What is Somatic Therapy? Bringing your Body into Therapy
By Peggy Loo, PhD
A lot of people assume that you can only talk your way towards change and healing in therapy. Having a conversation that helps you see a pattern, understand how past experiences affected you, or figuring out how to respond to hard stuff with professional guidance - this is what comes to mind for most. Yes, talking about things with your therapist can be powerful. Sharing, making connections, and feeling validated and seen through a conversation can be transformational.
I’ve always appreciated what Fred Rogers (yes, of the classic kids show Mister Roger’s Neighborhood) said: “Anything that’s human is mentionable, and anything that is mentionable can be more manageable. When we can talk about our feelings, they become less overwhelming, less upsetting, and less scary.”
And - maybe sometimes while it’s helpful to talk things out, you’re wondering if there’s another way to change how you’re feeling. Or you want to apply some bit of insight into your relationships, but when opportunity arises, for some reason you just can’t do it. Maybe processing in session with your therapist feels good, but once you leave, you have trouble being fully present or trusting your sense of things.
In somatic therapy* - each of these examples becomes an opportunity to bring your body into therapy.
What is somatic therapy?
The word “soma” means body in Greek. Somatic therapy focuses on what’s happening in your body to explore, understand, guide, and process lived experiences. Somatic therapists draw attention not just to your thoughts and emotions, but physical sensations and body reactions as relevant information - even wisdom.
Have you ever noticed wanting to believe something is true, but you can’t seem to talk yourself into it feeling true? Or maybe you’re in a situation you’d expect to go fine, but for some reason you’re completely thrown off and you don’t get why? Getting curious about what’s happening in your body, especially in moments where there’s a difference between what you think and how it feels internally is a common entry point for exploration in somatic therapy.
Somatic awareness is mindfulness of your body reactions and sensations
Much of somatic therapy starts with noticing and getting curious about the embodied parts of our lived experiences - and bringing that into the therapy conversation. Just as your therapist may encourage you to listen to real-time thoughts you’re having or tune into feelings bubbling up during session - you can also “listen” to the reactions or sensations happening in your body. This is also called somatic awareness.
Three key principles of somatic therapy
There are multiple types of somatic therapy, such as EMDR, IFS, AEDP, Dance/Movement Therapy, and Sensorimotor Therapy. Each somatic therapy has its own focus and approach, but they do share some things in common. This introductory post is about somatic therapies in general, but doesn’t go into depth about the different types.
Somatic therapies assume:
A mind-body connection exists for everyone.
Your mental and emotional health directly influence your physical health and body sensations, and vice versa. This connection exists both on a long-term level and a moment by moment level. If you’re anxious - you may notice chest tightening, shoulder tension, and trouble sleeping that night. Over time this could turn into back pain, insomnia, and other health issues.
It also works in the other direction. Maybe you’ve noticed your perspective change after stretching your legs, or how a hug brings your stress down (even if your external circumstances stay the same).
An emphasis on bottom up processing, or sensing things.
Humans use both bottom-up processing and top-down processing. We need both to make meaning of life experiences, and both are equally important. A simplified way of understanding it is this: bottom up processing is when your body’s senses gather raw information about a situation and sends it to your brain to figure out what you’re experiencing. Top-down processing happens when your brain uses existing knowledge, memories, or expectations to figure out what you’re experiencing.
In the therapy world, therapies that focus on working with your thoughts, internalized beliefs or narratives, or level of insight to facilitate change favor top-down processing (like CBT or psychodynamic therapy). These are great. If you have a different perspective or can understand something, that can majorly shift how you feel about it and how it lives in you.
Somatic therapies are bottom-up processing; they focus on “sensing” what’s happening. In other words, paying close attention to body reactions and sensations first - and then working with them therapeutically to create change. By changing how your body experiences something, you can change the thoughts and feelings you have about it.
The body is a trustworthy source and can guide therapy.
This is probably my favorite one. Somatic therapy inherently trusts the body to be a valid communicator. It just comes down to us listening and being open to what it’s saying. The language your body speaks through the activation, shift, or changes in physical sensation (including going numb) is worth listening to.
It can illuminate what feels risky or vulnerable to you, about unresolved experiences that somehow feel the same years later, whether a moment makes you feel alive or connected or shut down hard. Think of it like instincts - everyone has a capacity for them, and it’s a matter of tuning in, strengthening them, and discerning what they’re trying to tell you.
Can somatic therapy work if I have a complicated relationship with my body?
In short, yes. There are many reasons that being in your body, or connecting to sensation can be hard, which I want to acknowledge and validate. Some may have to do with your identities, some may have to do with the life experiences you’ve been through.
If you’re neurodivergent, it may be challenging for you to notice or differentiate internal sensations from each another. If your trauma had to do with something happening physically (sexual violence, racism, birth or medical trauma) - maybe you coped by detaching from your body.
Maybe you have a health diagnosis or disability, which means it’s complicated being in your body or you associate it with pain. Or you have health anxiety where intentional, guided focus on your body sounds like the last thing you want to do.
