What Is Somatic Therapy and How Does It Help With Anxiety?

I'm sure you've had the experience when you logically know that you are safe, but your body seems unconvinced. Maybe your heart races before an important conversation, your stomach drops when you receive a text, or you suddenly feel overwhelmed in a situation that doesn't appear particularly threatening. In these moments, you might understand exactly why you are feeling anxious but still find yourself unable to stop the physical response.

The gap between what we know intellectually and what our body is experiencing is one reason I lean into somatic approaches, nervous system education and Acceptance and Commitment Therapy (ACT) in my counselling sessions.

I have always been interested in the connection between the mind and body. As a lifelong athlete, with a background in Health and Physical Education, Biology, coaching and counselling, I have spent much of my life paying attention to how the body responds to stress, challenge and recovery. That curiosity has carried into my work as a counsellor, where I'm interested in helping clients understand not only what they are thinking and feeling, but also what is happening in their bodies and what their nervous system may be responding to.

What Is Somatic Therapy?

Somatic therapy is a broad term used to describe therapeutic approaches that include the body as part of understanding emotional experiences. Traditional talk therapy often focuses on thoughts, beliefs, emotions, memories and behaviours. Somatic approaches recognize that our bodies are also involved in how we experience stress and that sometimes the body is responding before our conscious mind has had a chance to catch up.

Dr. Peter Levine is one of the best-known figures in this area. He is the founder of Somatic Experiencing®, an approach developed around the idea that our responses to stressful and traumatic experiences involve the nervous system as well as our thoughts and memories. Levine became interested in how animals respond to threat and what happens when our natural protective responses are overwhelmed or interrupted. His work suggests that the way we respond to threat can continue to influence us after the original experience is over.

This can help explain why a person can have a surprisingly strong physical or emotional reaction to something that seems relatively minor in the present. A current situation may contain something that reminds the nervous system of an earlier experience, even if we aren't consciously making that connection.

When we feel threatened, overwhelmed or under pressure, our bodies respond automatically. We may notice our heart rate increase, our breathing become shallow or our muscles tighten. We might feel nauseous, restless, shaky or unable to think clearly. Other people may experience the opposite and feel tired, numb, disconnected or shut down.

Somatic approaches encourage us to become curious about these responses rather than immediately judging them or trying to make them disappear. What are you noticing in your body? What happened just before the feeling appeared? Does the sensation feel familiar? Is there something about the current situation that might be reminding your nervous system of something from the past?

Why Does Our Body React When We Are Actually Safe?

Our nervous system is designed to help us survive. We are constantly taking in information from the world around us and scanning for cues that may indicate safety or danger, often without conscious awareness. We notice facial expressions, tone of voice, body language, smells, sounds and subtle changes in our environment. We may pick up on tension in a room before anyone has said a word.

This is useful. Our brains and bodies are designed to notice potential threats quickly. The problem is that our nervous system doesn't always distinguish between something that is dangerous now and something that simply reminds us of something that was dangerous in the past.

Stressful experiences can become layered over time. A difficult experience in the present may activate feelings connected to an earlier experience of rejection, conflict, embarrassment, loss or feeling unsafe. Sometimes we know exactly what has been triggered. Other times, the connection is outside our conscious awareness. You can read more about this in my blog Are you often feeling triggered?!

You may logically know that your partner is not angry with you, but their tone of voice may remind your body of a previous relationship. You may know that your boss's email is simply asking a question, but your stomach drops as soon as you see their name because your nervous system associates that kind of message with previous criticism. You may walk into a room and immediately feel uncomfortable without being able to explain why.

The reaction doesn't necessarily mean there is danger. It means your nervous system has noticed something that feels familiar.

Understanding this can be incredibly helpful because it allows us to stop asking, “What's wrong with me?” and start asking, “What is my nervous system responding to?”

How Does Somatic Therapy Connect With Polyvagal Theory?

Somatic therapy and polyvagal theory are often discussed together because both focus on the relationship between the nervous system, our sense of safety and our responses to stress. They are not the same thing, and Somatic Experiencing® is not simply an application of polyvagal theory. However, polyvagal-informed concepts can provide a useful framework for understanding why our nervous system may respond differently depending on what it perceives around us.

