Somatic Interventions in Trauma Treatment

Trauma, anxiety, and depression can manifest as physical symptoms such as headaches, gastrointestinal issues, sensitivity to light, or any number of inflammatory conditions. Within an integrated health and wellness program, somatic (from the Greek sōmatikos, meaning “of the body”) interventions may help people gain insights about the relationship between physical ailments and emotional help. Equipped with this information, they can often find relief and improve their quality of life.

Unlike talk therapy, which engages the mind to heal trauma, somatic interventions encourage individuals to pay attention to the inner signals of the body. This might include tracking muscular tension, paying attention to the breath, or noticing physical postures during moments of emotional distress.

Learning the language of the body helps cultivate a mind-body connection that can generate a deep sense of well-being, as well as a greater capacity to endure discomfort. Somatic interventions can also contribute to an actual rewiring of the brain by interrupting thought patterns and narratives.

The term “somatic” encompasses a range of therapeutic techniques that treat the mind and body together. The practice relies on the belief that a traumatic event can “lock” negative emotions in the body. During a car accident or abusive relationship, the nervous system must operate in survival mode, releasing catecholamines such as epinephrine and norepinephrine to confront the threat.

The nervous system can become stuck in this survival state, even after the actual threat has passed. In this state of arousal, the body has higher levels of stress hormones, which can increase blood sugar and blood pressure, as well as weaken the immune system.

In addition to manifesting as physical symptoms, an aroused nervous system can contribute to negative thought patterns. An individual may develop persistent beliefs such as “I will never succeed” or “I am a bad parent.” Stored in the body, these thoughts can emerge during new stressful experiences.

Chronic pain is a common complaint among individuals who have been diagnosed with post-traumatic stress disorder (PTSD). Even though the original physical threat is no longer present, people continue to experience strong physical and emotional reactions to stimuli.

Utilizing mind-body techniques such as breathing, body movement, dance, or meditation, a somatic therapist may help a person release built-up tension to experience relief. In one study, patients with a diagnosis of PTSD participated in “somatic experiencing,” which involves thinking about traumatic events under the guidance of a therapist.

As they experienced high levels of stress and arousal, they learned body awareness techniques to help identify and diminish these feelings in the body. Participants in the study experienced significant reduction in depression and PTSD symptoms.

A 2014 review of 24 studies evaluated the efficacy of eye movement desensitization and reprocessing (EMDR), a type of somatic intervention that utilizes bilateral stimulation to reduce negative emotions associated with trauma.

An EMDR therapy session involves a therapist moving their fingers back and forth in front of a patient’s face, asking the patient to follow the movements while recalling a disturbing event. The biological mechanisms associated with rapid eye movement (REM) allow access to deeply stored memories and associations. The therapist then guides the patient toward more positive thoughts. In the review, 70 percent of studies showed that EMDR worked better than cognitive behavioral therapy (a type of talk therapy) to produce positive effects on trauma.

Additional somatic interventions include body awareness (which encourages patients to locate tension within the body) and grounding (which invites the person to feel the support of their feet on the ground to soothe the nervous system). Therapists may also teach sequencing techniques, allowing the individual to pay attention to the feeling of tension leaving the body, one location at a time.

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A Brief Overview of Acceptance and Commitment Therapy

Developed by University of Nevada psychology professor Steven C. Hayes in 1986, Acceptance and Commitment Therapy (ACT) encourages people to learn to accept and endure painful experiences, rather than escape or avoid them. Rooted in Hayes’ early work, which focused on the influence of language and thought on internal experience, ACT acknowledges that pain and suffering are not only inevitable, but essential. Instead of trying to avoid what causes fear, he encourages individuals to practice self-compassion.

When confronted with compassion, suffering can become a source of meaning and fulfillment. ACT is essentially a form of behavioral therapy that encourages psychological flexibility, allowing individuals to experience challenges without fear or resistance.

By confronting difficult experiences head-on, practitioners can increase their sense of self-acceptance. Combined with mindfulness-based therapeutic interventions, ACT has proven clinically effective in the treatment of conditions such as depression, anxiety, substance use disorder, and obsessive-compulsive disorder.

ACT aims to empower people to accept events and circumstances that are outside their control while committing to life-enriching actions. The intervention combines acceptance and mindfulness strategies with commitment and behavior change strategies to cultivate psychological flexibility. This strategy runs counter to popular ideas that hard work and right action can help people control their experiences.

The therapeutic framework for ACT involves six core processes. First, individuals must practice acceptance. Instead of denying or avoiding painful emotions, they must choose to allow unpleasant experiences to exist. Acceptance is not a goal, but rather an active choice.

Next, participants engage in cognitive defusion, which aims to decrease fixation on negative thoughts and experiences. By surrendering to what is, they can take away a negative event’s power to dominate their thoughts. The third core process of being present ties into this step, encouraging the person to maintain awareness of the present moment, without judging or trying to change it.

Self as context teaches that an individual’s identity comprises more than what happens to them, and that each person has a “self” outside their current experience. The fifth process (values) invites the person to consider their deepest principles. ACT then provides tools to help them bring their lives into alignment with these values. Finally, the committed action process guides practitioners in taking action. Once they are aware how their behavior choices affect their emotions, they can implement positive changes.

Like other behavior-based therapies, ACT focuses on acceptance instead of avoidance. During an ACT session, a therapist will help a person apply these six core processes to everyday life. For example, the therapist may implement mindfulness exercises that identify unpleasant sensations in the body. Instead of learning to “fix” these problems, the practitioner can spend time observing without judging.

A therapist may also guide a person in noticing where their actions did not align with their values, or may help them separate their sense of self from negative thoughts and feelings. Between sessions, the therapist may assign homework exercises to help individuals develop a healthy, non-judgmental awareness of memories or thoughts.

Because it aims to reduce the struggle to control anxious thoughts and encourages involvement in meaningful activities that align with chosen values, ACT has shown promise in improving the symptoms of generalized anxiety disorder (GAD). ACT has proven particularly beneficial for older adults with GAD.

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