What is somatic experiencing

Somatic Experiencing® (SE™) is a gentle, body-focused approach to treating the effects of stress, shock, and trauma (Levine, 1997, 2010). It works by helping you complete the self-protective responses that got interrupted and stayed stuck in your body, and by discharging the energy that came with them (Payne, Levine, & Crane-Godreau, 2015). As that happens, the alarm signaling danger starts to turn off and your system can settle. Because the focus is on bodily sensation rather than only on thoughts and memories, SE offers a different route into healing from trauma and back toward a sense of well-being and connection to life.

In practice, this means a practitioner teaches you skills and you practice them together in session. It usually starts with learning how to shift your focus. We come in focused on the pain, the problem, the tension or unconsciously avoiding the problem, pain and tension. But what happens when you take control of your attention? For example, what is it like when your attention is turned outward instead of inward feel like? The natural threat response cycle your biology already uses has a part called orienting. When you focus outward with your vision (an eye exercise called, no surprise, orienting) you engage that part of the cycle that signals to your system a sense of safety and gives your nervous system a break (Payne et al., 2015). Simple looking, but powerful when practiced regularly. Though if your system is cultivated to either shut down or blow up you might feel a lot of resistance to this as it is asking your system to do something different.

Then you might turn inward. What does activation feel like on the inside compared to deactivation? From there, with coaching, you learn to track your sensations and observe them in a way that lets the natural rhythm of your nervous system come back. Attention to internal sensation, both visceral and musculoskeletal, is the primary intervention in SE (Payne et al., 2015).

That can include quivering or shaking, either in session or later on. Sometimes when people experience the quivering they report feeling out of control, or scared that something is wrong with them. Nothing is wrong. Trembling is a normal part of sympathetic activation and the discharge that follows it (Payne et al., 2015). People also report shifts in digestion, with diarrhea starting or stopping. That is okay too. Your threat response system and your gut are in constant two-way communication (Mayer, 2011). Acute stress speeds up transit through the colon, which is where the diarrhea comes from, and at the same time slows the stomach's emptying (Taché & Bonaz, 2007). The deeper shutdown states that come with threat you cannot escape slow things down further still (Kozlowska, Walker, McLean, & Carrive, 2015).

There is more to it than that, but hopefully that sketches out the initial steps of how SE differs from traditional talk therapy. Yes, there is talking. There is also much more stopping, slowing down, taking cues from your nervous system, and being guided toward specific kinds of support for your body.

Another hallmark of SE is going slowly so the nervous system can avoid overwhelm. You feel a little, then back off. SE calls this titration, working drop by drop, paired with pendulation, the deliberate back and forth between activation and discharge (Payne et al., 2015). We will even interrupt a pre-conditioned pattern you may have of feeling something and flooding right away, so you can build new muscle for bite-sized portions of stress instead of all of it at once. That might look like me interrupting you and getting curious about what is happening on the inside, or asking you to stand up and move, or trying a regulation technique that runs through your body rather than your thinking.

Finally, there can be touch in SE. Fully trained practitioners have skills in using touch to aid the release of incomplete fight, flight, and freeze responses, and both practitioners and clients describe touch as one of the things that makes the work really effective (Kuhfuß, Maldei, Hetmanek, & Baumann, 2021). Touch is not where we start though. It comes later, after safety and connection are established, with your consent, and only when it is relevant to the work.

The Science Behind It

Now that I have described what it is, here is a little about why it is.

Trauma can come from intense stress, either from a single event or built up over time, and it disrupts our ability to live with ease and resilience. Accidents, surgeries, abuse, conflict, natural disasters. SE addresses these by working with the body's response to that stress.

SE's founder, Dr. Peter A. Levine, took his cue from how animals in the wild recover from life-threatening situations without carrying trauma forward. He noticed that animals naturally shake off the excess energy of the freeze response (Levine, 1997, 2010). SE applies that observation to humans, helping stuck energy move and release through a body-first approach to healing.

Like other mammals, we come with built-in protective responses to threat. We do not choose to feel threatened. It happens automatically and unconsciously, driven by instinct and long-term memory. Researchers describe these responses as a cascade: arousal, then fight or flight, then freezing, then tonic or collapsed immobility when the threat cannot be escaped, and finally a quiet recovery state (Kozlowska et al., 2015). To move through any of it, the body gathers energy, and gathering it creates dysregulation in our nervous and biological systems. That is supposed to be temporary. We spend the energy fighting, fleeing, or freezing, and the system re-regulates.

