Somatic experiencing (SE) is a form of alternative therapy aimed at treating trauma and stress-related disorders, such as post-traumatic stress disorder (PTSD). The primary goal of SE is to modify the trauma-related stress response through bottom-up processing. The client's attention is directed toward internal sensations (interoception, proprioception, and kinaesthesis) rather than cognitive or emotional experiences. Peter A. Levine developed the method. SE sessions are typically in-person and involve clients tracking their physical experiences. Practitioners are often mental health practitioners such as social workers, psychologists, therapists, psychiatrists, Rolfers, Feldenkrais practitioners, yoga and Daoyin therapists, educators, clergy, occupational therapists, etc.
Theory and methods
Basis Somatic experiencing, also known as somatic therapy, is heavily predicated on psychoanalyst Wilhelm Reich's theories of blocked emotion and how emotion is held and released from the body. It differs from traditional talk therapies such as cognitive behavioral therapy, which has a primary focus on the mind and not the body, by prioritizing disturbing thoughts and behavior patterns and seeking to change them. Instead, somatic therapy treats the body as the starting point for healing. It is less about desensitizing people to uncomfortable sensations and more about relieving tension in the body. Many Western somatic psychotherapy approaches are based on either Reich or Elsa Gindler. Gindler's vision preceded Reich's and greatly influenced him. Gindler's direct link to the United States was Charlotte Selver. Selver greatly influenced Peter Levine's work and the development of fine somatic tracking. Selver taught thousands of Americans her "sensory awareness" method at the Esalen Institute, including Levine. Somatic experiencing, like many of its sister modalities, is indebted to both Gindler and Reich. Each method has its twist that differentiates it in style "in a manner alike to the different sects of an overarching religion" and even becoming "cult-like" at one time.
Definitions Peter Payne and colleagues describe SE as "not a form of exposure therapy" in that it "avoids direct and intense evocation of traumatic memories, instead approaching the charged memories indirectly and very gradually." Leitch and colleagues describe the approach similarly as "working with small gradations of traumatic activation alternated with the use of bodily resources. Working with small increments of traumatic material is a key component of SE, as is the development of somatic resources". In SE people "gently and incrementally reimagine and experience" and are "slowly working in graduated 'doses'". Anderson and colleagues, however, states that SE "includes techniques known from interoceptive exposure for panic attacks, by combining arousal reduction strategies with mild exposure therapy."
Systematic desensitization One of the first exposure therapies, systematic desensitization, which Joseph Wolpe developed in the 1940s to treat anxiety disorders and phobias, is similarly described. Wolpe's systematic desensitization "consists of exposing the patient, while in a state of emotional calmness, to a small 'dose' of something he fears" using imaginal methods that allow the therapist to "control precisely the beginning and ending of each presentation". This graduated exposure is similar to the SE concept of "titration". Wolpe also relied on relaxation responses alternating with incremental or graduated exposure to anxiety-provoking stimuli, and this practice was standard within cognitive-behavioral protocols long before somatic experiencing was trademarked in 1989.
Pendulation One element of somatic experiencing therapy is "pendulation", a supposed natural intrinsic rhythm of the organism between contraction and expansion. The concept and its comparison to unicellular organisms can be traced to Wilhelm Reich, the father of somatic psychotherapy. Alexander Lowen and John Pierrakos, both psychiatrists, built upon Reich's foundational theories, developing Bioenergetics, and also compared the rhythm of this life-force-energy to a pendulum. The SE concept of the "healing vortex" is grounded in Ackert Ahsen's "law of bipolarity" according to Eckberg. Levine credits his inspiration for the healing vortex to a dream and not Ahsen. This principle involves the pendulatory tendency to weave back and forth between traumatic material and healing images and parasympathetic responses. Ahsen's "principle of bipolar configurations" asserts that "every significant eidetic state involves configuration . . . around two opposed nuclei which contend against each other. Every ISM of the negative type has a counter-ISM of the positive type."
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