Increasingly, I am hearing disturbing stories from new patients about what is being labeled in the SF Bay Area as ‘somatic therapy’. What is clear is how many clinical and non-clinical people are calling themselves ‘somatic therapists’ and offering subpar to damaging services to individuals in need of effective mental health treatment for PTSD.
Frankly, I have no idea what a somatic therapist is. Yet so many people are seeking somatic therapy because these days pop psychology views everything as traumatic and somatics as the cure for all trauma. This reminds me of what happened 15 years ago when mindfulness became the clinical intervention for every malady. We all know how poorly that worked out.
Integrative psychotherapy acknowledges that mental health is interdependently determined by the systemic quality of one’s mind states, emotions, and bodily responses. Human beings are organisms in constant flux; continually homeostatically reacting and responding to causes and conditions. Our thoughts are conditioned by body health as much as physical health is undermined by a chaotic mind and highly-reactive emotions.
Because traumatic experiences impact the entire human organism, resolving traumatic experiences must be a whole system endeavor. Changing thoughts is not enough. Loosening muscles and tissues will not prevent future bracing each time a challenging-enough situation occurs. And emotion regulation is a body-mind-heart mission.
Somatic Experiencing® (SE™) focuses on and accomplishes whole system trauma resolution. SE is a complex theoretical model delivered in a three-year training program. It takes time to learn how to recognize, work with, and deliver skills for effectively resolving the nervous system dysregulation commonly found in PTSD sufferers.
Other clinically helpful trauma methodologies include Sensorimotor Psychotherapy and EMDR. However, EMDR is often too activating and unhelpful for people with complex-PTSD who experienced early developmental trauma prior to adult traumatic events. SE is an excellent methodology for those individuals.
I encourage asking anyone claiming to be a ‘somatic therapist’ what training they have undergone and if they are a licensed clinical professional. Unlicensed practitioners are unregulated practitioners with no legal or ethical oversight. That is a minefield to avoid particularly for trauma sufferers.
8 thoughts on “The ‘somatic therapist’ nightmare”
Strongly agree one should require several years of training in somatic therapy in a potential therapist; strongly DISAGREE that one should require licensure as a psychotherapist! The standard skills taught for licensure as a psychotherapist are very different from those of somatic therapy. There are manipulative jerks everywhere, licensure does not prevent this, and can provide a pseudo-authority which is fertile ground for abuse. Don’t give your power away to ANYONE.
Thank you for reading this and commenting Peter. The stores I hear are not about manipulation but instead about incompetence, lack of training and knowledge of somatic interventions and C-PTSD treatments. I agree that licensing does not necessarily confer competence. But patients have recourse to report to a State licensing agency or authority when a licensed clinician is engaging in unethical or illegal conduct. No such regulating body exists for unlicensed practitioners. Also, most C-PTSD cases include physical symptoms or syndromes requiring appropriate medical intervention. For better or worse, physicians are more likely to collaborate with licensed mental health professionals and that is always good for the patient.
So, I am not sure if you, April, are agreeing with me or with Lisa’s response to me! Whichever, I am going to take the opportunity to expand on my response to Lisa’s initial post and to address her response to my first post.
Lisa, you say the stories you are hearing (out there on the West Coast) have to do with incompetence rather than manipulation. This should be addressed, as you suggest, by adequate training in Somatic therapies. A licensed ‘non-somatic’ therapist should take a training in somatic therapy which lasts several years. Somatic therapy involves a whole different skill set from conventional therapy. I repeatedly saw, while I was assisting in Somatic Experiencing trainings, that students with a background in psychotherapy–trained and licensed psychotherapists–had a much harder time ‘getting’ SE that those with a background in somatic disciplines such as bodywork, massage, Alexander, Rolfing, Feldenkrais, Continuum, etc. (Specifically, they had been so deeply trained that ‘giving advice’, ‘understanding’ and ‘talking about’, or on the other hand abreacting and ‘getting it out’ were therapeutic paths, that they had a lot of trouble grasping the organic unfolding of bodily felt processes which are key to somatic therapy.) What’s more, the psychotherapists tended not to be aware that they were not getting it, and exhibited a kind of unconscious arrogance that intimidated the somatic practitioners, who tended to believe, wrongly, that the psychotherapists were more accomplished. (All this is very general, ‘on average’, there were plenty of exceptions, but I saw a clear pattern.)
