Listening to the Body: The Power of Somatic Approaches in Healing Trauma

Introduction

Trauma is not just an event or a series of events from the past—it is often a lived experience within the body. For many survivors, the residue of trauma lingers in tense shoulders, shallow breaths, or a persistent feeling of disconnection. While traditional talk therapies can offer valuable insights, they often fall short in addressing trauma’s embodied nature.

Statistics highlight the pervasive impact of trauma. According to the World Health Organization (WHO, 2022), interpersonal violence is a leading cause of death and disability globally, with far-reaching consequences for mental health and well-being. Among LGBTQ individuals, the prevalence of trauma and post-traumatic stress disorder (PTSD) is significantly higher, with research showing a 2.2 times increased risk of PTSD compared to cisgender, heterosexual peers (Alessi et al., 2020). Discrimination, hate crimes, and increased exposure to violence are key contributors to this disparity (Grant et al., 2011; WHO, 2022).

For sexual assault survivors and others carrying the weight of trauma, therapy can be a critical component of recovery. Body-based approaches like Focusing-Oriented Therapy (FOT) and Sensorimotor Psychotherapy (SP) provide a path to reconnect with the body’s innate wisdom. These modalities invite survivors to gently explore their lived sensations, unlocking profound healing through embodied awareness.

This blog delves into how FOT and SP support trauma recovery, offering practical insights and a compassionate framework for healing. Whether you’re a therapist or someone navigating trauma yourself, this exploration provides tools to bridge the mind-body divide, fostering deeper connection and resilience.

Understanding Trauma and the Body: A Journey Beyond the Cognitive

Trauma impacts the entire human experience—mind, body, and spirit. While emotional and psychological scars may be more readily discussed, the physical imprints of trauma often remain overlooked. Yet, the body serves as both the canvas and container for trauma, storing its residue in the muscles, breath, and nervous system (van der Kolk, 2014). These embodied imprints underscore why effective trauma recovery must transcend traditional talk therapies to include somatic approaches that address the body’s role in healing.

The Neurobiological Foundations of Trauma: A System in Overdrive

At its core, trauma disrupts the autonomic nervous system (ANS), which regulates critical bodily functions such as heart rate, digestion, and respiration. According to Porges’ (2011) Polyvagal Theory, this disruption can leave survivors stuck in cycles of hyperarousal or hypoarousal. Hyperarousal, marked by heightened vigilance, irritability, and anxiety, reflects the body’s fight-or-flight response in overdrive. Conversely, hypoarousal manifests as emotional numbing, dissociation, and exhaustion—an extreme state of freeze or shutdown.

Central to this dynamic is neuroception, the body’s unconscious ability to assess safety or threat in its environment (Porges, 2011). For trauma survivors, neuroception often becomes skewed, interpreting benign situations as dangerous. This constant state of perceived threat can have profound physiological and psychological consequences, including chronic stress, emotional dysregulation, and difficulties in forming trusting relationships.

The ANS, while initially designed to protect, can become dysregulated when trauma persists or remains unresolved. This dysregulation contributes to long-term challenges, such as poor sleep quality, reduced immune function, and heightened sensitivity to stressors (Ogden et al., 2006). Recognising and addressing these patterns is a vital component of trauma recovery.

The Physical Manifestations of Trauma: When the Body Remembers

The body holds trauma in ways that may feel both tangible and inescapable. Chronic muscle tension, restricted breathing, gastrointestinal issues, and even cardiovascular problems are common among survivors (van der Kolk, 2014). These symptoms are not simply secondary effects of psychological trauma; rather, they are the body’s attempt to manage overwhelming stress. For instance, muscle tension may serve as a protective armour, guarding against further harm, while shallow breathing may minimise sensations that could trigger traumatic memories.

Unaddressed, these physical responses can reinforce a cycle of dysregulation. The narrowing of the breath, for example, reduces oxygen flow to the brain and body, intensifying feelings of anxiety and disconnection. This underscores the need for therapeutic approaches that help survivors safely reconnect with their bodies, breaking free from these patterns of physiological entrapment.

