There was a time when therapy was only one thing: Talk therapy, in an office, on a couch. Nowadays, that definition has expanded to not only include new technology — like teletherapy — but also alternative types, like somatic therapy. It’s become more popular recently, thanks, in part, to TikTok. That, plus the growing awareness of the importance of mental health, has helped make it mainstream.
We turned to a few somatic practitioners to learn the ins and outs of somatic therapy: licensed trauma therapist Arielle Schwartz, psychotherapist Monica Amorosi, and Barrie Sueskind, LMFT and psychotherapist.
Barrie Sueskind - Barrie Sueskind, LMFT, is a psychotherapist who works with clients in California and New York.
Monica Amorosi - Monica Amorosi is a licensed trauma therapist at Clarity Therapy NYC. She uses a combination of dialectical behavioral therapy (DBT) and sensorimotor psychotherapy to help her clients navigate stress.
Arielle Schwartz - Arielle Schwartz is a clinical psychologist and author who has been trained in somatic therapy for over 20 years. She works at a private practice in Boulder, CO.
What is somatic therapy?
While many forms of therapy focus on the mind first, somatic therapy focuses on the body first, then the mind. Instead of focusing on talking through painful memories or history, you’ll spend more time noticing how your body physically feels as those memories come up. It’s based on the idea that our experiences and emotions — and especially trauma — are often stored in the body. Some of the ways it can show up in real life include having tense, shrugged shoulders or chronic pain, says Amorosi.
Somatic therapy can treat a number of mental health issues like PTSD, anxiety, grief, depression, stress, and addiction. It can also help clients learn to manage stress, regulate their emotions, and “create a sense of safety,” Amorosi says. It’s often an ideal form of therapy for trauma, which Sueskind says isn't always treated effectively by other forms of therapy.
“While talk therapy can be very effective for allowing people to find insight and understanding … for some people who've been traumatized, that insight and understanding isn't enough,” she says. Her somatic healing practice, for example, uses a combination of both psychotherapy and somatic therapy.
Are there different types of somatic therapies?
There are several — which could include dance, breathwork, or in some cases, sitting still and noticing how your body feels when certain emotions or memories come up, says Amorosi. Here’s a breakdown of the most common types.
How it works: Schwartz says Hakomi is “an integration of mindfulness into psychotherapy.” Hakomi can help clients work through certain thought patterns and limiting beliefs through that mindfulness.
What to expect: A therapist may guide you through understanding how your past informs your beliefs and patterns today, while noticing how you react internally.
How it works: Somatic experiencing is based on how animals respond to stress: Think of a fox chasing a rabbit, says Schwartz. After getting to safety, the rabbit may go into a “freeze response,” she says. “But once the rabbit determines that there's no more threat, the rabbit will shake off that frozenness from the muscles, will reintegrate the breath, and eventually will move into a flee response to escape the danger and return to safety.” Unlike the rabbit, however, people often get stuck in that frozen state, she says, and “don't feel resolved.”
That can affect the way you feel physically. You may feel like your throat is blocked or like your chest or shoulders are tight, she says.
What to expect: In practice, your therapist may start by helping you develop “resources,” aka a way of creating a sense of mental peace and strength by thinking of positive memories, people, or figures. You may be encouraged to physically act out those movements (yelling or pushing away, for example) that you didn’t have a chance to during the traumatic event, says Schwartz. “We build in those experiences to allow the body to come to completion now, and then we can experience more satisfaction or ease.”
Eye Movement Desensitization and Reprocessing (EMDR)
How it works: EMDR is a form of somatic therapy that helps people work through traumatic memories through what’s called bilateral stimulation. It’s based on the theory that when something traumatic happens, a person’s memory doesn't get completely processed or resolved in the brain. It can leave someone feeling as if they are still in danger even when the threat is no longer there.
