Working with Touch in Somatic Experiencing: Clinical Approach and Practical Application

Working with touch in Somatic Experiencing. Touch represents one of the most powerful tools for accessing the deepest states of shock stored in the body. This therapeutic technique enables us direct access to tissue conditions and physical patterns associated with traumatic experiences in ways that verbal interventions often cannot reach. Through carefully applied touch, we can initiate profound reorganization of the nervous system and help clients access their own capacities for healing.

The fundamental premise of this work is that traumatic shock leaves lasting traces in bodily tissues, and touch is often the most direct way of accessing these deep layers of traumatic material. In the Somatic Experiencing model, the diaphragmatic system is understood as a container of affect, meaning that work with diaphragms enables access to and regulation of emotional content in a very direct manner.

Anatomical Approach: From Periphery to Center

Working with touch in Somatic Experiencing follows a clear anatomical hierarchy that respects the natural organization of the nervous system. We always begin work at the periphery of the body and gradually move toward the center, allowing the organism to prepare for deeper work without becoming overwhelmed.

The first step involves working with joints, which represent the safest initial point of contact. Joints provide us with important information about the general state of the nervous system and enable the establishment of trust before moving to more sensitive anatomical regions. This initial contact helps the client become accustomed to touch while the therapist gains an initial assessment of how the organism responds to physical contact.

The second step focuses on diaphragms, which have special significance in Somatic Experiencing as they function as containers for different emotional content. The respiratory diaphragm is connected with anxiety and fear, the throat diaphragm with expression and communication, the abdominal diaphragm with personal power and boundaries, and the pelvic diaphragm with sexuality and creativity. Working with diaphragms enables gradual release of held tensions and processing of emotional content that has accumulated in these areas.

The third and deepest step involves working with viscera, or abdominal organs. Here lies the deepest and most intense traumatic material, and work at this level represents the most powerful form of somatic work. The viscera hold memories of the earliest traumatic experiences and enable access to preverbal traumatic content that is often inaccessible through talk therapies.

Working with Touch in Somatic Experiencing – Practical Principles of Work

During touch work, it is crucial to maintain continuous contact with the client’s body. When we move our hands to a new location, we must not completely break physical contact as this can disrupt the sense of safety and continuity we have managed to establish. Our hands act as a gentle organizing force that helps the client’s organism increase its coherence and improve its capacity for self-regulation.

Special attention must be given to respecting the client’s boundaries and avoiding areas marked as “untouchable.” This respect for boundaries is not only an ethical obligation but also a therapeutic necessity, as violating boundaries can lead to retraumatization and completely disrupt the therapeutic process.

Bodywork Session Protocol

Bodywork sessions in Somatic Experiencing follow a clear structure that ensures safety and maximum therapeutic benefit. Sessions always begin in a seated position where we develop the theme and prepare the client for bodywork. This preparation includes discussion of previous work, identification of main themes and symptoms, and explanation of why bodywork might be beneficial at this moment.

Before transitioning to the table, it is important to establish clear orientation in space and time, which helps the client remain grounded and present during the work. Exploring resources and their effect on the body is also crucial as this gives us reference points of safety to which we can return if the work becomes too intense.

The transition to the table represents an important moment in the session that requires special attention. The therapist must make decisions about their position around the table, eliminate possible triggers from the environment such as bright lights or sounds, and ensure the client has everything needed for comfort and safety. Allowing the client to “arrive” in their body on the table is also important as many clients need time to adjust to the new position.

Beginning physical work always includes establishing containment through touching less sensitive areas such as deltoid muscles, shoulders, or ankles. This initial containment helps the nervous system regulate and prepare for deeper work. During this process, it is important to continuously inform the client about what we are doing and why.

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Working with Touch in Somatic Experiencing – Tracking Three Types of Experience

During bodywork, we continuously track three different types of experience in the client’s body. The positive pole represents places where the body feels good or where the client can access feelings of safety through thinking about a resource. The negative pole includes places of activation, discomfort, or even pain. The neutral pole represents areas without specific activation where the body simply “is” without particular sensations.

This tracking of three experiences enables us to navigate between different nervous system states and helps the client develop greater tolerance for different intensities of experience. The goal is not to avoid the negative pole but to gradually increase the client’s ability to be present with different forms of activation without becoming overwhelmed.

During work, we continuously explore different hand positions and anatomical areas, always respecting the hierarchy from periphery to center. It is important to remain in constant communication with the client and track signs from their nervous system that tell us how the organism is responding to our work.

SIBAM Elements in the Work

The SIBAM model provides a framework for understanding different dimensions of experience during therapeutic work. Sensation refers to bodily feelings, Image to pictures or visual experiences, Behavior to behaviors or impulses for movement, Affect to emotional content, and Meaning to cognitive interpretations and meanings.

During bodywork, we pay special attention to sensation and behavior dimensions as they are most accessible through bodily contact. The image dimension can be very powerful when clients begin experiencing spontaneous images connected to traumatic memories. Affect often appears as waves of emotion passing through the body when certain traumatic content becomes activated. The meaning dimension becomes relevant during integration when the client begins understanding connections between bodily sensations and their life experiences.