The Face-Heart Connection: Trauma and Social Engagement

Porges’ (2011) Polyvagal Theory highlights the “face-heart connection,” a neural pathway involving the vagus nerve that links the brainstem to the heart, lungs, and facial muscles. This connection plays a pivotal role in regulating emotional states and fostering social engagement. In a state of safety, the vagus nerve facilitates calm, attuned interactions. However, trauma disrupts this pathway, impairing the survivor’s ability to perceive and respond to social cues, establish trust, and maintain meaningful relationships.

When the vagus nerve is dysregulated, survivors may experience difficulty making eye contact, speaking with ease, or feeling relaxed in social settings. This disruption can perpetuate isolation and deepen the impact of trauma on interpersonal connections. Therapies that target vagal regulation, such as rhythmic breathing, humming, or guided movement, offer powerful tools for restoring this vital connection (Porges, 2011; Ogden et al., 2006). By fostering a sense of safety in the body, these practices pave the way for renewed relational trust.

The Role of Somatic Awareness in Recovery: Reclaiming the Body

Trauma recovery necessitates a reconnection with the body—a reconnection that allows survivors to access and process their embodied experiences. While traditional talk therapies excel at exploring the psychological dimensions of trauma, they often fall short in addressing its somatic roots. Approaches such as Sensorimotor Psychotherapy and Focusing-Oriented Therapy bridge this gap by helping survivors tune into their physical sensations, movements, and internal rhythms (Ogden et al., 2006; Gendlin, 1981).

Sensorimotor Psychotherapy offers survivors grounding techniques that anchor them in the present moment, expanding their capacity to tolerate distress without becoming overwhelmed. Meanwhile, Focusing-Oriented Therapy invites survivors to engage with the “felt sense”—a subtle, embodied awareness that often precedes conscious thought (Gendlin, 1981). This practice allows survivors to access their body’s innate wisdom, facilitating profound insights and shifts.

Both approaches empower survivors to reclaim their bodies as safe, resourceful spaces. By addressing trauma at its root, somatic therapies foster resilience and holistic healing, restoring the natural equilibrium that trauma once disrupted.

The Role of Focusing-Oriented Therapy: Unlocking Embodied Wisdom

Focusing-Oriented Therapy (FOT), pioneered by Eugene Gendlin, provides a profound pathway for trauma recovery by recognizing the body as a reservoir of insight and healing. Central to this approach is the concept of the felt sense—a holistic, embodied awareness that carries the complexities of an experience beyond what the mind alone can articulate (Gendlin, 1981). For trauma survivors, whose experiences are often fragmented and elusive, the felt sense offers a gentle means of reconnection and meaning-making.

The Felt Sense: Beyond the Cognitive

Unlike emotions, which tend to be reactive and transient, the felt sense emerges as a bodily knowing—a nuanced and layered awareness arising from lived experience (Gendlin, 1996). It is not merely a feeling or thought but a body-based perception of the whole situation, including aspects that are not yet verbalized or fully understood.

For instance, a trauma survivor might describe a persistent tightness in their chest or a lump in their throat when revisiting certain memories. These sensations are not random; they encapsulate the body’s attempt to hold and communicate unprocessed aspects of the trauma. FOT teaches survivors to approach these sensations with curiosity and care, allowing the body’s implicit wisdom to unfold gradually.

This embodied process is transformative because it bypasses the limitations of language and cognition. As Gendlin (1996) noted, the felt sense exists at the intersection of the conscious and the unconscious, providing a bridge to previously inaccessible layers of experience.

Techniques for Engaging with the Felt Sense

FOT employs a structured yet adaptable process to help clients engage with their felt sense, offering tools to navigate the often-intimidating terrain of trauma:

1. Clearing a Space: Clients are guided to set aside external concerns and tune into their internal world, creating a safe container for exploration (Hendricks, 2001).

2. Finding a Handle: This step involves identifying a word, phrase, or image that captures the essence of the felt sense. For example, a client might describe the lump in their throat as “a stuck voice” or “a heavy silence.”

3. Resonating: The therapist supports the client in comparing the chosen handle with their felt sense, refining it until there is an alignment or resonance that feels “just right” (Gendlin, 1981).

4. Letting It Unfold: As attention is held on the felt sense, it begins to shift, revealing insights, emotions, or memories that were previously hidden (Hendricks, 2001).

5. Receiving: The final step involves acknowledging and accepting whatever emerges, fostering a sense of safety and self-compassion.

