Complex Post Traumatic Stress: Working With The Body


Psychological trauma is a biophysical experience, that is, it takes a toll on a person’s body as well as on a person’s mind. For this reason, understanding how a person’s mind and body respond to, remember and relive traumatic psychological experiences is crucial for understanding and treating trauma. Much has been written on the question of how the mind is impacted by psychological trauma. This blog post focuses on how the body is impacted and how to intervene directly at the level of the body.

Memories that are stored in a person’s body are referred to as “somatic memories”.  In order to understand somatic memories it is necessary to first understand a bit about the sensory system and memory in general. All memory begins with sensory input through the senses one uses to perceive one’s internal and external environments. The external environment is perceived through the eyes, ears, tongue, nose and skin. The internal environment is perceived through the nerves that receive and transmit information from the viscera, muscles and connective tissue. The former is referred to as the exteroceptive system and the latter is referred to as the interoceptive system.  Thus, exteroceptors are nerves that receive and transmit information from outside the body, and interoceptors are nerves that receive and transmit information from inside the body.

We use our interoceptors to register an internal sense of the state of the body.  We may note our heart rate, respiration, the presence or absence of pain, internal temperature, visceral sensations and/or muscle tension.  This internal sense helps us to identify and name our emotions.  Each basic emotion has it’s own distinctive set of body sensations.

One of the hallmarks of CPTSD is persistent physiological dysregulation.  Some examples of this include chronic pain, sensory distortions, involuntary movements, numbing, disconnection from one’s body, loss of pain perception and the inability to feel the sensations associated with or to identity emotions in the body.  In addition, CPTSD sufferers often experience chronic, heightened sympathetic nervous system arousal, including rapid heart rate, constricted breathing and muscle tension.  As a result, many are stuck in fight/flight/freeze/fawn mode and thus lack the capacity to access cortical resources (the part of the brain that affords us executive decision making functions and greater self awareness).

Working directly with the body (rather than with the client’s narrative) in the ways described below, can circumvent the need for the client to tell their story which can sometimes be re-traumatizing.  The goals of somatic (bodily) interventions are to assist clients to learn how to regulate sympathetic nervous system arousal, reorganize self protective defenses, (re)activate the social engagement system, distinguish that past experience is in the past and not the present, develop new and more adaptive postures and physical action patterns, discriminate between an actual traumatic event and one that is merely reminiscent of a traumatic event and reorganize rather than relive past experience.

To meet the goals described above using a body oriented approach, the counsellor:

  • Helps the client make connections between particular body postures, internal sensations and accompanying thoughts, beliefs and emotions,
  • Models and teaches skills associated with regulating levels of nervous system arousal,
  • Encourages awareness of the interaction of thoughts, feelings, body sensation, perceptions and movement impulses associated with traumatic experiences,
  • Facilitates the completion of frozen or truncated impulses to act in self defense,
  • Assists the client to orient their awareness to the present rather than the past,
  • Helps clients to stay with and just notice (rather than dissociate from) physical sensations, and
  • Co-attunes to and mirrors postures and physical actions and encourages alternative postures and actions that challenge habitual trauma-related reactions
Complex Post Traumatic Stress: Working With The Body