Somatic Awareness: An Essential Part of Trauma Therapy
Updated: Mar 11, 2022
What is Somatic Awareness? What is Somatic Therapy?
‘’Somatic awareness’’ is mindful (intentional and focused) attention to the sensations in the body. ‘’Somatic therapy’’ is an umbrella term for therapeutic interventions that incorporate that awareness, typically to gain information about an emotional state or health condition and move toward a healing response.
While referencing the body may bring to mind movement practices such as yoga, or bodywork such as massage (and these are excellent somatic approaches), most mental health therapists use somatic interventions in much simpler ways. The most basic example would be directing a client to close their eyes and take some deep breaths as they discuss an unpleasant feeling, then asking ‘’What do you notice in your body as you focus on that?’’
This may sound too simplistic to be helpful, but you may be surprised by the shift in understanding the approach can provide. While we’ve been conditioned to think of our emotions as located only in our heads, multiple cultures regard lower areas as the seat of mind and emotion--including the ancient Greeks, who used the root ‘’phren’’ to refer to both the diaphragm and the mind (hence the modern term ‘’schizo-phren-ia’’). Having lost this conceptualization, we’re missing out on a rich resource of pure, direct data that isn’t skewed or complicated by the gymnastics of the reasoning mind.
The most common reference made to the phenomenon of getting immediate messages from the body is that of ‘’gut instinct.’’ However, this phrase is vague at best, and not everyone connects to this way of sensing at all. It’s important to note that when it comes to somatic awareness, the range of sensations can occur anywhere in the body (hands or feet, limbs, chest, head, heart area, etc.), and can be experienced in many different ways (e.g., tingling, heat or cold, pressure, pain).
During panic attacks, sensations like sweating, shaking, a pounding heart, or nausea are obvious. That intensity is both the problem and the messenger that urges someone toward seeking help and resolution. But keep in mind that the somatic cues underlying emotions (e-motions) other than anxiety--like depression, shame, or suppressed anger--are no less important because they may be subtle, or have to be sought out. This doesn’t mean the sensations are imaginary; we’re simply not accustomed to interacting with our feelings in this way. If it doesn’t come naturally to you, it’s a skill worth developing for better coping and self-awareness.
As noted by Peter Levine, author of Waking the Tiger: Healing Trauma and creator of Somatic Experiencing Therapy, sometimes somatic messages remain elusive even in the context of a trauma therapy session, but the process of simply paying attention with curiosity can become an organic path to developing greater embodiment of feelings. One definition of ‘’embodiment’’ is to experience feelings in a more tangible form.
Why is Somatic Awareness Important to Trauma Therapy?
As explained by Levine and other trauma experts such as Bessel van der Kolk (author of The Body Keeps the Score), trauma is literally stored in physiological patterns as much as in our memories and feelings. Via immediate communication between the brain, the vagus nerve, and the organs, the physical and emotional aspects of trauma are interconnected enough to describe mind and body as one.
Although the prefrontal cortex area of our brains evolved more recently to enable complex reasoning and abstract thought, our limbic system--a network between the inner brain structures and the rest of the body--is a vestige of primitive animal biology that promotes survival through danger and reward/pleasure cues. Threatening experiences engage the fight, flight, or freeze response to shape learning at the instinctual level, so that forms of defense or escape can be activated before it’s too late.
This is why sensory cues from the environment, such as crowds, noise, or scents, can trigger anxiety despite rational knowledge that you’re not in danger. Granted, you can use cognitive reasoning ability to calm down after this reaction occurs, reminding yourself that you are safe (a coping skill). You can also use it to describe traumatic experiences, discuss associated negative beliefs, and practice changing the related negative thoughts (a therapeutic approach). These strategies are known as cognitive or ‘’top down.’’
Somatic awareness, however, adds a ‘’bottom-up’’ component that allows you to connect with trauma at a more direct level. Post-traumatic stress symptoms result when the fight or flight response was thwarted or when the tension caused by a freeze response was not later discharged, creating an ‘’unfinished circuit’’ in the limbic system. In other words, because the neurohormones of distress never received sufficient signals of safety, they remain perpetually active in ways that cause symptoms throughout the body--such as mood fluctuation, inattention, gastrointestinal dysfunction, and chronic pain due to tissue inflammation.
By tuning into somatic sensations, an opportunity is created to 1) reopen that circuit in present time and 2) provide the body with the safety signals it needs to downshift ongoing physiological reactions. In doing so, shifts in negative beliefs created by a traumatic event tend to naturally take place as well, thereby achieving the same goal as ‘’top-down’’ approaches.
The concept of the subconscious mind is typically relegated to abstraction, and it’s regarded as having little to no practical application in contemporary mental health treatment. But the rapid shift in belief often enabled by somatic therapy supports the idea that our body’s record of trauma and wounding (and the latter includes anything that caused even a mild physical reaction) can actually be understood as the subconscious itself.
While the reinforcement of a new belief then requires top-down processing so that new neural pathways (thought patterns) can be forged in the brain, the initial change in perspective afforded by bottom-up processing tends to make somatic approaches more efficient and impactful than cognitive therapies alone.