These techniques empower survivors to engage with their embodied experiences without fear or overwhelm, enabling the body to release its hold on unprocessed trauma in a gradual and manageable way.

Practical Applications for Trauma Recovery

Trauma often creates a sense of being “stuck”—emotionally, physically, or cognitively. Focusing-Oriented Therapy addresses this stuckness by inviting survivors to listen deeply to their bodies. For example, a client who experiences chronic neck tension may discover, through FOT, that this sensation is tied to an unspoken need for vigilance stemming from a past threat. As the felt sense shifts, so too does the body’s habitual holding pattern, allowing for relief and healing (Levine, 2010).

Moreover, FOT helps rebuild the fractured relationship between mind and body that trauma often leaves in its wake. Survivors frequently describe feeling alienated from their bodies, as if the body itself is a site of betrayal or pain. By teaching clients to approach their bodily sensations with respect and compassion, FOT restores a sense of safety and agency, essential components of recovery (Gendlin, 1996).

Bridging Theory and Practice

Focusing-Oriented Therapy aligns with contemporary understandings of trauma as an embodied phenomenon. Its emphasis on bodily awareness and experiential processing complements and enhances other somatic approaches, such as Sensorimotor Psychotherapy and Polyvagal-informed therapy. By addressing trauma at its roots—within the body—FOT provides a pathway not only for symptom relief but also for profound transformation.

As Gendlin (1981) so aptly expressed, “The body knows more than words can say.” Through FOT, survivors are given the tools to access and trust this embodied wisdom, paving the way for healing that is as deep as it is enduring.

Sensorimotor Psychotherapy in Action: Integrating Body, Mind, and Emotion

Sensorimotor Psychotherapy (SP), pioneered by Pat Ogden, is a holistic method for addressing trauma by combining somatic awareness with cognitive and emotional processing. Unlike traditional talk therapies, SP directly engages the body as an entry point to healing, recognizing that trauma is stored not only in memories but also in physical sensations, postures, and movement patterns (Ogden & Minton, 2000). This integration makes SP particularly effective for clients who struggle with unresolved physiological responses to trauma.

Key Techniques of Sensorimotor Psychotherapy

Grounding and Orienting

Grounding exercises are foundational in SP, helping clients establish a sense of safety and presence by focusing on their body’s connection to the environment. These techniques often involve mindful attention to physical sensations, such as the feel of the feet on the ground or the rhythm of one’s breath, which can counteract the disorienting effects of trauma (Ogden et al., 2006). Orienting involves scanning the environment to identify safety cues, a practice that can regulate the autonomic nervous system and enhance a sense of security.

Pendulation and Titration

Building on Peter Levine’s concept of pendulation, SP alternates between activating and calming states to expand a client’s window of tolerance. This deliberate movement between distress and safety allows clients to process traumatic memories without becoming overwhelmed (Levine, 1997; Ogden & Minton, 2000). Titration, a related technique, involves breaking down traumatic experiences into manageable pieces, enabling survivors to engage with their trauma incrementally.

Repairing Attachment Systems

Attachment theory forms a critical pillar of SP, particularly for individuals whose trauma stems from relational experiences. SP uses body-based interventions—such as postural alignment and movement exercises—to repair disrupted attachment systems. For example, a client with a collapsed posture reflecting helplessness might be guided to experiment with more assertive stances, facilitating a sense of empowerment (Fisher, 2017). These exercises not only address physical symptoms but also foster relational trust and emotional connection.

The Role of the Therapist in Sensorimotor Psychotherapy

In SP, the therapist’s attuned presence is vital. By observing clients’ physical cues—such as shifts in posture, breathing patterns, or facial expressions—therapists can identify and respond to underlying trauma responses that may not yet be verbalized. This interactive regulation helps clients feel supported as they navigate distressing sensations and emotions (Ogden & Minton, 2000).

Therapists also model self-regulation by maintaining a calm and grounded presence, which can co-regulate clients’ arousal states. This relational safety is particularly important for survivors of relational trauma, who may struggle with trust and vulnerability.

Practical Applications and Outcomes

Sensorimotor Psychotherapy is especially effective for clients experiencing symptoms like dissociation, hyperarousal, or a persistent sense of disconnection from their bodies. For example, a survivor of childhood abuse might use SP to explore sensations of tightness in their chest that arise during discussions of intimacy. Through mindful tracking of these sensations and gradual experimentation with movement, the client may uncover suppressed memories or emotions, facilitating a deeper integration of their trauma (Ogden et al., 2006).

