Somatic Healing: Why Trauma Lives in the Body and How to Release It
Bessel van der Kolk's landmark book declared it most simply: "The Body Keeps the Score." The research behind this phrase is substantial, and its implications for trauma treatment are profound.
Trauma is not only a memory. It is a pattern of bodily organisation — of tension, bracing, breath-holding, and neurological activation — that persists long after the traumatic event has passed. The thinking brain can know that a situation is safe while the body remains in a state of physiological emergency.
Understanding this changes what healing looks like.
The Nervous System and Trauma
The polyvagal theory, developed by neuroscientist Stephen Porges, describes three states of the autonomic nervous system that are particularly relevant to trauma:
Ventral vagal (safe and social): The system is settled, social engagement is possible, attention can move between the external world and the internal world.
Sympathetic (fight or flight): The body mobilises energy for action — heart rate increases, muscles tense, attention narrows to threat.
Dorsal vagal (freeze or collapse): The system shuts down — dissociation, flatness, immobility.
Trauma creates dysregulation in this system. Survivors often oscillate between sympathetic hyperactivation (hypervigilance, anxiety, rage) and dorsal vagal hypoactivation (numbness, dissociation, exhaustion), without access to the ventral vagal zone of regulated safety.
What Somatic Therapy Offers
Somatic (body-based) approaches to trauma work with the physiological dimension of trauma rather than primarily with its narrative and cognitive dimensions.
This does not mean ignoring the story — but it means recognising that the story alone cannot update the nervous system. The body learned the threat; the body needs to be involved in learning safety.
Somatic approaches include:
Somatic Experiencing (SE): Developed by Peter Levine. Works with body sensations in a titrated way, helping the nervous system complete the defensive responses that were interrupted during trauma.
Sensorimotor Psychotherapy: Integrates somatic interventions with attachment theory and cognitive processing.
EMDR (Eye Movement Desensitisation and Reprocessing): Uses bilateral stimulation (typically eye movements) alongside trauma narrative processing, engaging the brain's natural information-processing systems.
Yoga and movement: Trauma-sensitive yoga, developed in collaboration with clinical research, helps survivors develop a friendly relationship with their body and build the capacity for interoception (inner sensing) that trauma disrupts.
What It Feels Like
Working somatically on trauma can feel unfamiliar and sometimes strange. The therapist might slow the conversation down and ask: "What do you notice in your body right now?" Or they might invite you to track a sensation as it shifts. Or they might work with a movement impulse — a reaching that wants to happen, a boundary that wants to be set.
The work can bring up material that is not primarily in words — images, impulses, emotions. This is the body's processing, and it is as valid and important as the cognitive processing that verbal therapy primarily engages.
Beginning
If you are curious about somatic work, the most important first step is finding a therapist who is trained in it. Somatic work done poorly — too fast, without adequate safety-building — can be overwhelming. Done well, it is often described as a way of finally coming home to one's body after years of feeling like a stranger to it.
The body is not the enemy. It is the location of healing.