Somatic therapy focuses on the connection between mind and body. It’s based on the idea that emotional and psychological struggles don’t just live in your thoughts — they also show up physically in your body.
When you’ve experienced trauma, chronic stress, or overwhelming emotions, your body can hold onto those experiences long after the event has passed. You might notice tension in your shoulders, a tight chest when you’re anxious, shallow breathing when you’re stressed, or physical pain that doesn’t seem to have a clear medical cause.
Somatic therapy helps you tune into these physical sensations and use them as a pathway to healing. Instead of just talking about what happened or how you feel, you’re also paying attention to how your body is responding and learning to release the tension, stress, and trauma that’s been stored there.
But what does this actually look like in practice? How does paying attention to physical sensations translate into real healing?
Working Through Anxiety That Shows Up as Physical Tension
A person might come to therapy struggling with anxiety that feels overwhelming. They wake up with their jaw clenched, their shoulders tight, and a knot in their stomach that won’t go away. They’ve tried traditional talk therapy and found it helpful for understanding their anxiety, but the physical symptoms persist.
Their somatic therapist would introduce body-centered techniques to help them work with the physical manifestations of anxiety. They might start with body awareness — simply noticing where tension shows up in the body and what that tension feels like.
The patient might realize that whenever they start worrying about work, their shoulders creep up toward their ears and their breathing becomes shallow. The therapist would help them notice this pattern in real time during sessions.
Once the patient can recognize the physical signs of their anxiety, the therapist would teach grounding techniques. One exercise might involve pressing their feet firmly into the floor and noticing the sensation of support beneath them. Another could involve gentle shoulder rolls and deep breathing to release the tension they’re holding.
Over time, the patient would learn to catch themselves when the physical symptoms start — before the anxiety spiral takes over. They could feel their shoulders tensing and use that as a signal to pause, breathe, and ground themselves. The physical symptoms become information rather than something to fear.
The combination of talk therapy and somatic work can help in ways that talk therapy alone sometimes doesn’t. The person understands their anxiety intellectually, but now they also have tools to work with it when it shows up in their body.
Processing Trauma That’s Stored in the Body
Someone might come to therapy years after a car accident. Physically, they’ve healed. But they find themselves constantly on edge while driving. Their heart races, their hands sweat, and sometimes they pull over because the panic is so intense.
They know logically that they’re safe. They may have even worked through the memories of the accident in EMDR therapy. But their body still reacts as if they’re in danger every time they get behind the wheel.
A somatic therapist would explain that trauma can get “stuck” in the nervous system. Even after the conscious mind has processed what happened, the body might still be stuck in the fight-or-flight response that was activated during the traumatic event.
The therapist might use somatic experiencing techniques to help the patient’s nervous system complete the survival response that was interrupted during the accident. This would involve carefully and slowly working through the physical sensations associated with the trauma.
The therapist would have the patient recall a moment from the accident and then immediately notice what happens in their body — the tightness in their chest, the tension in their arms, the urge to brace themselves.
Instead of pushing through these sensations or trying to make them go away, the therapist would help them pendulate — gently moving back and forth between the uncomfortable sensations and a sense of safety and calm in the present moment.
They might also use titration, which means working with small pieces of the traumatic memory at a time rather than diving into the full experience all at once. This allows the nervous system to process what happened without becoming overwhelmed.
Over several months, the patient might notice that their body’s panic response while driving begins to diminish. Their hands still tense up sometimes, but they can recognize it, breathe through it, and remind their body that they’re safe.
Managing Chronic Pain Connected to Emotional Stress
A patient might come to therapy dealing with chronic pain in their lower back that’s persisted for years. Medical tests haven’t found anything structurally wrong, but the pain is real and significantly impacts their daily life.
Their doctor suggests that stress might be contributing to the pain and refers them to therapy. The patient might be skeptical — their pain is physical, not psychological.
A somatic therapist would explain that while the pain is absolutely real, chronic stress can cause the body to hold tension in ways that create physical pain. When you’re under constant stress, your muscles stay tense, your breathing becomes shallow, and your nervous system remains in a heightened state of alert.
The therapist would begin with body awareness exercises. The patient might start noticing that their back pain is worse on particularly stressful days, and that it often intensifies when they’re worried or upset even if they’re not consciously aware of the emotional connection.
