Somatic Experiencing vs. Sensorimotor Psychotherapy: Uses, Benefits & More

Somatic experiencing (SE) and sensorimotor psychotherapy (SP) are both therapies that address trauma and stress by focusing on how the body is affected. While they are similar, the two therapies differ in some ways.

Developed in the 1970s by biophysicist and psychologist Peter Levine, SE is an alternative form of trauma therapy that emphasizes experiences that are interoceptive (perception of sensations from inside the body), kinesthetic (related to movement or sensation within the body), and proprioceptive (awareness of the body, where it is in space, etc.).

SP was created in the 1980s by psychotherapist Pat Ogden. It is a body-centered, or somatic, type of talk therapy that integrates sensorimotor processing with cognitive and emotional processing. It also uses the body to address trauma and stress, but with the addition of psychotherapy.

Read on to learn more about these two treatments and whether they may be right for you.

What to Know About Somatic Experiencing

SE uses "bottom-up" (body-oriented) processing. Rather than focusing on conscious thought processes (also known as "top-down" therapy) as many mainstream psychotherapies do, SE addresses the symptoms of chronic stress and post-traumatic stress. SE brings your attention to internal sensations (visceral and musculoskeletal) rather than cognitive or emotional experiences.

In contrast to more exposure-based psychotherapies for trauma, SE intentionally avoids addressing traumatic memories directly or intensely. This is based on the theory that when trauma narratives are retold, they can cause you to reactivate and reexperience physical symptoms associated with the event. Repeating this mind-body cycle keeps the past trauma active in the body.

Instead, traumatic memories are approached indirectly and very gradually, aiming to complete the response that was interrupted at the time of the trauma, and help you learn self-regulation skills.

How Does Somatic Experiencing Work?

When faced with stress or trauma, the autonomic nervous system (part of the nervous system that regulates involuntary bodily processes, such as heart rate, blood pressure, and digestion) activates the defense systems fight, flight, or freeze. This is a vital survival mechanism that helps keep you safe.

Ideally, once the situation is over, the system goes back to normal, but this doesn't always happen. Sometimes the stressor overwhelms the system or the stress happens repeatedly over time, leading to chronic activation of the system and dysregulation (difficulty managing the situation).

According to SE, this dysregulation can manifest as:

• Anxiety
• Depression
• Irritability
• Anger
• Panic attacks
• Physical illnesses (such as migraines, chronic pain, fibromyalgia, or gastrointestinal issues)
• Problems in relationships
• Difficulty thinking and focusing
• Insomnia
• Feeling numb emotionally
• Many other symptoms

SE aims to help you complete the defensive responses that were interrupted and discharge and regulate excess autonomic arousal.

SE theorizes that trauma is not in the event, but rather in the nervous system and body. This is why the same event affects different people in different ways.

Instead of having you relive your traumatic experiences, as happens in therapies that focus primarily on cognitive and emotional aspects, SE establishes feelings that are associated with safety, such as warmth or comfort, before approaching any sensations associated with trauma, such as hypervigilance or anxiety. You can then repeatedly return to these more adaptive sensations as a resource while they slowly, bit by bit, address the stress-associated sensations.

The therapist helps you tend to the visceral sensations and motor impulses that go along with the incomplete defense responses. This means biological completion and autonomic discharge happen in a controlled way through manageable steps.

This gradual exposure to bodily sensations associated with trauma alternating with sensations associated with comfort is called titration. By using techniques such as titration, you increase your tolerance for difficult bodily sensations and learns self-regulation skills.

Through this process, the therapist keeps you within a safe space (called the window of tolerance).

Delivery of Somatic Experiencing

An SE session can be in person or online. It can also be performed in a group therapy setting.

SE is mainly meant for adults, but elements of it have been adapted for use with children and adolescents. You typically attend sessions by yourself and usually get it along with ongoing trauma-focused psychotherapy.

Prices and Where to Get It

SE can be found through counseling and psychology practices that offer it. Prices may vary by location, but a 75-minute session can be about $165.

What to Know About Sensorimotor Psychotherapy

Simply put, SP is a type of somatic therapy that aims to integrate this somatic approach with other types of psychotherapy. It uses both sensorimotor processing, and cognitive and emotional processing to treat trauma and its effects. The premise of SP is that by treating the results of trauma on the body, it helps the person process the trauma emotionally and cognitively as well.

Since its development in the 1980s, SP has expanded to include neuroscience research, cognitive methods, and attachment theory, aiming for a broader approach meant to address the complex and interconnected nature of trauma.

How Does Sensorimotor Psychotherapy Work?

SP proposes that in order for healing to happen, trauma must be processed on three levels, which are:

• Sensorimotor
• Emotional
• Cognitive
  

This processing is achieved through a combination of body-based treatments and mindfulness-focused talk therapy.

The therapist fosters awareness of how your body communicates emotions. Together, you'll explore how trauma has impacted you physically. This helps you develop learning methods to manage these emotional and somatic (relating to the body) expressions.

