Somatic experiencing: using interoception and proprioception as core elements of trauma therapy

Summary & key facts

This paper explains a theory behind Somatic Experiencing, a type of trauma therapy that asks people to pay close attention to sensations inside the body and to movement. The authors describe how this focus on inner feeling and gentle body-based techniques might help finish interrupted fight-or-flight reactions and reduce long-term stress. They use a composite case study to show how the approach could work in the brain and nervous system, and they say Somatic Experiencing could add to existing talk therapies. The paper is a clinical theory and example, not proof from large controlled studies, so more research is needed to test the ideas.

Key facts:

• Somatic Experiencing is a therapy that guides people to notice bodily sensations like heartbeat, breathing, muscle tension, and the sense of the body in space.
• The authors argue that paying attention to these inner sensations and using body-based imagery can help complete interrupted protective reactions and lower excessive nervous-system arousal caused by trauma or chronic stress.
• They introduce the idea of a core response network, which is a collection of brain and body systems that control automatic reactions, emotions, movement, and arousal; the theory says trauma can make this network work poorly.
• The paper uses a combined example case from clinical practice to show how Somatic Experiencing techniques might restore better function in that core response network.
• The authors suggest Somatic Experiencing can be used alongside cognitive therapies and exposure therapies, and that similar body-focused processes may underlie benefits from meditation and other somatic practices.
• This work is a theoretical and clinical description rather than results from large, carefully controlled studies, so its effectiveness and mechanisms are proposed but not definitively proven.

Abstract

Here we present a theory of human trauma and chronic stress, based on the practice of Somatic Experiencing® (SE), a form of trauma therapy that emphasizes guiding the client's attention to interoceptive, kinesthetic and proprioceptive experience. SE™ claims that this style of inner attention, in addition to the use of kinesthetic and interoceptive imagery, can lead to the resolution of symptoms resulting from chronic and traumatic stress. This is accomplished through the completion of thwarted, biologically based, self-protective and defensive responses, and the discharge and regulation of excess autonomic arousal. We present this theory through a composite case study of an SE treatment; based on this example, we offer a possible neurophysiological rationale for the mechanisms involved, including a theory of trauma and chronic stress as a functional dysregulation of the complex dynamical system formed by the subcortical autonomic, limbic, motor and arousal systems, which we term the core response network (CRN). We demonstrate how the methods of SE help restore functionality to the CRN, and we emphasize the importance of taking into account the instinctive, bodily based protective reactions when dealing with stress and trauma, as well as the effectiveness of using attention to interoceptive, proprioceptive and kinesthetic sensation as a therapeutic tool. Finally, we point out that SE and similar somatic approaches offer a supplement to cognitive and exposure therapies, and that mechanisms similar to those discussed in the paper may also be involved in the benefits of meditation and other somatic practices.

Topics

Mental Health and Psychiatry Psychosomatic Disorders and Their Treatments Psychotherapy Techniques and Applications

Categories

Health Sciences Medicine Psychiatry and Mental health

Tags

Anxiety Arousal Cognition Cognitive psychology Developmental psychology Exposure therapy Interoception Kinesthetic learning Neuroscience Perception Proprioception Psychiatry Psychology Psychotherapist

Conditions & symptoms

Anxiety Burnout PTSD Anxiety or worry Chronic pain Difficulty focusing Feeling disconnected from others Panic Poor sleep Sadness or low mood