But often we cannot complete the response. We are at work, with our kids, in public, physically restrained. We cannot run, cannot let ourselves get that angry or that afraid, cannot shut down. The energy stays gathered and the dysregulation stays with it. Think of a wave that keeps building and never gets to break. Animals tend to return to baseline once the danger passes. People more often stay locked into the pattern that formed around the original event (Kozlowska et al., 2015). If that never gets tended to and completed, the dysregulation becomes the new baseline. The next time threat shows up, we are already starting from a more fragile place. If we do not complete that one either, it stacks. Over time we have less and less bandwidth for the ordinary stresses of life, and we usually start living in smaller and smaller ways. It can affect physical health too.

Who It Helps

SE is a holistic approach drawing on physiology, psychology, biology, neuroscience, and traditional healing practices. It can apply to many symptoms and needs. The bread and butter of it, though, is for people who have been through trauma: medical trauma, accidents, assaults, violence, trapped situations, and the like.

It also tends to help people who have already done a lot of talking about what happened and still feel it in their body. If you have told the story, understood the story, and your system still runs hot or still shuts down, that gap is what SE works with.

What the Research Says So Far

Somatic Experiencing is not considered a full evidenced based treatment (yet). The strongest study to date is a randomized controlled trial in which people with PTSD who received fifteen weekly SE sessions showed significant symptom reduction compared to a waitlist control group, with gains holding at follow-up (Brom et al., 2017). A later trial that added SE to physiotherapy for low back pain with post-traumatic stress symptoms found that both groups improved but that adding SE produced no additional benefit (Andersen, Ellegaard, Schiøttz-Christensen, Mejldal, & Manniche, 2020). A review of the literature concluded that the early results for PTSD symptoms are positive, and also that the evidence base is still small and does not yet meet the standards we would want for a well-established treatment (Kuhfuß et al., 2021).

So: promising, used widely, and still being studied. If you are considering this work, that is the honest picture. That said, anecdotally, solo or when paired with good psychotherapy or psychoanalysis I’ve seen SE to be life changing.

If you are wondering whether this is a fit, reach out. A first conversation is mostly about what you are carrying and what you want, and we go from there.

References

Andersen, T. E., Ellegaard, H., Schiøttz-Christensen, B., Mejldal, A., & Manniche, C. (2020). Somatic Experiencing® for patients with low back pain and comorbid posttraumatic stress symptoms: A randomised controlled trial. European Journal of Psychotraumatology, 11(1), 1797306. https://doi.org/10.1080/20008198.2020.1797306

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

Kozlowska, K., Walker, P., McLean, L., & Carrive, P. (2015). Fear and the defense cascade: Clinical implications and management. Harvard Review of Psychiatry, 23(4), 263–287. https://doi.org/10.1097/HRP.0000000000000065

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

Levine, P. A., with Frederick, A. (1997). Waking the tiger: Healing trauma. North Atlantic Books.

Levine, P. A. (2010). In an unspoken voice: How the body releases trauma and restores goodness. North Atlantic Books.

Mayer, E. A. (2011). Gut feelings: The emerging biology of gut-brain communication. Nature Reviews Neuroscience, 12(8), 453–466. https://doi.org/10.1038/nrn3071

Payne, P., Levine, P. A., & Crane-Godreau, M. A. (2015). Somatic experiencing: Using interoception and proprioception as core elements of trauma therapy. Frontiers in Psychology, 6, 93. https://doi.org/10.3389/fpsyg.2015.00093

Taché, Y., & Bonaz, B. (2007). Corticotropin-releasing factor receptors and stress-related alterations of gut motor function. The Journal of Clinical Investigation, 117(1), 33–40. https://doi.org/10.1172/JCI30085

why panic isn’t just fear: the attachment message behind it

I want it and I don’t want it at the same time

It happens in my office often. People are resistant to their feelings. Or to put it another way, they are protecting themselves from re-feeling overwhelm and flooding. This, of course, is a wisdom on their part. They have experienced overhwelm and instinctively avoid having to go through that again. This is not a weakness nor a stubborness. Yet they have also felt the cost of chronic avoidance, an act that is not conscious but automatic, and they have sought out help to feel their feelings and work with their unconscious habits around them. So they want their feelings and don't want their feelings at the same time. Whom among us can’t identify or relate to that? I know I can.

