Somatic therapies

Somatic therapies are talking therapies that pay close attention to the body. “Somatic” just means bodily. They work less with what you think about something. They work more with what your body does when it comes up: the tightening, the held breath, the urge to leave the room.

The reasoning behind them is that fear shows up in the body first, and can stay switched on there long after the danger has passed. Understanding that in your head, as a lot of people discover, doesn’t switch it off.

Several different approaches sit under the label. The two you’ll see most in Australia are Somatic Experiencing and sensorimotor psychotherapy. The first was developed in the United States by Peter Levine, the second by Pat Ogden. Plenty of therapists also work this way inside another Approach (modality) The kind of therapy someone uses, such as CBT or psychodynamic therapy. You'll also see it called a modality. More in the jargon decoder , without using either name.

How it works

What the approaches have in common is the pace. You take on difficult material in small amounts, and how much you take on at a time is yours to decide.

Noticing. You learn to describe what’s happening physically with more precision than “bad”: where it is, whether it’s moving, what it wants to do.
Small amounts. Difficult material is approached a little at a time rather than in one go. The word practitioners use is titration, borrowed from chemistry.
Going back and forth. You move between something difficult and something settled, deliberately and repeatedly, rather than staying in the hard thing until it eases.
Finding steady ground first. Before any of that, most of the work is on what actually calms you, so there’s somewhere to return to.

What people often notice first is that the body does something on its own: a shake, a deep breath, a shift in temperature, a wave of tiredness. These approaches treat that as the point rather than as an interruption.

None of this is massage or bodywork. Most somatic therapy involves no touch at all. Some practitioners are trained to use touch and will ask first, every time, and you can decline and keep the therapy.

What a session is like

Sessions look like an ordinary therapy session that keeps slowing down.

You’ll talk, and your therapist will stop you fairly often to ask what you notice physically as you say it. Then you sit with that for a moment before moving on. To someone used to getting through the story, it can feel frustratingly slow at first.

The part that matters most for trauma is what you’re not asked to do. You don’t have to give a detailed account of what happened, and you’re not expected to stay in distress until it comes down. If that’s what’s put you off other approaches, it’s the main practical difference.

Sessions run about an hour, and the length of the work varies a lot. Some people do six or eight sessions on one thing; other work is open-ended.

Who it tends to suit

Somatic work often suits people whose difficulty is clearly physical. Panic that arrives before any thought does. A body that won’t come down after a scare. Going numb or unreal under pressure, or sleep that won’t settle.

It also suits people who’ve done a lot of talking already. If you can explain your patterns clearly, at length, and none of it has changed how you feel, an approach that doesn’t run on explanation is worth a look.

It may suit you less if attention to your own body is itself frightening, which is common and not a failing. It doesn’t rule this work out, but it makes the therapist’s skill and a slow start more important.

If things feel unsafe right now, this kind of therapy isn’t where to start. Lifeline is on 13 11 14, the Suicide Call Back Service is on 1300 659 467, and Kids Helpline is on 1800 55 1800 for anyone aged 5 to 25. In an emergency, call 000. Crisis and emergency support has the full list.

What the evidence says

The evidence is thinner than the popularity suggests, and being straight about that is more useful than the alternative.

Somatic Experiencing has been studied in a handful of trials with small numbers. The most cited is a randomised trial of 63 people with post-traumatic stress disorder (PTSD). It found more improvement than waiting for treatment (Brom and colleagues, 2017). That’s a real result. It’s also one modest trial, against the many trials behind the established trauma therapies.

Australia’s national PTSD guidelines don’t recommend body-based approaches as a treatment. They say there isn’t enough evidence to recommend this group of therapies on their own. They do support using them alongside a treatment that has the evidence (Phoenix Australia, 2020–21). That’s a fair summary of where things stand.

So the honest position. The idea makes sense, the therapy is widely used, many people say it helps, and the trials that would settle it haven’t been done. If you’re choosing a first treatment for a single traumatic event, eye movement desensitisation and reprocessing (EMDR) and trauma-focused talking therapies have far more evidence behind them. Somatic work is easier to justify once those have been tried, or alongside them.

Getting it in Australia

Check the training underneath. “Somatic therapist” is not a protected title here, and nothing stops anyone using it. Both of the named approaches run their own long training, and both keep a list of the people who’ve done it, so you can check a name against those. Then check what the person trained in first. Are they a Registered For psychologists, psychiatrists and occupational therapists, registration with Ahpra is required, and using the title without it is an offence. Counsellors and psychotherapists can register with their national associations, which is voluntary. More in the jargon decoder Psychologist Someone trained to assess mental health problems and treat them with therapy. It takes at least six years of study and supervised practice, and they're registered with Ahpra, the national regulator. Psychologists can't prescribe medication. More in the jargon decoder ? A mental health social worker or occupational therapist? A Counsellor Someone trained to help people talk through and work on difficulties. The title isn't protected in Australia, so it's worth checking a counsellor's training and registration. Medicare doesn't give a rebate for counsellors. More in the jargon decoder or Psychotherapist Someone trained in therapy, often for longer-standing patterns. Like counsellor, the title isn't protected in Australia, and Medicare doesn't give a rebate for psychotherapists. More in the jargon decoder listed with one of the national associations? Who does what explains the differences, and how to find a therapist covers looking someone up.

Checking is also what separates this work from body-based services with nothing behind them. Energy healing, trauma said to be stored in a particular organ, and anything promising a cure in one session are not somatic therapy.

What Medicare Australia's public health insurance scheme. For mental health, it gives rebates on sessions with psychologists and some other professionals, usually through a Mental Health Treatment Plan. More in the jargon decoder Rebate The amount Medicare pays back towards a session. It comes back to you after you've paid, so what you pay yourself is the fee minus the rebate. More in the jargon decoder . A Mental Health Treatment Plan gives you a Medicare rebate on up to ten sessions a calendar year, but only with a psychologist, mental health social worker or Mental health occupational therapist An occupational therapist with a mental health endorsement. Their focus is on daily life, such as getting back to work, study and routine, alongside the therapy itself. More in the jargon decoder . Somatic training sits on top of one of those, rather than replacing it. The rebate follows the person, not the method. Many somatic practitioners are counsellors or psychotherapists, who aren’t covered at all.

Availability. Trained practitioners are mostly in capital cities. Full fees are common, waiting lists are normal, and access outside the cities is limited.

Telehealth A session by video or phone instead of in person. Medicare gives the same rebate for a session by video as in person. More in the jargon decoder . It can work, but probably not as well as in person. Video makes it harder for a therapist to see what your body is doing. Worth asking a practitioner what they think for your situation.

EMDR (eye movement desensitisation and reprocessing) A structured therapy for memories that still feel raw. You bring a painful memory to mind for short stretches while your attention is split, usually by following your therapist's hand as it moves from side to side. The aim is for the memory to become less upsetting. More in the jargon decoder also works without a detailed account of what happened, and it has much stronger evidence for single-event trauma.

Internal family systems shares the slow, inward pace, and often overlaps with somatic work in practice. It maps the inside differently.

The therapist matters more than the label on the door. That’s especially true where the label isn’t regulated. Why who you see matters more than what they do explains why. And if you’re still working out whether you want therapy at all, what therapy actually is covers the basics, and would I benefit from therapy? helps you work out whether it’s worth a try.