Living with chronic pain can feel like being trapped in a body that’s constantly sending distress signals. If you’ve tried conventional treatments with limited success, you may wonder if other approaches could help. Somatic therapy—a holistic mind-body approach—offers a different pathway to healing that many find valuable in their pain management journey. As a therapist specializing in both chronic pain and psychedelic therapy approaches, I’ve witnessed how somatic therapy can provide relief when other methods fall short.
Understanding Somatic Therapy
The word “somatic” refers to the body (as opposed to the mind), and somatic therapy is founded on the principle that our physical and mental experiences are deeply interconnected. Unlike traditional talk therapy, which primarily engages the mind, somatic therapy uses the body as the starting point for healing.
Somatic therapy recognizes that trauma, stress, and emotions don’t just affect our thoughts—they register within our bodies at a cellular level. Harvard Health explains that this therapeutic approach “cultivates an awareness of bodily sensations and teaches people to feel safe in their bodies while exploring thoughts, emotions, and memories.”
Several approaches fall under the somatic therapy umbrella, including:
- Somatic Experiencing (SE): Developed by Peter Levine in the 1970s, this approach focuses on releasing trapped traumatic energy in the body
- Sensorimotor Psychotherapy: Integrates talk therapy, mindfulness, and movement to address trauma and attachment patterns
- The Hakomi Method: Combines mindfulness with somatic practices, focusing on gentleness and compassion
- Neurosomatic Therapy: More physically oriented, often involving massage and posture correction
Research is still emerging, but there’s growing evidence for somatic therapy’s effectiveness in treating chronic pain. Studies have shown it can help reduce pain intensity, lessen fear of movement, and improve physical functioning. A systematic review found that somatic interventions had positive outcomes for individuals with chronic pain, including reduced pain perception and increased mobility.
How Somatic Therapy Works for Chronic Pain
To understand how somatic therapy helps with chronic pain, we need to recognize the complex relationship between pain, trauma, and the nervous system.
Chronic pain isn’t just about tissue damage—it involves heightened nervous system sensitivity that can persist long after initial injuries heal. This sensitization can be triggered or intensified by traumatic experiences, ongoing stress, and emotional distress.
Many people with chronic pain develop conditioned responses. Over time, the brain creates pain signals in anticipation of movement, creating a cycle where fear of pain increases tension, creating more pain.
Somatic therapy breaks this cycle by:
- Regulating the nervous system: Teaching your body to move from a state of high arousal (sympathetic “fight or flight” mode) to a calmer state (parasympathetic “rest and digest” mode)
- Building body awareness: Helping you notice subtle physical sensations without judgment
- Creating safety: Establishing a sense of safety and control within your body
- Releasing stored tension: Gently releasing physical patterns of holding and bracing that contribute to pain
- Addressing trauma: Working with emotional components that may be amplifying pain signals
The goal isn’t just pain reduction but helping you develop a new relationship with your body based on understanding, compassion, and resilience.
What to Expect in Your First Session
Walking into your first somatic therapy session, you might wonder what will happen. Unlike some therapeutic approaches that dive straight into complex emotional territory, somatic therapy typically begins with creating safety and building resources.
Your initial session will likely include:
- Conversation about your pain experience: Your therapist will ask about your pain history, its impact on your life, and previous treatments.
- Discussion of trauma history: Since trauma can significantly impact chronic pain, your therapist may explore past traumatic experiences—but only at a pace that feels comfortable for you.
- Education about the mind-body connection: Your therapist will explain how somatic therapy works and the relationship between stress, trauma, and pain.
- Simple somatic exercises: You might practice basic body awareness or breathing techniques to get a feel for the approach.
- Goal setting: You’ll identify what you hope to achieve through therapy.
The environment will typically be quiet, comfortable, and private. Remember that somatic therapy emphasizes consent and boundaries—you’re always in control of what happens in each session. If something doesn’t feel right, your therapist will adjust the approach to better suit your needs.
Core Techniques Used in Somatic Therapy
Somatic therapy employs various techniques to help you connect with your body and release patterns of tension and pain. Here are some approaches you might experience:
Body Awareness and “Tracking”
At the foundation of somatic therapy is developing awareness of your physical sensations. This practice, sometimes called “somatic tracking,” involves noticing what’s happening in your body without trying to change it.
Your therapist might guide you with prompts like:
- “Where do you feel the pain most intensely?”
- “What sensations accompany the pain—heat, tightness, pulsing?”
- “Are there parts of your body that feel comfortable or neutral?”
This awareness helps you observe pain rather than immediately reacting to it, creating space between sensation and response.
