How is Somatic Therapy Different From Other Kinds of Therapy?
How incorporating the body shapes the therapeutic experience
5 min read
Psychotherapy is traditionally thought of as talk therapy. One might conjure an image of a person laying down on a couch, and a stoic therapist across the room interpreting dreams or unconscious thoughts. Today, therapy offers a number of different modalities, each of which takes a unique spin on the human experience. Here at Downtown Somatic Therapy, our clinicians find meaning and purpose in incorporating the body into the therapeutic experience. This somatic approach is a healing and experiential one that distinguishes itself from other forms of therapy.
Somatic Therapies
Somatic work is a form of experiential therapy. It is perhaps most popularly recognized for healing trauma. There are a range of approaches within this umbrella category, among them: Somatic Experiencing (SE), Sensorimotor Psychotherapy (SP), The Hakomi Method, Accelerated Experiential Dynamic Psychotherapy (AEDP), Intensive Short-Term Dynamic Psychotherapy (ISTDP), and Eye Movement Desensitization and Reprocessing (EMDR). Check out 5 Kinds of Somatic Therapy for a more detailed description of these approaches.
Somatic work focuses on both verbal and non-verbal cues. Clients not only name their experience in words, but also bring attention and attunement to the responses their bodies have as they relay this information. In doing so, they enter into their inner landscape and connect with their truest, core emotions as a pathway to positive transformation.
Imagine a woman named Sally who is struggling in a romantic relationship. In a therapy session, she shares that she isn’t sure how to communicate her needs and isn’t feeling heard by her partner. The therapist slows her down in that moment and asks her to check in with her body and any sensations she might notice. She becomes aware of constriction in her throat.
The therapist invites her to stay with the sensation. As Sally lingers there, she starts to cry. She is reminded of being bullied as a child and ostracized by friends if she shared an opinion or voiced her needs. She becomes aware of sadness for her younger self.
By exploring this bodily energy, Sally not only gains insight into her experience, but importantly, also connects to a core emotion. She feels a release after crying. She feels lighter. That stuck energy has been discharged from her body.
“When we are able to recognize the origins of our feelings, we often feel more confident in sharing our feelings and supporting ourselves rather than repeating patterns of the past,” states Christine Menna, therapist at Downtown Somatic Therapy. This is exactly what happens to Sally, and it gently motivates her to continue to open up to these vulnerable places.
“Our bodies are intuitive and hold our emotions, experiences and past traumas.”
Somatic work is a bottom-up approach that honors the body as a vehicle for transformation. “Our bodies are intuitive and hold our emotions, experiences and past traumas in a number of ways. By tapping into these sensations – tightness in our jaw, tension in our chest, tingling in our hands – and curiously exploring them, we allow them to lead our experience in a very different way than traditional talk therapy,” says Menna.
If the emphasis on the body is characteristic of somatic therapy, what is it that other modalities focus on? Let’s take a closer look.
Cognitive Based Therapies
Cognitive based therapies - cognitive behavioral therapy (CBT), dialectical behavioral therapy (DBT) and rational emotive behavior therapy (REBT) among them - are top-down approaches. The premise is that thoughts impact feelings and behaviors; by changing irrational thoughts, a person can change their emotions and behaviors. The purest forms of cognitive models are structured both in and out of sessions, with homework being the norm. They’re solutions-focused with an emphasis on present day thoughts that cause distress versus past memories or events.
Let’s consider Sally’s situation from a CBT lens. She tells her therapist that she is having a hard time communicating with her partner and identifies a belief that “I’m not good at communicating.” The therapist asks her for evidence for and against that belief. After Sally weighs this information, she identifies a new, more realistic thought: “I’ve made a lot of progress in being able to speak up for my needs. It’s uncomfortable for me to do so sometimes, but I believe in my ability to work through that and communicate effectively with others.”
“When we are able to recognize the origins of our feelings, we often feel more confident in sharing our feelings and supporting ourselves.”
Sally acknowledges her challenges, but also identifies ways that she has been able to do the very thing she’s struggling with. The therapist then asks her to continue to track her experience outside of session - identifying thoughts in the moment, emotions they bring up, evidence for and against those thoughts. Then she creates a more balanced “replacement” thought and again notices related emotions.
It’s important to distinguish that while CBT tracks emotions in this way, it’s not the entry point or focus of the work. Emotions are named and tracked to gauge the impact of thoughts - first by signaling the way an irrational thought makes us feel and then by noticing changes that occur following the more balanced thought.
