Somatic Experiencing (SE)
Touch & Table Work
SE Touch is applied with hands and occasionally with forearm or foot contact, and can also be offered indirectly, such as providing support through a cushion. SE Touch is done fully clothed and is not used to manipulate the body. SE Touch offers support to muscles, joints, diaphragms and organs to support regulation and healthy functioning.
Touch can be applied with the client in a seated position or lying face up on a table, or standing during movement exercises. Some examples of when touch can be helpful are:
Identifying an area of the body for tracking internal sensations.
Supporting an area of the body to release tension or constriction.
Stabilizing a highly activated / dysregulated nervous system.
Containing and processing difficult emotions (e.g., feeling therapist’s hands on the outside of your upper arms to provide a sense of containment to reduce flooding).
Bringing awareness to an area of the body that feels disconnected or numb.
Engaging a reflexive action or defense to support completion / discharge of a response (e.g., (pushing into a therapist’s hands to engage a frozen fight response).
Resourcing an individual with positive sensation or a healthy body function (e.g., pressure on the feet can enhance a sense of grounding).
Calming an anxiety response, by supporting the brain stem or the kidney/adrenal area. Connecting with tissue / muscle memory or natural biological rhythms.
Increasing blood flow to damaged tissue.
What is Somatic Experiencing™ (SE)? Somatic Experiencing (SE) is a naturalistic approach to the resolution and healing of trauma developed by Dr. Peter Levine, resulting from his multidisciplinary study of stress physiology, psychology, ethology, biology, neuroscience, indigenous healing practices and medical biophysics. SE releases traumatic shock (freeze) and supports the body’s natural ability to regulate itself, which is key to transforming PTSD, chronic stress and the wounds of emotional and early developmental attachment trauma.
SE is based upon the observation that wild prey animals, though threatened routinely, are rarely traumatized. Animals in the wild naturally regulate and discharge the high levels of energy arousal (fight/flight) associated with defensive survival behaviors and chronic stress. This provides animals with a built-in “immunity” to trauma and stress that enables them to return to normal in the aftermath of highly charged life-threatening experiences.
SE facilitates the completion of self-protective motor responses and the release of survival energy bound in the body, thus addressing the root cause of trauma symptoms, which can result in subtle or more intense experiences as the body discharges. This is approached by gently guiding clients to develop increasing tolerance for difficult bodily sensations, impulses, movements, triggers and suppressed emotions, so as to not get overwhelmed. Note: Somatic Experiencing can be used with or without touch.
SE employs awareness of body sensation to help people “renegotiate” and heal rather than re-live or re-enact trauma.
SE’s guidance of the bodily “felt sense,” allows the highly aroused or frozen survival energies to be safely experienced and gradually discharged.
SE “titrates” your experience (breaks it down into small, incremental steps) so that you can remain embodied and present, rather than evoking a mindless catharsis or becoming flooded, which can overwhelm the regulatory mechanisms of the organism.
SE does not require you to re-tell or re-live the traumatic event, which is helpful in the case of pre-verbal trauma. However, working through the trauma narrative can be done more safely using SE, as it works more gradually to build capacity and resilience than typical prolonged exposure techniques. SE offer the opportunity to engage, complete and resolve—in a slow and supported way—the body’s instinctual fight, flight, freeze, and collapse responses. Individuals locked in anxiety or rage then relax into a growing sense of peace and safety. Those stuck in depression gradually find their feelings of hopelessness and numbness transformed into empowerment, triumph, and mastery. SE catalyzes corrective bodily experiences that contradict those of fear and helplessness and seeks to restore a sense of aliveness and pleasure. This resets the nervous system, restores inner balance, enhances resilience to stress, and increases people’s vitality, equanimity, and capacity to actively engage in life.
For more information about SE please note the following references:
Levine, P. and Frederick, A. (1997). Waking the Tiger: Healing Trauma: The Innate Capacity to Transform Overwhelming Experiences. Berkeley, CA: North Atlantic Books.
Kline, M. and Levine, P. (2007). Trauma Through A Child’s Eyes: Awakening the Ordinary Miracle of Healing. Berkeley, CA: North Atlantic Books.
For further references and information online about SE go to http://www.traumahealing.com
(This information adapted from the Somatic Experiencing website.)
What are Touch and Table Work?
Ideally our earliest experiences of being soothed, nurtured and held in a bonded relationship happen though attuned touch. However, some of the deepest shock experiences held in the body occur when we are so young that our brains and nervous system are not yet sufficiently developed to process those experiences cognitively. When caregivers are unavailable or the source of distress, co-regulation and soothing often weren’t available, resulting in the body’s tendency to flip between hyper-arousal or dorsal vagal shutdown (freeze) as a way to cope with overwhelm. As demonstrated by the Adverse Childhood Experiences study, this can result in complex health syndromes when the body becomes highly sensitive and has to hijack or tax other systems as a management strategy.
Since early developmental trauma is largely pre-verbal and involves body memory, the skilled and appropriate use of touch can be an essential part of the healing process and provide corrective emotional experiences, especially when words are not available, when there were significant attachment ruptures that were never repaired, or when the body is stuck in survival mode as a baseline state. Touch work can involve no touch at all, focusing instead to resolve the activation associated with anticipating touch or closeness, or voicing the ability to say no without shame, guilt or overriding to please others.