Moreover, SP’s emphasis on somatic processing complements other therapeutic modalities, such as EMDR or cognitive-behavioural therapy, by addressing the physiological roots of trauma. This integrative approach has been shown to reduce symptoms of PTSD, enhance emotional regulation, and improve overall well-being (Van der Kolk, 1996).

Embodied Healing Through Sensorimotor Psychotherapy

Sensorimotor Psychotherapy offers a profound pathway to healing by addressing trauma at its roots—within the body. By integrating somatic, cognitive, and emotional processing, SP empowers survivors to reconnect with their bodies, restore their sense of safety, and rebuild trust in themselves and others. This holistic approach not only alleviates trauma symptoms but also fosters resilience and self-compassion, paving the way for long-term recovery.

Polyvagal Theory and Trauma Recovery: A Pathway to Safety and Connection

Stephen Porges’ Polyvagal Theory offers profound insights into how the nervous system governs our responses to trauma, safety, and social engagement. At the core of this theory is the vagus nerve, a complex system that acts as a bridge between the brain and body, influencing our physiological and emotional states (Porges, 2018). Trauma often disrupts this system, impairing the ability to feel safe, connect with others, and regulate emotions. Understanding and applying Polyvagal Theory in therapy provides a framework for fostering healing and resilience.

The Role of the Vagus Nerve in Trauma

The vagus nerve is central to Polyvagal Theory, encompassing two branches that mediate distinct physiological responses. The ventral vagal branch supports social engagement, fostering calm, connection, and emotional regulation. In contrast, the dorsal vagal branch is associated with immobilisation, which can manifest as dissociation or shutdown in response to overwhelming stress (Porges, 2011).

Trauma often disrupts the balance between these systems, leaving survivors trapped in states of hyperarousal (fight-or-flight) or hypoarousal (freeze) (Van der Kolk, 2014). For example, a client who experienced prolonged abuse might feel perpetually on edge, unable to relax even in safe environments. Alternatively, they might struggle with feelings of numbness or detachment, indicative of dorsal vagal dominance. Polyvagal-informed therapies aim to restore the ventral vagal system’s functioning, enabling survivors to access a state of safety and connection.

Co-Regulation: Healing Through Relationships

One of the most critical components of Polyvagal Theory is the concept of co-regulation—the idea that humans require safe, attuned relationships to regulate their nervous systems. Trauma often isolates survivors, disrupting their capacity to trust and engage with others. In therapy, co-regulation occurs when the therapist provides a calm, steady presence, creating an environment of safety where the client’s nervous system can begin to stabilise (Dana, 2018).

For example, maintaining a warm, empathetic tone of voice and steady eye contact can activate the client’s ventral vagal system, promoting feelings of safety. This relational safety is particularly important for survivors of relational trauma, as it helps rebuild the trust and connection that trauma often erodes.

Activating the Ventral Vagal System: Practical Techniques

Polyvagal-informed interventions focus on activating the ventral vagal system, encouraging states of calm and connection. Key techniques include:

1. Rhythmic Breathing: Slow, diaphragmatic breathing can directly stimulate the vagus nerve, helping clients shift out of survival states and into calm (Porges, 2018).

2. Mindful Touch: Practices like placing a hand on the chest or gentle self-holding can enhance vagal tone, offering comfort and grounding.

3. Singing and Humming: Vocal exercises engage the vagus nerve through its connection to the larynx, promoting relaxation and social engagement (Dana, 2018).

4. Grounding Exercises: Focusing on physical sensations, such as the feel of the feet on the ground, helps anchor clients in the present moment, counteracting dissociation (Ogden et al., 2006).

The Transformative Power of Play and Movement

Play and creative movement are integral to engaging the ventral vagal system. Activities like dance, yoga, or even spontaneous laughter tap into the body’s natural rhythms, fostering resilience and joy. Play provides a safe, non-verbal avenue for exploring emotions and building connection, especially for clients who struggle with verbal processing (Porges, 2018).

