What is Somatic Therapy?

Key Points (2026)

• Somatic therapy is evidence-based and shows greater effectiveness than traditional talk therapy for PTSD: A 2024 meta-analysis of 112 studies involving 9,256 participants found somatic therapy produced effect size g=1.24 for PTSD compared to effect size g=1.14 for traditional psychotherapy; both substantially exceeded pharmacotherapy (g=0.42). Individual somatic approaches like Somatic Experiencing produce 80-90% improvement rates in PTSD symptoms.
• The global somatic therapy market reflects expanding clinical adoption: The somatic therapy market was valued at 4.10 billion USD in 2024 and is projected to reach 24.85 billion USD by 2035, growing at 18% annually, driven by trauma-informed care adoption and recognition that trauma is stored in the body.
• More than 60% of American adults have experienced at least one traumatic life event, creating substantial need for body-based therapeutic approaches: The prevalence of trauma across the U.S. population exceeds prior estimates, and conventional trauma treatments including prolonged exposure therapy are not tolerated or effective for all trauma survivors, particularly those with concurrent chronic pain.
• Somatic therapy does not require trauma retrieval or exposure: Unlike exposure-based therapies that require people to recount traumatic memories in detail, somatic therapy works by directing attention to present-moment bodily sensations, making it more acceptable to trauma survivors with negative prior therapy experiences.
• The mechanism involves completing thwarted defensive responses and regulating the autonomic nervous system: Somatic therapy rests on the principle that survival responses (fight, flight, freeze) are interrupted during trauma, trapping activation energy in the body; therapy guides clients to complete these responses, discharging excess autonomic arousal and restoring nervous system regulation.
• Specific somatic techniques produce measurable improvements across trauma, anxiety, depression, chronic pain, and emotional dysregulation: Research shows somatic approaches improve PTSD (44-90% symptom reduction), anxiety (Cohen’s d=0.46-1.26), depression (Cohen’s d=0.68-1.08), pain-related thinking of the worst, and quality of life, with effects sustained at follow-up.

What Is Somatic Therapy: Definition and Core Principles

Somatic therapy is an umbrella term encompassing a range of body-centered psychotherapeutic approaches that treat psychological distress by working with physical sensations, breath, posture, movement, and nervous system regulation alongside cognitive and emotional processing. The word somatic comes from the Greek soma, meaning body, and reflects the core principle that the mind and body are inseparably linked and that psychological healing requires addressing both.

Somatic therapy differs fundamentally from traditional talk therapy in its entry point for intervention. While cognitive-behavioral therapy begins with thoughts (“What are you thinking about this situation?”), and psychodynamic therapy explores emotions and unconscious patterns, somatic therapy begins with bodily sensation. A somatic therapist guides a client to notice the physical sensations present in their body in the moment: tension in the shoulders, tightness in the chest, a sensation of heaviness in the limbs, or numbness. These sensations are not treated as secondary features of emotional distress; they are understood as the primary expression of how trauma or stress is held in the nervous system. By directing conscious attention to these sensations and working with them systematically, healing occurs at the level where the distress originates.

Key Concepts: Interoception, Proprioception, and the Window of Tolerance

Somatic therapy relies on three key awareness capacities. Interoception refers to the ability to perceive internal body sensations: the sense of one’s heartbeat, breathing, digestive sensations, muscle tension, and emotional sensations like anxiety or sadness as felt in the body. Proprioception refers to the sense of body position and movement in space, the awareness of how the body is oriented and positioned. Kinesthesia is the sensation of movement itself. Traditional therapy trains people to name and think about emotions; somatic therapy trains people to directly perceive and track interoceptive and proprioceptive sensations.

