Positive Somatic Experiences

If you had told me six months ago that creating positive physical experiences is a treatment for trauma, I might have given you some serious side-eye. How does creating these positive somatic experiences help us overcome horrible, traumatic events or complex developmental trauma?

Our bodies store trauma in all sorts of ways: as anger, depression, anxiety, inability to sleep, hypervigilance, pain, to name a few. Our trauma memories are not even stored in the same place as our regular memories. They are stored in the amygdala (part of the body's alarm system), which is part of the limbic system, as opposed to the hippocampus where regular memories live. Trauma memories are less linear, and can be stored in flashes of sights or sounds. They (trauma memories) can come up without warning and intrude on daily life and despite attempts to keep the memories at bay, they seem to want to come back the more you don't want to think about them.

So how does something like a massage or yoga help improve the effects of PTSD and trauma? Dr. Bessel Van der Kolk has studied trauma victims for decades and his research found that providing certain types of physical (somatic) experiences can actually transform trauma. They way it works is this: people who have experienced trauma generally feel helpless in many ways and that helplessness can manifest as numbing behavior (think drinking excessively or watching Netflix 12 hours a day) all the way to rage (or clinically speaking 'hyper arousal'). By addressing feelings of helplessness through physical means we can provide a sense of success or as Van der Kolk says "self-mastery" which begins to heal the trauma, reconnecting the body and brain in a positive way.

This year I have been talking a lot about creating positive somatic experiences with certain clients. Typically I ask them to think about ways they can engage their senses in the intervening week between appointments which also doubles as grounding by bringing the client back to the present moment and out of their depressive and/or anxious thoughts. Thus far I've received positive feedback on this home-based practice (I shy away from calling it 'homework' due to the connotation, but home-based practice is language that connotes the client actively working on what we discussed in session but on their own, which can foster a sense of accomplishment and confidence to build on next session). Some of my favorite ways clients have engaged in this practice included foot rubs from significant others, nuzzling with their animals, eating comforting, favorite foods, a hot shower, and a walk in a beautiful area. These are all small, inexpensive ways for clients to practice creating positive somatic experiences for themselves. There are certainly others. One of my favorites is music and dance. The creative expression that happens through dance is a great way to reconnect oneself to their body in a positive way (and you are engaging several senses at once).

Massage can be one form of somatic experience that allows trauma survivors to reexperience their bodies in a positive way. Researchers have found that massage can improve physical & psychological well-being as well as improved connection with their body (Price, 2005). This research was done with female sexual abuse survivors and makes complete sense: that exposure to pleasant, positive somatic stimuli would over time, improve your thoughts about physical touch, and your brain/body connection. Timing in this case was over eight, one-hour sessions (~2 months) with a three month follow-up. Since massage may be out of some clients' budgets (and not generally covered by insurance) its important to consider other ways to create these positive somatic experiences like those described above that a client can create on their own.

Yoga is another method of reestablishing a positive brain/body connection for trauma survivors. This intervention is considered a 'bottom-up' approach to emotional regulation because is starts in the body vs. the brain (which would be considered 'top-down'). Van Der Kolk's research showed that in women who had experienced trauma, participation in a yoga practice significantly improved their "relationships to their body." They were able to say they now take better care of themselves and are aware of what signals their body sends regarding needs (ex. rest). Part of this study involved something called heart rate variability (HRV) and while I won't get into it much here, suffice to say that the women in this study saw improvement in this area as well. I'm feeling another post coming on specifically focused on yoga because of its wide range of benefits to numerous populations.

I have encouraged several clients to seek out live yoga classes online, as well as yoga videos on YouTube, and if it falls in their budget, yoga classes in person once it is safe to do so in the post COVID-19 world. For the clients to whom I have recommended it, they have reported that they found yoga helpful. As a registered yoga teacher (RYT-200), I would love to integrate yoga and meditation as part of my practice with clients (maybe in the form of additional group work in the evening once a week combined with their talk therapy). Providing this additional offering that could help clients establish positive somatic experience within the backdrop of a group therapeutic setting could really complement and enhance their one-on-one work in the area of trauma recovery.