For example, a therapy session might include playful mirroring exercises where the client and therapist mimic each other’s movements. This simple activity not only builds trust but also enhances vagal tone by engaging the social engagement system. Such practices demonstrate how creativity and spontaneity can be powerful tools for healing.

Restoring Safety and Connection

Trauma recovery requires more than resolving memories; it necessitates rebuilding the survivor’s capacity for safety and connection. Polyvagal-informed approaches offer a roadmap for this journey, leveraging the vagus nerve to create physiological and emotional shifts. By integrating techniques like co-regulation, rhythmic breathing, and playful movement, therapists can help clients rediscover their inherent resilience and re-establish trust in themselves and others.

As Porges (2011) emphasised, “Safety is the treatment.” By prioritising the nervous system’s need for safety and connection, Polyvagal Theory provides a transformative framework for healing trauma and fostering wholeness.

Applications and Challenges in Therapy: Bridging the Mind-Body Divide

Integrating body-based therapies such as Sensorimotor Psychotherapy (SP) and Focusing-Oriented Therapy (FOT) into trauma recovery presents a transformative opportunity, but it also demands nuanced consideration of the barriers survivors may face. While these approaches tap into the body’s innate capacity for healing, they often bring clients into direct contact with sensations and emotions that can feel overwhelming or alien. This duality—the body as both the site of trauma and the pathway to healing—underscores the delicate art of navigating somatic work in therapy.

Overcoming the Fear of Body Awareness

For many trauma survivors, bodily sensations are inextricably linked to feelings of vulnerability and pain. This disconnection from the body can manifest as avoidance, distrust, or even fear of physical sensations. Fisher (2017) highlights that survivors often experience their bodies as treacherous, associating physical awareness with re-experiencing traumatic memories or emotional overwhelm.

To address this, therapists can scaffold the process of body awareness by creating a foundation of safety. Introducing small, manageable practices—such as noticing the rhythm of the breath or identifying neutral physical sensations like the weight of the body on a chair—allows clients to reconnect with their bodies without feeling threatened. These initial steps build trust in the therapeutic process and help clients reclaim the body as a safe and supportive resource.

Expanding the Window of Tolerance (“Window of Capacity”)

A central goal of body-based therapies is to help clients expand their window of tolerance, the range of emotional and physiological states within which they can function without becoming overwhelmed (Ogden et al., 2006). Trauma narrows this window, leaving survivors oscillating between hyperarousal (e.g., anxiety, agitation) and hypoarousal (e.g., numbness, dissociation).

Grounding exercises, such as focusing on the texture of an object or the sensation of feet against the ground, are effective tools for bringing clients back into their window of tolerance when they feel destabilised. Co-regulation, wherein the therapist models calmness and attunement, further supports clients in navigating intense emotions. By gradually increasing their capacity to stay present with challenging sensations, survivors develop resilience and self-regulation skills that extend beyond therapy sessions.

Reclaiming Dissociated Body Parts

Trauma often fragments the relationship between mind and body, leading survivors to feel disconnected from or alienated by certain parts of their physical selves. Herman (2023) emphasises that this dissociation can be a protective mechanism, shielding survivors from the pain or terror associated with specific body areas. However, over time, this disconnection can perpetuate feelings of incompleteness and hinder recovery.

Gentle, somatic-focused dialogue can support the reintegration of dissociated body parts. For example, a therapist might guide a client to bring mindful attention to a neglected or numb area, such as a clenched fist or a tense jaw, and explore any associated sensations or memories. This process of reclaiming the body is not about forcing awareness but about creating space for curiosity and compassion. When survivors learn to approach their bodies with acceptance, they open pathways for healing that honour both their boundaries and their potential for growth.

Balancing the Challenges of Somatic Therapy

Body-based approaches require therapists to remain attuned to their clients’ readiness and capacity. While these methods hold immense promise, they also carry the risk of retraumatisation if introduced too quickly or without sufficient support. Van der Kolk (2014) cautions that therapists must pace somatic work carefully, constantly monitoring clients’ emotional and physiological responses.

Integrating psychoeducation about the body’s trauma responses can empower clients to understand their experiences and feel more in control. For example, explaining the concept of the window of tolerance or the role of the autonomic nervous system in trauma can demystify somatic sensations and reduce fear. These conversations build a collaborative therapeutic relationship, where clients feel supported in their journey toward embodied healing.

