An introduction to somatic therapy — how body-centred approaches address trauma, stress and emotional dysregulation where talk therapy cannot reach.
Somatic therapy is an umbrella term for a range of body-centred therapeutic approaches that work with the physical dimensions of psychological experience — the way trauma, stress and emotion are stored in the body, expressed through posture and movement, and held in patterns of tension, breath and physiological activation.
The fundamental premise of somatic therapy is captured in the title of Bessel van der Kolk's influential book: "The Body Keeps the Score." Traumatic and stressful experiences leave traces not only in the brain's narrative memory but in the body's physiology — in the nervous system's activation patterns, in chronic muscular tension, in postural habits and in disrupted breathing patterns. Talk-based therapies often cannot access these somatic imprints directly; somatic therapies address them at their source.
The Theoretical Foundation: Polyvagal Theory and Embodied Trauma
Somatic therapy draws extensively on Polyvagal Theory (Stephen Porges), Somatic Experiencing (Peter Levine) and the neurobiology of trauma (van der Kolk, Bessel). These frameworks share a common insight: the autonomic nervous system stores traumatic experience as incomplete biological responses — the fight-or-flight mobilisation that was initiated but could not complete during the original threatening experience.
This incomplete discharge remains in the body as chronic sympathetic activation, muscular bracing, altered breathing patterns and heightened threat vigilance. Somatic therapy provides a safe context in which these stored responses can be completed, discharged and integrated, allowing the nervous system to return to baseline regulatory capacity.
Major Somatic Therapy Approaches
Somatic Experiencing (SE)
Developed by Peter Levine over 40 years, SE tracks the client's body sensations (felt sense) while working with traumatic memories and their physiological correlates. Rather than reliving traumatic events in detail (which can re-traumatise), SE works at the edges of trauma activation, allowing the nervous system to gradually process and discharge activation without becoming overwhelmed. SE has a growing evidence base for PTSD, complex trauma and physical symptoms of nervous system dysregulation.
Sensorimotor Psychotherapy
Developed by Pat Ogden, Sensorimotor Psychotherapy integrates somatic approaches with attachment theory and cognitive-processing. It works directly with the body-level responses (posture, gesture, movement impulses) that accompany and often precede emotional experience, addressing both developmental trauma (childhood relational wounds) and shock trauma (acute traumatic events).
EMDR — Eye Movement Desensitisation and Reprocessing
While not strictly a somatic therapy, EMDR uses bilateral sensory stimulation (eye movements, tactile tapping or auditory tones) to facilitate the processing and integration of traumatic memories. It is the most extensively researched trauma therapy after CBT, with strong evidence for PTSD across diverse populations. Its bilateral stimulation component is thought to work through mechanisms related to REM sleep and the body's natural trauma processing systems.
TRE — Tension and Trauma Releasing Exercises
Developed by David Berceli, TRE is a self-help somatic practice that deliberately induces neurogenic trembling — the natural body response to stress and danger release that is commonly suppressed in humans. The practice involves a sequence of exercises that fatigue the psoas muscle (the primary muscle activated in fight-or-flight), then allow trembling to occur as a discharge mechanism. TRE can be practised independently once learned and has a growing evidence base for chronic stress, PTSD and muscle tension.
Somatic Therapy and Mindfulness: A Natural Partnership
Mindfulness-based approaches and somatic therapy are highly complementary. Mindfulness develops the capacity for interoceptive awareness — the ability to notice body sensations without immediately reacting — that is the foundational skill for somatic therapy work. Somatic therapy addresses the physiological material that mindfulness reveals: the stored tensions, activated states and survival responses that the body holds.
Trauma-sensitive yoga represents a particularly well-developed integration of the two approaches. Bessel van der Kolk's research showed that trauma-sensitive yoga significantly reduced PTSD symptoms in women with treatment-resistant PTSD — an effect comparable to pharmaceutical interventions. The yoga created the physical safety and embodied awareness that allowed the somatic processing of traumatic activation.
Frequently Asked Questions
How is somatic therapy different from standard psychotherapy?
Standard psychotherapy (including CBT) primarily works with the cognitive and narrative dimensions of psychological experience — thoughts, beliefs, stories. Somatic therapy works primarily with the physiological and embodied dimensions — body sensations, posture, breath, movement impulses. Both address mental health, but somatic approaches are particularly indicated when symptoms are predominantly physical (chronic pain, tension, somatic complaints) or when trauma is involved.
Do I need to have trauma to benefit from somatic therapy?
No. Somatic approaches benefit anyone with chronic stress, muscular tension, emotional regulation difficulties or disconnection from the body. Many people who have never experienced acute trauma nonetheless carry significant somatic stress from the accumulated pressures of modern life.
Can I practise somatic approaches at home?
Yes. TRE, trauma-sensitive yoga, body scan meditation and somatic breath practices all have self-directed versions. However, for trauma processing specifically, working with a qualified somatic therapist provides the relational safety and skilled guidance that self-practice cannot. Home practice is valuable as a complement to, not substitute for, therapeutic work when trauma is significant.
Explore The Holistic Care's Mindfulness and Yoga courses — including body-centred practices that draw on somatic awareness principles for healing and resilience. Our online Yoga courses include trauma-sensitive yoga approaches for those working with nervous system dysregulation.
