SE Therapy

SE — Somatic Experiencing

Somatic experiencing is a mind-body therapy which Peter Levine developed during the 80s and 90s. In his first book, Waking the Tiger, published in 1997, 

he expounds his understanding of how the nervous system (and consequently we) reacts to stress and trauma, as well as what it needs in order to regain equilibrium and balance. Since then, SE has been refined and taught in many countries, including Israel, where some ground-breaking research was conducted in recent years.

SE provides the necessary tools for rebooting the nervous system.

During a typical SE session, the patient is guided to tune in to his “felt sense,” 

a bodily awareness of the totality of all one knows and feels regarding a given situation, person or event. In other words, the felt sense is “ a medium through which we experience the fullness of sensation and knowledge about ourselves.” (Levine, 1997, p. 8). 

Bodily sensations can be divided into two main categories, constriction (e.g., tight, tense, heavy, burning) and expansion (e.g., light, airy, spacious). Constriction alters one’s breathing, muscle tone and posture. As blood vessels in the skin, viscera and extremities constrict, more blood becomes available to the muscles, which tense and prepare for defensive action. 

This focusing of attention and awareness on physical sensations requires practice, as it is not something we normally do. Often, an image, feeling, thought or perhaps even an impulse to move, may link up to the body sensation. This amplified body memory can then be used in the therapy to work through overwhelming, stressful or traumatic experiences and issues.

As the patient becomes increasingly able to identify how different body parts hold sensations of constriction (e.g., heart palpitations, throbbing temples, tense neck), he learns how to alleviate these constrictions via various SE exercises, first practicing this in the therapy session. During this work, his body spontaneously discharges excess energy stored in the musculature and physiology.

This energetic discharge allows us to become better able to function, and to contain experiences and feelings of all kinds (including positive ones) without the nervous system becoming unduly burdened, overwhelmed or stressed. 

As shall be seen, it is considered crucial for the treatment of traumatic symptoms.

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SE and Trauma

“…the body reacts profoundly in trauma, It tenses in readiness, braces in fear, and freezes and collapses in helpless terror. When the mind’s protective reaction to overwhelm returns to normal, the body’s response is also meant to normalize after the event. When this restorative process is thwarted, the effects of trauma become fixated and the person becomes traumatized.” (Levine, 1997, p. 6)

However, according to Peter Levine, “trauma is not a life sentence” and can be healed by consciously utilizing our physiological resources, harnessing what he elsewhere refers to as the body’s “innate wisdom to heal.” The key to healing trauma lies in our physiology. To quote Basel van der Kolk, “the body holds the score.” 

When potentially life-threatening events overwhelm our ability to respond effectively, and we are unable to fight or flee in order to save ourselves, we may instinctually freeze in terror. This last-ditch survival response may save us. 

The immobility of the freeze, coupled with helplessness, fear and terror, is understood to be the essence of trauma. Underneath this freeze, there lies a tremendous, locked in energy, originally recruited to cope with the life-threatening situation, but with nowhere to go. Whereas an animal would instinctually shake off this biological energy, a part of our brain (the neocortex) tends to inhibit this process, which, when not anticipated or understood, can be extremely frightening. At the same time, in order to resume previous levels of functioning, one must be able to move through and out of this state. This means tolerating the emotions associated with the freeze, namely fear and terror, and moving from helplessness to a sense of agency.

The uncoupling of fear from immobility and the concomitant physiological discharge of the vast energy hitherto bound in the immobility make it possible for us to re-establish a connection with our felt sense, an invaluable internal resource, and sense our physical sensations and nascent movements our body signals it wants to make. As we become increasingly grounded in our own body and the social world around us, we are able to reconnect to a hitherto unavailable sense of strength and resilience, regain a springiness in our step. We begin to regain a sense of flow and movement as we mobilize the healthy aggression necessary to complete both the original fight or flight response that was thwarted during the life-threatening event. 

Sometimes the orienting response to the changes in our environment when we became aware of the dangers of the challenging situation, becomes compromised and either extinguished or overly developed, as in the startle response. This too must be renegotiated.

