Somatic Work cptsd 2

Some the most rewarding work I do is working with people who are experiencing CPSTD (complex post traumatic stress disorder). Because I have worked in the bodywork field for so many years I’m in a unique position to be able to read the body and sense what is happening for clients. Bringing together Somatic work with counselling has practically given me a super power to be able to work with trauma and the felt sense of trauma. My job is to gently support a client’s nervous system to orient towards safety and away from a sense of threat.

What is CPTSD?

CPTSD can often go undiagnosed because the patient themselves doesn’t relate their current reality to a single event trauma but often an underlying sense of lack of safety inside themselves. It’s a felt sense that one can’t cope with life and a sense of being overwhelmed comes easily and often. It’s like life moving two speeds faster than you can process and so you are running or jogging just to keep up. One might get angry, get depressed or having an experience of not being able to control ones emotions may set in. It’s the general trauma picture of ‘too much, too fast, too soon’ and then an inability to self regulate takes over ones system.

Why classical talking therapy alone does not work with CPTSD

Sometimes talking isn’t enough. Going over what is happening inside your head again and again when it doesn’t change, when the intensity of what is happening doesn’t subside, can be more distressing for CPTSD clients. It doesn’t matter how much you understand why you do what you do if the triggers are all still there and your bodies response to them is the same.


How I work with CPTSD

The somatic approach to CPTSD is what is called a ‘bottom up’ approach. Rather than using the tools of cognitive understanding, the ‘top down approach’, we use ways of sensing into the body, and noticing specific sensations in the body. We help to teach the client to regulate the intensity of their experience by helping them find ways of slowing things down, making the steps clearer and helping them notice what is happening when they are distressed.

If you can start to slow things down and notice what is happening then the possibility of being able to make different choices emerge from the mist. It’s as if the body goes straight into ‘fight, flight or freeze’ mode so that one isn’t able to cognitively process the past as the past. The whole system is over ridden and a fight for survival kicks in when stimuli are misread by the nervous system as a threat.


Listening to the body

Learning to listen to the body is a fantastic and fascinating journey. It’s as if the nervous system of the client is literally malfunctioning or misfiring meaning we need to gently prise apart the way sensation and sensory input is wired into the nervous system. This allows the client to walk safely in the world once more.

The work might start with noticing a place in the body that feels safe, the toes for example. Then we might explore how it feels for the toes to have an experience. ‘What does it feel like for a part of your body to feel safe?’ - what does it feel like for that part of the body exploring the felt sense of touch with the ground?

How do you know it feels safe? What does it feel like in your body? Little by little we introduce the possibility of safety in the body; noticing safety in the body. Next we might play with going to the edge of a memory that is activating, a memory that brings the red mist, the fog, the fear and then move back to noticing safety. Noticing the room, noticing an object. By doing this work the body can learn the difference between a memory and the present moment. When we are traumatised the memory is so overwhelming that we loose contact with the present. So to remember a memory and also notice that you are sitting on a chair in a different time and place. Allowing both to exist at the same time is profound.


Learning to be with and de-escalate that which is too much is profound.


Learning to let your body be your trusted friend is profound.


Working with trauma is an educational process for the client’s nervous system. The nervous system learns to re-regulate; we help them find places of safety inside themselves and we teach techniques to de-escalate.  For example when we are traumatised, even our own breath can feel like a threat. What if you had a breathing technique to help you use the breath to feel safer rather instead of overwhelmed? How about you knew how to tap meridian points to de-escalate what you are feeling in your body? How about if you could use a protocol of scanning your environment to help you feel safe? Usually people scan to identify threat but what if, after scanning for threat, you found no threat. How about you scan for safety?

Having little tricks to help you de-escalate and find safety helps a client to feel safe in the world again sometimes for the first time. It is a life changing experience. The mind can then shift from the narrative of ‘I’m unsafe, I’m bad, I’m wrong’ to I’m OK, I look after myself, I know how to look after myself, I’m safe.

Anwar Picture

By Anwar Ravjani

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