Somatic therapy
Somatic work means paying close attention to what the body is already doing, and treating it as information rather than as a symptom to be overridden. It is one of the ways I work, woven through individual psychotherapy in Vero Beach and by video across Florida.
Starting with what the body is already doing.
Somatic simply means of the body. In practice, somatic therapy is less a technique than a direction of attention. Alongside what you are saying, we notice what is happening physically as you say it: the breath getting shallow, the shoulders rising, a sudden heaviness, a flicker of restlessness in the legs, the moment your attention goes somewhere else.
Those responses are not random. They are the nervous system doing its job, organizing itself around what it perceives as safe or unsafe. Startle, bracing, shutdown, disrupted sleep and a racing heart are all ways a system tries to protect itself. The trouble comes when they keep running long after the conditions that called for them have passed. That is a central idea of trauma and PTSD work as I understand it.
Attention rather than bodywork.
Somatic work here is part of talk therapy: attention to what the body is doing, not bodywork or massage. The word somatic covers a wide range of practices; here, it means noticing physical responses alongside what you are saying. You can decide what you want to explore.
The work happens through attention and conversation. I might ask what you notice in your body as you describe something, or invite you to slow down when I see your breathing change. You can always say no, or say that you do not notice anything, which is itself useful information. Somatic work is also entirely possible by video; it depends on attention, not on being in the same room.
The body often shifts before the thoughts do.
Many people arrive having already understood their difficulties very well. They can explain where the anxiety comes from and why the pattern formed. And yet understanding has not changed how they feel. That is common, and it is not a failure. Insight lives in one part of the system; the alarm lives somewhere older and faster.
Working with the body gives a second route in. When the nervous system has a direct experience of settling, even briefly, something registers that explanation alone cannot produce. Often the change shows up physically first, as a slightly easier breath or a quicker recovery after a hard conversation, and the thoughts catch up later. This is one reason somatic attention is useful with anxiety and with emotional dysregulation, where the reaction tends to arrive before the thought.
Capacity before intensity.
One of the four principles set out on how I work is capacity before intensity, and it is nowhere more important than here. Turning attention toward the body can bring up strong sensation and emotion quickly. If there is not enough steadiness around that, the experience can overwhelm rather than help.
So somatic work starts small. We find what settles you as well as what activates you, and we spend time there. We approach difficult material in small doses and come back out, a rhythm that builds tolerance gradually. If something gets too intense, we slow down or stop. Going slowly is not a delay; it is what makes the work hold.
Talking about it will make things worse is an objection people bring to therapy, and with trauma it is sometimes true. Somatic work offers a way to engage with difficult experience without having to narrate every detail of it.
Somatic work and homeostatic patterning.
The framework I am developing, Functional Systems Regulation Theory, treats a person as a living system that organizes itself to stay stable under the conditions it has known. One part of that framework, homeostatic patterning, describes how those stabilizing arrangements become fixed and keep running even when they are no longer needed.
Somatic attention is one of the most direct ways to see those patterns in action. The breath that holds, the jaw that clenches, the collapse into tiredness when something important comes up: these are homeostatic patterns expressed physically. Noticing them, and giving the system repeated experiences of not needing them, is part of how they begin to loosen.
Somatic work is rarely the only thing happening in a session. I also draw on psychodynamic therapy, Internal Family Systems, CBT and mindfulness-based work, depending on what is useful. It sits inside individual psychotherapy rather than being offered as a separate service.
Frequently Asked Questions
- Will I have to lie down or do physical exercises?
- Somatic work here is part of talk therapy: attention to what the body is doing, not bodywork or massage. We can talk about what feels useful to notice.
- Does somatic therapy work over video?
- Yes. It depends on noticing, not on physical proximity, so it works well by video from anywhere in Florida.
- What if I do not notice much in my body?
- That is common and is useful information in itself. Numbness or distance from the body is also a pattern, and we work with it gently.
Therapy outcomes vary from person to person. No result is promised or guaranteed.