Somatic Therapy: Learning to Sooth the Nervous System Through Bottom-Up Techniques.

Learning to calm the nervous system to decrease hyperarousal and reactivity.

As therapy becomes more mainstream, different types of therapy beyond traditional talk therapies are increasingly present in conversations and searches for treatment methodologies. Therapies such as EMDR, Somatic Therapy, or Internal Family Systems are often mentioned in therapist profiles and searches, particularly for treatment of trauma or PTSD. These therapies are evidence-based, a term that describes an approach supported by a body of empirical research demonstrating their efficacy in treating the diagnosis or symptoms they purport to treat. Using an evidence-based therapy means there is a body of research on similar symptoms, and it is effective at a consistent rate. While every person is different and their personal experience may vary, overall, it is deemed to be effective.

Bottom-up Techniques:

Bottom-up and top-down describe two different ways to approach therapy, treating symptoms first or cognitions first. Both can be extremely effective and may depend on an individual's comfort level and the counselor's training. Both would also include education and understanding of how the nervous system works and why an individual is experiencing their symptoms. When we talk about treating symptoms in therapy, we may be discussing hypervigilance, anxiety or fear, agitation, or difficulty concentrating, freezing, or avoidance, and the urge to run away.

Prolonged stress or traumatic events can leave us with a heightened arousal state; difficulty relaxing, difficulty sleeping, irregular eating, increased startle response, and trouble concentrating. In that constant state, the body becomes tired due to elevated cortisol and adrenaline. Long term, other body functions are affected, and a person may experience GI issues, chronic headaches, insomnia, increased anxiety, and/or depression.

In aroused states, we often are hyper aware of our environment and can be dismissive of our internal environment. We may be distracted or irritated by physical symptoms and try to minimize or ignore them, eventually becoming less aware of our internal state aside from distress.

Bottom-up therapy, such as somatic therapy, helps to learn to pay attention to and attend to the internal state first. With the premise that once you are in a more relaxed state and feel "in control" of your symptoms, you can reason out what is really happening and understand it so that you can respond differently.

For example, if a crisis occurs, say you lose your car keys but have an important meeting coming up that you need to drive to now, you may start to feel frantic. In that frantic state of looking for keys, your ability to stop and retrace your steps may be more difficult. Your heart races, you feel jittery, you can't track where you have or have not looked, and you keep repeating the same steps. If you can calm the internal distress and take a breath, you may be able to stop and recall where you put your keys with ease. The calmer you are, the more able you are to respond rather than react to the situation.

Bottom-up therapy teaches you to be aware of your body state, or internal environment, calm it, and then make a rational decision about how to respond. As we learn to calm our nervous system down, we are open to more realistic memories and solutions, which is the next step in the process.

What Does a Somatic Therapy Session Look Like?

In somatic therapy, we start by identifying how you feel in your body. For some people, that is a foreign idea because they have been trained to avoid attending to their own feelings, both the emotional and felt parts of themselves. Exercises such as yoga help people identify the different parts and processes of their bodies and how they feel in those parts. But initially in therapy, it may just be learning to identify where feelings lie. The therapist will gently guide the client to focus on feelings they often avoid and to recognize where they experience them in their body. For example, when you are upset about x,y,z, what do you notice? Now scan your body and notice any areas where you feel tightness, tension, pain, etc. Strong emotions always manifest in the body; most of us are unaware of them. With trained focus in a therapy session, the person can become more comfortable with discomfort, recognizing that they are safe in the moment. When you are safe, you can be curious and learn to calm or soothe your physical symptoms through learned techniques. For example, if you are angry and short of breath, learning to take slow, deep breaths can help change your internal state.

With a combination of education and learning to calm the nervous system, clients can then reprocess distressing events or causes of the symptoms, feeling more in control of their experience and decisions. Rather than reactive, they become responsive. With new ways to relax and soothe, they improve sleep and overall functioning.

The body and brain do not experience events or symptoms in a silo; the experience is integrated with thoughts affecting how we feel and physical symptoms affecting our ability to think or respond. Learning to understand, stay in tune with, and recognize physical symptoms and to manage them can have a profound impact on how we think and how we experience the environment, people, and situations around us.

Is Somatic Therapy for You?

Resounding yes! If you have a body and you think therapy might be helpful for you, then yes. You will not be asked to exercise or do anything hard, embarrassing, or strange. A good therapist will read you and adjust techniques to your comfort level. Additionally, you can always decline, and it isn't going to end therapy or keep you from progressing. If you don't feel comfortable with something in the moment, then say so. Therapy is something you are doing for you; if it isn't working, comfortable, or you aren't ready, you are the person in charge of that.

Chances are, if you are in counseling, you have already done some somatic therapy. "How does that feel?" Deep breathing exercises and relaxation techniques are all somatic therapies. If you practice yoga, you are doing somatic work: teaching yourself to be more physically aware, to breathe through discomfort, and to relax.