Somatic Experiencing (SE®)
Why work with the body in trauma therapy?
Despite the unquestionable benefits of cognitive behavioral therapy, advances in neuroscience have shown that to successfully heal from symptoms related to traumatic memories, we must work at the level of the body.
We know now that trauma not only impacts our cognition and behaviors, it conditions much more than just our thoughts and actions. “It can dissolve our sense of identity, diminish our capacity to locate ourselves accurately in time and space, inhibit our tolerance for interpersonal relatedness, disrupt the coherence of our experience, impair our capacity for emotional regulation, and so much more.” (Wong A. 2020)
Trauma is primarily biological, a physical phenomenon that happens at the level of our body's neurology, with the autonomic nervous system playing the main role. The body is a natural and super wise container that holds memories and imprints of every experience we have, from the first weeks in our mother’s womb, way before the development of consciousness or language. Because of this, some pieces of our life experience may have left traumatic traces that we’ll never be able to access with language, cognition or explicit memory.
The mind has selective memory but the memory of the body is unmistakable.
In ‘talk therapy’ we often repeat and revive the stories, and although feeling seen and heard is essential in the process, the retelling of story doesn’t necessarily allow the body to create new neuronal pathways and a more empowered relationship with whatever happened. It might even reinforce the old patterns that we’re trying to get rid of.
What is trauma through the lens of Somatic Experiencing?
SE® is based on the work of the american psychotherapist Dr. Peter Levine. His theory is based on observations of wildlife, where animals are regularly exposed to death threat and yet, they are rarely traumatized. This happens because their survival instinct kicks in, flooding their body with highly charged energy ready for taking effective defensive action – fighting back or running away. When the threat is over, they naturally allow that intense energy to be discharged, and the soon return to full normal health. Follow this link to get an idea of how mammals in the wild survive thanks to the freezing response, and how they shake off the stress energy when they perceive safety.
We all have the same capacity to overcome an overwhelming experience, but humans have also developed an upper rational brain that, frequently goes against the powerful primal instincts of the body. The result is that the intense fight/flight energy gets trapped in our nervous system, where it can lead to all sorts of symptoms, sometimes immediately, sometimes not until years later. It’s not that the rational mind is working against us, on the contrary. It’s also guiding us towards the best outcome based on our basic needs, but sometimes it choses a different pathway than our most basic instincts. E.g. a child who is feeling overwhelmed and wants to cry but knows that she will be reprimanded by the caregiver can easily develop a tendency to hold back the impulse to cry - this natural impulse is inhibited and the energy will remain stuck every time this person holds her tears.
So trauma is not about the event but the energy that gets trapped in our physiology in face of a real or perceived threat, and we do not have the time, strength or ability for self-protection. The extent to which a person experiences traumatic effects is directly related to their ability to restore the sense of safety after the threatening event. If they’re unable to effectively do that, their nervous system gets stuck in the survival states of fight, flight, or freeze.
In SE, the human experience has five core components of a therapeutic framework developed by Peter Levine called SIBAM:
Sensations - e.g. tension, cold, trembling, openness, firmness, heaviness, shivering, lightness, heat wave
Images - e.g. that can be internal like memories, dreams, pictures, metaphors, words, or external like smells, sounds, taste
Behaviors - e.g. posture, facial expressions, voluntary or involuntary movements, gestures, verbal expression
Affects - e.g. feelings or emotions like sadness, shame, fear, joy, hope, disgust, love
Meanings - e.g. cognitive associations like beliefs, judgments, thoughts and analysis easily expressed through words
Overwhelming experiences have a strong impact in the organization of these elements. One can for example associate some elements that were present in a threatening situation of the past with elements of the present that do not represent any danger but the nervous system keeps reacting the same way it learned many years ago. For example, a person that dealt with feelings of abandonment in childhood and went into a frequent state of hyperarousal (fight-or-flight), might find very challenging to trust in the commitment of a partner, even without any real that indication that the partner will ever leave.
On the other hand, it can also happen that these elements of SIBAM become inaccessible, or under-coupled, like the crying (a behavior) in the example given above.
In any case, there is a disorganization that was create the moment our nervous system faced an overwhelming threat. The purpose of SE is to restore the regulation of the nervous system and bring a new organization to the elements of the present experience, opening the doors for change and new possibilities in life.
It involves bottom-up processing by directing the client's attention to internal or external sensations, posture, behaviors and micro-movements, rather than primarily cognitive experiences. It specifically avoids direct and intense exposure to traumatic memories, “approaching the charged memories indirectly and very gradually, as well as facilitating the generation of new corrective interoceptive experiences that physically contradict those of overwhelm and helplessness” (Payne, Levine and Crane G., 2015).
The main goal is to bring the nervous system into a new flow of resilience and flexibility, by helping the individual restore their sense of safety. SE uses clinical maps to access physiological states of survival and helps the client to release the self-protective and defensive responses we hold in our body.
This process might take time and requires that the client develop a certain degree of tolerance and familiarity with sensations in the body. When we are unable to stay with our inner experience and the fluctuations in nervous system activation, our conscious brain will attempt to disconnect (dissociate) from them, seeking numbness on distractions or maladaptive behavior.
According to different authors and trauma experts, some elements need to be present so the client can progress and experience changes as the sessions evolve:
Awareness of what’s happening;
Some level of psycho-education and physiology comprehension;
Appreciation of the problem;
Safe connection - feeling relaxed, safe with and supported by the therapist;
Ability to sense and track body sensations, even discomforting ones;
Patience and respect for the body’s own rhythm;
Commitment and participation.
