Somatic therapy is a form of mental health treatment that works with the body as well as the mind. Instead of relying only on talking through thoughts and memories, a somatic therapist helps you notice physical sensations, such as a tight chest, shallow breathing, or a clenched jaw, and use them to calm your nervous system. It is most often used for trauma, anxiety, and chronic stress.
The word “somatic” comes from the Greek soma, meaning “body.” The idea behind it is simple: stress and trauma don’t live only in your thoughts. They can also show up as physical patterns that stay switched on long after the danger has passed.
This guide explains how somatic therapy works, what happens in a session, what it can help with, and what the research does and doesn’t show yet.
How Does Somatic Therapy Work?
Somatic therapy helps your nervous system leave “survival mode” and return to a calmer, more flexible state.
When you face a threat, your body reacts automatically. Your heart speeds up, your muscles tense, and you get ready to fight, run or freeze. Normally, that response winds down once you are safe. After trauma or long-term stress, it can stay partly switched on. You may know in your head that you are safe, but your body keeps acting as if you aren’t.
That can look like:
- Feeling on edge, jumpy or easily startled
- Tight muscles, headaches, or stomach problems with no clear medical cause
- Shutting down, going numb or feeling disconnected from your body
- Strong reactions that feel out of proportion to what is happening
Top-down vs. bottom-up
Most talk therapies are top-down: they start with thoughts and beliefs and work toward feelings and behavior. Somatic therapy is bottom-up: it starts with physical sensations and works toward emotions and meaning. Many therapists combine both.
The approach became widely known after psychiatrist Bessel van der Kolk’s 2014 book The Body Keeps the Score, which argued that trauma is stored in the body as well as the mind. Its roots go back much further, to early 20th-century psychoanalyst Wilhelm Reich, a student of Freud, who wrote about emotional tension held in the body.
Types of Somatic Therapy
“Somatic therapy” is an umbrella term, not a single method. These are the best-known approaches:
| Approach | Developed by | Main focus |
|---|---|---|
| Somatic Experiencing (SE) | Peter Levine, PhD | Gently releasing stuck survival responses so the nervous system can settle, without reliving the trauma in detail |
| Sensorimotor Psychotherapy | Pat Ogden, PhD | Connecting posture, movement and body sensations to emotions, beliefs and relationship patterns |
| Hakomi | Ron Kurtz | Mindful, gentle attention to the body to uncover core beliefs |
| Somatic-informed talk therapy | Many clinicians | Adding body awareness, breathing and grounding to CBT, DBT or other talk therapy |
Is EMDR a somatic therapy? Not exactly, though it overlaps. EMDR (eye movement desensitization and reprocessing) focuses on reprocessing specific memories using eye movements or tapping, and it pays attention to body sensations along the way. Many people group it with body-based therapies, but it is usually classed as its own approach.
What Happens in a Somatic Therapy Session?
A somatic therapy session looks a lot like regular therapy: you sit with a licensed therapist and talk. The difference is that your therapist will regularly pause and ask what you notice in your body.
A typical session might go like this:
- Check-in. You talk about what’s on your mind, as in any therapy session.
- Noticing. Your therapist asks where you feel a reaction, such as, “What happens in your chest as you say that?”
- Working with the sensation. You stay with it briefly, breathe, shift posture, or use a grounding tool.
- Settling. You return to a place in your body that feels calm or neutral before moving on.
- Practice. You may leave with one or two exercises to use between sessions.
Common somatic therapy techniques
- Body scanning (interoception): slowly noticing sensations from head to toe without trying to change them.
- Grounding: feeling your feet on the floor or your back against the chair to come back to the present.
- Resourcing: recalling a person, place, or memory that brings a sense of safety, and noticing how it feels physically.
- Titration: touching a hard feeling in small doses rather than all at once, so you don’t get overwhelmed.
- Pendulation: moving attention back and forth between a distressing sensation and a calm one.
- Breathwork: slowing and deepening the breath to calm the stress response.
- Movement: small, intentional movements, such as pushing against a wall, to complete a protective response the body never finished.
You stay in control. You do not have to describe your trauma in detail, and you can pause or stop at any time. Most somatic work does not involve touch; if a therapist uses it, they should explain why and ask your permission first.
What Can Somatic Therapy Help With?
Somatic therapy was developed mainly for trauma, and that is still where most of the research is. Therapists also use it for:
- PTSD and trauma, including single events (an accident) and long-term or childhood trauma
- Anxiety and panic, especially when it shows up physically
- Chronic stress and burnout
- Depression, often alongside other treatment
- Grief and loss
- Stress-related physical symptoms, such as tension, headaches, or stomach issues (after a medical checkup rules out other causes), and sometimes alongside chronic pain treatment
- Feeling numb or disconnected from your body or emotions
It is often combined with other care rather than used alone. For example, it can sit alongside individual counseling, medication management or an intensive outpatient program.
