Body-based Therapy Interventions for Healing Trauma

Traumatic experiences can have a profound impact on the body, mind, spirit, energy, emotions and relationships. Ultimately, all of these aspects are addressed in therapy to promote comprehensive healing. This article will provide a brief description of somatic therapy, 6 simple body-based interventions to help clients become more acquainted with their bodies and their stress response systems, as well as book recommendations from pioneers in this field.

What is Somatic Therapy?

Somatic therapy focuses on the connection between the mind and body, and helps clients to access, process and release emotional and psychological distress from the body (Muehsam et al., 2017, Grabbe & Miller-Karas, 2018). It is based on the awareness that trauma can leave physical and emotional imprints that are stored in the body. If left unaddressed, these imprints can disrupt the body’s natural capacity to regulate and process emotions, and can lead to a variety of psychological and physical symptoms (Dye, 2018). Physical and emotional imprints often make it difficult for trauma survivors to recognize the difference between real and imagined danger, and their body cues may be amplified, dulled or misinterpreted.

Somatic Interventions

Somatic interventions explore bodily sensations, movements, and traumatic experiences so they can be healed on a physical level. To help clients develop healthy patterns, start with some simple and quick techniques that clients can easily integrate into their lives. Begin with 30 second to two-minute versions of the techniques noted below and build from there.

1. Voo breathing is helpful when clients feel strong emotions or sensations, as it assists in the release of emotions from the body. Guide the client to take an easy and full breath in, all the way to their belly. On the exhale, invite them to make the sound “voo” as if the sound was coming from deep in their gut. Repeat multiple times.
2. Grounding can be used when clients feel nervous or unregulated. This technique will help the client to connect with their physical body and the present moment. Guide the client to feel their feet firmly planted on the ground, and to picture the roots of a tree coming from the bottom of their feet, going deep into the earth, far and wide. Then invite the client to scan their body from their head to their toes, noticing any tension, emotions or unwanted sensations. As they notice what they want to let go of, they can picture these things moving down their body, out of the bottom of their feet and going deep into the earth. Provide a few moments for the client to scan and release.
3. Body scanning alone can increase self-awareness and mindfulness. Simply invite your client to pay attention to one body part at a time and to notice the sensations, thoughts and emotions that arise. It’s often helpful for clients to keep a journal tracking their experience during body scans.
4. Orienting connects the client to the present moment using their senses. You can guide the client to notice the:
   • colors, shapes and textures they see
   • sounds they hear coming from their body, the room or outside
   • things they feel on their body (the texture of their clothes, the cool or warm air)
   • smells around them
   • taste in their mouth (which could be bitter, sweet, sour, etc.)

   A more simplified orienting technique is to have the client identify five things they can see, four things they can touch, three things they can hear, two things they can smell, and one thing they can taste.

5. Mindfulness exercises help clients to cultivate present-moment awareness and non-judgmental acceptance. A simple way to train the mind to be present is to start with the goal of anchoring the attention on one thing, like the breath, a word or a sense. In this case, you are not trying to relax or quiet their mind. The goal is to simply anchor the attention on one thing.
   Using the breath as the anchor, you would guide the client to breathe in and out while noticing the sensations around the breath. Where does the air first hit the body? Is it the tip of the nostrils, the back of the throat or the chest? Is there a sound associated with the breath? Is the air cold or warm? Is the breath deep or shallow? You would just notice the sensations around the breath. If the mind wanders, notice it and go back to the anchor, the breath. Clients may feel relaxed or agitated. There is no right or wrong response. You’re not trying to change anything. You are just paying attention to the experience.
6. Vagus Nerve Reset helps to reset the nervous system. This exercise transitions the client from a sitting position to lying down on their back. It is good to have a yoga mat present. While sitting up, ask the client to move their head to the left and then to the right, noticing any tightness or ease and if there is any difference in the two sides. This is done to gather a baseline. Ask client to lie on their back with their feet on the floor, knees bent and their hands behind their head, cradling it. With their nose pointing to the ceiling, ask the client to move their eyes to right as far as the eyes will go, keeping their head in place with their nose pointing to the ceiling. Have them hold this eye position for at least 30 seconds. Then, have them move their eyes back to the center for a moment and then to the left for 30 seconds and back to the middle. Typically, the client will naturally sigh, swallow or yawn, which are all signs of a reset and a release of tension. If they do not, the next time they can hold each eye position for a full minute. The client can simply sit up and notice how they feel and check the mobility of their neck. Has anything shifted for them? Is it easier to move from side to side, has either side changed?