Breathwork and Regulation
Breathing exercises are powerful tools for nervous system regulation. Your therapist may teach you various breathing patterns to activate the parasympathetic nervous system, which helps counteract the stress response that often amplifies pain.
These techniques might include:
- Diaphragmatic (belly) breathing
- Extended exhale breathing
- Three-dimensional breathing (expanding in all directions)
Grounding and Resourcing
Grounding techniques help anchor you to the present moment when pain or distress feels overwhelming. These practices might include:
- Feeling the weight of your body against the chair or floor
- Noticing points of contact between your body and surfaces
- Using the five senses to connect with your environment
“Resourcing” involves identifying and connecting with sources of support, comfort, and safety—both internal and external. These resources might include supportive relationships, pleasant memories, or places where you feel secure.
Pendulation and Titration
Two key concepts in Somatic Experiencing therapy are “pendulation” and “titration,” which allow for gentle processing of complex sensations:
- Pendulation: Moving back and forth between uncomfortable sensations and more comfortable ones, allowing your nervous system to experience that relief is possible
- Titration: Working with small, manageable amounts of activation or discomfort at a time rather than diving into the most intense sensations
Movement and Posture Work
Chronic pain often leads to protective postures and movement patterns that actually increase tension and pain over time. Your therapist may incorporate gentle movement explorations to:
- Release muscle tension
- Improve body alignment
- Increase movement confidence
- Reduce fear of movement (kinesiophobia)
These might include simple stretches, gentle joint mobilizations, or mindful walking—always working within your comfort zone.
The Somatic Therapy Journey
Healing with somatic therapy is typically a gradual process, and the journey varies for each person. The initial focus is building safety, awareness, and basic regulation skills. During this phase, your therapist also learns about your unique needs and responses, allowing them to tailor the approach accordingly.
As therapy progresses, you’ll likely develop a more nuanced understanding of your body signals, address emotional components that may be related to your pain, and learn to apply somatic techniques in daily life. Some people experience emotional releases during this phase—tears, trembling, or waves of feeling accompanying physical releases. These are standard parts of the healing process, typically followed by a sense of relief or integration.
With continued practice, you may find increased confidence in managing flare-ups, greater overall body awareness and comfort, or more capacity to engage in activities you value. Many continue with less frequent “maintenance” sessions after their initial treatment course, finding that periodic check-ins help sustain their progress.
Complementary Approaches
Somatic therapy works well alongside other approaches to pain management. In fact, an integrative approach often yields the best results.
Medical Treatments
Somatic therapy is a complement to, not a replacement for, appropriate medical care. It can be used alongside:
- Pain medication
- Physical therapy
- Interventional procedures
- Specialized medical treatments
Be sure to keep all your healthcare providers informed about the different approaches you’re using.
Mind-Body Practices
Many people find that other mind-body practices enhance the benefits of somatic therapy:
- Meditation and mindfulness
- Gentle yoga or tai chi
- Progressive muscle relaxation
- Guided imagery
Ketamine-Assisted Therapy
For those with treatment-resistant chronic pain, ketamine-assisted psychotherapy (which I offer in my practice) can work synergistically with somatic approaches. Ketamine’s effects on the nervous system can create an opportunity for deeper somatic processing and release of entrenched pain patterns.
Self-Care Practices
Your therapist will likely encourage daily practices to support your healing:
- Brief body scan meditations
- Gentle movement routines
- Stress management strategies
- Sleep hygiene practices
- Boundary-setting in relationships that affect your pain
Remember that healing happens both in and between sessions—the practices you incorporate into daily life are just as important as what happens in therapy.
Is Somatic Therapy Right for You?
Somatic therapy may be particularly helpful if:
- You’ve tried purely physical or purely psychological approaches with limited success
- You notice connections between stress and pain flare-ups
- You experience anxiety or trauma symptoms alongside your pain
- You feel disconnected from your body or have trouble identifying sensations
- You’re looking for tools to actively participate in your healing process
It’s worth noting that while many people benefit from somatic therapy, it’s not a quick fix. The approach requires patience, practice, and a willingness to explore new ways of relating to your body and pain.
Conclusion
Living with chronic pain is challenging, but somatic therapy offers hope and practical tools for reclaiming your relationship with your body. This approach can help you build a foundation for sustainable pain management and improved quality of life by addressing the complex interconnections between physical sensations, emotions, and nervous system patterns.
As you consider whether somatic therapy might be right for you, remember that healing is a personal journey. The most effective approach is one that resonates with your unique needs and experiences.
If you’re interested in exploring somatic therapy for chronic pain or learning more about how it can complement ketamine-assisted psychotherapy, I welcome you to reach out. Together, we can develop a personalized approach to help you live well despite pain—and perhaps even discover new possibilities for healing you hadn’t thought possible.