Psychotherapy What Is Somatic Experiencing Therapy? By Theodora Blanchfield, AMFT Theodora Blanchfield, AMFT Twitter Theodora Blanchfield is an Associate Marriage and Family Therapist and mental health writer. Learn about our editorial process Updated on November 02, 2021 Medically reviewed Verywell Mind articles are reviewed by board-certified physicians and mental healthcare professionals. Medical Reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by Steven Gans, MD Medically reviewed by Steven Gans, MD Steven Gans, MD is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital. Learn about our Medical Review Board Print PeopleImages / Getty Images Table of Contents View All Table of Contents What Is Somatic Experiencing Therapy? Techniques What Somatic Experiencing Therapy Can Help With Benefits Effectiveness Things to Consider How to Get Started What Is Somatic Experiencing Therapy? Somatic experiencing therapy is a type of alternative therapy geared towards helping people find healing from trauma. Created by Peter Levine, PhD, this therapy works on the principle that trauma gets trapped in the body, leading to some of the symptoms people with PTSD or people who have experienced trauma might experience. Through this method, practitioners work on releasing this stress from the body. Many people who have experienced trauma, especially those who have experienced physical trauma such as domestic violence or sexual assault, can dissociate or disconnect from their bodies. Somatic experiencing helps them have an increased sense of awareness of their internal experience (interoceptive, proprioceptive, and kinesthetic sensations). What Is Trauma Therapy? Techniques Somatic experiencing practitioners use a framework known as SIBAM (Sensation, Imagery, Behavior, Affect, and Meaning) to help clients incorporate their bodies in processing trauma. Typically, most therapy uses our cognitive skills to access our memories or traumas via “top-down” methods. However, somatic experiencing uses a “bottom-up” approach, which starts with bodily sensations before returning to our thoughts. Sensation: You may not be used to sitting with the sensations that are constantly coursing through your body, or you may not have previously realized how they were linked with your emotions. You will begin with simply noting what you are feeling in your body. Imagery: This part of the framework uses guided imagery (where the practitioner leads you through imagining a scene while you listen) or interactive guided imagery. The latter is an ongoing conversation between you and the practitioner where you share what’s coming up as you are being led through this exercise. Behavior: While much of this therapy consists of you reporting your internal experiences, the behavior part of Levine's model involves the therapist observing your behavioral responses, such as your body language or posture. Affect: This is how you display your emotions to the outside world, such as through your word choices, tone, and speed. Meaning: Finally, this part of the model looks at how you perceive the therapy and what your experiences mean to you. How to Find a PTSD Therapist What Somatic Experiencing Therapy Can Help With Somatic experiencing therapy may be helpful with aspects of: Trauma Anxiety Grief Substance use disorders PTSD Chronic pain How Pain and PTSD Occur Together Benefits of Somatic Experiencing Therapy The trauma that is held within the body may lead to emotional dysregulation. It is believed that somatic experiencing therapy works by releasing the trauma that becomes “trapped” in the body. One aspect of this dysregulation is known as the freeze response, our body’s primitive defense against danger. This response would activate if someone were being chased by a tiger. Unlike the "fight or flight" response that takes place in response to an acute threat, which causes the sympathetic nervous system to increase heart rate, breathing, and focus, the "freeze" response can cause the opposite. The freeze response in the human body is akin to an animal “playing dead.” It is said that the body doesn’t know how to distinguish physical trauma from mental trauma. If the danger is life-threatening, like that tiger, you may be able to physically shake off that fear once the tiger is no longer around. With emotional trauma, however, the brain can get stuck believing that you are still in a state of danger. The freeze response may manifest in both cognitive and physical symptoms such as: Cognitive Symptoms Confusion Detachment Difficulty concentrating Physical Symptoms Difficulty moving Slowed breath Lower heart rate Effectiveness of Somatic Experiencing Therapy While not much research has been published on somatic experiencing, one study, a randomized controlled trial, showed that 44% of the participants lost the diagnosis