Somatic Approaches
What Is Somatic Therapy?
Somatic comes from the Greek soma, meaning body. Somatic therapy works with the body: not as a broken machine to fix, but as a living, feeling entity that holds experiences and participates in healing.
This may seem obvious, yet it represents a significant departure from how mental health has traditionally been approached in the West. The dominant paradigm for much of the twentieth century was fundamentally dualist: treating mind and body as separate domains. Mental health was the province of talk therapy; physical health belonged to medicine. The body, in this framework, was largely irrelevant to psychological healing except as a source of symptoms to be managed.
Somatic approaches challenge this division. They recognise that our psychological experiences are embodied: that emotions, memories, and stress responses are not just mental phenomena but are held and expressed through the body. When we feel anxious, it is not merely a thought; it is a quickening of the heart, a tightening of the muscles, a change in breathing. When we experience trauma, the body doesn't simply forget once the mind has processed the event. The body remembers.
The body is not simply along for the ride. It is a full participant in how we experience, process, and heal from life's challenges.
– Pat Ogden, Sensorimotor Psychotherapy
Body and Mind Work Together
The relationship between body and mind is not one-directional. Just as our psychological states affect our bodies (stress causes muscle tension; anxiety speeds the heart), our physical states profoundly affect our psychology. Research in embodied cognition has demonstrated that body posture affects mood, facial expressions influence emotional experience, and breathing patterns shape our mental states.
This bidirectional relationship is the foundation of somatic work. If chronic stress has left a residue of tension in the body, addressing this tension directly can shift the underlying psychological state. Conversely, working with the body can access experiences and memories that are difficult to reach through verbal processing alone.
Consider the experience of chronic stress. A demanding job or difficult life circumstances might lead to years of elevated cortisol, shallow breathing, and muscular bracing. Even after the external circumstances change, the body may continue to hold this stress pattern. The nervous system has learned that the world is dangerous and continues to behave accordingly. Talk therapy can help someone understand this pattern intellectually, but the body itself may need to experience release and safety for lasting change to occur.
Two Ways to Heal
Traditional psychotherapy typically works top-down: starting with thoughts, beliefs, and narratives, with the assumption that changing these will eventually affect felt experience and behaviour. Cognitive behavioural therapy (CBT), for example, focuses on identifying and restructuring unhelpful thought patterns.
Somatic approaches work bottom-up: starting with bodily sensations, movements, and physiological states, with the understanding that shifts at this level will naturally affect thoughts and emotions. Rather than trying to think your way to feeling better, you work directly with how you feel in your body.
Top-down: "I notice I'm thinking anxious thoughts. Let me challenge these thoughts and consider whether they're realistic."
Bottom-up: "I notice my chest feels tight and my breathing is shallow. Let me slow my breathing and allow my body to settle, and observe how my thoughts shift as a result."
Neither approach is superior: both have value, and they often work best in combination. However, many people find that bottom-up work can reach places that top-down approaches cannot. Certain experiences, particularly early or traumatic ones, may be stored in the body in ways that are not easily accessible through verbal processing. The body may hold tensions, postures, and response patterns that formed before we had language to describe them.
This is particularly relevant for trauma work. Traumatic experiences can become encoded in the body's stress response system in ways that persist long after the conscious mind has "moved on." A person might understand perfectly well that they are now safe, yet their body continues to react as if danger is imminent. Bottom-up approaches work with these body-level responses directly.
Why Work With the Body?
There are several reasons why working with the body is so valuable in healing:
Completion of stress responses. When we experience threat, the body mobilises for action: fight or flight. If this mobilisation is interrupted or suppressed (as often happens in modern life, where we cannot physically fight or flee our stressors), the energy remains held in the body. Somatic approaches allow this energy to complete its natural cycle and discharge.
Accessing pre-verbal experiences. Many of our most formative experiences occurred before we developed language. These experiences are encoded in the body – in posture, tension patterns, and autonomic responses – and may not be accessible through talking. Body-based work can reach these early layers.
Building new experiences. Healing is not just about processing the past; it is about building new capacities for the present. Through somatic work, we can develop new experiences of safety, groundedness, and regulation that gradually reshape our baseline state.
Integration. Many people experience a disconnect between what they know intellectually and how they feel. They understand that they are safe, yet feel anxious. They know they are capable, yet feel inadequate. Somatic work helps bridge this gap, bringing intellectual understanding and felt experience into alignment.
Other Somatic Practices
TRE is one of many somatic modalities. Understanding where it sits in the broader landscape can help contextualise the practice:
Somatic Experiencing (SE), developed by Peter Levine, focuses on tracking bodily sensations and supporting the completion of defensive responses. It emphasises titration – working in small, manageable doses – and pendulation – moving between areas of activation and resource.
Sensorimotor Psychotherapy, developed by Pat Ogden, integrates body-based interventions with traditional psychotherapy, working with posture, movement, and gesture alongside verbal processing.
Hakomi combines somatic awareness with mindfulness and a belief in the body's innate wisdom, using gentle experiments to explore how core beliefs are held in the body.
Rolfing and other structural integration approaches work with the fascia and soft tissue to release chronic holding patterns.
Body-Mind Centering, Alexander Technique, and Feldenkrais Method focus on movement and posture, helping people develop new patterns of embodiment.
TRE occupies a unique position in this landscape. Unlike many somatic therapies, which require a trained practitioner to guide the work, TRE is designed to be self-administered. Once learned, it becomes a tool that individuals can use independently, whenever and wherever they need it. This accessibility – combined with the simplicity of the technique – makes TRE a powerful entry point into somatic work.
TRE is both a standalone practice and a complement to other approaches. Many therapists incorporate TRE into their existing modalities, and many individuals use TRE alongside other healing work they are engaged in.
Moving Forward
In the following pages, we explore the foundations needed to understand TRE: how trauma affects the body and nervous system, the concept of the window of tolerance, and the importance of co-regulation and safety. With this context established, you will be well prepared to engage with the TRE practice itself.
As you continue reading, I invite you to approach this material not just intellectually but somatically. Pause periodically to notice your body. Are you holding tension anywhere? How is your breathing? What is your posture? This embodied engagement with the material is itself a form of somatic practice.