Somatic therapy has been found to significantly decrease the severity of trauma symptoms and depression (Brom et al., 2017). With additional training, therapists can learn Trauma Release Exercises that use physical movement and shaking to release tension and stored trauma from the body. Therapists can also work with trained professionals who use touch and bodywork to help clients feel safe and connected to their bodies. Additionally, clinicians can get certified in a particular somatic therapy method. As a whole, somatic interventions provide clients the opportunity to fully process the physical, emotional and psychological impact of their traumatic experiences.

Somatic Therapy Pioneers

Adding body-based interventions to your repertoire can increase the depth and effectiveness of your work. To learn more about integrating somatic interventions into your therapeutic approach, the following authors have made significant contributions to the development and practice of somatic therapy.

• Bessel van der Kolk: Founder and medical director of the Trauma Center at Justice Resource Institute and author of “The Body Keeps the Score: Brain, Mind and Body in the Healing of Trauma,” an important book on the role of the body in trauma healing.
• Peter Levine: Founder of Somatic Experiencing® and author of several books on somatic therapy, including “In an Unspoken Voice: How the Body Releases Trauma and Restores Goodness” and “Waking the Tiger: Healing Trauma.”
• Pat Ogden: Founder of the Sensorimotor Psychotherapy Institute and author of “Sensorimotor Psychotherapy: Interventions for Trauma and Attachment.”
• Stephen Porges: Creator of the Polyvagal Theory, which provides a neurobiological understanding of the relationship between the autonomic nervous system and social behavior. He is the author of “The Polyvagal Theory: Neurophysiological Foundations of Emotions, Attachment, Communication and Self-Regulation.”
• Dan Siegel: Psychiatrist, Executive Director of the Mindsight Institute and author of several books, including “The Developing Mind: How Relationships and the Brain Interact to Shape Who We Are” and “Mindsight: The New Science of Personal Transformation.” Dr. Siegal has integrated insights from neuroscience, attachment theory, and mindfulness into his somatic therapy work.
• Bonnie Badenoch: Therapist and author of “The Heart of Trauma: Healing the Embodied Brain in the Context of Relationships” and “Being a Brain-Wise Therapist: A Practical Guide to Interpersonal Neurobiology” who has developed a relational approach to somatic therapy.
• Kathy Kain: Somatic therapist and author of “Nurturing Resilience: Helping Clients Move Forward from Developmental Trauma-An Integrative Somatic Approach.”
• Diana Fosha: Founder of the AEDP Institute and author of “The Transforming Power of Affect: A Model for Accelerated Change” who has integrated experiential and relational techniques into somatic therapy.
• Deb Dana: Clinician, consultant, and author of “The Polyvagal Theory in Therapy: Engaging the Rhythm of Regulation,” and “Polyvagal Exercises for Safety and Connection: 50 Client Centered Practices,” who has helped to practically apply Polyvagal Theory in somatic therapy.
• Raja Selvam: Founder of the Integral Somatic Psychology Institute and author of “The Practice of Embodying Emotions: A Guide for Improving Cognitive, Emotional and Behavioral Outcomes.” Dr. Selvam has developed a comprehensive model of somatic therapy that integrates Eastern and Western approaches to healing.

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, 304–312. 10.1002/jts.22189

Dye, H. (2018). The impact and long-term effects of childhood trauma. Journal of Human Behavior in the Social Environment, 28:3, 381-392. 10.1080/10911359.2018.1435328

Grabbe, L. & Miller-Karas, E. (2018). The Trauma Resiliency Model: A “Bottom-Up” Intervention for Trauma Psychotherapy. Journal of the American Psychiatric Nurses Association. 24(1), 76-84. 10.1177/1078390317745133

Muehsam, D., Lutgendorf, S., Mills, P. J., Rickhi, B., Chevalier, G., Bat, N., Chopra, D., & Gurfein, B. (2017). The embodied mind: A review of functional genomic and neurological correlates of mind-body therapies. Neuroscience and Biobehavioral Reviews, 73, 165–181. 10.1016/j.neubiorev.2016.12.027