Somatic therapy is a body-focused approach that works with physical sensations, movement, breathing, thoughts, and emotions. It is often used when trauma, chronic stress, anxiety, or other distress continues to affect the body even after someone has talked extensively about their experiences.
What is somatic therapy and how does it work?
Somatic therapy is an umbrella term for therapeutic approaches that include the body in psychological treatment. Instead of focusing only on thoughts and verbal processing, these approaches pay attention to physical sensations, breathing, posture, movement, and other bodily responses. Different modalities use different techniques, but the shared idea is that physical experiences can provide useful information during trauma and stress treatment.
In somatic therapy, a therapist may help you notice what is happening physically while you talk about difficult experiences.
For example, you might notice:
- tightness in your chest;
- a clenched jaw;
- shallow breathing;
- muscle tension;
- changes in your heart rate;
- a feeling of heaviness or numbness.
Rather than treating these sensations only as symptoms to eliminate, somatic approaches use them as information that can be explored during therapy.
Several approaches fall under the broader somatic therapy umbrella:
- Somatic Experiencing (SE): developed by Dr. Peter Levine, this approach focuses on physical responses associated with survival and trauma.
- Sensorimotor Psychotherapy: combines body awareness with psychological approaches, including attention to attachment.
- EMDR (Eye Movement Desensitization and Reprocessing): uses bilateral stimulation while working with distressing memories to support trauma processing.
Why can trauma affect the body?
Traumatic experiences can affect the way the nervous system responds to perceived threats, sometimes long after the original danger has passed. During a threatening situation, the autonomic nervous system can activate survival responses such as fight, flight, or freeze. Trauma-related symptoms can subsequently include physical hypervigilance, muscle tension, fatigue, gastrointestinal problems, and dissociation.
The expression “the body keeps the score,” popularized by psychiatrist Bessel van der Kolk, is often used to describe the connection between trauma and physical experience.
During a threat, the body can respond with changes such as:
- increased heart rate;
- muscle tension;
- changes in breathing;
- heightened alertness;
- the release of stress hormones such as cortisol and adrenaline.
Research cited in the literature on PTSD has also identified changes involving brain regions such as the amygdala, hippocampus, and prefrontal cortex, which are involved in fear responses, memory, and emotional regulation.
This helps explain why trauma-related distress may be experienced physically as well as psychologically. Symptoms can include:
- hypervigilance;
- chronic muscle tension;
- fatigue;
- gastrointestinal difficulties;
- dissociation;
- strong physical reactions to reminders of the traumatic experience.
Somatic therapy approaches therefore pay attention to both psychological and physical aspects of trauma rather than treating them as completely separate experiences.
What happens during a somatic therapy session?
A somatic therapy session usually involves noticing physical sensations and responses while maintaining a sense of safety and present-moment awareness. A therapist may begin with grounding before approaching difficult material. Depending on the modality, the session may involve tracking sensations, breathing, movement, or bilateral stimulation while discussing stressful or traumatic experiences.
A session may include several elements:
- Grounding: You may be asked to notice your feet on the floor, your breathing, or your surroundings to help you remain present.
- Body awareness: The therapist may ask what you notice in your chest, shoulders, stomach, jaw, or other parts of your body.
- Tracking sensations: In Somatic Experiencing, you may gradually observe changes in physical sensations while discussing stressful material.
- Titration: Difficult material can be approached in smaller amounts rather than explored all at once, helping to avoid becoming overwhelmed.
- Trauma processing: Depending on the modality, the therapist may use specific techniques to work with traumatic memories and associated responses.
In EMDR, for example, you may focus on a distressing memory while following bilateral stimulation, such as eye movements or tactile stimulation.
The exact structure of a session depends on the therapist’s training, the modality being used, and your individual needs.
Who can benefit from somatic therapy?
Somatic therapy may be particularly relevant when psychological distress has a strong physical component or when someone feels that traditional talk therapy has not fully addressed their difficulties. Somatic approaches are used in trauma-focused treatment and may also be considered for anxiety, chronic stress, grief, dissociation, and some forms of chronic pain with a psychological component.
Somatic therapy may be used when someone is experiencing:
- childhood trauma or adverse childhood experiences (ACEs);
- PTSD or trauma-related symptoms;
- chronic stress or burnout;
- anxiety that is strongly experienced through physical sensations;
- grief that continues despite talking about the experience;
- dissociation or a sense of disconnection from the body;
- chronic pain with a psychological component.
The evidence base differs between individual somatic modalities. EMDR has a more established evidence base for PTSD, while research into other body-oriented approaches continues to develop.
Somatic therapy is also not necessarily appropriate in exactly the same way for everyone. People with severe dissociative disorders or significant psychological instability may require a carefully paced or specialized approach. A trained professional can assess what type and pace of treatment is appropriate.
Is somatic therapy different from talk therapy?
Somatic therapy does not necessarily replace talk therapy. Many somatic approaches still involve verbal processing, but they add deliberate attention to physical sensations, breathing, posture, movement, and other bodily experiences. In practice, approaches can overlap: a therapist may use verbal discussion to build understanding while incorporating body-focused techniques into the therapeutic process.