This doesn’t mean somatic therapy can’t work for you - but it does mean that you should discuss a thoughtful approach and pace with your therapist before wading in. Think of it this way - we know not every thought we have is true and emotions can be complicated, evolving, and mixed - but that doesn’t mean we can’t benefit from therapies that helps us sort our thoughts and feelings so we can learn from them. What matters is growing in wisdom - how to listen to what thoughts and feelings may be telling you (or not), when situation or context affects the meaning. The same is true for somatic therapy and body sensations.
Should I try somatic therapy?
A lot of the folks I work with have spent a lifetime being validated for their smarts, which can translate into a greater trust in their capacity to think their way through something. Sometimes it also means assuming the body is just the vessel for your brain, or that your body sensations are lesser in value than the high-level thinking you’re capable of. This can make the idea of somatic therapy seem woo-woo-hippy-dippy, or simple, or scammy.
As a psychologist who’s trained in cognitive, emotion-focused, and somatic therapies - I couldn’t disagree more. There’s nothing more powerful than seeing someone who can tune into every part of themselves - their thoughts, feelings, and body. Our rational, emotional, and somatic selves rely on each other to navigate our daily lives. For me, it’s like hearing a full orchestra play together - each section contributes a sound only it is capable of making. And the total effect is greater and richer for it.
And if you’re someone who finds bottom-up processing more intuitive or natural, or you’re considering therapy but the idea of only sitting and talking doesn’t totally appeal, great news. Somatic therapy or a therapist familiar with body-based skills may be a better fit. Here are three reasons to try somatic therapy.
Three reasons to try somatic therapy
Somatic therapies are an effective way to address trauma.
Somatic therapies are gaining attention as trauma experts recognize that trauma doesn’t just affect the way we think and feel - it affects us on a nervous system level. When we experience extreme or chronic helplessness and overwhelm - our bodies experience it. And for many of us, there wasn’t safety, time, or support to process the effects of trauma when it happened. So you find ways to get by - but it’s not the same as getting what you really needed. Somatic therapy can be a way for you to work through the unresolved, embodied effects of trauma.
You feel like a brain, not a body - and you want to be present.
Today, more than ever - it’s hard to be present and stay present. A really helpful aspect of somatic therapy is it demands that you slow down, tune in, and be curious about what’s happening in your body in real time. Just as your body can't walk forwards, backwards, and sideways at the same time - becoming mindfully aware of your body in the now can helpfully narrow your focus.
If you’re someone who tends to get overwhelmed by the chatter in your head, or you feel disconnected from your inner world - a somatic approach in therapy may help. It’s not that using your reasoning is wrong or bad - self-reflection is a great way to gain perspective, define your values and hopes, and help you problem solve proactively. However, if you’re feeling disconnected from you body and want that to change - somatic exercises can be a great way in towards understanding yourself, no matter your starting point.
You’re curious about somatic skills or bringing your body into therapy.
This is a great reason! Maybe you’re someone who notices what’s happening in your body pretty easily and have a tougher time trying to put words to things or explain them to others. Maybe you’ve never known that your physical reactions or sensations were meaningful observations to bring into therapy. The body can be an incredible source of information, self-knowledge, and guidance, showing us a valuable route to travel in therapy.
Can I add somatic skills to my therapy or try somatic awareness on my own?
Absolutely, yes. Most therapists have some training in a body-based, or somatic skill that can easily be incorporated into sessions regularly. For example, mindfulness, grounding strategies, and body scans are all somatic exercises. Noticing where in your body you’re experiencing an emotion is a great one. Even answering the question “how are you” and including a body-focused observation (e.g., I noticed my shoulders are tight coming into session today) works!
Sometimes therapists encourage folks to track their thoughts or feelings between sessions to become more mindful of their inner world. You could do the same for body sensations related to that situation - this is called somatic awareness.
There are many creative and practical ways to bring somatic observations into your self-reflection or therapy. If you’re not sure if it makes sense to do this or how - ask your therapist and brainstorm together. If, however, you are interested in a specific somatic therapy to address trauma or your therapy goals - make sure you work with someone who is specifically trained in that approach to help you.
Bringing your body into therapy
If you’re interested in becoming more mindful of your body as a way to take care of your mental health, integrating somatic awareness, or trying somatic therapy - reach out to our team of therapists at Manhattan Therapy Collective. There are many creative ways to notice and bring your body into therapy, whether that’s sharing how your body feels during sessions, practicing body scans to strengthen your somatic awareness, or asking about a specific somatic therapy.
*(In this post, I’m using the term “somatic therapy" to generally describe approaches to therapy that are body-centric. I’m not referencing Somatic Experiencing, which is one type of somatic therapy)
About the Author: Dr Loo is the clinical director at Manhattan Therapy Collective. She is jealous of her dog Hamilton’s built-in ability to shake off stress and is EMDR-trained. She enjoys helping her patients build interoceptive attention, or the ability to notice internal sensations as a way to understand themselves better.