Somatic Experiencing, in tandem with talk therapy, is a more complete therapy approach that impacts deep layers of the mind and body leading to transformative psychological and physiological shifts.
Standard treatment for substance abuse includes cognitive behavioral therapy, motivational interviewing, and other talk-based ‘top-down’ approaches to help individuals overcome their addictive tendencies. Although vital in the healing process, the talk therapy approach can be limiting or downright overstimulating and destabilizing for someone with chronic, overwhelming traumas that they may not even remember.
Talk therapy addresses the symptoms of the trauma– getting high, compulsively gambling, restricting or binge eating – but not the root cause of the trauma that has left its mark on the nervous system. ‘Bottom up’ (or body-based) approaches can access, renegotiate, and resolve traumas that are at the root of the substance abuse without directly talking about the trauma and risking overwhelming or triggering the person. Somatic Experiencing is a ‘bottom up’ approach, which includes touch work, eye work, and mindfully tracking sensations, that support individuals in developing a greater capacity to heal and live by creating resilience and regulation in the nervous system.
What is Somatic Experiencing?
Somatic Experiencing was created by Dr. Peter Levine, who began by questioning why animals could have near-death experiences and not be traumatized while humans developed post-traumatic stress disorder (PTSD) following major life-threatening events or became traumatized by events that seem insignificant.
Levine observed how animals responded to threats and reacted accordingly by the fight, flight, freeze survival responses. Through decades of research, Levine realized that by completing the survival responses, most animals are able to discharge the energy and trauma through a deactivation process. A deer that successfully evaded a wolf experiences a complete deactivation response that might show up as uncontrollable twitching, rearing, bucking, and trembling. This deactivation of energy triggers a chemical discharge that passes through the deer’s nervous system, allowing the animal to come back to baseline, letting the mind and body reorganize and be ready for the next encounter.
Humans are similar to the deer mentioned above. Every human being is wired for survival and has survival responses including fight, flight, and freeze. As humans, we get in our own way and override what naturally wants to happen in the body and nervous system. By overriding our natural responses, there is a build-up that eventually shows up as accumulated stress, mood disorders, PTSD, chronic pain, ulcers, digestive issues, etc.
As an example, imagine you are a soldier running towards an enemy on the battlefield. Your body is screaming to run the other way, but the mind overrides the survival response and keeps you running forward. Or, imagine that you grew up in an emotionally and physically abusive home. The only way to get your needs met was to lie and strategize because you never knew what state your caretaker was in. You were caught in a paradox of wanting to get close to your caretaker while at the same time wanting to run away. Or, you wake up on a Monday morning dreading going to work. You feel sick to your stomach just thinking about your toxic work environment, but you feel like you have no choice even though you’re overwhelmed with dread.
Levine developed a method that helps renegotiate an overwhelmed nervous system. When it comes to trauma, specifically relating to the diagnosis of PTSD and/or developmental trauma, we know that the nervous system cannot tell the difference between events that happened in the past and what is happening in the present moment. The nervous system and the body (by extension) are locked in a moment in time and perpetually orienting to survival. This orientation accumulates survival strategies like hypervigilance and increased muscle tension in the body, which help prepare the individual for fight or flight. To the outside eye, this might look like irritability, depression, numbness, mood disorders or glossy eyes because the individual is so checked out or dissociated.
How does SE Relate to Substance Abuse?
Looking at substance abuse and drug of choice can say a great deal about a person’s nervous system and how they orient to the world. For example, if an individual is suffering from PTSD, then the sympathetic part of their nervous system (flight/fight response) might dominate and orient this individual to a hyper state, leading them to crave some sort of depressant, like alcohol, to help numb and bring down the system. If the orientation is instead to a depressed or collapsed state, the individual might choose a drug of choice that is a stimulant, like Adderall, to help activate the nervous system.
Somatic Experiencing can touch into the heart of the use, specifically what needs the substance meets for the individual. Somatic Experiencing builds the individual’s mental capacity as well as capacity in the nervous system. This enables the individual to tolerate being in the present moment for both the uncomfortable moments and pleasurable moments that life has to offer, reducing the compulsion to use substances as a survival strategy.
