In the world of Western medicine, with its reliance on pharmaceutics for the treatment of everything from physical diseases to psychological disorders, it can be mind-expanding to learn of proven therapies for serious health conditions that rely exclusively on the human body’s ability to self-heal.
Such therapies do exist and can be found even in the mainstream of the healing arts. Dr. Peter Levine’s somatic experiencing (SE) is one.
SE is a body-oriented approach to healing difficult-to-treat post-traumatic stress disorder (PTSD)ㅡwhich, with inspiration taken from injured military veterans, he now refers to as PTSI, for post-traumatic stress injury.
Though Levine’s relabeling of PTSD as PTSI is arguably a more accurate description of the phenomenon, throughout this profile we will refer to it by its more commonly known acronym, which is PTSD.
What’s behind the terminology change?
“The idea is that trauma rather than… being a disorder, is an injury,” Levine explained in a YouTube video. “It’s an injury where we…feel overwhelmed, paralyzed by terror, by loss, overloaded in such a way that we’re unable to make sense of what’s going on. And as an injury, there are ways to heal an injury.”
Levine asserts that trauma is not just a psychological condition but also a physiological one. According to his theory, trauma disrupts the body’s natural ability to regulate and discharge stress. This disruption leads to a state of being “stuck” in a fight, flight, or freeze response.
What is PTSD?
One of the most prevalent trauma disorders is post-traumatic stress disorder, which is a debilitating condition triggered by experiencing or witnessing a traumatic event.
In the United States, it is estimated that approximately 8 million adults suffer from PTSD in any given year.
Approximately 70% of adults in the US will encounter at least one traumatic event in their lifetime, which can lead to various mental health issues, including PTSD, according to SingleCare.
Symptoms of PTSD include:
- Recurrent, involuntary memories of the traumatic event, flashbacks, or nightmares.
- Avoiding reminders of the trauma, including places, activities, or people.
- Negative thoughts about oneself or the world, feeling detached from others, inability to experience positive emotions, and difficulties in dealing with people, especially in social settings.
- Being easily startled, feeling tense, having difficulty sleeping, or experiencing angry outbursts.
Levine views PTSD as a condition where the body’s natural recovery process from trauma gets interrupted. This causes a person to remain in a state of heightened emotional arousal or numbness. His SE therapy focuses on restoring the body’s natural ability to regulate and release the energy associated with traumatic experiences.
What is somatic experiencing?
Somatic experiencing (SE) focuses on helping individuals become aware of their bodily sensations and gently releasing the physical tension associated with traumatic experiences.
Levine points out that many trauma responses are unconscious and automatic. He believes that traumatic experiences are stored in the body’s memory and that physical sensations hold the key to healing. By tuning into these sensations, individuals can gradually release the energy and tension trapped in their bodies.
“Healing trauma is not about exposure to the memory of the trauma, but helping the body complete the process and move through it,” he explained in Healing Trauma: A Pioneering Program for Restoring the Wisdom of Your Body. He noted that “the body is designed to heal itself. When given the right support, it can discharge the energy of trauma and reset itself.”
SE therapeutic techniques
Levine’s SE techniques include the following approaches:
- Somatic tracking: SE practitioners guide clients to notice and track their bodily sensations. This process helps clients become more aware of their responses to trauma and begin to release stored tension.
- Pendulation: This technique involves moving between states of comfort and discomfort. By gently oscillating between these states, clients can gradually expand their capacity to tolerate distress and integrate traumatic memories.
- Titration: Levine advocates for a gradual approach to trauma therapy. Rather than confronting traumatic memories head-on, SE practitioners use titration: a slow and gradual process to break down the trauma into manageable pieces, which reduces the risk of re-traumatization.
- Discharge of energy: SE focuses on the release of pent-up energy associated with trauma. This can involve shaking, trembling, or other physical movements that allow the body to complete the interrupted fight, flight, or freeze response.
Case studies that highlight Levine’s approach to treating PTSD
Here are two examples that illustrate how SE works:
Nancy’s car accident
Nancy experienced a severe car accident that left her with PTSD symptoms including flashbacks, anxiety, and hypervigilance. The accident caused her body to remain in a state of high arousal, unable to complete the natural cycle of fight, flight, or freeze response.
This natural cycle refers to the body’s automatic reaction to perceived threats, which is a survival mechanism deeply embedded in the nervous system. In a healthy scenario, once a threat has passed, the body goes through a natural process of returning to a state of equilibrium.
Levine encouraged Nancy to become aware of her bodily sensations related to the accident, focusing on areas of tension and discomfort. Through pendulation, as described above, he guided her to oscillate between sensations of distress and safety.
Nancy gradually learned to discharge the energy associated with her traumatic experience. She experienced shaking and trembling, which Levine identified as the body’s way of releasing the pent-up stress. Over several sessions, Nancy’s symptoms significantly diminished and she regained a sense of safety and normalcy in her life.
Levine’s SE exercises help individuals complete this natural cycle. By guiding them to become aware of their bodily sensations and encouraging the safe release of trapped energy, SE aims to restore the body’s equilibrium and facilitate healing from trauma.
Source: Case study from Waking the Tiger: Healing Trauma
Michael’s combat trauma
Michael, a combat veteran, suffered from severe PTSD. His symptoms included intense flashbacks, nightmares, and avoidance behaviors. He often felt detached from reality and had difficulty engaging in everyday activities.
Levine helped Michael focus on his bodily sensations in a safe and controlled environment. He used titration, as described above, to break down his trauma into smaller, manageable pieces. He guided Michael to slowly explore these sensations without becoming overwhelmed.