Somatic Therapy vs. Talk Therapy vs. EMDR
The main difference is the starting point: talk therapy starts with thoughts, EMDR starts with a specific memory, and somatic therapy starts with what you feel in your body.
| Somatic therapy | Talk therapy (e.g., CBT) | EMDR | |
|---|---|---|---|
| Starting point | Body sensations and nervous system state | Thoughts, beliefs and behaviors | A specific distressing memory |
| Main tools | Noticing sensations, grounding, breath, movement | Conversation, reframing thoughts, skill practice | Eye movements or tapping while recalling the memory |
| Need to describe the trauma in detail? | No | Sometimes | You focus on the memory, but you don’t need to describe it at length |
| Research base for PTSD | Promising but early | Strong | Strong |
| Often a good fit if… | You understand your patterns but still feel stuck, numb or on edge | You want practical skills and structure | You have specific memories that still feel “live” |
These approaches aren’t competitors. Many people do best with a combination, chosen with their therapist.
Does Somatic Therapy Work? What the Research Says
The research on somatic therapy is promising but still limited. Here is an honest summary of the main studies:
- First randomized trial for PTSD (2017). In a study of 63 adults with PTSD, people who had 15 weekly Somatic Experiencing sessions showed large improvements in PTSD symptoms and depression compared with a waitlist group. (Brom et al., Journal of Traumatic Stress)
- Back pain with PTSD (2017). Among 91 patients with chronic low back pain and PTSD symptoms, adding Somatic Experiencing to standard care reduced PTSD symptoms more than standard care alone. The researchers noted the overall effect was smaller than they expected. (Andersen et al., European Journal of Psychotraumatology)
- First review of the evidence (2021). A review of 16 studies found preliminary evidence that Somatic Experiencing helps PTSD-related symptoms. It also found the quality of studies was mixed and called for more rigorous trials. (Kuhfuß et al., European Journal of Psychotraumatology)
Experts at Harvard Health Publishing note that somatic therapy doesn’t yet have the research backing of cognitive behavioral therapy (CBT), and some clinicians suggest starting with a proven approach and adding somatic work.
The bottom line: somatic therapy is a reasonable option, especially for trauma and stress that talk therapy alone hasn’t resolved. It works best as part of a plan built with a licensed clinician, not as a replacement for well-established treatments.
Is Somatic Therapy Right for You?
Somatic therapy may be a good fit if several of these sound familiar:
- You understand why you feel anxious or stuck, but understanding hasn’t changed how you feel
- Stress shows up in your body as tension, a racing heart, stomach trouble or exhaustion
- You often feel on edge, or you shut down and go numb
- Talking about the past feels overwhelming, and you want an approach that doesn’t require reliving it
It may need extra care, or a different starting point, if you have severe dissociation, active psychosis, or are in a mental health crisis. In those cases, a clinician will usually focus first on stability and safety. A full mental health assessment helps decide what order makes sense.
Somatic and Body-Based Care at Mental Health Center of America
Mental Health Center of America offers somatic, polyvagal-informed therapy as part of its trauma treatment. Therapists combine body-based techniques with proven approaches like CBT, DBT and EMDR, so you don’t have to choose one or the other.
Body-based care at MHCA can also include neurofeedback for arousal, sleep and focus, and wellness therapies such as infrared sauna, cold plunge, and red light therapy. You can meet the team on the providers page.
MHCA sees patients in person at its Glendale and Mesa clinics and through virtual care anywhere in Arizona. If you’re looking for somatic therapy in the Phoenix area, schedule an appointment or call (602) 224-2277.
Frequently Asked Questions
Is somatic therapy evidence-based?
Partly. Somatic Experiencing has positive results in randomized trials for PTSD, and a 2021 review called the evidence promising. But it has far fewer studies than CBT or EMDR, so it is best described as an emerging, promising approach.
Is somatic therapy covered by insurance?
Often, when it’s part of therapy with a licensed provider. Insurance generally pays for psychotherapy sessions rather than for a specific technique. Coverage varies by plan, so check with your insurer or see MHCA’s accepted insurance plans before you start.
What are some simple somatic exercises I can try at home?
Try grounding: sit, press your feet into the floor, and name five things you can see. Or place a hand on your chest, breathe out slowly, and notice what changes. These are self-care tools, not a substitute for treatment.
How long does somatic therapy take?
It varies. Some people notice they feel calmer within a few sessions. The first randomized trial for PTSD used 15 weekly sessions. Long-term or complex trauma usually takes longer.
Can somatic therapy be done online?
Yes. Most techniques, like noticing sensations, breathing, and grounding, work over video. MHCA offers virtual therapy anywhere in Arizona. Your therapist will guide you the same way they would in person.
Will I have to relive my trauma?
No. Somatic therapy works with what you feel in the present and moves in small steps. You decide how much to share.
This is for general information and is not medical advice. Talk with a licensed mental health professional about your situation. If you are in crisis or thinking about harming yourself, call or text 988 (Suicide & Crisis Lifeline) or call 911
