Five Kinds of Somatic Therapies
What are the different kinds of somatic therapies and what are the key differences?
6 min read
Somatic therapy has received more attention in the past few years, as more people have brushed up against the limits of traditional talk therapy and as social media platforms like TikTok have popularized the term. It can be difficult to sift through the jargon soup of various somatic therapies and understand their similarities and differences.
This article will explore five kinds of somatic therapy approaches: Somatic Experiencing (SE), Accelerated Experiential Dynamic Psychotherapy (AEDP), Sensorimotor Psychotherapy, Eye movement desensitization and reprocessing (EMDR), and Gestalt.
There are some key similarities and differences between these approaches. “These five somatic therapies prioritize embodied awareness–how a client notices, identifies and responds to body sensations that emerge in session–and uses this awareness as a lever in the healing process,” says Melanie Berkowitz, a therapist at Downtown Somatic Therapy trained in Gestalt and AEDP.
One of the first distinctions in these models is their intended area of focus. AEDP and Sensorimotor Psychotherapy were developed to heal attachment trauma–that is, how relationships with caregivers or attachment figures from an early age have created psychological imprints that impact a person’s sense of themselves and of others.
SE and EMDR generally focus more on addressing impacts of specific traumatic experiences (i.e. a car accident) and nervous system regulation. Gestalt does not address trauma specifically and focuses more on relational and existential concerns, like how clients can create meaning and purpose in their lives.
Below offers a summary of each of these five somatic approaches. There is special focus on how each approach addresses trauma in the body, whether the approach is more structured or more spontaneous, and the importance of the relationship between therapist and client.
“Somatic therapies prioritize embodied awareness–how a client notices, identifies and responds to body sensations that emerge in session–and uses this awareness as a lever in the healing process.”
1. Somatic Experiencing (SE) is a somatic therapy that focuses on healing the impacts of trauma. It was developed by Peter Levine, who observed that even though wild animals are threatened routinely by predators, they generally return to calm states after these attacks–and do so by shaking and trembling to discharge their ‘charged’ energy.
Levine noticed that many humans have more difficulty releasing this charged energy after a traumatic experience and instead trap the post-traumatic stress in their bodies–through contracted muscles, heart racing, or going numb. SE supports clients to learn about their autonomic nervous system so that they can release this trapped physical energy.
SE often doesn’t require clients to completely process a specific trauma: the therapy prioritizes supporting clients to learn how to “pendulate”--or move back and forth–between the distinct nervous system states of feeling charged and feeling calm so clients can learn how to soothe themselves more effectively.
SE practitioners do this by supporting clients to track their own body sensations through various exercises. Many SE practitioners are also trained in touch work, and can use touch to more directly interact with the client’s nervous system if clients are interested.
“Somatic Experiencing supports clients to learn about their autonomic nervous system so that they can release this trapped physical energy.”
2. Accelerated Experiential Dynamic Psychotherapy (AEDP) therapists believe that our core emotions–grief, anger, fear, joy, disgust, and excitement--are fundamentally healthy ones and naturally help guide us toward growth, transformation, and healing when fully processed.
However, many of us get wounded in relationships with others when we experience what AEDP founder Diana Fosha calls “unbearable aloneness in the face of overwhelming emotion.” AEDP therapists work to heal such attachment wounds by “undoing” the client’s aloneness in session and help clients process these core emotional feelings in a new, safe and healthy way.
This stance is unique to AEDP: AEDP therapists view their relationship with clients as a primary vehicle for healing. Instead of coaching clients to regulate their nervous systems from the sidelines, AEDP therapists are deeply affirming and bring their felt experiences to sessions.
When AEDP therapists track somatic markers and share their own felt experiences, clients feel seen and heard, and it is an entry way for clients to more easily drop into new and healing emotional experiences, which can result in immediate neuroplastic changes.
One way AEDP therapists help guide clients into core emotional experiences is by attending to the physical sensations that spontaneously emerge in a session, similar to Sensorimotor Psychotherapy or Gestalt.
“AEDP therapists view their relationship with clients as a primary vehicle for healing.”
3. Sensorimotor Psychotherapy tracks how our body holds specific patterns and habits from our early attachment relationships and past experiences. Mirror neuron research shows that learning first occurs through the body before it is integrated into our thoughts.
Pat Ogden, who developed Sensorimotor Psychotherapy and was deeply influenced by The Hakomi Method, developed Sensorimotor Psychotherapy to specifically heal the impact of attachment trauma and how it gets stored in a person's body, postures, and felt experience.
Sensorimotor Psychotherapy addresses how limiting cognitive beliefs–such as feeling unlovable--are experienced in the body and supports clients to become aware of how embodying a positive belief impacts their felt experience in a different way. Interventions focus on making the client aware of how their movements, gestures and impulses are connected to attachment needs.
4. Eye Movement Desensitization and Reprocessing (EMDR) is a structured therapy that addresses specific traumatic memories and how they live in the brain. Unlike many other trauma therapies, EMDR directly targets a traumatic memory through “bilateral stimulation” to change the way this memory lives in the brain.
Bilateral stimulation means moving your body in a rhythmic way that activates both sides of the brain–such as rapidly moving your eyes from left to right or alternating tapping your left and right knee–while focusing on a specific memory. EMDR has standardized producers and is a more regimented approach than the other therapies on this list.
“Unlike many other trauma therapies, EMDR directly targets a traumatic memory through ‘bilateral stimulation’ to change the way this memory lives in the brain.”
5. Gestalt is a holistic approach that focuses on the present moment and supports clients to loosen the defensive patterns that inhibit someone's natural ability to access their vitality. “Gestalt embraces the ‘paradoxical theory of change’: that people transform when they deeply become aware of who they are, not by trying to become someone else,” adds Melanie.
Gestalt is a process-oriented approach founded in the 1950s that has influenced the development of modalities like AEDP and Sensorimotor Psychotherapy. Unlike them, Gestalt does not specialize in attachment trauma specifically but rather centers on how clients can create meaning and purpose for themselves.
Gestalt practitioners, like AEDP and Sensorimotor Psychotherapy therapists, focus on the present moment and track the body sensations, gestures and sounds of their clients to bring awareness to core emotions underneath the surface. Like AEDP, Gestalt practitioners engage in spontaneous ‘experiments’ to help a client feel an emotion more deeply, such as encouraging a client to exaggerate a movement or phrase.
“Gestalt practitioners engage in spontaneous ‘experiments’ to help a client feel an emotion more deeply, such as encouraging a client to exaggerate a movement or phrase.”
All somatic therapies incorporate the body and body sensations in treatment, yet there are many different kinds of somatic therapies out there. Depending on what you’re looking for–whether that’s healing from a specific traumatic experience, wounds from childhood, or more existential concerns–one of these five different approaches might be best suited for you.