Somatic Therapy: Getting at the Root of Trauma to Overcome It

Especially given today’s world, still grappling with the grief and loss associated with the COVID-19 pandemic while forging ahead, we’re collectively talking more about mental health. While millennials and members of Gen Z have also helped to normalize mental healthcare and therapy in recent years, one type of therapy provides a lasting solution to work through trauma specifically: somatic therapy.

Also called somatic experiencing and somatic experiencing therapy, this type of therapy differs from mental health therapies like cognitive behavioral therapy, which focuses predominantly on the mind, to incorporate elements of the mind, body, and spirit into the healing work. This type of therapy specifically looks at how the physical body holds onto stress, tension, and trauma, not solely focusing on talk therapy and resolving problems verbally.

In regard to trauma treatment—in which the goal is processing and working through that trauma to show the brain that it isn’t still in danger—it’s important to discuss how trauma often manifests. While our brains are built to naturally recover from traumatic and stressful events, some experiences need further help to process. 

We have stress responses as part of our natural fight, flight, and freeze instincts. When we are still distressed from a disturbing event, those images, thoughts, and emotions can bring a person back to that initial moment and potentially back to that initial instinct, despite the fact that there is no present danger in reality. 

“Fight, flight, or freeze essentially means our body’s primary goal in that moment is just to survive what’s happening. And for human beings, because our brains are kind of complex, that can be a real or perceived threat,” says Darcey Cunningham, a certified Eye Movement Desensitization and Reprocessing (EMDR) therapist and clinical supervisor at Mental Health Center of Denver.

EMDR is one type of somatic therapy that tackles this cycle head on. It helps the brain to process those memories and resume normal healing; a person will remember the event, but EMDR works to resolve that recurring instinctual response.

Cunningham says EMDR looks to integrate both hemispheres of the brain. Resourcing is a crucial, initial element of the treatment, which Cunningham generally defines as basic coping skills, though it’s both broader and more specific than that simultaneously.

“We’re trying to build awareness in the sense of choice: I can identify what’s happening for me, and then when I’m able to identify what’s happening, I have some choice in how I move myself through it, how I find safety,” Cunningham says. “How do I define safety for myself? How do you know when you feel safe? Or how do you know when you feel relaxed; what’s happening in your body? And what are some of the things that you have control over?”

Cunningham says EMDR therapy also utilizes techniques to contain those intense emotions and experiences by turning back to body work and what might ground someone in the moment. These exercises could include tapping, throwing a ball from hand to hand, a stress ball, breathing exercises, and more, using the body to help folks move through the anxiety and dysregulation they experience around trauma.

“We want to make sure that, first, we’re able to work on that grounding piece, that awareness of what’s happening in our body,” Cunningham says. “And then instead of going into our heads, like, ‘Oh, my God, what’s happening?’ I’m noticing that my heart rate is increasing a little bit—doesn’t necessarily mean anything. I’m just noticing that that’s happening, right?”

After resourcing, EMDR guides clients through a series of rapid eye movements, allowing the brain to process small chunks of the trauma at a time. That dual attention keeps the person grounded and present, creating a bodily rhythm that encourages safety; it works to keep the patient focused on the present while accessing memories from the past.

Cunningham also notes that EMDR, and other somatic therapies, can treat a wide variety of patients dealing with varying trauma, ranging from a single, profound, and identifiable event to traumas that might rest in the background or be less obvious. While the fidelity of the model is crucial, EMDR allows therapists to meet clients where they are and with what they need. Some clients might opt to directly address the traumatic events; others might not want to relive it and are just looking for relief.

She adds that—given the resourcing process, along with building trust and rapport with a client—it can take some time, usually a minimum of three to four months. Even once that box is “checked off,” so to speak, she’ll continue working with clients to revisit their healing to reevaluate if needed.

In terms of access, Cunningham says it’s a completely different conversation, noting that EMDR therapy is often geared toward folks working in private practice and that she’s seen firsthand how challenging it can be to apply to people receiving community mental health services. While the efficacy of the treatment comes from the fidelity to EMDR protocol, it opens the question of how to modify and expand the practice to folks without houses, working to meet their basic needs, or may not have insurance to cover treatments.

“There is some awareness of that. My focus, along with a number of other colleagues I’ve worked with, has been, well, how can we try to get folks some of the relief they can get from EMDR, even if we are only focusing on the D, the desensitization, of some of these triggers and symptoms so that they can get more stable and then maybe work deeper into the trauma? That access piece can be really challenging.”

EMDR is often considered a gentler approach to working through trauma. Though she admits her bias toward EMDR, Cunningham is also a talk therapist. She points specifically to folks in the LGBTQ+ community, which she is part of, who are largely pro-mental health and support therapy. 

Referencing feedback from queer folks, she says that, despite years of talk therapy, some say their trauma is still unresolved. Cunningham says that LGBTQ+ folks especially experience the world a lot differently than others because of the discrimination and oftentimes violence the community faces, potentially perceiving threats in their everyday life in a way other folks might not identify the same way.

“As cliche as this is, we have to get under the surface of the iceberg, and there’s not a whole lot of talking going on when we’re in an actual processing session. I think a lot of the trauma folks are just used to carrying with them. Sometimes we have to go deeper; we can’t just talk our way through it.” 

Photo Courtesy of Samantha Markey