Touch and table work are applied with hands and occasionally with forearm or foot contact, and can also be offered indirectly, such as providing support through a cushion. Touch work is done fully clothed, occasionally over blankets or a sheet if preferred, and is not used to manipulate, rehabilitate or repair the body as done in physiotherapy, kinesiology, chiropractics or massage. It does not constitute medical treatment and it is not a replacement for other bodywork approaches, which are different in focus, intent and method. Touch and table work are used primarily to explore interpersonal processing and attachment as well as self-regulation, safe touch, healthy boundaries, as well as work through early pre-verbal trauma and shock trauma. It can be incorporated while seated, as well as lying face up on a table, or standing during movement-based exercises.
Touch was incorporated in Somatic Experiencing by Dr. Peter Levine, and was further refined as a practice by Kathy Kain, MA, SEP, somatic and bodywork practitioner and senior faculty member with the Somatic Experiencing Trauma Institute, in collaboration with Steve Terrell, PsyD, SEP (www.somaticpractice.net). Stephen co-created Somatic Resilience and Regulation; Early Trauma with Kathy Kain. Together, they teach students internationally. Stephen developed Transforming The Experience-Based Brain: An Integrative Neurodevelopment Approach to the Treatment of Developmental Trauma utilizing Transforming Touch® and teaches the program worldwide.
Somatic Experiencing, touch and table work, especially during the release of a self-protective response or body memory, can bring up unexpected emotions, thoughts, pain, physical reactions or memories. It is also quite common for the body to vibrate or tremble during a release, and for clients to experience a sense of fatigue or soreness. This is typically temporary, and your therapist will support you to work through these in a helpful and contained way that reduces the likelihood of overwhelm. It is important to honor the body’s needs and rest following sessions to support integration.
Additional Approaches: Nicholas Bolton, M.S.Ed., LPCC, SEP integrates additional therapies into his trauma work depending on the situation, including parts work for individuals with complex dissociation, trauma-sensitive mindfulness, nature-based therapy, transpersonal work, Contextual Behavioral Sciences, and Acceptance and Commitment Therapy, etc. For more information refer to the ‘Clinical Informed Consent’ document and visit www.NicholasBoltonCounseling.com
Scheduling Sessions: Sessions can be held at a frequency that works best for you. However, scheduling sessions closer together is recommended initially in order to maximize results. Your therapist will indicate a specific frequency of sessions based on your goals and your initial response to these modalities.
Ethics of Touch
Nicholas is a member of The United States Association for Body Psychotherapy, which has outlined ethical considerations for the use of touch and body-based approaches in therapy. To read the standards outlined for the safe and ethical practice of touch in psychotherapy, visit: www.zurinstitute.com/ethicsoftouch.html. A summary of these guidelines follows:
Consent is required when using touch-related techniques in therapy and can be withdrawn at any time. Nicholas will ask you permission to use touch and you have the right to decline or refuse touch without fear or punishment, even if you previously provided consent. Nicholas will ensure that you understand the nature and purpose of using touch. Nicholas will explore with you and evaluate the appropriateness of the use of touch in your situation. He will also check in with you about your comfort level with regards to the location of touch, amount of pressure, length of contact, and his proximity to you both before and during each session. If touch is overwhelming, or the intention of appropriate touch in likely to be misunderstood by a particular client due to development or cultural reasons, touch is not used.
Sexual touch of clients by therapists is unethical and illegal. Genital touching is not performed, nor do therapists use touch to sexually stimulate clients deliberately. Touch should not be used to foster dependency of the client on the therapist, and therapists are cautious about the potential to re-enact dynamics or trigger transference coming from early, vulnerable experiences/states. Clear boundaries are outlined prior to and during the use of touch in a manner that is not enmeshing, shaming or derogatory.
Touch is only used in your best interest to benefit your healing with respect to your self-determination, and never to gratify the personal needs of your therapist. Your needs and wishes take priority over any clinical or theoretical approach. You may request not to be touched at any time during therapy without needing to explain it, if you choose not to, and without fear of punishment. You might also change your mind about touch and decide that you feel comfortable receiving touch support in areas that were formerly uncomfortable.
"Before there are words, there is the wordless communication of the body.”
— Michael Changaris, Psy.D.
“Being able to feel safe with other people is probably the single most important aspect of mental health; safe connections are fundamental to meaningful and satisfying lives.”
― Bessel A. van der Kolk, The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma
"The power of touch helps to soothe the nervous system, restoring a sense of safety and trust in the moment. Warm, safe touch activates the release of oxytocin—the “tend and befriend” hormone that creates pleasant feelings in the body and is the brain’s direct and immediate antidote to the stress hormone, cortisol."
— Stephen Terrell, developer of Transforming the Experience-Based Brain (TEB)
“These techniques seem to target the most common patterns of hypervigilance and bracing in preparation for threat. By using direct contact with specific physical structures and regions of the body that play a large role in physiological resilience and self-regulation, the practitioner can invite their clients to alter long-standing habits in their stress responses. As clients are supported in letting go of these habitual patterns, they become more adept at allowing the full range of physiological responses to flow without the urge to stop or suppress them; they stay more somatically present, even in the face of strong somatic experiences."
― Kathy Kain co-author: Nurturing Resilience: An Integrative Somatic Approach