If these are not present from the beginning (which commonly they're not), the role of the SE therapist is to help and guide the client in developing them.
Do we talk in SE sessions?
Yes, there is talking, but in SE talking is a tool to track body sensations, emotions and meanings that might be attached to past experiences, repetitive patterns, or just to how the person experiences the present moment, rather than focusing too much on the event that originated the trauma.
SE works with a “bottom-up” approach of sensory and motor processing to guide the client through the most primitive brain systems with the awareness of the most complex ones. Working through the body to reach the mind.
The therapist guides the client to track sensations and movements, developing the perception of the felt sense of inner states like tension, relaxation, respiration cycles, temperature changes, and body needs, usually left out of the scope of the conscious mind by the traumatic experience. Cultivating this self awareness ability is the foundation of healing the physiological effects of trauma.
Using a very gentle and gradual tracking process, the therapist helps the client to tolerate and complete the physiological impulses trapped in the body leading to the regulation of the autonomic nervous system.
Titrated pendulation is key to successfully accessing and working with traumatic imprints. It allows the client to develop the resources that make possible the exploration of memory states that would otherwise be overwhelming. For example: if a person is experiencing an intense tension in the jaw or some discomfort in the throat, the therapist may ask to observe the tension, but also pay attention to other parts of the body that feel more neutral, or even something outside of the internal awareness. Through this gradual process, the client learns to tolerate the inner experience and begins to develop a sense of being in charge of their physiology, feeling more confident and self-empowered.
Slowing down and allowing the organic intelligence of the body to participate in the process gives us the greatest opportunity to recognize further resources, bringing the whole self into the healing process, the body as well as the mind.
As the client builds trust and the capacity to be with sensations and emotions without a sense of overwhelming, there will be a desire to discharge the traumatic energy through whatever the body needs to do, just like the animal in the wild. Discharges can come in the form of shaking, tears, shivers, openness, warm waves spreading over the body, or other bodily experiences.
What to Expect from a SE Session?
If you have never had a Somatic Experiencing session before we will start with some education about how SE is different than traditional talk therapy, explore your available awareness of internal states, practicing orienting pendulation, and start by experiencing regulation of activation in the body. We will explore any questions or concerns about SE therapy and discuss how to best proceed and what progress would look like for you to achieve.
The next sessions we will work on improving ease and a sense of control around the concern that lead you to seek therapy, establishing safety, and helping you to feel comfortable connecting to your body.
Touch might be used in certain situations for the purpose of grounding, containment, support, awareness building or stimulate mobilization, if needed. You will always be asked before being touched and have the right and full support to decline. If you do not feel comfortable with touch, or if the development of the session does not call for it, touch will not be used.
We will work at your body’s pace (not your mind) to manage and integrate difficult experiences in an empowering way. It might require different levels of social connection and somatic education to allow us to address your concerns from a place of grounded, confident, and relaxed awareness, and not from a place of overwhelming uncertainty. Working this way will gives us the greatest window for the achievement of healing and lasting positive change.
Gradually, sessions will look more like me inviting your awareness and curiosity to the sensations in your body, revisiting and exploring the five different elements that, according to Peter Levine, are vital to a complete a phenomenological experience, the elements of SIBAM - sensation, images, behavior, affect, and meaning.
“When we have a coherent experience, what is happening is we are blending (at least) five constituent elements — the image of what is going on, the feeling and sensations that accompany the experience, our behavioral impulses that are attached to that experience, and the meaning to which we ascribe the event.
What this model suggests — and what contemporary findings in neuroscience seem to validate — is that: trauma creates fragmentation in the coherence of experience. Sensation becomes separated from images. Affect becomes separated from meaning. Behavior becomes separate from affect. Our inner experience, literally, begins to fall apart. The world is like a scattered, torn puzzle — with pieces cast to the wind — pieces that have not yet found their way back into a whole.”
(Wong A. 2020)
When people attempt to recount their traumatic memory, they frequently only remember fragments of their experience — the sound of a door opening, the image of a fence, some persistent behavior that seems to make no sense.
In SE sessions, as we dive deeper into the body’s biology and wisdom, we might catch some of those lost pieces, giving back form and coherence to the internal experience.
The SE methodology might help with:
Resolving depression and/or anxiety;
Exploring and healing underlying shame;
Healing the symptoms of traumatic and chronic stress;
Clarifying and practicing personal boundaries;
Clarifying and acting on wants and needs;
Strengthening communication skills;
Addressing addiction issues;
Developing meaningful relationships;
Strengthening self-esteem, confidence, and assertiveness.
How many sessions are required to experience benefits?
Clients commonly report feelings of ease, inner-trust, less anxiety, frustration, anger, or other chronic emotional triggers in a few sessions. But, depending on the kind of trauma and the amount of stress involved, it's hard to know at first how many therapy sessions we need. For example, when the default response is shut down or freeze, before embodying regulation and balance, the client often experiences triggering and potentially activating sensations (as a result of coming out of freeze) that must be addressed at a very slow and titrated pace.
You can find more information about my practice here.
“Life challenges are an invitation to awaken to more internal resiliency, growth, and clarity, to gain more freedom from social conditioning and an invitation to experience a level of support that actually matches our level of challenge — becoming stronger through our challenges”. (Decker J. 2011)