Sally won’t explore past experiences and deeper traumas in an active, visceral way and embody her experience as we saw above via somatic therapy. She won’t work with the energy present inside of her as a catalyst for transformation. Rather, she will continue to work on shifting her internal dialogue throughout her CBT sessions. As she questions negative automatic beliefs and their accuracy, she will also build new habits in service of her therapeutic goals.
Insight Oriented Therapies
Contrary to cognitive behavioral models, insight oriented approaches - such as psychoanalytic, psychodynamic, and humanistic therapies - emphasize the past to make sense of the present. They believe that history dictates our present, and that by exploring and processing past events we can better understand our current experience. Through this process of personal discovery, a person can gain the enlightenment to create desired changes in their life.
Let’s get back to Sally again. After she shares her fears of communicating with her partner, Sally’s insight oriented therapist comments “it sounds like it’s uncomfortable for you to voice your needs. Can you say more?” Sally and her therapist focus on the content of her story. The therapist takes a neutral stance when inquiring about Sally’s experience.
This line of questioning leads to an insight that Sally developed a fear of having a voice or an opinion because she was punished by her friends when she did so. She brings this internal blockage to light, lessening the weight of this entrenched belief.
According to these therapies, knowledge creates freedom. As the name suggests, insight is the aim. Sally’s therapist won’t acknowledge her non-verbal cues and invite her to deepen into that bodily experience. She won’t be challenged to safely access her underlying emotions. Rather, Sally and her therapist will continue to lead with content, working with the assumption that as Sally knows herself better, she will begin to function better. By bringing unconscious internal barriers into consciousness, she can change entrenched, detrimental patterns.
“Other forms of therapy don’t pick up on the totality of this human experience like somatic therapies do.”
Mindfulness Based Therapies
Mindfulness practices may be incorporated into any number of therapeutic modalities, but mindfulness based therapies lean on these philosophies as the cornerstone of therapeutic work; examples include Acceptance and Commitment Therapy (ACT), Mindfulness Based Cognitive Therapy (MBCT) and Compassion Focused Therapy (CFT).
Jon Kabat Zinn defines mindfulness as “awareness that arises through paying attention, on purpose, in the present moment, non-judgmentally […] in the service of self-understanding and wisdom.” By bringing awareness to thoughts and feelings in an observant way - particularly those that are feared and avoided - they have less of a hold on us. Observation also allows them to simply be, not pull us in one direction or another, back to the past or into the future. The invitation is to stay in the present.
Let’s revisit Sally once again. Sally tells her mindfulness based therapist about her struggles communicating. Her therapist invites her to pause, bring her attention to her breath, and as she grounds in this way, to simply be with any thoughts, sensations and feelings that arise.
Sally spends time with this exercise and, after doing so, feels like she has more spaciousness inside of herself. She feels a bit more clear headed and less burdened by spiraling thoughts and “what ifs.” Her presence in that moment creates a greater sense of agency in the way she communicates. She realizes she doesn’t have to believe the thoughts that have been running through her mind.
Sally will notice sensations in her body during this work, but she won’t linger and deepen into the experience - contacting and listening to that energy, tracking where it wants to go and what it has to say, and bringing release to it. Rather, she will maintain her detached stance in these moments, observing and letting be. She will continue to practice mindful behaviors in her day-to-day activities. Maybe she’ll formally practice seated meditation, do yoga, or cultivate a self-compassion practice. She will lead with these behaviors for liberation from the mind.
Somatic Therapies: Conclusions
As Sally has taught us, there’s more than one way to approach the same person and situation. We’ve seen how cognitive models focus on thoughts and behaviors to create change; insight oriented therapies look to the past to illuminate the present; and mindfulness based approaches that invite us to be with our experience without having to act on it.
We’ve also witnessed somatic therapies. “Somatic therapies don’t deny the significance of thoughts, past experiences, or mindfulness. Rather, they integrate and add to these important elements by honoring that our body also holds events and traumas,” says Menna.
Peter Levine, founder of Somatic Experiencing, developed the SIBAM model to describe a complete experience. SIBAM stands for sensation, image, behavior, affect and meaning. We need all of these channels to flow smoothly in order to have a cohesive, holistic experience. If there’s fragmentation in any part (i.e. with trauma), then there’s discord in the system.
Other forms of therapy don’t pick up on the totality of this human experience like somatic therapies do. For instance, CBT emphasizes behavior and meaning (cognition). Somatic therapies address all aspects of a person’s phenomenological experience. In doing so, they allow for a richer, more profound healing experience.
If you’re interested in learning more about somatic therapy and its effectiveness, check out other Downtown Somatic Therapy blogs. If you think it might be a good fit for your own therapy, reach out via our contact page. We will help you find a therapist to accompany you on your journey.