What is a Somatic Approach to Therapy?

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Somatic approaches to counseling and therapy pay attention explicitly to the physical reactions that accompany psychological issues or symptoms. They take into account current information about the autonomic nervous system (ANS) and how it works. (The ANS is the part of your nervous system that controls things like heart rate, blood pressure and other non-conscious functions.) Traumatic experiences overwhelm the body’s natural defenses. Sometimes people heal from this on their own; sometimes we don’t. When that happens, we develop some form of PTSD (or something similar to it).

Somatic Therapy: What it Isn’t

When I say that a somatic approach to therapy works with the body, I’m not talking about massage or touch; these things can be helpful, but that’s not what I provide. A somatic approach does involve talking. But we don’t just talk about problems, issues, ideas, solutions, relationships and the other things that more traditional “talk therapy” involves. Instead, we actually work with your ANS to jump-start your natural healing process and move it forward. While this involves talking, we’re talking about you as a whole person–with emotions and physical reactions–not just about your thoughts.

Paying Attention

Everything starts with paying attention. In modern culture, we are used to using (or abusing) our bodies. We feed them, exercise them, allow them to rest–sort of like we do our pets. We think of ourselves as brains that own bodies. But this is a flawed perspective. We are¬†bodies. Our brains are just a part of us, even if they are a very important part.

So the first aspect of a somatic approach is to learn to simply pay attention to our physical selves. When you’re angry,
for example, what does it actually feel like? What do you feel in your chest, in your arms or legs, on your skin? To work with anger, we don’t just work with the thoughts that go with it, we work with the ANS reactions, the physical reactions that we don’t consciously control. Paying attention is the beginning of this.

Taking it Further

Of course, there is more to a somatic approach than just paying attention. If we are going to change, the physical reactions we have will need to change. This is particularly the case with PTSD. The symptoms of PTSD (whether due to adult trauma or childhood trauma) are mostly not conscious reactions. They are not things we choose. They are things that happen even though we don’t want them to. To change them, we have to involve the system that manages those reactions, the ANS.

There are a number of ways to accomplish this. If you’ve heard of EMDR or Trauma Dynamics, you’ve heard of approaches to therapy that work with the body to heal the effects from past events that still linger with us. There are other approaches, and there are new ones being created all the time, along with modifications of the “old” ones (almost all somatic approaches are new, based on a modern understanding of how the ANS works).

If you live in Colorado Springs and have physical reactions that you don’t like (the agitation of anxiety, the listlessness and muscle pain of depression, flashbacks or uncontrolled anger), then you may benefit from some of the somatic approaches I can provide. Please contact me (below) to see if we’re a good fit.

EMDR

What is EMDR?

EMDR stands for Eye Movement Desensitization and Reprocessing.  It is a treatment modality that was originally developed to treat trauma/PTSD.  It has an 8-phase protocol that is used to work with the underlying causes of PTSD.

By now, you should have read something about what causes PTSD or how treatment works.  If not, you might want to check out one of those links.

Somatic Psychotherapy

EMDR is a somatic psychotherapy modality, which means that it works with the body (or more accurately, the part of the mind that is most closely connected to the body, the autonomic nervous system, or ANS).  When traumatic events occur, it is the ANS, not our conscious mind, that responds.  The responses are simple and very basic (most animals can do these things):  Fight, Run, Freeze or Disconnect (we call this “Dissociating”).  These responses can be very adaptive, very helpful, when we are in a threatening situation.  Oftentimes, they will save our lives.

The problem comes later–when the threat is gone.  Sometimes (not all the time), people can feel like the threat is still going on.  We call this PTSD.  It’s fundamentally an ANS problem, and to my way of thinking, an ANS problem requires an ANS solution.  That’s why I’m not a fan of just talking about the traumatic events (many therapists, for example, use a Cognitive Behavioral approach, which I don’t generally use for trauma, as I don’t think it really heals the underlying problem).

In somatic approaches (such as Trauma Dynamics and EMDR), you don’t have to talk as much about what happened.  Certainly we need to talk enough so that you can remember and bring up the memory, but it’s not about giving me the details of the event–I don’t need them.  Somatic therapies help allow the body to heal.  We have to somehow convince the body that the traumatic event is over, by allowing that part of the mind to process it.

How does it help PTSD?

EMDR helps the the mind/body resolve trauma by using what’s called bilateral stimulation.  The most common (and preferred) form of this is working with eye movements.  However, it can be done by using sounds or touch, in several ways.  Bilateral stimulation seems to allow the brain to process traumatic memories faster.  It seems to “jump-start” the healing process.

Why does it work?  We don’t know.  Actually, we don’t know for sure why any therapies work–we just know that some of them do.  We think that it has to do with facilitating communication between the two sides of the brain, which process information differently.  The theory behind this is called the Adaptive Information Processing model.  It explains how EMDR helps your brain turn your trauma from something that feels like it’s still happening into something that happened, and is over.

But you don’t need to know this to use EMDR.  All you need is a therapist who is trained in and willing to follow the proper protocol, one that you trust and who has listened well to you as you have described your issues.

Can something as strange as EMDR really work?

Short answer:  Yes.  And when EMDR works, it’s extremely helpful.  It can sometimes remove 100% of PTSD symptoms.  Of course, childhood trauma is tougher than adult trauma most of the time, and can take longer to resolve.  But still, we are talking about much less time than used to be spent on talking therapies.  In fact, many people used to be in therapy just talking for many years, never getting much better.  This doesn’t happen when EMDR works.  And the research says it works well most of the time.

