Somatic Therapy Techniques for Clinicians
By Kristen McClure, MSW, LCSW | TherapistWorksheet.com
The body holds what the mind cannot yet articulate. This is not poetry — it is neuroscience. Somatic therapy approaches work with the body as an entry point to healing, particularly for trauma, anxiety, and chronic stress. Here is what those approaches look like in clinical practice.
What Somatic Therapy Is
Somatic therapy is an umbrella term for therapeutic approaches that work with the body — sensation, movement, posture, breath, and physiological states — as part of the healing process. Key modalities include Somatic Experiencing (Peter Levine), Sensorimotor Psychotherapy (Pat Ogden), Hakomi, and EMDR (which has significant somatic components).
Somatic approaches are particularly relevant for trauma because traumatic experiences are encoded not just in memory and cognition but in the body — in chronic tension patterns, autonomic responses, and procedural memory that does not respond to verbal processing alone.
Somatic Techniques Therapists Can Use in Session
Tracking body sensation
The foundational somatic skill is teaching clients to notice and name body sensation. This requires slowing down and turning attention inward — which is genuinely difficult for many clients.
“Where do you feel that in your body? Can you describe the sensation? Is it tight, heavy, warm, buzzing? What size is it? Does it have movement?”
Do not jump to interpretation. Tracking sensation is itself therapeutic — it builds interoceptive awareness and tolerance for body experience.
Pendulation
Moving attention between a resource (something that feels neutral or positive in the body) and a charge (something activating) — in small titrated doses. This builds the nervous system’s capacity to approach difficult material without being overwhelmed.
“Let’s notice what it feels like in your body when you think about [the safe place]. Just the sensation. Good. Now, very briefly, turn your attention toward [the difficult thing]. Notice what shifts. Now come back to [the safe sensation]. What do you notice?”
Grounding through the body
Pressing feet into the floor, noticing the support of the chair, feeling gravity — these activate the proprioceptive system and support regulatory return when clients move out of their window of tolerance.
“Feel both your feet on the floor. Press down a little. Notice what that’s like. Notice that the floor is holding you.”
Orienting
Slow, deliberate orienting to the environment — moving the eyes and head to take in the room — activates the social engagement system and helps the nervous system register that the current environment is safe.
“Take a slow look around the room. Let your eyes move naturally, not rushing. What do you notice?”
Working with impulse and completion
Trauma can be understood as an incomplete defensive response — a freeze or collapse that interrupted a fight or flight. Somatic approaches explore the impulses that were arrested and support their completion in slow, titrated ways.
“When you feel that activation in your chest, notice if there is any impulse — to move, to push away, to run. Don’t act on it fully — just notice it. What does your body want to do?”
Breath work
Extended exhale (making the exhale longer than the inhale) activates the parasympathetic system. Box breathing, diaphragmatic breathing, and physiological sigh (double inhale through the nose followed by extended exhale through the mouth) are evidence-supported regulatory tools.
What to Watch For
Somatic work can move quickly and deeply. Watch for:
- Signs the client is leaving their window of tolerance
- Dissociation (going “away,” glazed eyes, losing contact)
- Abreaction — sudden flooding of emotion or sensation that exceeds the client’s capacity
If you see any of these, slow down, orient the client back to the present, and return to a resource before continuing.
Frequently Asked Questions
Do I need specialized training to use somatic techniques?
Basic somatic techniques — tracking sensation, grounding, breath work — can be used by any therapist with a sound understanding of the nervous system and trauma. For more advanced somatic work (Somatic Experiencing, Sensorimotor Psychotherapy), formal training is required. These approaches involve significant experiential learning that cannot be gained from reading alone.
What if a client is uncomfortable with body awareness?
Go slowly and follow the client’s pace. Many trauma survivors have good reason to distrust body experience — their body has been a site of danger. Body awareness can be introduced gradually, starting with neutral sensations (feet on floor, weight in chair) before moving toward more charged material.
Can somatic work be done via telehealth?
Yes, with adaptations. Grounding, breath work, and tracking sensation translate well to video. Movement-based and touch-based elements require modification. Many somatic therapists have developed effective telehealth approaches.
How do somatic approaches integrate with talk therapy?
Most effectively as an integrated approach rather than a separate modality. Somatic tracking can be woven into any session — noticing what happens in the body when a client discusses something significant, using grounding when they become activated. You do not need to structure an entire session around somatic work to use somatic awareness.
Kristen McClure, MSW, LCSW is a licensed therapist who creates practical clinical tools to help therapists navigate the hardest moments in their work.