What is somatic therapy?

Breath, movement, posture and attention to physical sensation, aimed at stress and trauma responses.

In a randomised trial of Somatic Experiencing for PTSD (Brom et al., 2017), 63 adults were split between 15 weekly sessions and a waiting list, and 44.1% of the treated group no longer met the criteria for PTSD afterwards. In South Africa, a University of Pretoria review has gathered 18 studies on TRE, a related body-based method.

What is somatic trauma memory?

Somatic trauma memory is the idea that a frightening experience is held in the body as well as in the mind: a racing heart, a knot in the stomach or a startle that fires when something brushes against the old event. The psychiatrist Bessel van der Kolk proposed this view in a 1994 paper titled “The Body Keeps the Score” in the Harvard Review of Psychiatry, linking traumatic memory to the body’s stress response.

Somatic therapists work with a model of “stored activation”, a defensive response that started and never finished. Peter Payne, Peter Levine and Mardi Crane-Godreau present it in Frontiers in Psychology (2015) as a theory with “a possible neurophysiological rationale”.

How does somatic release help in treating trauma?

Somatic release works by turning attention to physical sensation in small, safe doses instead of retelling the event. The therapist guides you toward a tight chest or a clenched jaw for a few seconds, then back to something neutral, such as your feet on the floor. Somatic therapists describe the aim as teaching the body, over many rounds, that it can feel the old alarm and come back down.

Nobody asks you to describe the worst day of your life in detail, so the work can feel more manageable for someone who finds talking about it too raw.

What exactly is somatic therapy?

Somatic therapy is an umbrella term for psychotherapy that brings the body into the session, alongside conversation. Payne and colleagues describe Somatic Experiencing as guiding attention to interoceptive, kinesthetic and proprioceptive experience: what you feel inside, how you move and where your body is in space.

Talk therapy asks what happened. Somatic therapy adds a second question: what is happening in your chest, your shoulders and your stomach right now, while you talk about it. The therapist notices small signals, a held breath or a restless leg, and works with them too.

What types of somatic therapy exist?

The main types differ in how much talking, touch and structure they use:

• Somatic Experiencing (SE), developed by Peter Levine around post-traumatic stress: one to one, tracking activation in small doses so it can settle without flooding.
• Sensorimotor Psychotherapy, developed by Pat Ogden, uses posture and movement as a way into the beliefs and habits trauma left behind.
• Hakomi, developed by Ron Kurtz, is a mindfulness-centred method that notices bodily sensation and the meaning a person attaches to it.
• Tension and Trauma Releasing Exercises (TRE) are a short set of physical exercises that trigger the body’s natural tremor, and a person can learn to use them alone.
• Yoga and breathwork, used therapeutically to calm arousal and build body awareness.

At Renewed Life Center, Kerry Dominie-Williams, our TRE practitioner, teaches TRE on site.

How does somatic therapy use experiences in emotional processing?

Somatic therapy processes emotion by starting from the physical side of it: the heat of shame in the face, the drop in the stomach before a hard conversation. Feelings that are hard to put into words often show up first as a sensation.

In a body that has learned to brace, the danger response keeps firing long after the danger has passed: a tight chest, sleep that never goes deep, a jump at ordinary noise. Alcohol, benzodiazepines and opioids switch that activation off fast. For many people the first drink or pill was the quickest way to turn the volume down, which is part of why stopping is harder than deciding to. Somatic work aims at that alarm itself, the one the substance was switching off.

Kerry starts from the same place. Asked why people become addicted, she quotes the physician Gabor Maté:

“Don’t ask why the addiction, ask why the pain. The response to that is, what is the pain? Where is it? Where does it come from? And let’s go and find it. And let’s deal with what started this. What wound started this? Because oftentimes in dual diagnosis, there’s trauma.”

Who benefits from somatic therapy?

Somatic therapy is used for PTSD, anxiety and addiction, usually as part of wider PTSD treatment or trauma counselling. Some people who freeze or feel little in talk therapy find the body route opens something. In anxiety treatment, it can reach feelings such as sadness or shame that words skip. The gains in the Brom trial covered depression as well as PTSD.

The link between trauma and addiction is strong. In the original CDC-Kaiser ACE analysis of 9,508 adults, those with four or more kinds of childhood adversity had a 4- to 12-fold higher risk of alcoholism and drug abuse (Felitti et al., 1998).

We treat the drinking or the drug and the reason under it together, in one place. Ruby Weber, the psychologist who heads psychology at the centre, leads the psychological side of our dual diagnosis work and has more than twenty years in the addictions field with South African and international clients, with a particular interest in trauma. Here is why dual diagnosis treatment matters.

Digging into what sits underneath can bring old pain to the surface, and if it ever brings thoughts of not wanting to be here, those thoughts need professional help early. If you might act on them now, or cannot keep yourself safe, get emergency help immediately rather than waiting for a reply from us; the SADAG Suicide Crisis Helpline is 0800 567 567, day or night. When the drinking or using and the pain under it need treating, you or someone close to you can talk the situation through with us. A relative can speak to our team before the person has agreed to come, and medication someone already takes, such as an antidepressant, is reviewed by our GP.

Is Somatic Experiencing an evidence-based treatment?

Somatic Experiencing has early trial evidence: two randomised trials that found fewer PTSD symptoms, one in PTSD and one in chronic low back pain with PTSD symptoms, and a 2021 scoping review that calls the findings promising but asks for more unbiased trials. Yoga has more trials, but in substance use rather than trauma, and TRE has the youngest research of the three: the Pretoria reviewers call their results preliminary.

