Somatic Experiencing in Practice: What Happens in a Session?

By Brooke Levy

Somatic Experiencing (SE) is structured around restoring a sense of safety, control, and regulation in the body. But what does that actually look like in a therapy session?

Let’s break down how SE is typically practiced and why it’s so different from approaches that rely on retelling or reprocessing trauma through words alone.

The First Step: Assessment and Intake

The initial phase of SE involves a clinical interview and a series of structured assessments that explore the client’s trauma history, psychiatric background, and general health (Brom et al., 2017). This first step is critical as it helps the therapist determine whether SE is the right fit for the client and whether it can be used safely.

Early sessions focus on helping the client build awareness of bodily sensations. For example, the therapist may observe physical cues such as a shift in posture, a flinch at a loud noise, or sudden back pain when trauma is discussed. These subtle reactions provide a starting point for deeper exploration and healing.

It’s also important to determine whether the client may have conditions that could make SE destabilizing. Brom et al. (2017) recommend caution when working with individuals experiencing psychosis, active suicidal ideation, substance misuse, or brain injury. Because SE works directly with bodily memory and sensation, it can be overwhelming for clients with certain severe mental health conditions. That said, if SE is a good fit, it offers a powerful pathway to recovery.

Core Techniques in SE Practice

Once SE begins, the therapist draws on a handful of core techniques that help guide the client through a process of regulation and release.

1. Psychoeducation

A foundational piece of SE is helping clients understand their trauma responses. The therapist explains how trauma isn’t just psychological but physiological as well. Clients often feel relieved to learn that their symptoms aren’t “all in their head” but are part of a biological response that was never completed.

The goal here is to introduce the concept of biological completion - the idea that traumatic energy can get “stuck” in the body if it isn’t fully released at the time of the event. The therapist normalizes feelings like frozenness, dissociation, or hyperarousal as part of the body’s survival mechanism. This understanding alone can reduce shame and self-blame (Payne et al., 2015).

2. Resourcing & Grounding

Before diving into trauma material, SE focuses on establishing safety in the body. The therapist helps the client build internal and external resources - sensations, images, or memories that feel comforting or neutral. These might include the feeling of feet on the floor, the sound of a calming voice, or a memory of a peaceful place.

Clients are encouraged to bring awareness to parts of their body that feel unaffected by trauma. For example, their hands or feet to use these “anchors” as stabilizers throughout the work. The therapist also uses relationship-based tools like eye contact, voice tone, and physical proximity (when appropriate) to foster co-regulation and trust (Payne et al., 2015).

3. Pendulation

In SE, the therapist intentionally guides the client between states of activation (when trauma-related sensations arise) and states of calm or neutrality. This process is called pendulation. It helps the nervous system learn flexibility and resilience, the ability to move into activation without getting stuck there.

The client may begin by exploring a challenging memory, then be gently redirected back to a resourced state using grounding techniques. This “ebb and flow” allows for the safe processing of trauma without overwhelming the system (Payne et al., 2015).

4. Titration

Titration builds on pendulation. It means the therapist helps the client approach trauma in small, manageable doses. Instead of diving deep into painful memories or physical sensations all at once, SE encourages gradual exploration.

For instance, a client who’s triggered by sound might be introduced to gentle tones in session. The therapist helps the client pause, notice what sensations are coming up, and then return to a calm state. Over time, exposure can be slowly increased, helping to reduce sensitivity and fear responses (Payne et al., 2015).

This method helps avoid retraumatization and keeps the client in a window of tolerance, the optimal zone for emotional processing.

Goals of SE Treatment

The overarching goal of SE is to stabilize the nervous system. By helping clients reduce dissociation and hyperarousal, SE supports their ability to stay grounded and regulated in daily life. This often means fewer panic responses, reduced pain, better sleep, and less emotional overwhelm (Brom et al., 2017).

As sessions progress, the therapist may guide clients through body scans, where they pay attention to breath, heartbeat, posture, and tension. These exercises enhance interoceptive (internal awareness) and proprioceptive (movement/position) skills, both of which are essential to nervous system recovery (Payne et al., 2015).

Over time, clients become more attuned to their internal states and more equipped to self-regulate, often for the first time since their trauma occurred.

Risks and Considerations

While SE is generally considered safe and non-invasive, it’s not risk-free. Briggs, Hayes, and Changaris (2018) note that SE can bring up intense emotions, especially when clients begin accessing physical memories of trauma. That’s why the therapist’s attunement, intuition, and training are critical.

Brom et al. (2017) emphasize that the success of SE is largely dependent on the relationship between client and therapist. If that relationship lacks safety or clarity, sessions can become overwhelming or counterproductive. When practiced with skill and care, however, SE offers a powerful alternative to traditional trauma therapies.

Staying Grounded as a Therapist

Because SE involves working closely with embodied trauma, therapists are also at risk for compassion fatigue or countertransference. That’s why it’s essential for practitioners to stay grounded and resourced themselves.

Sanders and Kim (2024) recommend the S.M.A.R.T.E.R. model of therapist self-care: Specific, Measurable, Achievable, Relevant, Time-bound, Engaging, and Reflective. Strategies like mindfulness, supervision, journaling, and boundary-setting help practitioners stay emotionally regulated, which directly supports the safety and success of the therapeutic process.

Conclusion

Somatic Experiencing is a body-first approach to trauma healing that emphasizes safety, pacing, and nervous system regulation. Rather than relying on verbal retelling, SE allows clients to access and release trauma through the body gently, over time, and in a way that feels manageable.

By combining techniques like grounding, titration, pendulation, and psychoeducation, SE helps people reconnect with their bodies and reduce symptoms that may have felt unchangeable. For those who haven’t found relief through traditional therapy, SE offers an alternative route focused on releasing what’s held in the body, not just talking through it.

References

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