Polyvagal theory, developed by Dr. Stephen Porges, focuses on how the autonomic nervous system responds to cues of safety and danger. A polyvagal-informed perspective can help us understand why we may feel calm and connected in one situation, highly activated in another, or shut down and disconnected when we become overwhelmed.

What I find particularly useful about this way of thinking is that it gives us another way to understand our reactions. Anxiety, anger, avoidance or shutting down are not necessarily signs that something is wrong with us. They are often protective responses from a nervous system that is trying to keep us safe.

The stress response is not always accurate. Our nervous system can sound the alarm when there isn't actually a threat. The goal isn't to blindly trust every physical sensation as evidence that something is wrong. Instead, we can learn to recognize the response, understand that it may be protective, and then assess what is actually happening.

If you'd like some simple, everyday ways to support your nervous system, you may also want to read my article on resetting your nervous system through movement, nature, rest and connection: How to Reset Your Nervous System This Summer.

Where Does ACT Fit In?

This is where Acceptance and Commitment Therapy fits particularly well with somatic and nervous system-informed work.

My approach draws on ACT to help clients develop psychological flexibility. Rather than teaching us that difficult thoughts and feelings need to disappear before we can move forward, ACT helps us change our relationship with those experiences. We can notice a thought without automatically believing it, make room for an uncomfortable emotion and choose actions that are consistent with our values.

This is particularly relevant to anxiety because we often make anxiety worse by fighting it. We feel our heart racing and become frightened by the sensation. We notice our stomach is tight and start worrying about why we feel sick. We realize we're anxious and then become anxious about being anxious.

Now there are two problems: the original stress response and our reaction to having the stress response.

Somatic awareness gives us an opportunity to interrupt that cycle. We can notice what is happening in the body without immediately judging it. We can acknowledge, “My heart is racing. My chest feels tight. My body is having a stress response.” We don't have to decide immediately that something is wrong.

ACT then helps us make room for the experience rather than getting caught up in trying to eliminate it. We can become curious about the feeling, notice the thoughts that accompany it and ask ourselves what matters in this situation. You can learn more about ACT and how it can help you move toward what matters most, even when difficult thoughts and feelings are present, in my article on ACT Therapy.

The goal isn't to convince ourselves that we shouldn't be anxious. It's to create enough space that anxiety doesn't automatically determine what we do next.

Notice the Response, Then Decide What to Do

When I work with anxiety and stress responses, I often think about the process as notice,  regulate, understand, assess and move forward. It isn't always this neat or linear, but it can be a useful way to think about what is happening.

First, notice the response. What are you feeling in your body? Maybe your heart is racing, your breathing has changed, your shoulders are tense or your stomach feels unsettled. Instead of immediately trying to push the feeling away, see if you can simply notice it.

The next step is to support your body. Slow, intentional breathing can help. So can grounding, movement, noticing your surroundings or other strategies that help you settle. The purpose isn't to become perfectly calm. It's to bring the intensity down enough that you can think more clearly and assess the situation.

Then become curious about it. What happened just before the feeling appeared? Is there something about the situation that feels familiar? Could your nervous system be responding to something from the past? You may find an answer, or you may not. We don't always need to know exactly where a response came from in order to work with it.

When we are highly activated, it can be difficult to access the part of our brain involved in reasoning, planning and making thoughtful decisions. Once the intensity has come down, we have more capacity to step back and ask, “What is actually happening here? Is there a real threat? Is there something I need to address? Or has my nervous system responded to something that feels familiar?”

If there is a genuine problem, we can respond to it. If we determine that we are safe, we can choose to move forward.

And this is an important distinction: regulating your nervous system doesn't mean avoiding the thing that makes you anxious. Sometimes it means getting calm enough to approach it.

We Don't Need to Get Anxious About Our Anxiety

One of the ideas I return to often is that we don't need to get anxious about our anxiety.

Anxiety is uncomfortable, but discomfort isn't necessarily danger. If we can learn to recognize the physical sensations of anxiety as a stress response, we may be less likely to interpret those sensations as evidence that something terrible is happening.