Like SE, SP also uses the window of tolerance to assess arousal level. Arousal describes physiological functioning using indicators such as:

• Heart rate
• Breath rate
• Muscle tension
• Impulse for movement
  

Arousal levels can be above the window of tolerance, causing you to experience strong impulses and reach for help, flee, fight, or freeze. They can also be below the window of tolerance, prompting sleepiness or giving up.

Arousal levels are also connected to emotions. By using the window of tolerance, a therapist can help you learn to sort through different levels of emotions, such as fear vs. terror, or anger vs. rage.

With SP, the dysregulated physiological response (such as a racing heart) is distanced from the emotional experience and cognitive details. In this example, the focus would be solely on your heart rate, with you and the therapist working together to find methods that help slow the heart rate down until it is back within the window of tolerance. Over time, you learn to manage your states of arousal and can return to this window of tolerance during times of stress.

During SP sessions, the therapist uses your window of tolerance as a guide while you slowly recall parts of a traumatic or stressful experience. The therapist also supports you as you mindfully track physical movements and sensations.

Over the course of SP, you will learn to:

• Use somatic, cognitive, and behavioral skills to gain greater control over responses to trauma-related stimuli
• Understand the process of trauma recollection and how it affects thought patterns, emotions, and autonomic activation
  
• Notice thoughts, feelings, and bodily reactions to trauma-related stimuli, without judging or interpreting them instead of focusing on the traumatic events themselves
  
• Direct attention away from the event to the physical and emotional response to the recall of the event as a way to regulate autonomic arousal
  
• Achieve a sense of distance from the event by being able to differentiate past from present (experiencing and recognizing the event as finished as opposed to still happening)

Delivery of Sensorimotor Psychotherapy

SP is typically delivered in a one-on-one environment. It is aimed at adults, but elements of it have been adapted for use with children and adolescents. It can be used with ongoing trauma-focused psychotherapy or as a standalone treatment for complex trauma.

The three phases of SP are:

1. Symptom reduction and stabilization: This phase is about gentle exploration and awareness of emotional and physical trauma responses. The therapist works with you to help you learn your triggers and understand how your thoughts and emotions are interconnected.
2. Process traumatic memories: During this phase, the therapist helps you process the trauma by bringing awareness to ineffective coping mechanisms and to build healthier ones. Instead of speaking of the memories in full detail, the therapist helps you process the memories in small bits, using words, sensations, and movements.
3. Reintegration: This phase is about strengthening your sense of self, well-being, and connections made in previous phases using mental practice, physical exercises, and mindful self-awareness. The therapist will give you tools to communicate your emotions and set healthy boundaries.

The SP sessions are loosely structured, with the therapist helping you find what you need from within yourself rather than directing you.

As you slowly talk through the event or experience, the therapist helps you focus on the nonverbal and autonomic responses you are experiencing. The therapist asks you to mindfully notice rather look to the therapist to interpret or analyze these thoughts, feelings, body sensations, or movements.

Over the course of several sessions, you'll notice patterns of response. With help from the therapist, you'll see how trauma-related body sensation leads to cognition, and how cognition evokes emotional responses. These emotional responses can lead to body responses that lead to negative thoughts, creating emotional overwhelm.

By practicing mindful observation, you'll learn to be aware of these experiences without being overwhelmed by them.

Prices and Where to Get It

SP can be found through counseling and psychology practices that offer it. Prices vary among providers, so it's best to call them directly to ask about fees.

Which Treatment Is Best for You?

It's important to note that while there's research to support how well SE works, evidence is limited. SP is based on principles of established psychotherapy methods, however, it does not have a significant evidence base of its own.

SE primarily focuses on PTSD (post-traumatic stress disorder) and attachment trauma. SE may be used as a standalone treatment, but is often used along with other trauma-based interventions. Its principles may also be beneficial to use with other treatments or in various healing professions, such as:

• Mental health
• Medicine
• Physical and occupational therapies
• Bodywork
• Substance use
• First response
• Education
  

SP can be used by itself or with other treatments.

SP may be helpful for:

• Trauma counseling
• PTSD
• Panic disorders
• Anxiety
• Depression
• Attachment issues
• Substance use
• Relationship or family counseling
• Relational trauma
• Anger management
• Abuse counseling

Because it doesn't rely solely on language, SP can be helpful for addressing the nonverbal aspect of trauma.

Can Somatic Experiencing and Sensorimotor Psychotherapy Be Used Together?

Both techniques are somatic-focused therapies and overlap a great deal. Therapies may draw from the principles and language of both SE and SP.

Summary

Somatic experiencing is a therapy approach that addresses the ways in which trauma imprints on the body. SE involves working through the body sensations and responses that are connected to trauma.

Sensorimotor psychotherapy is built on a similar premise as SE, but adds a talk therapy approach after the person has worked through the body's responses to trauma.

SE is typically, although not always, used in combination with other treatments. SP can be used with other treatments or as a standalone treatment.

A Word From Verywell

If you are experiencing the effects of trauma or stress, you have several avenues available to pursue in terms of treatment, and several different approaches that can be taken. If focusing on and learning to work through the physical effects of trauma as a way to control your response to stressful situations is appealing to you, you may wish to look into SE or SP.