of PTSD. One study looked at the efficacy of somatic experiencing interventions following a 2004 tsunami in India. While there was no control group, 90% of the 150 participants in one study reported either no symptoms or a reduction in symptoms at an eight-month follow-up interval following a single 75-minute session. Another non-controlled intervention study followed 53 participants who received one to two sessions of treatment a month after a tsunami and were evaluated three to five days post-treatment and a year later. After the first session, 67% of participants reported a full or partial reduction in symptoms. When evaluated a year later, 90% of these people had sustained improvement in that time period. Things to Consider While somatic experiencing therapy does not involve a complete retelling and processing of your past trauma like some other trauma therapies might, you will be asked to bring up some of these painful memories. Doing so may result in you feeling “activated” or feeling a high level of energetic arousal in your body. This may also be known as feeling triggered. This may feel uncomfortable, but that is the point. Before reaching this stage, your therapist will work with you on "resourcing," or finding tools that will help you self-soothe when you are feeling emotionally overloaded so that you can handle working with these memories when they come up in therapy. How to Get Started With Somatic Experiencing Therapy If you're interested in this type of therapy, below is actionable advice that you can use to begin your search for this kind of care. How to Find a Therapist There are many therapists who may call themselves somatic therapists, but somatic experiencing therapy is a particular method, developed by Dr. Peter Levine. His organization offers training in this particular approach. You can find a list of practitioners on their website. What to Expect Be prepared for your practitioner to ask you about your trauma history. Remember, this is your therapy, so you can only answer as much as you feel comfortable with. A good practitioner should recognize and respect that and work with you to feel safe as you disclose more. What Does a Session Look Like? First, the practitioner or therapist will do a pre-interview to learn about your trauma and overall health history and answer any questions about your expectations. They will then ask questions centered around assessing how your body is responding to your trauma and stress. The therapeutic process will involve facilitating states of arousal triggered by the trauma and sensations of safety and calm. This process of going back and forth between these states is called pendulation, and it focuses on recognizing these sensations. Trauma can interfere with our ability to recognize our internal state, and this technique helps us reconnect with ourselves and what’s going on in our bodies. This is practiced in the safety of your therapy so that you become familiar with these sensations and once learned you will hopefully be able to down-regulate on your own. Because of how our bodies hold and express trauma primitively, your therapist may see small movements that indicate your body moving into flight mode. You will learn to safely ride these somatic experiences out as you begin to heal. 6 Sources Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Payne P, Levine PA, Crane-Godreau MA. Somatic experiencing: using interoception and proprioception as core elements of trauma therapy. Frontiers in Psychology. 2015;6. https://doi.org/10.3389/fpsyg.2015.00093 Schmidt NB, Richey JA, Zvolensky MJ, Maner JK. Exploring human freeze responses to a threat stressor. Journal of behavior therapy and experimental psychiatry. 2008;39(3):292. https://doi.org/10.1016/j.jbtep.2007.08.002 Brom D, Stokar Y, Lawi C, et al. Somatic experiencing for posttraumatic stress disorder: a randomized controlled outcome study. Journal of Traumatic Stress. 2017;30(3):304. https://doi.org/10.1002/jts.22189 Parker C, Doctor RM, Selvam R. Somatic therapy treatment effects with tsunami survivors. Traumatology. 2008;14(3):103-109. doi:10.1177/1534765608319080 Leitch ML. Somatic Experiencing treatment with tsunami survivors in Thailand: Broadening the scope of early intervention. Traumatology. 2007;13(3):11-20. doi:110.1177/1534765607305439 Park ER, Traeger L, Vranceanu AM, et al. The development of a patient-centered program based on the relaxation response: the Relaxation Response Resiliency Program (3RP). Psychosomatics. 2013;54(2):165-174. https://doi.org/10.1016/j.psym.2012.09.001 By Theodora Blanchfield, AMFT Theodora Blanchfield is an Associate Marriage and Family Therapist and mental health writer. See Our Editorial Process Meet Our Review Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? 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