The therapist would teach breathing exercises that help regulate the nervous system and release some of the muscular tension contributing to the pain. They might practice progressive muscle relaxation, where the patient systematically tenses and then releases different muscle groups.
The patient might also learn to use movement as a way to process stress before it settles into their body as pain. When they notice themselves starting to feel stressed, they could take a short walk, do some gentle stretching, or practice the breathing techniques they learned in therapy.
The pain might not disappear completely, but it could become more manageable. More importantly, the patient would feel like they have some control over it rather than feeling victimized by unpredictable pain that seems to have no cause.
Releasing Emotions Held in the Body After Loss
After experiencing a significant loss, a person might come to therapy feeling numb. They know they should be grieving, but they can’t cry. They can’t really feel much of anything. Their chest feels heavy and tight, but no emotions will come.
A somatic therapist might recognize that the person’s grief is stuck. Sometimes when emotions are too overwhelming, the body shuts them down as a protective mechanism. But the feelings don’t go away — they get trapped.
The therapist would use somatic techniques to help the patient access and release the grief that’s locked in their body. The therapist might have them notice the heaviness in their chest and the tightness they describe. They would sit with those sensations together.
The therapist might ask questions like “If that tightness had a shape, what would it be?” or “If you could give that heaviness a color, what color would it be?” These questions help the patient connect to the physical experience of their grief without needing to find words for it.
Sometimes the therapist would guide them through gentle movement — pressing their hands into their chest where they feel the heaviness, or taking deep breaths and imagining space opening up where everything feels tight.
During a session, as the patient focuses on the sensation in their chest, they might suddenly start crying. Not controlled, polite tears, but deep, body-shaking sobs. The grief that had been trapped finally has a way out.
Working with the body’s physical response to loss can give patients access to emotions that they can’t reach through talking alone.
Building a Felt Sense of Safety After Years of Hypervigilance
Someone might come to therapy having grown up in an environment where they never felt safe. As an adult, they’re objectively safe — they have a stable job, supportive relationships, and no immediate threats in their life. But they can’t shake the constant feeling of being on edge.
Their nervous system is stuck in hypervigilance. They can’t relax. They startle easily. They scan every room for exits. Intellectually they know they’re safe, but their body doesn’t believe it.
A somatic therapist would explain that because the patient’s nervous system learned to stay alert during childhood, it doesn’t know how to shift into a calm, restful state. They need to teach their body what safety actually feels like.
The therapist might start with resourcing — identifying people, places, memories, or sensations that make the patient feel even slightly more at ease. This might be thinking about a pet, remembering a peaceful vacation, or visualizing a place where they felt calm.
The therapist would have them bring these resources to mind and notice what happens in their body. Does their breathing slow down? Do their shoulders drop even slightly? Does the tightness in their jaw ease just a bit?
They might practice orienting exercises, where the patient looks around the room and names things they can see, consciously noticing that they’re in a safe space in the present moment rather than in danger from the past.
Over time, the patient’s nervous system could begin to learn that it can relax sometimes. The hypervigilance might not disappear entirely, but they could start having moments — then minutes, then longer periods — where their body feels at ease.
When Somatic Therapy Makes Sense
Somatic therapy isn’t the only approach to healing, and it’s not always the first choice for everyone. But it can be particularly helpful when you notice that your struggles show up physically in your body, when talk therapy alone hasn’t been enough, when you feel disconnected from your body or your emotions, when you’ve experienced trauma that your body still seems to remember, or when you want a more holistic approach that addresses both mind and body.
At Flourish Psychology, our therapists are trained in somatic approaches and can help you determine whether this type of work would be beneficial for you. Sometimes somatic therapy is used as the primary approach. Other times it’s integrated with other modalities like CBT, DBT, or traditional talk therapy to create a more comprehensive treatment plan.
If you’re struggling with anxiety, trauma, chronic stress, or physical symptoms that seem connected to your emotional wellbeing, somatic therapy might offer a pathway to healing that addresses not just your thoughts and feelings, but also the way your body holds and processes your experiences.
Reach out to Flourish Psychology to learn more about how somatic therapy could help you reconnect with your body and find relief from the struggles you’re facing.