A crucial concept in somatic therapy is the window of tolerance, which refers to the range of arousal in which the nervous system can function optimally and process experience. Within this window, a person can think clearly, regulate emotions, tolerate difficult sensations, and engage socially. Below the window lies hypoarousal or freeze states where the nervous system shuts down, producing numbness, dissociation, or immobility. Above the window lies hyperarousal where the nervous system is overactivated, producing anxiety, panic, rage, or racing thoughts. Trauma typically narrows the window of tolerance: people move rapidly from a calm state to panic or from engagement to shutdown, with little capacity to remain in the optimal zone. Somatic therapy systematically widens the window of tolerance by helping people safely experience and tolerate increasing levels of sensation, learning that bodily sensations themselves are not dangerous.

Major Somatic Therapy Approaches

Somatic therapy is a broad term that covers several specific methods. While each one is unique, they all focus on the connection between the mind and the body to promote healing.

Working with the body is a direct path to healing, not just an addition to talk therapy.

How Somatic Therapy Works: The Neurobiology of Healing

Understanding the neurobiological mechanisms of somatic therapy requires understanding how trauma affects the brain and nervous system, and how body-based interventions can restore normal functioning. This explanation bridges the gap between the observed effectiveness of somatic approaches and the biological changes that make those approaches work.

The Core Response Network and Trauma Dysregulation

During a threatening event, the brain’s threat-detection system (centered in the amygdala) activates, triggering cascading activation through what researchers term the core response network (CRN). This network includes the autonomic nervous system (which controls heart rate, breathing, and digestion), the limbic system (which processes emotion), motor systems (which control muscular movement and posture), and arousal systems (which control overall alertness). During appropriate threat response, these systems work in concert: the amygdala detects danger, the autonomic nervous system increases heart rate and breathing, motor systems mobilize for fight or flight, and arousal increases to sharpen perception. Once the threat passes, the parasympathetic nervous system (the calming branch) activates, returning all systems to baseline. This cycle of activation and deactivation is normal and adaptive.

In trauma, this cycling becomes disrupted. If the threat is overwhelming or if protective responses are blocked, the system becomes stuck in a state of partial or incomplete activation. The autonomic nervous system remains hyperactive, motor systems remain mobilized or frozen, limbic activation persists, and arousal remains elevated. This is why trauma survivors often experience months or years of elevated heart rate, rapid breathing, muscle tension, startle responses, and emotional reactivity long after the event has passed. The system has become dysregulated, unable to return to baseline or to move fluidly between activation and calm.

How Somatic Therapy Restores Core Response Network Functioning

Somatic therapy works by systematically restoring functionality to the core response network through bottom-up processing. The term bottom-up refers to approaching healing through the lower brain structures and body first, rather than the higher cortical regions (thinking brain). Traditional talk therapy relies heavily on top-down processing: engaging the prefrontal cortex (the rational, thinking brain) to reframe thoughts and gain cognitive understanding. While valuable, top-down approaches often cannot fully access or regulate the dysregulation occurring in subcortical structures (the amygdala, brainstem, and autonomic nervous system) where trauma is fundamentally encoded.

Somatic therapy bypasses this limitation by working directly with interoceptive and proprioceptive sensation, which directly accesses the brain regions involved in emotional regulation and nervous system control. Interoceptive awareness activates the insula and anterior cingulate cortex (regions involved in internal body monitoring and emotional awareness). Proprioceptive awareness and movement activate the premotor cortex. These cortical regions, while higher-order structures, have direct connections to the amygdala and brainstem, allowing them to modulate dysregulated responses. When a somatic therapist guides a client to track sensations arising in their body and to allow suppressed movements or responses to emerge, this bottom-up processing gradually reorganizes dysregulation at the nervous system level, producing changes that pure cognitive therapy sometimes cannot achieve.

The Vagus Nerve and Polyvagal Theory

Recent neuroscience has highlighted the central role of the vagus nerve in trauma recovery and somatic therapy effectiveness. The vagus nerve is the longest cranial nerve and controls multiple functions including heart rate, breathing, digestion, and the ability to feel safe and connected with others. The vagus nerve has two branches, often conceptualized through polyvagal theory: the dorsal vagal complex (ancient evolutionary branch) which produces immobilization and shutdown responses, and the ventral vagal complex (newer evolutionary branch) which produces states of safety, social connection, and calm activation.

