Somatic therapy is an approach to therapy that includes the body, not just thoughts and words, in the process of healing. The word “somatic” comes from the Greek soma, meaning body. Somatic approaches pay close attention to physical sensations, posture, breathing, movement, and the body’s stress responses, on the understanding that emotional experiences, especially stressful or traumatic ones, are felt and held in the body as well as the mind.
Interest in somatic therapy has grown rapidly in recent years, particularly for trauma, anxiety, and chronic stress. Alongside that popularity has come a lot of confusion, bold claims, and mixed information online. This guide explains what somatic therapy is, the main approaches, what a session might involve, what the research does and does not show, and how to decide whether it might be right for you.
What is somatic therapy?
Somatic therapy is an umbrella term rather than a single method. It covers several body-oriented approaches to psychotherapy that share a core idea: working with bodily experience can help people process stress and trauma, regulate emotions, and feel more present and safe.
Traditional talk therapy often works “top-down,” starting with thoughts, beliefs, and meaning-making. Somatic approaches often work “bottom-up,” starting with sensations and physical responses, and then linking them to emotions, memories, and meaning. In practice, many therapists blend both.
Core ideas behind somatic therapy
The body responds to threat. When we face danger, the nervous system mobilizes responses such as fight, flight, or freeze. These are automatic and protective. Somatic approaches suggest that after overwhelming experiences, some of these survival responses can stay “switched on” or become easily triggered, showing up as tension, hypervigilance, numbness, or collapse.
Awareness of body sensations matters. Noticing internal sensations, sometimes called interoception, is a central skill in somatic work. Learning to notice sensations such as tightness, warmth, heaviness, or a racing heart, without being overwhelmed by them, can help people understand and regulate their emotional states.
Staying within a manageable range. Many somatic therapists use the idea of a “window of tolerance,” a term introduced by psychiatrist Daniel Siegel, to describe the zone in which a person can experience emotion without becoming overwhelmed or shutting down. Much somatic work focuses on gently widening this window.
Going slowly. Somatic approaches typically emphasize working in small, manageable doses. In Somatic Experiencing, this is often described as “titration,” approaching difficult material a little at a time, and “pendulation,” moving gently between distressing sensations and sensations of safety or calm.
Types of somatic therapy
Somatic Experiencing (SE)
Developed by Peter Levine, Somatic Experiencing focuses on tracking body sensations and gradually releasing stress responses associated with trauma. It emphasizes resources, safety, and working slowly with physical reactions.
Sensorimotor Psychotherapy
Developed by Pat Ogden, Sensorimotor Psychotherapy integrates attention to the body, such as posture, gesture, and movement, with traditional talk therapy and attachment-informed approaches.
Body-oriented elements in other therapies
Many evidence-based therapies include somatic elements even if they are not labelled “somatic therapy.” Eye Movement Desensitization and Reprocessing (EMDR) attends to body sensations during processing. Mindfulness-based approaches, dialectical behaviour therapy (DBT), and some forms of trauma-focused cognitive behavioural therapy also use breathing, grounding, and body awareness.
Movement-based and complementary approaches
Some practitioners use trauma-sensitive yoga, breathwork, or movement. These can be helpful for some people, but they vary widely in training and evidence, and they are not all forms of psychotherapy.
What happens in a somatic therapy session?
Somatic therapy sessions often look much like other therapy sessions: you sit and talk with a therapist. The difference is that your therapist may invite you, at times, to pause and notice what is happening in your body.
For example, your therapist might ask:
“What do you notice in your body as you talk about that?”
“Where do you feel that tension?”
“What happens if you let your feet press into the floor?”
“Is there anywhere in your body that feels a little more settled right now?”
Sessions may include grounding, slow breathing, noticing posture, small movements, or orienting to the room. The focus is usually on building a sense of safety and capacity first, before approaching difficult memories or emotions.
A note on touch: Some somatic methods include therapeutic touch, but many somatic therapists never use it. If touch is ever part of therapy, it should be discussed in advance, offered only with your clear and ongoing consent, and consistent with your therapist’s professional standards. You can always say no.
What does the research say?
The evidence for somatic therapy is promising but still developing.
Somatic Experiencing. In a randomized controlled trial of 63 adults with PTSD, those who received 15 weekly sessions of Somatic Experiencing showed significant reductions in PTSD and depression symptoms compared with a waitlist group (Brom et al., 2017). A later scoping review concluded that there is preliminary evidence for positive effects on PTSD symptoms and wellbeing, but that study quality was mixed and more rigorous randomized controlled trials are needed (Kuhfuß et al., 2021).
Popular theories versus established science. Many somatic approaches draw on ideas such as polyvagal theory, which describes how the nervous system responds to safety and threat. Polyvagal theory has been widely embraced in therapy and wellness spaces, and many clients and clinicians find its language useful. However, several of its core scientific claims have been strongly challenged by researchers (Grossman, 2023). It is reasonable to use these ideas as a helpful metaphor while recognizing that the underlying science is debated.
