The Difference Between Talk Therapy and Somatic Work

In a session one time, I remember sitting down as the client and feeling flooded with emotion, and I said, “Where do I begin? There’s just so much to unpack here.”

And, in a traditional talk therapy session, I might have begun to relate all that had happened. We could have examined my cognitive distortions and traced the emotions back to childhood attachment. There is a place for that and research to support the efficacy of CBT.

However, as a Somatic Experiencing Practitioner, she said, “Why don’t you start with physiology?” What’s happening in the body right now?

I felt a wave of relief wash through my lungs when she said that. Sometimes life can feel unspeakable. And, the fear or retraumatization is why some people shy away from traditional therapy. I did not want to talk about what was happening, but I did want to heal!

I noticed I felt absent from my stomach– unaware of any hunger or sensation. My vision felt foggy, yet my eyes were fixed and intense. This became the information for the session. 

Talk therapy is sometimes called a top-down approach. You work with the mind and then the body. Somatic work is a bottom-up approach. You work with the body and then the mind. That’s not exactly true because the word “soma” implies that the body and mind are connected, so you can’t actually work with one without working with the other. 

I’ve supported clients through painful, traumatic experiences– high conflict divorces and custody battles, tragic health diagnoses, egregious abuse, and more. Often, I knew minimal about the details of their experience. I practice as an SEP, not as an LPC. Many of my clients also see LPCs or LCSWs to process cognition and create new patterns of behavior. 

What we track in sessions is how the body responds to the stimuli. In the moment and in my office as they recall the experience in their memory. With the anchor of the present moment environment and a grounded, regulated practitioner, some of the overwhelming sensation feels less treacherous to traverse. 

“Instead of diving right into the pit of your stomach, I wonder about exploring right around the edges where you do notice sensation. What’s that like?”

We want to work within the window of tolerance. This is different for each individual in each moment. 

“How is it for you to blink your eyes softly– slow, soft blinks?”

The tears begin to unstick from my eyes. It helps that I know intellectually that tears are part of the process of integration. I learned early not to cry and to stuff my emotions. And, now I learn to let them fall. 

The tears are thick and murky; no wonder my vision has felt foggy. As they come to an end, I feel as if I am seeing the office for the first time. My eyes are somehow softer and the surroundings more vibrant. The tension in my jaw and neck has dissipated. I hadn’t even known I was holding tension there until it released. My stomach begins to gurgle. Hunger is online again. 

I feel a little more space between the events occurring in my life and my physiology. My mind is quieter, too.