A Path Toward Wholeness

The challenges of somatic therapy are not obstacles but opportunities to deepen the healing process. By addressing barriers such as fear of body awareness, narrowing windows of tolerance, and dissociation, therapists guide survivors toward greater integration and resilience. Body-based therapies like SP and FOT reaffirm that healing is not solely about resolving trauma’s cognitive and emotional impacts but also about reclaiming the body as a place of safety, vitality, and connection.

As Herman (2023) poignantly notes, “Trauma shatters the self, but healing rebuilds it piece by piece.” Through thoughtful and compassionate somatic practices, survivors can reconnect with their bodies and emerge with a renewed sense of agency and wholeness.

Conclusion

Trauma recovery is far from linear; it is a dynamic, deeply personal journey of reconnection and rediscovery. Body-based approaches like Focusing-Oriented Therapy (FOT) and Sensorimotor Psychotherapy (SP) offer survivors a profound opportunity to engage with their bodies in ways that nurture resilience, self-trust, and healing. By addressing the physiological imprints of trauma and honouring the body’s unique wisdom, these therapies help survivors rebuild a sense of safety and wholeness.

Your body is not only the site of trauma but also the source of its healing. Through gentle curiosity, compassionate attention, and the guidance of a skilled and attuned therapist, survivors can move beyond the cycles of survival and into a life enriched with connection, agency, and flourishing. This journey is not about erasing the scars of the past but about transforming them into sources of strength and wisdom, affirming that healing is both possible and deeply human.

Continue the Convo

If these ideas resonate with you, I warmly invite you to connect with me. Whether you’re a therapist seeking insights or a survivor ready to explore somatic approaches, I’m here to support you. Book individual therapy sessions or peer consultations online. Be sure to bookmark this blog for future reflections, insights, and updates.

References

American Psychiatric Association. (2018). Understanding PTSD and PTSD treatment. Veterans Affairs PTSD Booklet. Retrieved from https://www.ptsd.va.gov

Briere, J., & Scott, C. (2015). Complex trauma in adolescents and adults: Effects and treatment. Psychiatric Clinics of North America, 38(3), 515–528. https://doi.org/10.1016/j.psc.2015.05.004

Fisher, J. (2017). Healing the fragmented selves of trauma survivors: Overcoming internal self-alienation. Routledge.

Gendlin, E. T. (1981). Focusing. Bantam Books.

Gendlin, E. T. (1996). Focusing-oriented psychotherapy: A manual of the experiential method. Guilford Press.

Hendricks, M. N. (2001). Focusing-oriented/experiential psychotherapy. In D. Cain & J. Seeman (Eds.), Humanistic psychotherapy: Handbook of research and practice (pp. 221–246). American Psychological Association.

Herman, J. L. (2023). Truth and repair: How trauma survivors envision justice. Basic Books.

Levine, P. A. (2010). In an unspoken voice: How the body releases trauma and restores goodness. North Atlantic Books.

Ogden, P., & Fisher, J. (2015). Sensory-based treatment for trauma: An overview. Journal of Trauma and Dissociation, 16(4), 355–376. https://doi.org/10.1080/15299732.2015.1037073

Ogden, P., Minton, K., & Pain, C. (2006). Trauma and the body: A sensorimotor approach to psychotherapy. W. W. Norton & Company.

Porges, S. W. (2003). The polyvagal theory: Phylogenetic contributions to social behaviour. Physiology & Behaviour, 79(3), 503–513. https://doi.org/10.1016/S0031-9384(03)00156-2

Porges, S. W. (2011). The polyvagal theory: Neurophysiological foundations of emotions, attachment, communication, and self-regulation. W. W. Norton & Company.

Porges, S. W. (2018). The pocket guide to the polyvagal theory: The transformative power of feeling safe. W. W. Norton & Company.

van der Kolk, B. A. (1994). The body keeps the score: Memory and the evolving psychobiology of posttraumatic stress. Harvard Review of Psychiatry, 1(5), 253–265. https://doi.org/10.3109/10673229409017088

van der Kolk, B. A. (2014). The body keeps the score: Brain, mind, and body in the healing of trauma. Penguin Books.

Whitfield, C. L. (2003). Memory and abuse: Remembering and healing the effects of trauma. Health Communications.