Method	Best evidence so far	How strong
Somatic Experiencing	Two randomised trials (2017): 63 adults with PTSD, 44.1% no longer met criteria (treated group, against a waiting list); 91 patients with back pain and PTSD symptoms, fewer PTSD symptoms; scoping review of 16 studies (2021)	Early, promising, for PTSD
Yoga	Review of 8 randomised trials in substance use, 7 with significant benefit	More trials, for substance use, as a complement
TRE	Scoping review of 18 studies, University of Pretoria	Preliminary, for stress

What does a typical somatic session look like?

A session opens with a check-in on what the body feels right now, then slow attention to sensation through breath, gentle movement or stillness, stopping well before anything feels too much.

What are the benefits of somatic therapy?

The benefits of somatic therapy are fewer PTSD symptoms, lower depression and anxiety, and practical tools for calming the body that you can use on your own. In the yoga review the benefits covered anxiety, pain and substance use.

After addiction treatment, the last of these counts most. A craving often arrives as a body state before it becomes a thought: restlessness, a tight chest, the evening slump. A person who can notice that state and bring it down with breath, a few minutes of TRE or a yoga sequence has an option between the urge and the bottle. TRE is learned here so that you can keep using it at home, and every discharge from Renewed Life Center includes a written relapse-prevention plan built for your home.

In a randomised trial of 91 patients with chronic low back pain and PTSD symptoms (Andersen et al., 2017), adding 6 to 12 sessions of Somatic Experiencing to usual care cut PTSD symptoms and fear of movement more than usual care alone. If the drinking or pills began as a way to manage pain, that result is worth knowing.

What are the criticisms of somatic therapy?

The main criticism is that somatic therapy is young: there are few large randomised trials, and the stored-activation model is a theory. Body-focused work can also stir things up. That is why it works best inside a programme built on therapies with a long track record. With us, your own counsellor works with you one-to-one every week, alongside group work every weekday, so whatever surfaces has somewhere to go.

Is somatic therapy the same as EMDR?

No. EMDR (Eye Movement Desensitisation and Reprocessing) works on a specific traumatic memory using guided eye movements, while somatic therapy starts from what the body is doing right now. At Renewed Life Center EMDR is one of the methods we use, alongside TRE.

Is somatic therapy better for addiction than CBT?

Somatic therapy does a different job from CBT, and the two work together. CBT works on the thoughts and habits that lead to using, and the WHO and UNODC International Standards (2020) list it among the treatments that have proved effective. Somatic work helps with the body states those thoughts ride on.

What substance abuse treatments work alongside somatic therapy?

Substance abuse treatment rests on therapies that change thinking and habits, with medical detox first where it is needed. Somatic work is one of the rehabilitation options for substance abuse that sit next to them.

We use cognitive behavioural therapy, one of the psychological treatments NICE recommends for alcohol dependence, alongside DBT for urges, schema therapy for old patterns, family therapy, relapse prevention and evening 12-step meetings. For trauma we use EMDR, which NICE and the WHO include in their PTSD guidance, with TRE, yoga and art therapy in the same week.

Drug addiction treatment here runs over months, and a doctor examines you after you arrive; if you need a detox, our medical team runs it. The first month is about getting safe and steady with therapy every weekday, the second goes deeper into what the drinking or drugs were covering, and the Recovery Integration Programme and sober living follow.

Breathing and TRE help with stress, but they do not make withdrawal safe. If you drink every day or take benzos, sleeping tablets, mandrax, GHB or opioids, do not stop suddenly on your own. Write to us before you cut down, and we will go through the next steps for treatment with you.

Not sure whether trauma sits under the drinking or using? Talk it through on WhatsApp.Not sure whether trauma sits under the drinking or using? Call +27 79 880 0045, free and confidential.

Where can you get somatic therapy in Cape Town?

At Renewed Life Center in Lakeside, a residential suburb of Cape Town, body-based work means TRE with Kerry Dominie-Williams and yoga, both in the weekday group programme of our residential addiction treatment. Whatever surfaces on the mat, you can take to your own counsellor. The mountain rises behind the house and the beach is a short drive away, and that quiet helps when the work asks you to notice your own body.

Nikki Edwards, who leads the programme as Programme Director and Clinical Manager, and John Roberts, Senior Recovery Specialist and Operations Manager, help shape your plan; both are also in recovery themselves, Nikki for 11 years and John for 39. Dr John Wulz, our GP, examines you after you arrive. See our dual diagnosis treatment and holistic therapies in Cape Town.

The fee depends on the programme and how long you stay; we give it on the free first call and send it in writing the same day.

How do you start?

Start with a free, confidential conversation of twenty to forty minutes by WhatsApp, video or phone. A partner or parent can make the call instead of you. A clinical assessment comes next, and admission can be immediate, typically within three days of first contact. Send us a message and we reply the same day.

Questions people ask

Is Somatic Experiencing scientifically proven?

It has early trial evidence: two randomised trials that found fewer PTSD symptoms and a 2021 review of 16 studies that called the results promising. Here, body-based work such as TRE and yoga runs alongside CBT, schema therapy and DBT.

What is the difference between TRE and Somatic Experiencing?

In general, Somatic Experiencing is delivered one to one by a trained psychotherapist over a course of sessions, while TRE is a set of exercises that a person learns and can eventually use on their own. Here TRE is part of the weekday group programme.

Do I have to talk about my trauma in detail during a somatic session?

No. The focus stays on present-moment physical sensation. Many people find this easier than describing an event in words.

Can somatic therapy replace talk therapy?

No, it sits next to it. CBT and individual therapy stay, and the body work gives you a way to calm the state those thoughts ride on. Here TRE and yoga run inside the same weekly plan.

Where can I get help for substance abuse in Cape Town?

Renewed Life Center in Lakeside offers residential treatment over months, sober living and an outpatient programme, with TRE and yoga inside the plan; if you need a detox, our medical team runs it. The first call is free and confidential, and admission typically happens within three days of first contact.