How it compares. Trauma-focused therapies such as prolonged exposure, cognitive processing therapy, trauma-focused CBT, and EMDR currently have a larger and stronger research base for PTSD. Somatic approaches may be helpful on their own for some people, or alongside these therapies, but they are not yet as thoroughly studied.
Who might benefit from somatic therapy?
Somatic approaches may appeal to, and help, people who:
Feel disconnected from their body or emotions.
Experience chronic tension, hypervigilance, or feeling “on edge.”
Find it difficult to talk about trauma directly.
Feel stuck in talk therapy, understanding their patterns but still reacting the same way.
Experience dissociation, numbness, or shutdown.
Want to build skills for regulating stress in the moment.
When to be cautious
Somatic work is not right for everyone, and it should be done carefully:
Body awareness can sometimes increase distress, especially for people with significant trauma or dissociation. A skilled therapist will go slowly and prioritize stability.
Physical symptoms should always be assessed by a doctor. Somatic therapy does not replace medical care.
“Somatic” has become a popular label, and training and qualifications vary widely. Look for a regulated mental health professional with specific training in the approach they offer.
Be cautious of claims that any single method can “release” all trauma, cure physical illness, or work for everyone.
Somatic therapy vs. somatic symptoms
These terms are sometimes confused. Somatic therapy is a body-oriented approach to psychotherapy. Somatic symptoms are physical symptoms, such as pain, fatigue, or digestive problems, which may or may not have a clear medical cause and may be linked to stress. Somatic therapy is sometimes used to help people with stress-related physical symptoms, but always alongside appropriate medical care.
Frequently asked questions about somatic therapy
Is somatic therapy evidence-based?
There is promising early research, including a randomized controlled trial of Somatic Experiencing for PTSD, but the overall evidence base is still developing and more high-quality studies are needed.
Does somatic therapy involve touch?
Not usually. Most somatic therapy involves talking and noticing body sensations. If touch is ever offered, it should only happen with your explicit consent.
Is somatic therapy good for trauma?
It may help some people, particularly with body-based symptoms such as tension, hypervigilance, and dissociation. Other trauma-focused therapies currently have stronger evidence for PTSD, and some people benefit from combining approaches.
Is “the body keeps the score” scientifically proven?
The idea that trauma affects the body is well supported. Some specific claims made in popular books and online are more debated. It is reasonable to recognize the body’s role in trauma while staying curious and cautious about bold claims.
Can I do somatic exercises on my own?
Simple practices such as grounding, slow breathing, and noticing your feet on the floor can be helpful. Deeper work with trauma is best done with a trained professional.
Reflection questions worth exploring
These prompts are best explored with a professional rather than used to reach conclusions on your own.
How aware am I of what my body feels throughout the day?
Where do I tend to hold stress or tension?
What happens in my body when I feel anxious, angry, or unsafe?
What helps my body feel more settled?
Have I felt that understanding my patterns has not been enough to change them?
Support at Vive Wellness Therapy
At Vive Wellness Therapy, we take a trauma-informed approach that recognizes the connection between body and mind. We may draw on body-based skills such as grounding and nervous system regulation alongside evidence-based therapies, always at a pace that feels safe for you. If you would like support, we would be glad to hear from you whenever you feel ready.
References
Brom, D., Stokar, Y., Lawi, C., Nuriel-Porat, V., Ziv, Y., Lerner, K., & Ross, G. (2017). Somatic Experiencing for posttraumatic stress disorder: A randomized controlled outcome study. Journal of Traumatic Stress, 30(3), 304–312. https://doi.org/10.1002/jts.22189
Grossman, P. (2023). Fundamental challenges and likely refutations of the five basic premises of the polyvagal theory. Biological Psychology, 180, 108589. https://doi.org/10.1016/j.biopsycho.2023.108589
Kuhfuß, M., Maldei, T., Hetmanek, A., & Baumann, N. (2021). Somatic experiencing: Effectiveness and key factors of a body-oriented trauma therapy: A scoping literature review. European Journal of Psychotraumatology, 12(1), 1929023. https://doi.org/10.1080/20008198.2021.1929023
This article is provided by Vive Wellness Therapy for general informational and educational purposes only. It is intended to be used alongside professional therapy and medical care and is not a substitute for assessment, diagnosis, or treatment by a qualified health professional. Physical symptoms should always be assessed by a doctor. Research and clinical guidance evolve over time, and information in this article may become outdated or contain inaccuracies. If you are in crisis or thinking about suicide, call or text 9-8-8 (Suicide Crisis Helpline, available 24/7 across Canada; in Quebec, calls connect to 1-866-APPELLE). If you or someone else is in immediate danger, call 9-1-1 or go to your nearest emergency department.