Over time, Michael’s body began to release the stored energy from his combat experiences. He experienced spontaneous movements and physical releases, such as shaking and deep breathing. These physical responses were signs of his processing and releasing the trauma.
Michael reported a reduction in PTSD symptoms, improved sleep, and a greater ability to connect with others.
“One of the most surprising discoveries is how simple, natural movements and awareness of physical sensations can profoundly heal trauma,” Levine writes in Waking the Tiger: Healing Trauma. “Trauma is a fact of life. It does not, however, have to be a life sentence.”
Indeed, it is surprising that with effective direction and persistent effort, the body can release itself from deep-seated traumas. Such healing can be gradual but nevertheless dramatic over time.
Source: Case study from In an Unspoken Voice: How the Body Releases Trauma and Restores Goodness
Where trauma resides in the body
One of Levine’s most striking discoveries is how the human body physiologically reacts to trauma. “Trauma is not in the event itself, but in the nervous system,” Levine writes in Waking the Tiger: Healing Trauma. Basically, trauma resides in the body’s central nervous system.
Let’s take a short side trip into the human anatomy to explain how this works.
The vagus nerve plays a central role in the autonomic nervous system, which regulates many involuntary bodily functions, including responses to stress. It is part of the parasympathetic nervous system. This system helps your body relax and recover after stress by slowing down your heart rate and promoting calmness.
The sympathetic nervous system, on the other hand, prepares your body for action and stress by increasing your heart rate and alertness. So, the vagus nerve is involved in the “rest and digest” processes, not the “fight or flight” responses.
“The vagus nerve is involved particularly in life threat,” Levine explained in a recent video on effective exercises to overcome trauma and PTSD. It “goes from the back of the brain, then…down into the body cavities, and connects to the gastrointestinal system, the heart, and the lungs, and really to all of the other organs as well…
“It’s the largest nerve in the body by far. It’s the grand information highway because it’s not only sending signals from the brain stem down to our guts, to our organs, but it’s receiving information from our guts and our organs and relaying it back up to the brain…
“A lot of the exercises that I’ve designed in somatic experiencing [are] to get information changing from the gut back up to the brain,” he explained.
The vagus nerve’s role in responding to trauma
The vagus nerve’s two branches are the dorsal vagal complex and the ventral vagal complex. The dorsal vagal complex (DVS) is associated with immobilization and shutdown responses, while the ventral vagal complex (VVC) is associated with social engagement and calming responses.
During a traumatic event, the body may activate the dorsal vagal complex, which leads to a shutting down of emotions. This is a survival mechanism the body uses to protect itself from perceived threats.
If the traumatic response is not adequately processed and resolved, the body can remain in a shutdown state. This shutdown can result in the body retaining trauma memory and being unable to process and release it effectively.
Retaining trauma memories
The vagus nerve is a conduit for encoding and retaining traumatic memories in the body, which can manifest as physical sensations, emotional responses, and physiological symptoms.
These memories can be re-triggered by stimuli that remind the individual of the original traumatic event and cause the body to react as if the trauma is occurring in the present moment.
Processing and releasing trauma
Dr. Levine’s somatic experiencing therapy helps individuals process and release stored-up trauma by engaging the vagus nerve and the autonomic nervous system in a controlled and therapeutic manner. In this manner, individuals can gradually discharge the retained energy from the trauma, which allows the body to return to a state of equilibrium.
Techniques such as gentle movement, breathwork, and body awareness exercises can help activate the ventral vagal complex. This activation promotes feelings of relaxation, safety, and social engagement, which are essential for healing from trauma.
Hypervigilance and the sympathetic nervous system
In response to trauma, the body may enter a state of hypervigilance or increased arousal, driven by the activation of the sympathetic nervous system.
Characteristics of hypervigilance include a heightened sense of alertness, increased heart rate, rapid breathing, and the release of stress hormones like adrenaline and cortisol.
The fight or flight response
Hypervigilance is part of the fight or flight response, a survival mechanism that prepares the body to either confront or escape perceived threats. In this state, the body is on constant alert, scanning the environment for potential danger, which can lead to chronic stress and anxiety if sustained over time.
The freeze response
The freeze response is another defense mechanism that kicks in when the body perceives that neither fight nor flight is an option. It involves the simultaneous activation of both the sympathetic and parasympathetic nervous systems. This leads to a state of immobility known as freezing.
Therapies such as SE assist individuals in safely discharging the energy associated with fight, flight, or freeze responses. Their goal is to enable the vagus nerve to help the body return to a state of safety and relaxation.
These mechanisms highlight the complex interplay between different parts of the autonomic nervous system and the importance of addressing both hypervigilance and shutdown states in trauma therapy.
The promise of Levine’s trauma-release therapies
It took Peter Levine years to develop trauma-release therapies that tap into the human body’s amazing ability to self-heal.
“When I first started to work with trauma, to make my discoveries with trauma, this was quite a while before the definition of trauma as PTSD had been put forth and was then in the diagnostic manual,” he explained in a YouTube video.
Levine was originally taught that “trauma was a disorder, a disease that could not be cured, that it was an incurable disorder and maybe manageable by medications.”
However, once he began viewing trauma as an injury instead of a disorder, he started to research therapies that tapped into the body’s natural ability to heal itself from an injury.
Some of his therapies seem amazingly simple, like the use of vocal and breathing techniques to process trauma symptoms. Yet, simplicity doesn’t preclude powerful results. Today, Levine’s trauma-release therapies and techniques are used worldwide for the profound relief they bring to those who suffer from PTSD.