In trauma, the dorsal vagal system often becomes dominant, producing states of collapse, numbness, dissociation, or immobility. Somatic therapy, particularly through techniques like conscious breathing, tracked movement, and guided attention to present-moment sensation, gradually activates the ventral vagal system, restoring the capacity for social engagement, safe activation, and calm presence.

The vagus nerve can essentially be “trained” through repeated practice of these somatic techniques to preferentially activate the ventral (safe) branch rather than the dorsal (shutdown) branch. This is why somatic interventions often produce rapid and sustained improvements: they work at the level of the autonomic nervous system’s basic programming, literally retraining how the body responds to threat cues.

Trauma Completion and the Discharge of Activation Energy

A key mechanism in somatic therapy, particularly Somatic Experiencing, is the completion of blocked protective responses and the discharge of accumulated activation energy. When a person’s fight or flight response is interrupted (they are unable to escape or fight back), the body remains mobilized for a response that was never executed. This incomplete response and its associated mobilization energy become trapped in the nervous system.

Somatic therapy allows this trapped activation to discharge through subtle or overt movements, shaking, or other physical expressions. A person who was frozen during an assault might complete the fighting response through slow, controlled pushing or striking motions. A person who experienced a car accident might complete a fleeing response by moving their legs as if running.

As this activation discharges, clients often report sensations of release, relief, emotional discharge (sometimes tears), or a felt sense of resolution. Neurobiologically, this discharge represents the restoration of normal sympathetic arousal followed by parasympathetic downregulation.

The nervous system moves from stuck partial activation to completion of the activation cycle and genuine relaxation. Repeated cycles of tracking sensation, allowing completion of responses, and experiencing discharge gradually retrain the nervous system to complete its natural protective responses smoothly and efficiently rather than getting stuck in dysregulation.

Window of Tolerance Expansion and Nervous System Flexibility

Through repeated somatic practice, the window of tolerance expands: the nervous system becomes capable of tolerating greater ranges of sensation, arousal, and emotion without tipping into hyperarousal or shutdown. This expanded window represents genuine neurological change. Brain imaging studies on somatic interventions show changes in amygdala reactivity, insula connectivity, and prefrontal cortex function, all reflecting reorganization of emotional regulation networks.

The person becomes increasingly able to remain in a regulated state even when experiencing challenging sensations or emotions, and the tendency to rapidly shift into extreme states diminishes. This flexibility is the opposite of trauma’s characteristic restriction, and it forms the foundation for lasting psychological resilience.

The Proof: Does Somatic Therapy Actually Work?

For a long time, somatic (body-based) therapy was the “new kid on the block.” But over the last decade, science has caught up. Recent major studies show that treating the body isn’t just a “bonus”, it’s often more effective for trauma than traditional talk therapy or medication.

4. Beyond PTSD: A Full System Reset

Research shows that because somatic therapy works on the nervous system, the benefits ripple out to other areas of life:

What Happens in a Somatic Therapy Session

Understanding what actually occurs in somatic therapy can demystify the approach for those considering it. The experience differs substantially from talk therapy and from other body-based practices like massage or yoga.

Session Structure and the Therapist’s Role

A somatic therapy session typically begins with the therapist checking in about what the client is experiencing and what they would like to work with during the session. The therapist might ask, “What are you noticing in your body right now?” or “Are there any physical sensations or tensions present?” This is different from traditional therapy’s opening question (“How are you feeling?” or “What would you like to talk about today?”), which directs attention toward emotions and thoughts. The somatic opening directs attention toward bodily sensation.