Somatics and Somatic therapy not only involve a different set of skills, but are also based on a radically different philosophy from conventional psychotherapy. Despite its progress from the early days of Freud, conventional psychotherapy and its training are firmly science-based, and implicitly embrace the mind-body dualism on which science is founded. This Cartesian split is profoundly toxic, and fosters authoritarianism and hierarchy. This shows up strongly in Western culture generally, and specifically in science, medicine, and conventional psychotherapy. The very word, “psycho-‘ implies that the mind and body are separate and must be addressed separately. Somatic approaches specifically disavow this split, and come from a view of the whole person; “mind” and “body” are abstractions, at most facets of the complex jewel of the whole being. Training in conventional psychotherapy carries the danger that the Cartesian split is implicitly conveyed within the training; and in my experience with conventionally trained psychotherapists, a subtle authoritarian arrogance can manifest, which I believe to be in part due to the factors I just presented.
A doctor’s unwillingness to collaborate with a well-trained but unlicensed somatic therapist is just a manifestation of this same arrogance.
As yet of course, there is no licensing process for somatic practitioners; I believe that they should be accorded equal status with psychotherapists, doctors, etc., but it may be a while before we progress to that point.
It is of course unconscionable for someone to take a couple of weekend courses and present themselves as a somatic therapist. I am against this. The same applies to conventionally trained psychotherapists. I do not know this, but it would not surprise me that licensed psychotherapists would be more likely to take a couple of short courses and then add ‘somatic therapy’ to their self-description, than would a non-licensed practitioner.
The point about non-licensed practitioners not having an ethical or legal supervisory body applies mainly to instances of manipulation, which Lisa says is not her main concern. Unskillful practice generally does not bring institutional sanction among licensed practitioners. In my own experiences of trying to bring accountability to a licensed practitioner, I found that he was able to use the machinery of institutional supervision to intimidate, manipulate, and evade accountability. Institutional supervisory bodies, made up as they often are by practitioners, can act to protect instead of to hold accountable.
In the case of a non-licensed practitioner who is incompetent or acting unethically, word of mouth and/or established legal processes of lawsuits or the threat thereof can act as remedies; also, the organization that provided the somatic training may provide a degree of oversight. Additionally, it is false to imply that those without an institutionally enforced code of ethics are more likely to act unethically; that is like the Christian view that those who do not believe in the Bible will be sinners due to the lack of a guiding (Christian) moral code.
Peter I believe we are in agreement about the necessity of training and competence when it comes to somatic interventions no matter who is providing the service, which is the main point of this post. I will not dispute your insights about steering Western psychology professionals out of their narrow treatment menu when they undertake SE training. It is a necessary opening to a integrated set of skills that allows them to provide more comprehensive treatment for PTSD and C-PTSD, which effects the entire organism in a variety of ways. But this is precisely why scope of practice becomes particularly important when offering treatment for complex trauma disorders. I do not provide medical advice to patients nor do I provide physical treatment that can only be gotten from a physical therapist or massage therapist. I refer and stay in my lane. Likewise, my clinical training in psychology and psychotherapy gives me training and skills in trauma psychotherapy that medical professionals, physical therapists, and massage therapists do not have and these professionals refer patients to work with me.
Hi Lisa, I agree with your viewpoints and have has personal experience with this. I’d add the label ‘somatic coach’ to this discussion. I’m not saying that every somatic therapist / coach isn’t properly qualified to help but I have found that every single somatic therapist / coach that I worked with was doing some sort of proper qualification bypass in order to sell their trade. And these were the ones who did the most hurt. I’m older, perhaps wiser, but definitely more cynical about somatic therapists. It’s hard to regulate this whole area. Emma
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I agree Peter, I have had a similar experience with psychotherapists’ limitations yet arrogance during the SE trainings… and it took a lot of time to regather myself from all of that and realize, “no, they were just pretending to have more experience.” (note: to say the obvious… of course they have valuable experience, it’s just not the kind of experience that overlaps with the training required to really attune to something like a direct relationship to pre-perinatal levels of an experience, the slow presence required to attune to syndromal lock up…)
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Yes, thank you for the support!