Made Simple: EMDR and Somatic Psychology

In one sentence: Learn how to integrate somatic psychology principles and interventions into the eight-phase model to enhance your EMDR practice.

In one paragraph: Many therapists have heard of somatic psychology and are aware of the value of body-centered interventions in trauma treatment. However, most EMDR therapy trainings do not cover in-depth how to work with disturbing physical sensations. These sensations can interfere with resource development in the preparation phase or lead to stuck processing during the desensitization phase. For me, it was a key clinical error that taught me about the need to integrate somatic psychology into my trauma treatment and forever changed my work. Read on to learn more about this pivotal moment and how you can cultivate an embodied approach to care.

A Clinical Error as Inspiration for Change

The journey of becoming a therapist involves many joys, moments of growth, and some bumpy moments along the way. The rough patches often occur as misunderstandings or times in which we are poorly attuned to the deeper needs of our client. While therapeutic ruptures are an inevitable part of the work, ideally we also have opportunities to learn from our clinical errors. This is the case in all forms of therapy, and it can be especially true when learning the intricacies of EMDR therapy. Having been a therapist for over 25 years and an EMDR therapist for 23 of those years, I can confidently say that it is navigating these clinical errors that have taught me the most about successful psychotherapy.

When first trained in EMDR I, like many of us, felt inspired to bring this new set of tools to my clients. But despite having a relatively good understanding of dissociation and complex PTSD, I made a clinical error that would turn out to be one of the most important events of my career and dramatically changed my approach to the work.

My plan was to use EMDR with a client who came into therapy because of her developmental trauma resulting from an alcoholic and narcissistically abusive father. I experienced this woman as intelligent and generally resourced at this stage of her life. She had a history of cutting; however, her self-harm was under control and she no longer reported urges or incidents.

After what seemed like adequate preparation we moved into phase 4 and began to work with a specific episode in which her father’s alcoholic rage had terrified her as a child. Between each set of bilateral stimulation, she reported with great detail the scenes of the past and after only thirty minutes her SUDs dropped from a nine to a two.

Magic, or so I thought.

Prior to ending the session she was able to contain the remaining disturbance and appeared grounded prior to leaving the session.

I was counseled by my consultant to reach out to clients a few days after their first EMDR session to see how they were doing post-treatment.

When I called her two days later I was shocked by what I heard.

She rather robotically reported to me that the night after our session she had gone out to a party with her girlfriend. As the night went on, her girlfriend began drinking and then flirting with another woman at the party. The client shared that she was profoundly triggered by this sequence of events. She went home alone and proceeded to engage in a serious self-harming incident for the first time in over two years.

It did not occur to the client that her urge to cut herself was linked to the EMDR session we had earlier that day. However, in retrospect I could see it all so clearly. During the desensitization phase, the client sat completely still on the couch. Her breath had grown shallow. She reported the scene without any body awareness at all. She hadn’t reprocessed the event, she had dissociated. What seemed like adaptive information processing was a well-developed capacity to intellectually report about her experience.

Furthermore, I realized that in my adherence to a protocol I had disconnected from my intuition, that if I had listened to it would have let me know that something felt off.

Gratefully, the client returned and we were able to discuss what had happened. Moreover, we were able to find a new way of moving forward together that focused on helping her be oriented to her body and to cues of safety in the present moment.

Most importantly, somatic psychology is not just a set of interventions for the client—rather it is a foundation for the attuned presence of the therapist.

The Body Keeps the Score

The biggest change to my work was the integration of somatic psychology into EMDR therapy.

At this point, I already had a master’s degree in body-centered psychotherapy; however, I had abandoned my own embodied intelligence as a newbie EMDR therapist. This clinical error from 23 years ago helped me develop the integrative approach that forms the basis of successful EMDR treatment for complex PTSD and dissociation.

If you are unfamiliar with somatic psychology, you might be wondering what this entails. Let me share a few of the core principles of a body-centered approach to trauma treatment:

• Difficult life experiences are held as patterns of physical tension. This includes restricted breathing, and tendencies to either feel flooded by or disconnected from bodily sensations.
• The body is a guide. Body awareness helps us access an internal source of wisdom that guides the healing process.
• The body can be used to heal. Not only does the body “keep the score” of the traumatic events from the past, but it also holds keys to healing from them.
• Our aim is to honor the intelligence of the body. We are not here to override the embodied experience.
• We engage body awareness at a pace that the client can tolerate. We invite the client to turn toward distress for short periods at a time, which allows them to build greater capacity to sense the body.

Most importantly, somatic psychology is not just a set of interventions for the client—rather it is a foundation for the attuned presence of the therapist. When we as therapists are mindful of our own embodiment we are more congruent between our words and our body language, which enhances trustworthiness with our clients. From this foundation we can guide clients to develop their own embodied self-awareness.

EMDR Therapy and Somatic Psychology

This synthesis of EMDR therapy and somatic psychology retains Francine Shapiro’s eight-phase model. Body-centered interventions can easily be integrated into each phase of treatment.

Key somatic interventions involve noticing the breath, enhancing embodied self-awareness, and developing comfort incorporating movement into the therapy room. For example, if you notice the client is breathing in a shallow manner during any phase of treatment you can invite the client to pause and notice their breath or experiment with taking a deeper breath together.

Likewise, if your client reports little awareness of sensations then you can invite them to enhance somatic awareness through movement or self-applied touch by placing a hand over their face, arms, or torso. Alternatively, if your client feels tension that is stuck while reprocessing a traumatic memory, you can invite them to squeeze and contract around the sensation or explore any movements that create a sense of resolution of the tension.

The Takeaway

Whether you are new to EMDR or a seasoned EMDR therapist, I encourage you to embark upon the courageous journey of embodiment not only as the foundation for clinical interventions to use with your clients, but as a personal journey that guides you to connect to your integral whole Self.

The integration of EMDR therapy and somatic psychology invites you to be willing to grow and change. In truth, many of us have become therapists because of our own wounds. If left unaddressed, our own trauma can interfere with our work with clients. However, once addressed, these life experiences can provide a foundation for the compassionate presence that we offer to our clients.

---

Curious to learn more? Check out Arielle’s book EMDR Therapy and Somatic Psychology, which expands your repertoire of body-centered care with over 45 interventions to help your clients heal from trauma.