Somatic Therapies

Christine Caldwell, founder of the Somatic Psychology Department at Naropa University in Boulder, Colorado, traces the history of body-oriented methods (Caldwell & Hendricks, 1997).

She particularly traces the origins of somatic therapies in Psychoanalysis: starting with Freud, Josef Breuer who focused on the nervous system, Ferenczi who asked his patients to abstain from certain repetitive movements to exacerbate the emotional charge they were dissipating, then Reich who had identified neuroses as character armor manifesting as tensions in certain parts of the body (Reich 1949).

Eugene Gendlin was probably one of the first to emphasize the felt sense of bodily sensations in his Focusing psychotherapy (Gendlin 1981). Focusing involves paying attention to the bodily sensations associated with a problem or belief and allowing symbols to emerge. It is already an exploration of the unconscious through bodily sensations.

More recently, bodily sensations have received more attention thanks to the discoveries of Damasio and his Somatic Marker Hypothesis (Bechara & Damasio, 2005). It has now been shown that the integration of bodily sensations impacts behaviors and emotional processing. It is likely that somatic approaches will garner increasing interest from CBT.

Another major influence is Steven Porges's Polyvagal Theory (Porges, 2011), which describes the different modes of activation of the autonomic nervous system, with the sympathetic and parasympathetic branches of the vagal nerve system. To simplify, these are the Fight, Flight, Freeze modes.

Peter Levine was one of the first to study the nervous system's regulatory systems in animals under dangerous conditions. He then applied these observations to help patients overcome chronic stress linked, according to his model, to a blockage of the autonomic nervous system in Freeze mode. This led to Somatic Experiencing therapy (Levine, 1997), which is recognized as an effective method for managing psychotrauma. There is evidence of its effectiveness in treating PTSD (Brom et al. 2017).

Methods like Somatic Experiencing can be expanded to address not only shock traumas, such as accidents, violence, etc., but also developmental traumas where a child is exposed to chronic stress situations or even more benign conditions that lead to an atrophy of the Self, porous boundaries, etc.

In this case, a central idea of somatic therapies is that our experience is organized into a system involving different channels, such as sensations, emotions, thoughts, sight, etc., movements, tensions and postures, and fundamental beliefs such as "I am worthy of love," or conversely "I am a bad object." Pat Ogden speaks of Core Organizers of experience (Ogden 1997), a central idea in Hakomi therapy. These organizers of our experience are intimately linked: with a belief like "I am a bad object" are associated thoughts, emotions, memories, bodily sensations, muscle tensions, and postures. One cannot address the belief without involving the other organizers, which is why cognitive restructuring alone does not work (according to testimonials from CBT practitioners). In somatic therapy, all these organizers are activated to access plasticity of the deep and unconscious organizers. Generally, mindfulness is brought in to study the organizers and their interconnections, networks participating in a pattern are activated, and a corrective experience (for example, the sensation of being loved) is provided. This is typically how developmental traumas are addressed.

Among the methods that address developmental and attachment trauma, we note NARM (Neuro Affective Relational Model) (Heller, 2012), Sensorimotor Psychotherapy (Ogden 2015), Hakomi (Kurtz 2015), and Somatic Transformation (Stanley 2025).

Today, somatic methods have a certain influence in the United States; there are 3 Master's degrees specializing in Somatic Psychotherapy, and these methods are used for psychedelic-assisted therapies (Mischke-Reeds, 2025). Some works are translated into French with some training courses available in France.

Hakomi Somatic Therapy

Hakomi (Kurtz, 2015; Weiss et al., 2015) is a therapy modality in which I am training; it is a major inspiration in my orientation.

It is difficult to describe the processes at play in a Hakomi session, and I think one needs to experience it to fully grasp it, but I will try to outline some principles.

Firstly, there is a great emotional proximity between the therapist and the client; a Hakomi therapist learns to be very finely attuned to the patient's internal state and adapts in real-time to their changes. This is analogous to the attunement observed between a caregiver and a baby. This very fine attunement allows for great safety in the client and the gradual opening of defenses. It allows for welcoming and regulating all states that may arise.

Once this "therapeutic bubble" is established, and following either the therapist's observations or a problem presented by the client, the therapeutic process can begin. The idea is to study in mindfulness how the said problem arises in the patient. What thoughts, emotions, sensations, movements, postures are manifest, and what unconscious mechanisms, beliefs, learnings, traumas are underlying?

By studying manifest phenomena in mindfulness and immersing the client in this experience, one can access deeper unconscious structures and transform them.

Here is a commented example of a Hakomi therapy session by the method's founder, Ron Kurtz, where a gesture is used as an entry point for accessing a traumatic event and transforming the associated memory/belief.

Bibliography

Bechara, A., & Damasio, A. R. (2005). The somatic marker hypothesis : A neural theory of economic decision. Games and Economic Behavior, 52(2), 336‑372.

Brom, D., Stokar, Y., Lawi, C., Nuriel‐Porat, V., Ziv, Y., Lerner, K., & Ross, G. (2017). Somatic Experiencing for Posttraumatic Stress Disorder : A Randomized Controlled Outcome Study. Journal of Traumatic Stress, 30(3), 304‑312.

Caldwell, C., & Hendricks, K. (Eds.). (1997). Getting in touch : The guide to new body-centered therapies; [founders and leaders in the field tell how Hakomi, Dreambodywork, The Moving Circle and other techniques can help you] (1. Quest ed). Quest Books.

Heller, L. (with LaPierre, A.). (2012). Healing Developmental Trauma : How Early Trauma Affects Self-Regulation, Self-Image, and the Capacity for Relationship. North Atlantic Books.

Gendlin, E. T. (1981). Focusing (2nd ed., new rev. instructions). Bantam Books.

Kurtz, R. (2015). Body-Centered Psychotherapy : The Hakomi Method. LifeRhythm.

Levine, P. A. (with Frederick, A.). (1997). Waking the Tiger : The Innate Capacity to Transform Overwhelming Experiences (1st ed). North Atlantic Books.

Mischke-Reeds, M. (with Sylvae, J.). (2025). Embodied Psychedelic Therapy : A Somatic Guide (1st ed). W. W. Norton & Company, Incorporated.

Ogden, P. (with Fisher, J.). (2015). Sensorimotor Psychotherapy. W. W. Norton & Company, Incorporated.

Ogden, P. (1997). Hakomi Integrative Somatics : Hands-On Psychotherapy. In Getting in touch : The guide to new body-centered therapies; (1. Quest ed). Quest Books.

Porges, S. W. (2011). The Polyvagal Theory. W. W. Norton & Company, Incorporated.

Reich, W. (1949). Character-analysis, 3rd ed. (p. xxvi, 519). Orgone Institute Press.

Stanley, S. (2025). Relational and body-centered practices for healing trauma : Lifting the burdens of the past (Second edition). Routledge.

Weiss, H., Johanson, G., & Monda, L. (2015). Hakomi mindfulness-centered somatic psychotherapy : A comprehensive guide to theory and practice. W. W. Norton & company.