This doesn't mean ignoring symptoms or assuming that every physical sensation is anxiety. It means developing a little more curiosity about what is happening rather than immediately becoming frightened by it.

The stress response shows up. We acknowledge it. We breathe. We give the body some support. We step back and assess the situation. Then we decide what to do.

Often, this allows us to ride the anxiety wave rather than fighting it. And when we stop adding fear and judgment to the original feeling, the experience can move through more quickly.

This is where ACT is so helpful. You don't have to wait until anxiety disappears before you do something important. You can feel anxious and have the difficult conversation. You can feel nervous and get on the plane. You can feel uncomfortable and still move toward something that matters to you.

The goal isn't to eliminate every uncomfortable feeling. It's to develop the flexibility to experience the feeling without allowing it to completely dictate your behaviour.

Who Might Benefit From This Approach?

This combination of somatic awareness, nervous system education and ACT can be particularly useful for people who understand their patterns intellectually but still feel stuck when their body reacts. You may know why you have anxiety. You may understand where certain patterns came from. You may have spent years talking about your experiences and have a great deal of insight, yet still find yourself reacting in ways that don't seem to match what you know logically.

It can also be helpful for people experiencing chronic stress, high-functioning anxiety, ADHD and emotional dysregulation, as well as people who have experienced difficult or overwhelming situations that continue to influence their responses today. Some people describe feeling as though they are “stuck in their heads”, they are very good at analyzing their thoughts but less comfortable noticing what is happening in their bodies.

For these clients, incorporating the body into therapy can provide another piece of the puzzle. Instead of continuing to analyze why you feel a certain way, you can begin to notice what the feeling actually feels like, understand the protective response underneath it and practice responding differently.

Of course, this approach isn't right for everyone. Therapy should always be individualized and paced according to the person. For some people, focusing on physical sensations can initially feel uncomfortable or overwhelming, particularly when working with trauma. A good therapist will work collaboratively and make sure that the approach feels safe and manageable.

The Goal Isn't Perfect Regulation

There is a lot of discussion about “nervous system regulation” online, and sometimes it can sound as though the goal is to remain calm all the time. I don't think that's realistic or even desirable.

We are supposed to experience stress, excitement, fear, frustration and sadness. Our bodies are supposed to respond to things that matter to us. The goal isn't to eliminate the stress response; it's to understand it and become more flexible in how we respond.

Can you notice when your body is becoming activated? Can you recognize that your nervous system may be trying to protect you? Can you become curious instead of judgmental? Can you give yourself enough space to assess whether there is actually a threat? And if there isn't, can you choose to move forward even though some anxiety may still be present?

For me, this is where somatic awareness, nervous system education and ACT come together so well. The body gives us information, but it doesn't have to make every decision. Our thoughts and past experiences influence how we interpret the present, but they don't have to determine what we do next.

We can notice the response, understand it, support the body, assess the situation and decide how we want to move forward.

Looking for Somatic-Informed or ACT Counselling?

At Advance Counselling Services, we believe therapy works best when we look at the whole person, including thoughts, emotions, behaviours, relationships, past experiences and what is happening in the body and nervous system.

My approach draws from Acceptance and Commitment Therapy (ACT), nervous system education, somatic awareness and other evidence-informed approaches. Therapy is adapted to the individual rather than following a single formula.

You don't have to get rid of anxiety before moving forward. Sometimes the first step is simply learning to notice the response, become curious about what may be happening, support your body and assess the situation. From there, you can decide how you want to respond and move forward, even if some anxiety is still present.

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Advance Counselling offers in-person counselling and walk-and-talk counselling in North Vancouver, as well as secure online counselling across British Columbia, Manitoba, Saskatchewan, Yukon, and the Northwest Territories. 

This article was written by Ashleigh Gold, MA, RCC, co-owner of Advance Counselling. Ashleigh and co-owner Natasha Chalke provide compassionate, evidence-based counselling for couples, adults, teens, and families navigating anxiety, ADHD, trauma, relationship challenges, parenting, co-parenting, and life transitions.