SE therapy is geared to achieve these various goals. In the therapy, we recreate the necessary conditions for allowing the completion of instinctive responses, protective movements of fight or flight originally thwarted or truncated, even as we facilitate the discharging of the tremendous excess energy in a gradual and controlled fashion, to avoid retraumatization. As the traumatic event is renegotiated in the session, the patient becomes empowered. This memory can now be stored as a positive, rather than merely negative experience, one with adaptive value. Against all odds, the patient survived. 

It appears that the SE therapeutic process creates new neural pathways. To the extent that the frozen residual energy is resolved and discharged, the experience renegotiated, it is expected that the patient’s symptoms (e.g., anxiety, depression, psychosomatic or behavioral problems) will subside.

Frequently Asked Questions

Somatic Experiencing (SE) is a somatic psychotherapy that was originally devel-oped in order to treat trauma. Today it is used through-out the world to treat people with a variety of symptoms or syndromes (a cluster of symptoms, such as fibromylgia). According to this aproach, trauma does nt reside in the event but in the nervous system’s response to it.

 

In SE, we rely on an understanding of the body and how it works, especially the various branches of the autonomous nervous system and its interconnections with subcortical (e.g., brain stem, limbic system) and cortical systems.

Our working assumption is that the body remembers everything, and can be our ally in recovery from trauma and mental distress. Thus, we learn to focus our at-tention on bodily sensations (e.g., of constriction and expansion) in order to promote well-being, one based on deep relaxation of the whole body and its mus-cles.

In addition, much like in other therapies (although they may conceptualize this differently) we use the therapeutic relationship to promote self-regulation and whole brain neural integration via co-regulation. This is a bidirectional process through which the nervous system becomes attuned to the other’s nervous sys-tem via “face-heart connection” with another. This promotes calm and a sense of safety.

SE treatment is based on a body-oriented talk therapy, through which the patient learns to become increasingly attuned to his or her body and its sensations, all of which comprise the Felt Sense, which becomes their inner compass. The overall Felt Sense we develop of things and people includes information from other channels, in addition to that derived from physical Sensations: multimodal Imag-es, Behavior, Affect and Meaning (for short, we can use the acronym SIBAM). In addition, use is made of touch and movement, especially slow micromovements.

When SE treatment is provided by a professional who uses touch in their original line of work, safe touch may be an important part of SE work. In other cases, the patient may be directed to use self-touch in a therapeutic way, or even to imagine touch.

The overall aim is to complete previously thwarted and thus incomplete orient-ing, self-protective and defensive movements related to action patterns of Fight and Flight. This allows one to ease out of the Freeze and the Fold and Collapse modes, respectively, as one slowly discharges trapped energy in a controlled fashion.

A case in point is the automobile accident, where typically, there is not enough time to flee, before the moment of impact. Utilizing specialized SE techniques, the patient becomes able to renegotiate the accident, complete orienting and defensive responses, and thus achieve an alternative ending, one leading to the creation of a new neural pathway in the brain that counters the old one.
(In EMDR terms, once discharged via SE techniques, the targeted images com-prising the memories of the accident are in effect “reprocessed” and can now be stored in the brain in a different, more adaptive way.)

Yes.

Once one “thinks SE,” one is compelled to heed the body and its various com-munications.

Some therapists, such as myself, may formulate an integrative, stepwise treat-ment program, based on the patient’s needs and preferences yet informed by various treatment approaches. I use principles from Somatic Experiencing (SE), Integral Somatic Psychotherapy (ISP), Eye Movement Desensitization and Re-processing (EMDR) and psychodynamic therapy.

Others will refer their patients to a SE practitioner for work in a circumscribed area, such as working through a single-episode trauma.

SE therapists are professionals from various fields (such as psychologists, marriage and family counselors, cranio-sacral therapists, Feldenkreis thera-pists and other body workers) who received formal SE training (a three year course) and were certified as Somatic Experiencing Practitioners (SEP) via SETI, the international SE Training Institute headed by Dr. Peter Levine, the originator of SE. It is a SETI requirement that they be licensed in their particular field of expertise.

בשל נגיף הקורונה, אדגיש שניתן לערוך טיפולים מרחוק.

Given the Corona virus, I’d like to emphasize the availability of online therapy.

ד"ר רות שידלו פסיכולוגית בתל אביב

בשל נגיף הקורונה, אדגיש שניתן לערוך טיפולים מרחוק.

Given the Corona virus, I’d like to emphasize that I conduct online therapy.