Psychotherapy vs Somatic Therapy

When someone says they are going to therapy there may be a clear image that jumps to mind; a person lying on a couch recounting their challenges to an individual with a clipboard sitting nearby. The reality is however that in the realm of mental health and healing, various therapeutic approaches exist to serve the diverse and multifaceted needs of clients and patients. Two such therapeutic approaches are psychotherapy and somatic therapy. While psychotherapy and somatic therapy can both be used by therapists to heal similar diseases and afflictions they differ in their historical origins, underlying focuses, and modalities. 

The historical roots of somatic therapy reach back millennia to original healers in Eastern traditions like yoga, tai chi, and Buddhist mindfulness practices. While many of these original forms of somatic therapy arise from spiritual roots, they were often utilized for the healing of mental or physical illness. In more recent history, Wilhelm Reich, a student of Sigmund Freud, introduced the concept of "character armor". According to an article published by Meridian University, Reich proposed in his 1933 book Character Analysis that trauma can impact the body through pain, inflammation, chronic tension, and other reactions (Meridian University, 2022). Later other approaches, such as Alexander Lowen's Bioenergetic Analysis and Peter Levine's Somatic Experiencing, expanded on Reich's work by creating new ways to access and heal the felt sense of trauma, mental illness, or chronic stress in the body.  Over time, the field has gained recognition for its ability to address trauma, stress, and anxiety by reconnecting individuals with their physical sensations. Even today, many studies are being conducted on the potential of somatic therapies for diseases such as heart disease or high blood pressure as they often include a degree of self-awareness and down-regulation which can be impactful on physiological processes. 

Psychotherapy, also known as talk therapy, has roots in Western philosophy, medicine, and psychology. Sigmund Freud is often credited with formalizing psychotherapy in the late 19th and early 20th centuries through his development of psychoanalysis. Freud also helped lead the way in offering psychotherapy in an out-patient environment. As the field evolved, other individuals introduced new approaches which they often discovered through trial and error with their own clients. In the early 1900s, Carl Jung expanded on psychoanalysis and emphasized the role of archetypes and the collective unconscious which contributed to later system theories. In the mid-20th century, cognitive-behavioral therapy (CBT) emerged, combining cognitive psychology and behavioral techniques. Psychotherapy’s relatively new approach to healing continues to evolve with new modalities appearing as therapists continue to explore how combining various approaches can improve client outcomes. 

The underlying focus of somatic therapy is the integration of mind and body. Somatic therapy operates on the principle that the body holds unresolved trauma and stress, manifesting them as physical symptoms such as tension, chronic pain, idiopathic diseases, or disrupted breathing patterns. Practitioners often guide clients to notice sensations, movements, and postures, encouraging them to explore how these physical experiences might correlate with emotions or the context of their lives. For example, a clenched jaw might be a sign from the body of suppressed anger, while shallow breathing often indicates uncontrolled anxiety. The ultimate goal is to help clients develop resilience, regulate their nervous systems, and achieve a sense of safety and presence in their bodies. The belief is that a person at peace in their body will find peace of mind.

Psychotherapy, however, primarily engages the cognitive and emotional dimensions of the human experience rather than the body. Its underlying focus lies in understanding and transforming thoughts, emotions, and behaviors. By exploring past experiences, relationship dynamics, and internal conflicts, psychotherapy intends to help individuals gain insight into their mental patterns and develop healthier mental coping skills. Different psychotherapeutic approaches vary in their approaches and their models of the mind and cognition. For example, psychoanalysis and psychodynamic therapies delve into unconscious processes and childhood influences, while CBT targets specific thought patterns and behaviors. Regardless of the specific approach, psychotherapy centers on fostering self-awareness and emotional well-being through dialogue and introspection of one’s own thought patterns and context.   

Somatic therapy is composed of many different modalities that can look radically different in practice but are all connected to the concept that the body holds emotions, experiences, and trauma. Somatic experiencing is one modality which was developed by Peter Levine. Somatic experiencing focuses on resolving trauma by helping clients complete their body’s natural stress responses through narrative and physical re-enactment of traumatic moments, imagining an alternate reality where the client is able to come out victorious. This often takes the form of talking and some movement. Bodywork and movement modalities are heavily focused on the body itself. Techniques such as yoga therapy, craniosacral therapy, and dance therapy emphasize movement and body alignment to foster emotional release, nervous system regulation, and healing of trauma. Somatic therapists often use techniques like grounding exercises, breathwork, and guided imagery to help clients reconnect with their bodies or reorient to physical sensations. These modalities encourage an embodied approach to healing, recognizing the body as an active participant in psychological well-being.  

While somatic therapy often integrates movement or physical touch, psychotherapy consists of modalities that leverage verbal exchange and discussion. For example, cognitive-behavioral therapy uses discussion between the client and the therapist to identify and alter negative thought patterns. Gestalt therapy focuses on establishing personal responsibility and process understanding for clients throughout sessions. Dialectical behavioral Therapy, which is a specialized form of CBT, utilizes distress tolerance and encourages emotional regulation through sessions. All of the aforementioned modalities and the many others utilized in psychotherapy are often done through a talk-based approach. Effective talk therapists need to be effective communicators as the primary delivery of their therapy is via language and active listening. 

Psychotherapy and somatic therapy, while different, share the common goal of promoting mental and emotional healing for clients. Both have been proven to be effective for a wide range of mental illnesses and challenges. While they differ in their history, their underlying focus, and their modalities they share common goals and can be utilized effectively both on their own and together. Ultimately, the most important thing in any therapeutic relationship is not the methodology but the strength of the therapeutic connection and the intention of both therapist and client to show up with intention. 

Sources:

Meridian University. Somatic Psychology: Meaning and Origins, Meridian University, 22 Nov. 2022, meridianuniversity.edu/content/somatic-psychology-meaning-and-origins.