What about when it doesn’t work well?  Usually there are things we can do to enhance it.  But in the final analysis, it’s up to you.  If you are one of the few people it doesn’t work for, or you’d rather not do it, that’s no problem.  There are other ways to work on PTSD that are helpful and promote healing and can allow you to be successful in reaching your goals (a reduction or elimination of PTSD symptoms).

So when we start talking trauma, I’ll start talking about somatic psychotherapies like EMDR or Trauma Dynamics.  I like to go with what works. ūüôā

How Trauma Therapy Works

What should I expect from trauma therapy?¬† How will I feel?¬† Will it take long?¬† How do I know if it’s going well? These are natural questions about how trauma therapy works.¬† Let’s dive in.

A thousand kinds of trauma

Because trauma can come in many different forms–physical, psychological, sexual, short-term or long-term–trauma therapy will look different for each person.¬† Some of it will depend on the symptoms you’re facing.¬† It will depend on your resiliency and your resources.¬† Yet, no matter what kind of trauma and exactly how it affected you, there are some important similarities.¬† (For a list of classic PTSD symptoms, read here.¬†Or learn about childhood trauma and its impacts.)¬† Because of these similarities, all effective trauma treatments share some basic themes.

How trauma therapy works–safety first

The first thing that’s needed to address trauma is safety.¬† Without it, there can be no recovery.¬† Why should there be?¬† Trauma reactions are adaptive–they are actually¬†helpful if you are under threat.¬† If you’re in the war zone, you’d better wake up at the slightest noise and grab your rifle without thinking.¬† If you’re in an abusive relationship, you’d better be hypersensitive to your abuser’s moods.¬† And if you’re being repeatedly beaten or raped week after week, then it’s best if your brain finds a way to¬†just not be there.¬†¬†Your mind checks you out of reality–it’s the only way to tolerate the intolerable.

But when it’s over, and the traumatic experience isn’t happening anymore, these things, these things that were so helpful while it was happening–they suddenly become symptoms.¬† You’re avoiding crowds and jumping at small noises, you’re hypersensitive to those around you and fly off the handle at tiny provocations.¬† Or you find yourself constantly checking out of work, checking out of your marriage.¬† You don’t feel like you’re there; and that’s because you aren’t.

So where are you?¬† Well, you’re back in the trauma.¬† You know it’s over, but your body doesn’t.¬† It’s not enough for it to actually be over.¬† You have to somehow fully experience that.¬† That’s why we start with safety.

Safety means several things.¬† First, you have to feel safe with your therapist.¬† If you don’t, find a different one.¬† Second, you have to be safe in your life.¬† You can’t still be living with your abuser, you can’t still be tolerating their denial.¬† You also have to get free from toxic relationships that will trigger your abuse reactions.¬† For some reason, when we’ve been traumatized, we sometimes unknowingly seek out situations that are similar.¬† That’s got to stop.¬† You have to be in control of your life in order to heal.

Remembering

Next comes the heart of how trauma therapy works.¬† In the past, we used talk therapy alone.¬† This can work, but it takes a long time (sometimes many years).¬† Nowadays, we have powerful techniques which are based on working with the body, such as EMDR.¬† They’re often very effective, and usually shorter.¬† Sometimes a lot shorter.

Trauma therapy helps your brain/body process the memory of the trauma.¬† Even though you may not remember it well, your body remembers it.¬† Your body remembers every blow, every word, every move your perpetrator made, and it remembers not only what happened and what you did to try to help and defend yourself, but also what your body¬†wanted to do.¬† The problem is, this memory is stuck.¬† The brain hasn’t put it into place, the way it does with normal memories.¬† Once it has done this, the trauma goes from being something that is still happening to something that happened in the past.¬† It’s a bad thing, for sure, but a bad thing that is finally¬†over.

Why use special techniques?

There are a number of special techniques that can be helpful here.¬† I’m trained in several of them, and they can be very effective.¬† They work with what is happening in the body–I teach you how to pay attention to it, and how to start letting it resolve itself (remember, the body¬†wants¬†to heal).¬† So in our sessions, we’ll jump-start that positive, healing process. The techniques help us get “unstuck.”

There’s a lot to do here.¬† The charge has to be let out of the body, and the sadness has to be let out of the soul. Trauma therapy work takes some time and effort.¬† You don’t feel better after every session.¬† Sometimes you feel a bit worse.¬† But gradually, as you go through the process, you begin to get relief.¬† As a result, you begin to feel lighter, more clear, more present, more confident and capable, more (dare we say) normal.¬† You begin to feel more like yourself.

Reconnecting

Once this happens, you can begin to rejoin your life.  You reconnect with others, build new relationships, engage in new activities (or dust off the old ones).  Love, work and play:  All the things that were on hold while you were suffering so much.

How long does it take?¬† No one can say.¬† But if it’s going well, there should be things happening at almost every step that are helpful to you.¬† And it can take a lot less time than it used to, again, if it’s done well.¬† Some of the modern therapies seem strange (actually, all of the ones that seem to work well seem strange), but they’re pretty powerful.¬† If you don’t feel anything is happening or changing after a few months, you might want to re-evaluate.¬† On the other hand, you can’t put a time limit on it, either.¬† It takes what it takes. Just keep walking downhill and you’ll eventually make it to the river.