The distinction can be summarized as follows:
- Talk therapy: primarily explores thoughts, emotions, beliefs, memories, and experiences through conversation.
- Somatic therapy: incorporates those areas while also paying attention to physical sensations and bodily responses.
- Integrated therapy: may combine verbal processing with body-focused techniques depending on the person’s needs and the therapist’s training.
Some therapists trained in approaches such as Cognitive Behavioral Therapy (CBT) or psychodynamic therapy may also incorporate techniques involving the body, including diaphragmatic breathing, progressive muscle relaxation, or mindfulness-based interventions.
For complex trauma, therapy may also be organized in phases:
- Stabilization: developing safety, grounding, and coping skills.
- Trauma processing: gradually working with traumatic experiences.
- Integration: incorporating the experience into a broader sense of self and daily life.
For someone who can clearly describe their past but continues to experience numbness or disconnection, body-focused work may provide another way of addressing the problem alongside verbal processing.
How can I find a somatic therapist in the US?
In the United States, somatic therapy may be provided by licensed mental health professionals who have completed additional training in a particular somatic modality. When choosing a therapist, ask about their professional license, specific somatic training, experience with your concerns, and how they incorporate body-focused techniques into treatment.
When evaluating a provider, you can ask:
- What somatic modality are you trained in?
- What formal training or certification have you completed?
- How do you incorporate somatic techniques into therapy?
- Do you have experience working with trauma or PTSD?
- How would you adapt the approach if I become overwhelmed during a session?
- Can you provide online therapy?
- Do you accept my insurance or provide a superbill?
Examples of modality-specific credentials include SE Practitioner (SEP) for Somatic Experiencing and EMDR certification through EMDRIA (EMDR International Association).
How much does somatic therapy cost in the US?
The cost of somatic therapy varies depending on the provider and location ($100–$250 per hour). Insurance coverage also varies. Some therapists are in-network, while others may be out-of-network and provide a superbill that can potentially be submitted for reimbursement.
Before starting therapy, you can contact your insurance provider and ask about:
- in-network mental health coverage;
- out-of-network mental health benefits;
- copays or coinsurance;
- reimbursement procedures;
- whether a superbill is accepted.
Frequently asked questions
What is somatic therapy used for?
Somatic therapy is used to address trauma, PTSD, anxiety, chronic stress, and other difficulties that may involve strong physical responses. It may also be used when someone continues to experience distress despite previous verbal processing. Somatic approaches can address experiences such as burnout, grief, dissociation, and chronic pain with a psychological component.
How is somatic therapy different from regular therapy?
Traditional talk therapy primarily uses conversation to explore thoughts, emotions, beliefs, and experiences. Somatic therapy includes verbal processing but also deliberately works with physical sensations, breathing, posture, movement, and bodily responses. The body therefore becomes an additional focus of therapeutic work rather than being considered separately from psychological experience.
Can somatic therapy be done online?
Yes. Many licensed somatic therapists offer telehealth sessions. Techniques such as grounding, breathwork, and EMDR can be adapted for video sessions, although online therapy may not replicate every in-person technique. Whether online treatment is appropriate depends on the therapist, modality, and individual circumstances.
Does insurance cover somatic therapy?
Insurance coverage depends on your plan and therapist. If a somatic therapist is in-network, sessions may be covered according to your mental health benefits. Some therapists are out-of-network but may provide a superbill that you can submit for possible reimbursement. Check your insurer’s current out-of-network mental health benefits before starting treatment.
How long does somatic therapy take?
There is no fixed treatment timeline. The duration can depend on the complexity of the difficulties being addressed, the pace of treatment, and how frequently sessions take place. Some people may notice changes within several sessions, while complex or developmental trauma may require longer-term work. A therapist can establish goals and review progress collaboratively.
Is somatic therapy safe for everyone?
Somatic therapy conducted by a trained professional is generally considered safe, but the approach and pacing may need to be adapted for people with severe dissociative disorders, active psychosis, or significant instability. In these situations, a therapist may recommend a specialized approach or prioritize stabilization before trauma-focused work.
Sources
- van der Kolk, B. A. (2014). The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma. Viking.
- Brom, D., Stokar, Y., Lawi, C., Nuriel-Porat, V., Ziv, Y., Lerner, K., & Ross, G. (2017). Somatic experiencing for posttraumatic stress disorder: A randomized controlled outcome study. Journal of Traumatic Stress, 30(3), 304–312. https://doi.org/10.1002/jts.22189
- World Health Organization. (2013). Guidelines for the Management of Conditions Specifically Related to Stress. WHO Press. https://www.who.int/publications/i/item/9789241505406
- American Psychological Association. (2017). Clinical Practice Guideline for the Treatment of PTSD. APA. https://www.apa.org/ptsd-guideline
- National Institute of Mental Health. (2024). Post-Traumatic Stress Disorder. NIMH. https://www.nimh.nih.gov/health/topics/post-traumatic-stress-disorder-ptsd
If you’re considering therapy for trauma, anxiety, chronic stress, or related concerns, you can explore therapists trained in approaches that may fit your needs.
