Frequently asked questions.

The word “somatic” just means “of the body.” There are many different types of somatic therapy or somatic practices and the type that I use is grounded in Polyvagal Theory and attachment theory, such as Somatic Experiencing (SE), NeuroAffective Relational Model (NARM), Trauma Sensitive Yoga, iRest yoga nidra, EMDR, and Internal Family Systems (IFS). The difference between Somatic Experiencing and a lot of the “somatic exercises” you often see on social media, is that Somatic Experiencing works with the implicit, or unconscious movements of the body, which is the root of PTSD, or what is often referred to as shock trauma. This is done to complete thwarted self-protective responses and build the capacity to contain big emotions and regulate the nervous system. Regulation is not synonymous with relaxation. We can be angry and regulated. We can be experiencing grief and sadness and be regulated.  Dysregulation occurs when the state of our nervous system or emotional experience is not in alignment with the present moment experience. It is an incomplete stress response. Although we will sometimes use directed and conscious movement, it is often to prime the body for the implicit movements that may be incomplete, as a resource to be used while re-negotiating a trauma response, or to build body-awareness. We don’t use these practices as a means of inciting a cathartic experience or just to induce temporary states of relaxation. A lot of the “somatic” practices and exercises we see advertised on social media are just management strategies for internal states. Management strategies aren’t a bad thing, per se, they just do not lead to lasting and integrated change in the nervous system. It’s temporary. When it comes to complex trauma, the somatic work we do together will look different, is more subtle, and can look more like traditional talk therapy, because we are working with the attachment, sense of self, identity, and survival strategies, not so much brainstem survival responses. Click here to learn more about each modality I offer.

“Top-down” approaches to therapy are focusing on cognition (thoughts, beliefs, perceptions, meaning making). Another way of thinking about this is it focuses on the functions of our frontal lobes of our brains, whereas “bottom-up” approaches are focused on the body, the nervous system, and the “bottom” parts of our brains that function automatically and subconsciously as survival responses, as well as our emotional experience in our bodies. A holistic approach to treatment should include both top-down and bottom-up approaches for the most effective outcomes.

-Our first session will be an intake session that will consist of taking information about your history, including physical, psychological, behavioral, relational, family, attachment, and the present moment symptoms or difficulties you are experiencing that brought you to therapy. Then we will work together to identify some treatment goals, what you are hoping to be different, and how you are hoping to feel when this is accomplished.

-The next few sessions will also include you and I both getting to know your nervous system, how much capacity it has for stress and for pleasure, what activates it and what soothes it.

-Psychoeducation is also provided to help add context to what you are experiencing both internally and externally within relationships. Adding context, or understanding, is also an integral part of building a sense of safety.

-Beginning to build a sense of safety in the body is fundamental to trauma healing. It is THE MOST IMPORTANT step and there is no set number of sessions for doing so. For some people, their system already has a fair amount of access to this and can be accomplished in a session or two. For others, it can take much longer, for various reasons. We will take time to build up this sense of safety and agency, using resourcing and other skills. Diving into the stories of our trauma, whether this is showing up verbally, emotionally, or behaviorally, without this foundation is harmful and unethical. This step requires a lot of patience, curiosity, non-judgement, compassion, and pacing.

-From here, the next steps we take will depend on the type of trauma or symptoms you are experiencing and how this is presently impacting your life. Going back and re-telling your trauma narrative in great detail, is often not necessary and can even lead to further traumatization if not done without sufficient skill and preparation. When working with shock trauma (PTSD), we work with the nervous system to slowly build its capacity to modulate states of aliveness, expansion, activation, and contraction. When using Somatic Experiencing we will use the skills of tracking sensation, titration, pendulation, and coupling dynamics, creating the conditions for the body to complete incomplete motor responses in the form of self-protection responses.  When working with CPTSD, we are working more with how we relate to ourselves, others, and the world. It is the sense of self, affect regulation, and interpersonal relationships that are most impacted. This also has an impact on physiology and we will still be working with the nervous system, but in a different, more subtle manner. We will be tracking moments of agency, connection/expansion and disconnection/contraction, primary and default emotions, working towards emotional completion or containment, and bringing awareness to the psychobiological shifts that follow in order to integrate them.

I will never tell you what to do or what to work on. I am not the expert of your internal experience or your life. The work we will do together will aid you in building or reconnecting to a sense of agency and empowerment as well as a connection to your authentic Self, your heart, your boundaries, and your body. You get to decide what it is you most want for yourself, but we will not be focusing on behaviors of yours or others. We will go deeper and explore together how you are relating to yourself and others and what is getting in the way of what you want, whether it is symptoms of shock trauma or strategies and adaptations to complex trauma. You will find that the more you are able to access true connection to your self, the appropriate responses will make themselves known to you and you will be able to make choices that are in alignment with what you want or need for yourself. Connecting to our hearts, and living authentically is inherently regulating to the nervous system. That being said, I am not in the business of colluding with strategies, parts, ways of relating to yourself and others, or ways of being that keep you stuck in the same patterns of child consciousness. The reason for this is that therapy will do you no good if you are just coming to have someone to validate, reinforce and collude with harmful or destructive strategies that are not in alignment with your stated intentions for yourself. Sometimes this means challenging or confronting these strategies and beliefs, which can be uncomfortable. But this is a good thing! It means we are moving away from old patterns and moving towards growth! Therapy should be hard work, not just staying in your comfort zone. Are you up for it?

Sometimes, I might provide some resources and handouts that are helpful for getting to know your nervous system that we work on together in session and you are welcome to continue working on them between sessions. Most of the time if I give “homework” it is more like a “practice”, such as bringing awareness to your internal state, or practicing Somatic Experiencing skills, mindfulness, meditation, or yoga. These are always an invitation to practice and never required. But keep in mind that we will only be seeing each other for 2-4 hours a month so continuing to put to practice what you are learning in sessions will serve you well.