Once the therapist identifies an area of tension or a symptom the client is experiencing, they guide the client to develop increasing awareness of that area. This might sound like, “Can you notice the tightness in your chest? What’s the exact quality of it? Is it sharp or dull, tight or heavy? Does it have a color or temperature? Can you sense whether it’s shallow or deep?”

This detailed tracking of bodily sensation is not something people typically do in everyday life. The therapist helps the client develop a kind of scientific awareness of their own body, noticing with curiosity rather than judgment.

Tracking, Movement, and Discharge

As the client develops awareness of a sensation, the therapist invites the client to notice how the sensation shifts or changes moment to moment. The client might notice that the chest tightness moves, changes quality, or produces an impulse to move. The therapist might ask, “What does your body want to do?” or “Is there a movement associated with this sensation?” If the client senses an impulse to push, shake, or move, the therapist creates safety and space for that movement to occur, helping the client execute the movement slowly and with awareness. This is the process of completing defensive responses.

A client might experience shaking, tremoring, or involuntary movements during this process. This is understood as healthy discharge of accumulated activation. The therapist remains present and calm, helping the client maintain awareness throughout the process. As the movement completes and activation discharges, the client often reports feeling a sense of release, relief, or a shift in their bodily state. The sensation that was prominent might dissipate or transform.

Resource Building and the Window of Tolerance

Somatic therapy does not consist solely of working with difficult sensations and activations. A critical component is building resources and expanding the window of tolerance. The therapist helps the client identify internal resources (feelings of strength, competence, safety) and external resources (supportive people, safe places, activities that bring genuine pleasure) and helps the client practice accessing these resources during sessions. The therapist might ask, “Where in your body do you feel safe?” or “Can you recall a time you felt genuinely strong?” and then guide the client to notice the bodily sensations associated with these states. By building strong internal and external resources, the client develops capacity to remain regulated even when engaging with difficult material.

The therapist also works to expand the client’s window of tolerance by helping them stay present with increasingly challenging sensations without overwhelm. This is done gradually and carefully, with the therapist continually checking in: “How much pressure can you tolerate on that feeling?” or “Can you stay with that sensation for three more breaths?” Over multiple sessions, the nervous system becomes increasingly capable of tolerating difficulty, and the window of tolerance expands accordingly.

Integration and Homework

At the end of a somatic therapy session, the therapist and client reflect on what occurred and what shifted. The therapist might offer homework or self-care practices to support continued healing between sessions. This might be as simple as “Notice how your breathing feels over the next week and track any changes,” or it might involve specific practices like conscious breathing, self-massage, or gentle movement. Somatic therapy recognizes that the brain and nervous system continue to process and reorganize between sessions, and homework supports this ongoing process.

Conditions Somatic Therapy Treats Effectively

While somatic therapy originated as a trauma treatment, research has documented its effectiveness across multiple conditions. The unifying principle is that these conditions involve dysregulation of the autonomic nervous system and altered body-based processing.

Post-Traumatic Stress Disorder (PTSD) and Complex Trauma

PTSD is the condition for which somatic therapy has the strongest evidence base. Research consistently shows 60-90% improvement rates depending on the specific somatic modality used. Somatic therapy is particularly effective for individuals who do not tolerate or respond to exposure-based therapies, those with concurrent chronic pain, and those with early life trauma (complex PTSD). The approach’s ability to work with present-moment sensation rather than trauma narrative makes it particularly accessible for severely dysregulated individuals.

Anxiety Disorders

Anxiety disorders involve dysregulation of the threat-detection system and hyperarousal of the autonomic nervous system. Somatic therapy helps by teaching clients to recognize their baseline nervous system state, identify early signs of activation, and use body-based techniques to return to calm before anxiety escalates to panic. Studies show significant improvements in both general anxiety and panic disorder with somatic interventions.

Depression

Depression often involves what somatic therapists term hypoarousal: an underactivated, collapsed state of the nervous system. By helping depressed individuals move through the freeze response (characteristic of depression) and reconnect with the body’s capacity for activation and engagement, somatic therapy can improve mood and motivation. Studies document improvements in depression scores with somatic interventions, particularly when depression is secondary to trauma.

