What is the evidence behind somatic therapy?

Somatics is becoming quite popular and quite the buzz word. With so many varying perspectives and definitions of what somatics could mean, it is understandable that you may be confused or even skeptical.

What is beautiful about somatics is that it can hold that skepticism. Somatics by definition is about one’s personal experience within the body and therefore it is hard to have a difficult universal definition. That being said, it is important we keep the conversation going so people can come to learn, understand, and perhaps even trust these approaches in the ways that feel right for their individual nervous system.

Somatics has not yet been fully standardized as a field, however there are growing organizations such as the The International Somatic Movement Education and Therapy Association that are holding clearer standards for somatic movement education and therapy can mean. 

Both of the therapists as Bodyful Physical Therapy and Wellness are currently studying the work of Body-Mind Centering® by Bonnie Bainbridge Cohen which is recognized by ISMETA legally. This influences our approach towards physical therapy, pelvic health, and how we hold our somatic lens as individuals. 

At Bodyful, we do not choose between science and the body- we hold space for both and integrate both for deeper healing. 

What Is Somatic Therapy?

There can be many definitions for somatics and somatic therapy. Oftentimes, somatic practices will incorporate some sort of body awareness, interoception, nervous system awareness, and bottom-up processing. As described by Meehan et al: “Somatic practices encompass a series of movement forms that can be drawn together through their shared focus on body awareness through reflection on movement habits, opening up movement capacity and developing self-directed or personal movement styles.”Somatic therapy is not one single modality, but rather it is an umbrella term. It speaks to a culture that often shares similar principles and can be explored in a myriad of creative and abundant ways. Some examples include:

• Somatic Experiencing

• Body-Mind Centering®

• Feldenkrais

• Alexander Technique

• Hakomi 

• And so much more!

Is Somatic Therapy Evidence-Based?

Aspects of somatic therapy are strongly evidence-based—even if the term itself is not always studied directly.

Evidence #1: The Biopsychosocial Model of Pain 

What countless studies have now shown time and time again is that chronic pain is not purely due to a structural issue. Large studies using MRI have shown that a majority of people with no pain still have disc bulges, degeneration, or other ‘abnormalities.’ In fact, by age 50, around 80% of pain-free individuals show structural changes on imaging. This tells us something important: what we see on an MRI does not always explain someone’s pain.

Evidence: 

1. https://pubmed.ncbi.nlm.nih.gov/25430861/

2. https://pmc.ncbi.nlm.nih.gov/articles/PMC3579079/

The core IASP definition now states that pain is “an unpleasant sensory and emotional experience associated with, or resembling that associated with, actual or potential tissue damage” (Raja et al., 2020). We now know that pain is a complex mix of physical, sensory, emotional, cognitive and contextual factors. Pelvic pain often persists without clear tissue damage. The nervous system plays a key role in sensitization and symptoms. This is why somatic approaches exist and can be effective for people with chronic pain patterns. 

Evidence #2: Nervous System & Brain-Based Interventions for Chronic Pain

One term coined in research around chronic pain is called central sensitization. “Nociceptor inputs can trigger a prolonged but reversible increase in the excitability and synaptic efficacy of neurons in central nociceptive pathways, the phenomenon of central sensitization” (Woolf et al 2011). 

Mindfulness  and interoception changes brain activity. Meditation alters brain regions like insula and anterior cingulate. The same brain regions targeted in somatic work are the ones shown to change in pain and stress research.

Evidence #3: Movement & Body-Based Interventions Reduce Pain

Exercise reduces inflammatory markers in chronic musculoskeletal pain There have been improvements shown in CRP, IL-6, and TNF-alpha. Somatic movement influences inflammation, nervous system tone, and pain perception.