel that?" or "What happens in your chest as you say that?" The client learns to attend to physical sensations — tightening, heaviness, warmth, trembling, tingling — and to track how they change moment to moment. The therapist supports the natural completion of incomplete physical responses: if the client's hands want to push, the therapist may encourage them to follow that impulse slowly; if the body wants to tremble, the therapist holds space for that discharge rather than suppressing it.

The process can feel strange at first, particularly for people who are accustomed to using language and narrative as their primary mode of self-understanding. But for many trauma survivors, this body-based approach accesses material that words have never been able to reach.

Body-Based Self-Help Practices

While somatic therapy in its full form requires a trained practitioner, several body-based practices can be used independently to support nervous system regulation.

Physiological sigh: A double inhale through the nose (two short inhales in quick succession) followed by a long, slow exhale through the mouth rapidly deflates the air sacs in the lungs and resets carbon dioxide/oxygen balance. Research by Andrew Huberman at Stanford has shown this to be one of the most rapidly effective techniques for reducing physiological arousal — more effective than box breathing or other techniques for acute stress reduction.

Self-holding and orienting: When activated, place one hand on your sternum and one on your belly. Simply feel the warmth and pressure of your own hands. Slowly turn your head and let your eyes scan the room — not looking for threats, but genuinely orienting to your actual environment. Remind yourself, with this physical scanning: I am here. This is now. The threat is not present.

Therapeutic shaking: Inspired by Peter Levine's observation of animal trauma discharge, deliberate shaking of the legs and body can facilitate the release of held tension. Begin by standing and gently bouncing on the balls of your feet, allowing the movement to travel up through the legs, hips, and spine. This can feel ridiculous at first but often produces a noticeable reduction in muscular tension and nervous system activation.

Grounding through the senses: Engage each of the five senses sequentially and deliberately: what can you see, hear, touch, smell, taste right now? This is a simple but powerful exercise for returning from dissociated or overwhelmed states to present-moment sensory reality.

Boundary exercises: Many trauma survivors have compromised physical boundary sense — the felt sense of where their body ends and the environment begins. Simple exercises like firmly pressing the soles of your feet into the floor, pushing your back against a chair, or pressing your palms against a wall can reinforce the felt sense of a body with edges — a foundational aspect of physical safety.

Who Benefits Most from Somatic Approaches

Somatic therapy is not the right fit for everyone or every situation. It is particularly indicated for people whose trauma symptoms include significant somatic (physical) components — chronic tension, physical dissociation, unexplained physical symptoms, hypervigilance expressed through the body, or a disconnection from body sensation.

People who have tried standard talk therapy or CBT for trauma without adequate results are often good candidates for somatic approaches. The research literature on treatment-resistant PTSD consistently identifies people who have "run out of words" for their experience — who can describe what happened but cannot shift the emotional and physiological response — as the population most likely to benefit from body-based interventions.

Somatic approaches are also particularly useful for complex PTSD arising from chronic childhood trauma, where the body-level adaptations are deeply engrained and not amenable to simple cognitive processing. In this context, somatic therapy provides the felt experience of safety that purely cognitive approaches cannot deliver.

People with significant dissociation need careful assessment before beginning somatic work. Dissociation is itself a somatic response — a disconnection from body experience — and somatic therapy aims to reverse it. But the process of reconnecting with body experience can temporarily increase dissociation in people who have relied heavily on it as a coping mechanism. In these cases, specialised approaches and careful pacing are essential.

How to Find a Qualified Somatic Therapist

Somatic therapy encompasses a range of approaches with varying levels of evidence and training requirements. Somatic Experiencing (SE) has the most developed training programme and research base. Practitioners can be certified through the Somatic Experiencing International (SEI), and certified practitioners are listed on their website. Look for someone who has completed the full SE training programme (three years, across beginner, intermediate, and advanced levels) and has achieved Somatic Experiencing Practitioner (SEP) status.

Other somatic approaches with established training programmes include Sensorimotor Psychotherapy, Hakomi, and Trauma-Sensitive Yoga. Each has somewhat different theoretical underpinnings and practical approaches but shares the fundamental commitment to working with body experience rather than primarily with narrative.

When approaching any somatic therapist, it is reasonable to ask about their specific training, how many years they have been practising, what populations they specialise in, and how they work with the body specifically. A good somatic therapist should be able to explain their approach clearly and should demonstrate genuine attunement to your comfort level with body-based work.

To begin exploring options for somatic therapy or somatic-informed support, visit the specialists directory on this platform. Related reading that will deepen your understanding includes the articles on PTSD and psychological trauma, psychosomatics: body and mind, and grounding techniques — the last of which provides practical body-based practices you can begin using immediately.