Locating Trauma in the Body

To successfully treat trauma, one must consider and confront the way trauma is held in the body as well as the mind.

Mental illness is a unique physical experience, and too much therapeutic attention paid to the mind independent of the body is doomed to fail, or possibly even make matters worse.


This idea is key in the work I do, so I was intrigued to read a book that takes that idea even further and insists trauma must primarily be treated though physical interventions.  At least I think that’s the point the book is trying to make.

Moving Beyond Trauma, The Roadmap to Healing from Your Past and Living with Ease and Vitality is a book by Ilene Smith about Somatic Experiencing (SE). From what I can surmise, SE is a therapeutic approach that works with finding places in the body where trauma is held, and in paying attention to and practicing with the intense emotional response found in these areas of the body one can be free of the most negative effects of traumatic experiences.

I had to surmise this from the book because in 252 pages and several case studies Smith never really explains what SE is.

Mind body medicine has gained wide acceptance, and many practitioners believe that trauma and affective disorders, especially anxiety, need to be approached through body work as well as talk therapy. Intimate connections have been found between the entire nervous system, not just the brain, and one’s mental well-being.

The mind, or at least the self, is made up of our entire experience and doesn’t just reside in the head. To effectively treat the self the practitioner must focus not only on thoughts, but on physical symptoms that accompany mental illness.

In Moving Beyond Trauma Smith makes the case that trauma is primarily held in the body and treatment will fail, or even cause the person to relive the trauma and experience worsening symptoms, if only talk therapy is used.

While she distinguishes between psychoanalysis, cognitive behavioral therapy, and dialectical behavioral therapy, she lumps them all together in her assertion that talk therapy forces the client to relive, through thought and talk, the traumatic event over and over. Smith muses that it’s common sense that this will only lead to trauma piling on trauma, and the client will get well very slowly, and painfully, if at all.

Advocates of a mind body approach like Smith, and myself, insist that most mental illness is experienced as a physical condition as well as a psychiatric one, and therapies to treat it must attend to the body as well as the mind. Some of us believe you can’t even separate the two.

But Smith, in her presentation of SE, seems hostile to talk therapy. She presents SE as a method of bodywork that can free a person from the negative effects of trauma that psychotherapy fails to address. Yet even though there are several types of talk therapy, Smith seems to lump all of them into some generic conversation between the therapist and client that sounds an awful lot like psychoanalysis which, as time passes, fewer and fewer people undertake anyway.

In the case studies she uses to explain and exemplify SE, much of what goes on between Smith and her clients curiously reads just like talk therapy. When she gets to examples of the therapies that distinguish Somatic Experiencing, she presents very little detail.

Very little.

SE appears to involve touch, although it’s vague in the book whether this touch is like massage or chiropractic or some modified form of Reiki. Smith writes often of working with a client’s brainstem, or their vagus nerve, but gives no description at all of what this “working with” entails.

The only session she presents which describes an actual example of SE involves Smith and her client sitting across from each other on the floor with their feet touching. My BS meter began to stir.

The case studies involve people who experienced serious trauma, all of whom found relief from Smith’s methods. You’d expect this in a self-help book. But while the examples confront serious trauma Smith repeatedly makes the case that everyone experiences some trauma that significantly impacts their life. I find this risks alienating people whose experience with trauma is so disabling that they cannot function day-to-day. I’m also suspicious that a therapy that involves sitting with the soles of your feet touching can ever get at the root cause of that trauma.

Trauma is experienced physically, as is anxiety and other mental illness. Smith errs in presenting schizophrenia as the only mental illness that is truly biochemically based. Still, her emphasis on the physical in treatment is commendable.

She even makes the wonderful point that the therapists needs to first ask not what the client is thinking when experiencing the effects of trauma and anxiety, she needs to ask, “tell me what you’re doing when you experience anxiety?”

When she gets the answer to this critical question Smith embarks with the client on a journey into Somatic Experiencing that in her book Moving Beyond Trauma, The Roadmap to Healing from Your Past and Living with Ease and Vitality she does not detail or explain.


Reviewer George Hofmann’s book Resilience: Handling Anxiety in a Time of Crisis is available wherever books are sold.

This review originally appeared on my blog for PsychCentral, "Getting Older With Bipolar."