Somatic Experiencing can also help individuals renegotiate trauma, which is underlying the substance use, and help the nervous system complete a self-protective response that did not have the opportunity to complete previously. For instance, if an individual was held down in a traumatic event, the Somatic Experiencing Practitioner might implement a boundary exercise to help the survivor reestablish their felt sense of safety. This might mean experimenting with the survivor pressing their hands against the practitioner’s hands and pushing the practitioner away, or it might mean tracking the internal experience in the body as the practitioner, with the permission of the survivor, moves their chair closer and then further away, so the survivor can feel what distance feels comfortable. Every Somatic Experiencing session is different, and each session focuses on the needs of the individual and that person’s nervous system in that moment.
How Somatic Experiencing Can Help Resolve Complex Trauma
For individuals who have experienced multiple traumatic events, near-death experiences, and/or developmental trauma (not getting needs met in childhood, ongoing disconnection, neglect, or abuse), the body develops different management strategies to help them survive. Over time, these management strategies become habitual, manifesting as severe dysregulation in the nervous system and causing the body to hold tension in such a way that it can eventually lead to chronic pain, irritable bowel syndrome, unexplained autoimmune diseases, fibromyalgia, and chronic fatigue. Once potential medical causes have been ruled out, Somatic Experiencing can be a powerful way to help bring more regulation to the nervous system and resolve or soften these symptoms.
Through the lens of Somatic Experiencing, touch work can be utilized to access some of the innermost trauma conditions held in the body including in the body diaphragms, joints, and viscera because traditional talk therapy cannot access these deep states. Somatic Experiencing touch work is not manipulative like massage but focuses on regulation in the nervous system, coherence, and building capacity for containment.
Coherence is a measurable indicator of proper communication and cooperation across a body system and between systems. Coherence can be measured in a system by the quality of the breath (is it fluid, short, or pressured); the relationship to the breath to muscle tension; the relationship to breath to heart rate; and the relationship of breath to heart rate variability and thermoregulation.
If there is high coherence within all body systems, it is easier for the body to function without too many challenges. If there is low coherence within and across all body systems, the body will be primarily focused on compensating with the previously discussed strategies, resulting in a host of side effects that make it incredibly difficult for the individual to function effectively in life.
To help resolve some of the deepest held shock states in the system, Somatic Experiencing eye work can be utilized. Somatic Experiencing eye work is a way to interact with the incomplete body responses that have been affected by trauma, directly relating to defensive responses and incomplete orienting responses.
Integration of Top Down and Bottom Up Strategies in the Healing Process
Somatic Experiencing is a powerful method to access, resolve, and renegotiate various traumas. For Somatic Experiencing to be effective, stabilization, openness, and a certain level of curiosity must be present, otherwise, the bottom up approach will not integrate.
Top down strategies, like trauma-informed cognitive behavioral therapy (TF-CBT) and motivational interviewing (MI) can support getting stabilization onboard, and inspire curiosity to deepen the healing process. In the early stages of recovery, it is possible to weave in TF-CBT, MI, and Somatic Experiencing techniques by mindfully exploring bodily sensations, internal sensations, behavior, affect, meaning, and thoughts to help greater understanding of the self and the internal experience.
By integrating top down and bottom up strategies, therapists can empower individuals in recovery and create an internal state of balance, so clients can resource themselves and manage everyday stressors without relying on substances to bring relief or to regulate their discomfort.
Somatic Experiencing Treatment in Virginia
Encore Outpatient Services offers a range of treatment protocols to guide those in need toward recovery. We offer partial-hospitalization programs, intensive outpatient programs as well as transitional/extended care programs. If you have any questions about the use of somatic experiencing to treat trauma, visit our contact page and we’d love to provide answers!
Additional Resources for Healing & Learning
Books:
Waking the Tiger Healing Trauma The Innate Capacity to Transform Overwhelming Experiences by Peter Levine
Nurturing Resilience by Kathy L. Kain, Stephen J. Terrell, Peter A. Levine Ph.D.
Somatic experiencing (journal): Using interoception and proprioception as core elements of trauma therapy
Videos:
Peter Levine – Trauma Resolution and Addiction Treatment
Dr. Peter A Levine Interview on Healing Trauma and Restoring Goodness
Peter A Levine, PhD on Shame – Interview by Caryn Scotto D’Luzia
Somatic Experiencing® — Ray’s Story
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