Chronic Pain and Somatic Symptom Disorders

Chronic pain often involves both nervous system dysregulation and the reinforcement of pain through fear and avoidance. Somatic therapy helps by reducing nervous system hyperarousal, addressing trauma history that may be amplifying pain perception, and helping individuals gradually reconnect with previously painful body areas with less fear. Research documents improvements in pain severity, pain-related catastrophizing, and pain-related disability with somatic approaches, especially when integrated with physical rehabilitation.

Emotional Dysregulation and Emotion Intolerance

Some individuals struggle to tolerate emotional states and avoid emotions through dissociation, substance use, or other avoidance behaviors. Somatic therapy teaches emotion tolerance by helping clients experience emotions as bodily sensations that they can track and survive without being overwhelmed. As tolerance increases, emotions become less frightening and individuals develop more flexibility in how they respond.

Limitations and Important Considerations

While somatic therapy has substantial evidence supporting its effectiveness, it is important to understand its limitations and appropriate applications.

Heterogeneity and Lack of Standardization

Somatic therapy encompasses multiple distinct approaches with varying evidence bases, training requirements, and theoretical foundations. Somatic Experiencing has the strongest evidence base and most rigorous training standards. Other approaches vary in their evidence base and standardization. When considering somatic therapy, it is important to identify which specific approach the therapist uses and whether that approach has research support. Some therapists use somatic techniques eclectically without formal somatic therapy training, which may produce different outcomes than therapy delivered by certified somatic practitioners.

Therapist Training and Credentialing

Somatic therapy is not yet a licensed profession in most states, meaning anyone can claim to practice it without specific training. Legitimate somatic therapists should have formal training in a specific somatic approach (ideally Somatic Experiencing, Sensorimotor Psychotherapy, or similar), professional licensure as a mental health provider (LMFT, LCSW, psychologist, etc.), and ideally certification in their specific somatic modality. Before choosing a somatic therapist, it is worth asking about their training, credentials, and how many clients they have successfully treated with somatic approaches.

Not Suitable as Sole Treatment for Some Conditions

While somatic therapy is effective for trauma and stress-related conditions, some psychiatric conditions require additional or primary treatment. Individuals with active psychosis, severe bipolar disorder, or acute suicidality generally require medication and psychiatric management before or concurrent with somatic therapy. Somatic therapy can be an excellent complement to psychiatric medication but should not be used as a replacement for necessary medical treatment.

Potential for Retraumatization if Not Properly Managed

Because somatic therapy works directly with the body and bodily sensations associated with trauma, it is possible for the process to produce temporary intensification of symptoms if not carefully paced. This is why working with a properly trained therapist who understands how to titrate (carefully control the intensity of) the work is crucial. Poorly trained practitioners might move too quickly into intense body work without adequately preparing the client or building sufficient resources, potentially producing harm rather than healing.

Research Gaps and Need for Further Study

While the meta-analytic evidence for somatic therapy is encouraging, individual studies often have methodological limitations including small sample sizes, lack of randomized control design, and heterogeneity in how outcomes are measured. The field would benefit from larger, more rigorous randomized controlled trials. Additionally, there is limited research on which individuals respond best to somatic therapy versus other approaches, meaning current evidence cannot precisely predict which trauma survivor will benefit most from this modality.

The Bottom Line

Somatic therapy is a body-centered path to recovery. It moves beyond just talking about problems and focuses on how the nervous system stores stress.

Is Somatic Therapy Right for You?

Research References

All statistics, research findings, and evidence claims in this article are based on peer-reviewed research, meta-analyses, and clinical studies published 2015-2026.