Panic is a guard

One symptom of this conflict is panic. Panic can act like a guard dog for repressed feelings. When people feel panic, they believe something is wrong, and they work to get away from wherever they are emotionally. But in effect, it's more like a guard pointing a gun loaded with blanks. It can hurt, but it can't kill. When we engage panic with somatic and therapeutic techniques, it opens the locked room where the feelings live.

The relationship between panic and attachment

Underneath that guard duty, panic is also an attachment signal. Panksepp identified a distinct PANIC/GRIEF system in the mammalian brain, separate from ordinary fear, whose job is to register separation and pull us back toward connection. It is the same circuitry behind a child's cry for a caregiver. When it fires in an adult, the underlying request hasn't changed: be seen, be safe, be soothed, so a person can feel secure again, to borrow Dan Siegel's language used with kiddos (but from experience I think this applies to adults too). Attachment researchers Mikulincer and Shaver describe this as the attachment system's basic move: distress activates a search for someone to turn toward, and finding them is what lets the distress settle. So panic isn't only a guard at the door. It's also a call for someone to come find you. This is why often if someone is having a panic attack, if they are connected with in a helpful way they shift from panic to the vulnerable feelings of grief or rage or fear. Their nervous system needed the added safety and increased connection of the attachment to be able to allow the feelings.

Panic isn't an obvious sign, but it's often a dependable one, that you're looking in the right place for the lost feelings, and places in need of connection underneath them.

References

Busch, F. N., Shear, M. K., Cooper, A. M., Shapiro, T., & Leon, A. C. (1995). An empirical study of defense mechanisms in panic disorder. Journal of Nervous and Mental Disease, 183(5), 299–303. Found that panic patients relied more heavily on reaction formation and undoing, defenses consistent with difficulty tolerating angry feelings toward others.

Milrod, B., Busch, F., Cooper, A., & Shapiro, T. (1997). Manual of Panic-Focused Psychodynamic Psychotherapy. American Psychiatric Press. Lays out Freud's concept of signal anxiety, in which a small dose of anxiety alerts the ego to dangerous unconscious wishes, and how a failure of defenses to contain that signal can escalate into panic-level anxiety.

De Masi, F. (2004). The psychodynamic of panic attacks: A useful integration of psychoanalysis and neuroscience. International Journal of Psychoanalysis, 85, 311–336. Describes panic attacks as arising from a breakdown of a person's defense organization, often during periods of life crisis, linking psychoanalytic theory with neuroscience findings on implicit fear memory.

Porges, S. W. (2011). The Polyvagal Theory: Neurophysiological Foundations of Emotions, Attachment, Communication, and Self-Regulation. W. W. Norton. Introduces neuroception, the nervous system's involuntary, non-conscious process for detecting safety or danger, which underlies automatic defensive responses like panic.

Levine, P. A. (1997). Waking the Tiger: Healing Trauma. North Atlantic Books. Describes Somatic Experiencing as a body-based approach that helps complete thwarted defensive responses stored in the nervous system, with case reports showing reduced panic symptoms as this completion occurs.

Levine, P. A. (2009). Panic, Biology, and Reason: Giving the Body Its Due. Documents a case in which restoring a client's interrupted defensive response led to a progressive decrease in panic anxiety.

Panksepp, J. (1998). Affective Neuroscience: The Foundations of Human and Animal Emotions. Oxford University Press. Identifies PANIC/GRIEF as a distinct primary emotional system governing separation distress, distinct from the FEAR system, and rooted in attachment biology.

Panksepp, J., & Watt, D. (2011). Why does depression hurt? Ancestral primary-process separation-distress (PANIC/GRIEF) and diminished brain reward (SEEKING) processes in the genesis of depressive affect. Psychiatry, 74(1), 5–13. Describes the PANIC/GRIEF system's role in social bonding and the pain generated by separation from attachment figures.

Siegel, D. J., & Bryson, T. P. (2020). The Power of Showing Up. Ballantine Books. Outlines the four S's of secure attachment: a child (and, by extension, an adult) needs to feel safe, seen, and soothed in order to develop a lasting sense of security.

Mikulincer, M., & Shaver, P. R. (2003). The Attachment Behavioral System in Adulthood: Activation, Psychodynamics, and Interpersonal Processes. In Advances in Experimental Social Psychology (Vol. 35). Describes how distress activates the attachment system and drives proximity-seeking, and how a responsive attachment figure allows that distress to resolve into felt security.