What to expect: Bilateral stimulation can help complete the process and signal to your brain that you’re safe. That might look like moving your eyes back and forth, listening to sound or music that alternates between your ears, or tapping your knees or shoulders alternately while thinking about the memory or feeling that comes up. “As we think about the traumatic memory, we're also simultaneously paying attention to the cues that let us know that it's over now,” Schwartz says.
“EMDR can help restore people to thinking of themselves as survivors,” Sueskind says. It may help with a number of mental health concerns like anxiety disorders, depression, and trauma disorders (like PTSD).
How it works: Sensorimotor psychotherapy combines elements of somatic therapy and psychotherapy to help someone process trauma or painful memories.
What to expect: It may not look that different from other forms of therapy, Schwartz notes. Your therapist may use a combination of talking through memories and emotions, while asking you to pay attention to how your body feels as you do. The strategy can help you learn how to self-regulate your emotions.
How it works: Similarly to EDMR, brainspotting is based on the theory that traumatic memories get stuck in certain parts of the brain. David Grand, who developed brainspotting, observed that his clients would get fixated in certain spots in the room when they thought of certain memories, which helped them dive deeper into their trauma to work through the emotions that came up. It’s worth noting that there’s limited research around how effective brainspotting is.
What to expect: Your therapist may guide you through exploring your history, and track where your gaze lands as you do. From there, you can dive deeper into how that history affected you and talk through what you feel.
How does somatic therapy impact physical health?
Just like how stress can make you more likely to get sick, trauma that gets stuck in the body can impact your health. Case in point: Unresolved trauma may contribute to chronic pain, digestive problems, and muscle tension. Somatic therapy may relieve some of those symptoms as a side effect of working through trauma. Generally speaking, anything you can do to reduce your stress levels is good for your health.
This sounds expensive. How much does somatic therapy cost?
The exact number may vary, depending on where you live. But according to Schwartz, you can expect to pay between $150-$200 per hour without insurance. If your insurance plan covers other forms of therapy (you can call them to find out), Amorosi says they will likely cover somatic therapy at the same practice, since they’re typically billed the same way.
If you’re ready to find a somatic therapist, you can start by finding a practice in your area (or one that offers virtual therapy). Once you find one, don’t feel like you have to commit, says Sueskind. “Interview them as if you're interviewing someone for a job, and see if you really feel like you could be comfortable talking about some of the most sensitive experiences of your life with this person,” she says.
Can I practice somatic therapy at home?
You typically do somatic therapy with a somatic therapist or practitioner. But videos of people practicing somatic stretches at home have sprouted up all over TikTok. When it comes to DIY-ing your somatic healing, however, the experts say to proceed with caution. Especially if you have unhealed trauma. That’s because diving into somatic therapy alone, whether it’s from a TikTok or a YouTube video, can put you at risk of retraumatization.
“If I'm watching someone do a TikTok live stretching and I've got sore shoulders, cool. Anyone can benefit from that, right?” says Amorosi. “But if my shoulders are tight because I have an attachment disorder … then releasing that shoulder tension could trigger a whole skew of psychological responses of: ‘Oh God, now I'm exposed,’ ‘I'm not used to my body feeling this way,’ or ‘Oh my God, why does my body hurt? Does that mean something bad is happening?’”
That said, Schwartz notes that access to mental health care is “one of the biggest barriers we're facing in mental health right now.” That’s especially true for communities of color. She says that social media can be a great tool to access something that’s typically only accessible in a therapist’s office. If you really want to try somatic stretching online, her tip is to be mindful of who you follow. Meaning, check the bio of the TikToker before you try their somatic stretches. Schwartz says to ask yourself: “Do they have some kind of trauma-informed background? Have they done any kind of training on how to guide you wisely?”
If social media is good for one thing, it’s opening up the conversation around mental health. TikTok might be a helpful jump-off point, but a professional can more effectively help you process your trauma — without getting retriggered. If you’re interested in trying somatic therapy, finding a licensed practitioner is a good first step.
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