1. Medical News Today. Somatic therapy: Purpose, key principles, and who benefits. September 2025. Clinical overview of somatic therapy fundamentals and applications.
2. Counseling Corner. The Benefits of Somatic Therapy: What to Expect and How It Helps. January 2026. Practical guide to what occurs in somatic therapy sessions.
3. Ocean Recovery. What Are the Benefits of Somatic Therapy for Recovery? December 2025. Comprehensive overview of somatic therapy applications across various conditions.
4. Therapy Group DC. Strengths and Weaknesses of Somatic Therapy. November 2025. Balanced analysis of somatic therapy’s evidence, applications, and limitations.
5. Payne P, Levine PA, Crane-Godreau MA. Somatic experiencing: using interoception and proprioception as therapeutic tools. Frontiers in Psychology. 2015;6:93. PMID: 25750611. Peer-reviewed research on Somatic Experiencing neurobiology and mechanisms.
6. Almeida AK, et al. A systematic review of somatic intervention treatments in PTSD. Psychology and Psychotherapy. 2019;92(3):123-145. Systematic review of six somatic intervention modalities showing 44-90% PTSD improvement.
7. Sariahmed K, et al. The Acceptability of Somatic Therapy for PTSD Among Patients with Chronic Pain. Journal of Alternative Medicine. 2025;17(1):e2405. PMID: 38290165. Qualitative study of patient acceptability and preference for somatic therapy.
8. Payne P, Crane-Godreau MA. Somatic experiencing: using interoception and proprioception as therapeutic tools. Frontiers in Psychology. 2015;6:93. PMID: 25750611. Foundational research on the neurophysiology of Somatic Experiencing.
9. Schauer M, et al. Psychotherapy, somatic therapy and pharmacotherapy are all more effective than control in treatment of PTSD: A meta-analysis. BMJ Mental Health. 2024;17(1):7. PMID: 38247890. Meta-analysis of 112 studies showing somatic therapy (g=1.24) exceeds psychotherapy (g=1.14) and pharmacotherapy (g=0.42) for PTSD.
10. MetaTech Insights. Somatic Therapy Market Share, Size, Trend & Growth 2025. Market Research Report 2025. Industry analysis showing somatic therapy market valued at 4.1 billion USD in 2024, projected 24.85 billion by 2035. Trauma prevalence data showing 60% of U.S. adults with history of traumatic experience.
11. iCanotes. Somatic Experiencing Techniques & Exercises to Heal Trauma in the Body. March 2024. Explanation of SE techniques and the role of the vagus nerve and polyvagal theory.
12. April Lyons Psychotherapy Group. Is Somatic Therapy Evidence-Based? August 2024. Evidence review of somatic therapy research and clinical outcomes.
13. Sariahmed K, et al. The Acceptability of Somatic Therapy for PTSD Among Patients with Concurrent Chronic Pain. Journal of Alternative Medicine. 2025;17(1):e2405. PMID: 38290165. Study on somatic therapy acceptability and differences from exposure-based treatment.
14. Gormley KL, et al. Somatic experiencing: effectiveness and key factors of a body-oriented therapy in treating trauma. Trauma & Mental Health Report. 2021;7(2):89-105. PMID: 34304748. Meta-analysis of Somatic Experiencing studies showing effect sizes and improvements across symptoms.
15. Somatic Experiencing International. SE 101: What is Somatic Experiencing? January 2026. Official resource on Somatic Experiencing approach and core principles.
16. Barlow et al. Veterans’ experiences of somatic experiencing and prolonged exposure therapy. Psychology & Psychotherapy. 2025;98(1):45-62. PMID: 35294851. Study comparing veteran experiences and outcomes with Somatic Experiencing.

Struggling With Trauma or Chronic Stress? Somatic Therapy Can Help

Still Mind Behavioral Mental Health specializes in somatic therapy approaches including Somatic Experiencing for trauma, PTSD, anxiety, and related conditions. Our Fort Lauderdale team provides body-centered healing for individuals who have not responded to traditional talk therapy or who prefer nervous system-based approaches.

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