Somatic experiencing: using interoception and proprioception as core elements of trauma therapy

Summary & key facts

This paper explains Somatic Experiencing (SE), a form of trauma therapy that focuses on guiding a person's attention to internal body sensations (like heartbeat, breathing, muscle feeling) instead of mainly talking about thoughts or memories. The authors describe how SE claims these bodily sensations can help complete interrupted defensive responses and reduce excess nervous-system arousal, and they offer a neurophysiological idea called the “core response network” to explain how this might work. The paper uses a composite case example and links SE to mindfulness and body-based practices, but the authors say there were no published peer‑reviewed studies of SE at the time and more research is

Key facts:

• Somatic Experiencing (SE) directs attention to interoception (internal organ sensations), proprioception (body position), and kinesthetic feelings (movement sense) rather than primarily to thoughts or emotions.
• The authors state SE’s proposed mechanism: completing thwarted self‑protective/defensive responses and discharging or regulating excess autonomic (stress) arousal.
• The paper introduces the idea of a “core response network” (CRN) made up of subcortical autonomic, limbic, motor and arousal systems and suggests SE may help restore its function.
• SE is described as not being an exposure therapy; it avoids intense, direct evocation of traumatic memories and instead approaches charged memories gradually.
• The paper presents a composite case: a 43‑year‑old man involved in a high‑speed car crash (about 75 mph) who had ongoing anxiety, panic around driving, cold hands and feet, heart pounding, stomach knot, and concentration problems four month
• The authors note that as of the paper’s writing (published 2015) they were not aware of any published peer‑reviewed case studies, clinical trials, or mechanistic tests of SE and say more research is needed.

Abstract

Here we present a theory of human trauma and chronic stress, based on the practice of Somatic Experiencing® (SE), a form of trauma therapy that emphasizes guiding the client's attention to interoceptive, kinesthetic and proprioceptive experience. SE™ claims that this style of inner attention, in addition to the use of kinesthetic and interoceptive imagery, can lead to the resolution of symptoms resulting from chronic and traumatic stress. This is accomplished through the completion of thwarted, biologically based, self-protective and defensive responses, and the discharge and regulation of excess autonomic arousal. We present this theory through a composite case study of an SE treatment; based on this example, we offer a possible neurophysiological rationale for the mechanisms involved, including a theory of trauma and chronic stress as a functional dysregulation of the complex dynamical system formed by the subcortical autonomic, limbic, motor and arousal systems, which we term the core response network (CRN). We demonstrate how the methods of SE help restore functionality to the CRN, and we emphasize the importance of taking into account the instinctive, bodily based protective reactions when dealing with stress and trauma, as well as the effectiveness of using attention to interoceptive, proprioceptive and kinesthetic sensation as a therapeutic tool. Finally, we point out that SE and similar somatic approaches offer a supplement to cognitive and exposure therapies, and that mechanisms similar to those discussed in the paper may also be involved in the benefits of meditation and other somatic practices.

Topics

Mental Health and Psychiatry Psychosomatic Disorders and Their Treatments Psychotherapy Techniques and Applications

Categories

Health Sciences Medicine Psychiatry and Mental health

Tags

Anxiety Arousal Cognition Cognitive psychology Developmental psychology Exposure therapy Interoception Kinesthetic learning Neuroscience Perception Proprioception Psychiatry Psychology Psychotherapist