Somatic & Body-Oriented Therapies
Traumatic experience leaves the autonomic nervous system dysregulated and defensive responses incomplete, so treatment works through titrated attention to bodily sensation and the completion of thwarted survival responses rather than through narrative or cognitive processing.
Trauma is held in the body’s incomplete defensive responses, not only in the story about it.
Who built it
Wilhelm Reich
1897–1957Analyst
Character armour: the idea that psychological defense is embodied as chronic muscular tension. The origin of the body-oriented tradition, and a figure whose later work departed entirely from science.
Character analysisPeter Levine
Psychologist
Somatic Experiencing: titration, pendulation, and the completion of thwarted defensive responses, drawing on observation of how animals discharge survival activation.
Somatic ExperiencingPat Ogden
Psychotherapist
Sensorimotor Psychotherapy: integrated body-oriented technique with attachment theory and a phase-oriented trauma framework.
SensorimotorBessel van der Kolk
Psychiatrist
Popularised the neurobiological framing of trauma and the body; a major force in the field’s attention to somatic approaches, and a figure whose confident claims have outrun the evidence in places.
Trauma neurobiology
Theory of personality
The body-oriented traditions hold that experience is encoded somatically and that the autonomic nervous system’s state determines what psychological work is possible. Porges’ polyvagal theory is the most cited framework: a hierarchy of ventral vagal social engagement, sympathetic mobilisation, and dorsal vagal shutdown, with neuroception — unconscious appraisal of safety — determining which is active.
The window of tolerance
Siegel’s concept, and the most useful idea this tradition has contributed: a zone of autonomic arousal within which a person can think, feel and relate simultaneously. Above it is hyperarousal — panic, rage, flooding; below it is hypoarousal — numbness, shutdown, dissociation. Therapeutic work is only possible inside the window, and much of somatic technique is about widening it and returning to it.
Theory of psychopathology
Trauma symptoms are understood as incomplete self-protective responses. The fight or flight that could not be executed remains as unresolved activation in the nervous system, producing hyperarousal, hypoarousal, or oscillation between them. The narrative is secondary; the physiology is the problem.
Theory of change
- 1Establish resources — internal and external experiences of safety and competence, located in the body.
- 2Titration: contact a small, tolerable amount of activation rather than the whole memory.
- 3Pendulation: move between activation and resource, building the capacity to go and return.
- 4Track sensation without narrative; the story is deliberately kept peripheral.
- 5Complete the thwarted defensive response — the movement that could not be made — in slow motion.
- 6Discharge and integration, with the window of tolerance widened.
Key concepts
The vocabulary you need to read the literature and to be understood in supervision.
Where it sits in the transtheoretical grid
Which change processes the system leans on, and at what level of content it aims.
- Counterconditioning
Substituting an incompatible response for the problem response - relaxation, assertion, exposure, defusion, opposite action.
- Catharsis / dramatic relief
Experiencing and expressing affect about the problem, whether by corrective emotional experience or by evoking what has been avoided.
- Consciousness raising
Increasing information about oneself and the problem - feedback, interpretation, education, observation.
- Helping relationship
Being open and trusting about problems with someone who cares; the relationship as vehicle, and as medicine in its own right.
- Symptom & situational problems
- Intrapersonal conflicts