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Somatic Experiencing®

Somatic Experiencing® - or SE®, is a treatment approach to trauma developed by Dr. Peter Levine, psychologist and biological physicist. His approach is based on a phylogenetic model which states that trauma symptoms arise from a frozen residue of energy that is trapped in the body after traumatic events.

According to Levine, a healthy, or regulated autonomic nervous system exhibits continuous, gentle oscillations between its sympathetic (activating, energizing) and parasympathetic (relaxing) branches. This usually happens outside of our awareness, although at times we may choose to activate one system over the other (ie – parasympathetic dominance of meditative states, or the sympathetic dominance of athletic pursuits). A healthy autonomic nervous system, then is one that is in balance and can return to a regulated state after dysregulating circumstances (ie – you will feel an adrenalin surge with an increase in your heart rate and respirations after a "near miss" at a crosswalk, but will soon return to normal as you realize you are unhurt).

The sympathetic and parasympathetic nervous systems also drive the emergency responses of fight/flight or freeze that are called into play by the reptilian and limbic brains in response to threat. When the threat is determined to be over, or if the protective, defensive responses have been successful (you have survived), the healthy, resilient autonomic nervous system (ANS) returns to regulation, to ongoing cycles of charge (SNS) and discharge (PNS). As we have seen, traumatic stress produces ANS dysregulation. The normal cycles of charge and discharge are interrupted and may remain in fixed positions, creating symptoms of traumatic stress.

How unprocessed trauma is stored in the body

Recall here my earlier references to the phenomenon of kindling and the autonomic nervous system dysregulation that can occur as a result of trauma. Levine believes that stored and undissipated energy from the truncated fight/flight response contributes to the lack of recovery from the immobility, or freeze response.

Indeed, stories of people able to perform superhuman feats of strength in efforts to rescue loved ones from danger attest to the degree of mobilized energy he is referring to. He further believes that this sustained state of sympathetic arousal drives the memory and arousal-based symptoms of trauma and PTSD.

Central to Levine's treatment model is the understanding that animals in the wild exhibit prototypical behaviours which seem to discharge this retained energy after trauma. Think here of how a mouse will go into a freeze response when caught by a cat – after the cat walks away (hence, a successful survival strategy because cats won't eat dead prey) the mouse gradually "thaws", shaking and then running away. Unlike wild animals however, human beings experience inhibition of these natural discharge strategies by our well-developed neocortical structures – our "thinking" brains.

How Somatic Experiencing® works

Protocols for assisting in the release of this "trapped" energy are therefore an important part of the SE model. Therapists are trained to recognize the various stages of incomplete fight/flight freeze responses and to help clients to allow their own instinctual body wisdom to move those processes to completion. Levine conceptualizes the threat response cycle as consisting of various stages, organized instinctually by the reptilian and limbic circuits of the brain.  Symptoms are seen as arising from the point at which the response cycle was interrupted.  As a result, normal survival responses of orienting, fight, flight and freeze may either be exaggerated (as in hypervigilance or a hyper startle response) or may be extinguished altogether (as in a fight response when a child is repeatedly overpowered and moves directly into a freeze response).  In other words, trauma can override instinctual responses with learned responses.

The goal of Somatic Experiencing then, is to enable the renegotiation of trauma by completing and thereby restoring healthy survival responses.

Because of the dysregulated, highly sensitive nature of the traumatized nervous system, work with arousal, or activation is titrated (small, tolerable amounts of arousal related to the trauma) and the pace is slowed to address the changes occurring in the lower brain structures that are responsible for the survival responses.

Titration has the effect of exposing the person to small, tolerable amounts of arousal related to the trauma, thereby reducing the risk of triggering dysregulation and further traumatization. The therapist is always holding the autonomic nervous system in mind, with the goal of "prompting" it to move back into the normal pattern of oscillation between the sympathetic and parasympathetic systems. In this case then, "less is more".

Levine uses the acronym SIBAM to describe the elements that make up the whole of our experience. These are: sensation, image (impression), behaviour (verbal and nonverbal), affect (emotion) and meaning. Sensation relates to experiences that occur inside the body. It is considered to be the central organizer of experience and the language of the reptilian brain. A fundamental aspect of treatment then is the tracking of sensation in the body, both by the therapist and the client. It is felt that this tracking allows for access to the reptilian brain, where the survival responses are held.

It is believed that in the fragmenting process of trauma, these elements of experience may be separated from one another in an attempt to modulate the arousal in the nervous system.

Conversely, some elements may have become connected in a conditioned response and need to be separated from one another. An example of this might be a woman who, years after an assault by a man in a red shirt, is totally confused when she has a panic attack when she sees a man in a red coat on the subway. In this case, an image and a feeling are over-associated (overcoupled), as have past and present, while meaning has been under-associated (undercoupled).

A further example might be the inability of an individual who has experienced childhood abuse to set protective boundaries in a present day relationship with a demanding employer. In this case, feeling (fear) has been overcoupled with meaning ("I can't protect myself") and behaviour (passivity/immobility).

This process is referred to as traumatic coupling and is thought to occur in the reptilian (subcortical structure) rather than the neocortex. Because work is aimed at these lower brain centres, therapists are trained in specific methods to recognize, address and resolve these common dynamics.

Central to the work of Somatic Experiencing is the engagement of the individual's "observing self" – that is, the ability to stay present with awareness while tracking bodily sensations, images, behaviours, meanings and emotions. The therapist's role is to remain mindful of the optimal degree of ANS activation required to bring about changes in the system while not overwhelming it. The end result is an increase in self-regulation and a return to a healthy nervous system.

Read about Trauma Therapy.