Working with Touch in Somatic Experiencing – Recognizing Discharge Processes

One of the most important aspects of the work is recognizing and tracking natural discharge processes that activate when the organism begins releasing trapped traumatic energy. Discharge can manifest through various forms of spontaneous movement, changes in breathing, trembling, sweating, or other autonomic changes.

It is important to distinguish productive discharge that leads toward regulation from unproductive discharge that can lead to overwhelm. Productive discharge is usually accompanied by gradual calming of the nervous system and increased sense of coherence in the body. Unproductive discharge can lead to hyperactivation or even retraumatization if not carefully managed.

Managing Activation

During work, we continuously track signs of nervous system activation and adjust our approach according to the client’s current needs. The red zone indicates a state of hyperactivation where the client is overwhelmed and we need to slow down the work or even return to resources. The blue zone indicates a state of hypoactivation or “freezing” where we need to gently stimulate energy and vital capacity. The green zone represents the optimal state for therapeutic work where the client can be present with activation without becoming overwhelmed.

Managing these different zones requires continuous assessment and flexibility in approach. Sometimes it is necessary to completely stop physical work and return to verbal techniques or resourcing. At other times, we can gently encourage the client to remain present with a certain level of activation while developing greater tolerance.

Ending and Integration

The end of a session is as important as the beginning. We announce the ending in advance and plan sufficient time for gradual transition back to a seated position. Placing feet on the ground, stimulating movement, and enabling contact with the environment helps the client return to everyday states of consciousness.

Tracking post-effects while the client sits enables us to assess how the session has affected their overall system. Orientation in space and testing different movements helps integrate new bodily experiences. It is important to explore how the new state can be transferred to daily life and which activities or situations might support continuation of therapeutic changes.

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Indications for Bodywork

Bodywork is especially indicated when verbal approaches reach their limitations. This often happens after a certain number of hours of regular somatic work when the client still has symptoms that appear or worsen in a seated position. Early shock trauma with a predominantly physical basis, especially from the preverbal developmental period, is also a strong indication for bodywork.

Clients with primarily somatic symptoms or developmental disorders of physical origin often respond very well to bodywork. Specific trauma categories such as anesthesia, drowning, high-impact trauma, or perinatal trauma often require a bodily approach as verbal techniques cannot reach preverbal traumatic traces.

Touch represents a special indication for clients who need to relearn the difference between appropriate, caring touch and inappropriate, harmful touch. This is especially important for sexual abuse survivors who can, through therapeutic touch, reestablish a positive relationship with physical contact.

Working with Touch in Somatic Experiencing – Contraindications and Cautions

Bodywork is not appropriate for all clients nor at all times in therapy. Absolute contraindications include situations where the therapist is not clear about the purpose of touch or cannot explain this purpose to the client. Transference or countertransference dynamics that confuse or overwhelm the therapist also represent contraindications as they can lead to inappropriate or harmful work.

Special caution is needed with clients who have many negative experiences with physical contact, especially from caregivers. Tendency toward regressive behavior or difficulties recognizing appropriate boundaries also require a modified approach or postponement of bodywork.

Cultural differences in attitudes toward touch must be carefully assessed and respected. What is appropriate in one culture may be inappropriate or even offensive in another, requiring cultural sensitivity and adaptation of approach.

Coherence vs. Activation

During work, we continuously assess whether the client is in a state of coherence or activation. Coherence is recognized by slow and deep breathing, absence of rigidity in the muscular system, and breathing rhythm that extends uniformly through all bodily regions. There is a sense of resonance between different parts of the body and a general feeling of integration.

Activation manifests through rapid or restricted breathing, rigid or flaccid tissue, and inability for rhythmic waves of breathing to be transmitted through different bodily areas. There is no sense of connection between bodily regions and there may be a general feeling of fragmentation or disorganization.

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Therapeutic Boundaries and Professionalism

Touch work poses special challenges for maintaining appropriate therapeutic boundaries. The therapist must be clearly grounded in their own body and aware of their own resources and limitations. Distinguishing “I am me, and you are you” is crucial for maintaining clear interpersonal boundaries during intimate physical work.

Merging with the client represents a common risk in touch work as physical contact can activate our own unresolved issues and countertransference reactions. It is important to recognize when we begin feeling the need to “rescue” the client or fight against their resistance, as this often indicates we have lost our own boundaries.

Working with touch in Somatic Experiencing represents a sophisticated therapeutic tool that requires deep understanding of anatomy, physiology, and traumatic processes. Successful application depends on clear protocols, respect for boundaries, and continuous assessment of the client’s condition. When applied competently and ethically, this approach can enable access to traumatic content that is inaccessible to other techniques and facilitate profound reorganization of the nervous system leading to lasting healing.

This work requires from the therapist not only technical skills but also deep personal maturity, clear boundaries, and the ability to maintain their own regulation during intense therapeutic work. Continuous supervision and personal therapy work are not a luxury but a necessity for all who engage in this type of deeper therapeutic intervention.

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