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Somatic therapy and chronic pain

By April Lyons MA, LPC

Somatic therapy for chronic pain proves there’s more than one way to heal. 

That concept is at the heart of somatic therapy. And when it comes to healing from chronic pain, the relief this kind of therapy brings is keenly unique and transformational. 

Understanding your pain and potential relief within a body-centered framework is vital for many somatic therapy participants. Working with a qualified therapist, you may even come to understand your discomfort as stuck, unresolved responses to a difficult past or trauma.

Are you are suffering tense, twisted muscles or aching joints. Are your gut or other organs in frequent distress?  If so, your chronic situation has likely changed you. It may feel as though pain is just something you do.

Pain like that can make life complicated and fraught with negative fallout as you attempt to feel like yourself. In fact, you may have even come to believe that your pain state is how things are now and wonder if a change is really even possible.

That’s fair. Somatic therapy for chronic pain can have that effect. After a while, feeling any different can be difficult to imagine.

Just know, somatic therapy acknowledges the powerful connection between your body and your brain. Its methods are introduced gently, with the primary goal of transforming your pain from stuck and unprocessed to relieved and resolved.

This is often eye-opening and a source of hope. Hope, which may have been in short supply amid your long period of aches and pain. 

In short, It’s time to get the real you back into your body and move pain out.

3 Ways Somatic Therapy for Chronic Pain Gets You Back in Your Body

In specific ways, you and your somatic therapist can examine and renegotiate your nervous system’s responses to the stress, trauma, physical injury, and medical illness that support your chronic pain. Here are several ways how:

1. Somatic therapy for chronic pain:

Increase your bodily awareness

Somatic therapy can help improve your ability to truly sense your own body internally. You will have the opportunity to observe and appreciate its present state and changing sensations. In a safe, focused manner, you can pay attention to how your body feels, works, and how its parts relate to each other. This process is often called interoception.

As you work with your therapist, you will expand your bodily awareness. Slowly, you can build improved tolerance for the physical sensations linked with the current pain. In addition, you’ll tune into the sensations connected with tension and release, stretching, motion, inhalation, and exhalation. All the while you develop language to accurately describe what you are feeling (tingling, stinging, achy).

2.  Somatic therapy for chronic pain: Recognize and disrupt painful patterns

Chronic pain is often cyclical and prone to generating more pain. Why? When you hurt all the time that discomfort triggers fear and anxiety. You tense at the thought of more pain or go out of your way to avoid and suppress pain triggers. Effectively, you override your body’s natural fight or flight process of facing fear, complicating an action to deal with it and releasing the tension. Chronic pain results from a chronic inability to access the parasympathetic relaxation response.

Developing a sense of body position and orientation within yourself can help you calm your activated nervous system and recognize the ways you are contributing to your pain. Your therapist can help draw attention to how changes in your stance, gaze, facial expression, muscle tension, breath, and more are responses to pain that habitually foster more discomfort. Practicing mindful awareness of your body, pain, and your responses allow for clarity and consciousness. This opens the door to movement and feelings that can finally complete, fear-based actions in your body, help you understand why you feel so bad and choose different bodily behavior. 

3. Somatic therapy for chronic pain:

Locate and discharge the origins of pain and tension

You may or may not know what caused your chronic pain initially. All your body knows is that a chronic state of high arousal exists. Thus you may experience poor respiration, digestion, blood pressure, and bodily control as well as more pain. Somatic therapy can help you (without revisiting a past trauma) increase your ability to regulate and resolve pain with movement.

Via sensory exploration, breathing techniques, and gentle natural movements, somatic therapy works directly with the nervous system. The goal? To gradually help discharge the unprocessed survival energy that keeps you tense and hurting.

Ideally, you and your therapist will get you back into your body by facing the fear or resistance to movement that is limiting your life. Conscious breathing, stretching or gently shaking your limbs, and practicing yoga can help soothe you and engage your parasympathetic nervous system. Such deep relaxation reflects a return to more bodily control, optimal functioning, and clarity that can help you reclaim your peace of mind.

Move forward, relieved and more relaxed

Finally, trust that significant alleviation of chronic pain is possible over time. Combined with somatic therapy you need to treat your body well. Nutrition, sleep, appropriate medicine, and community connection are all part of supporting your body-mind connection going forward.

Through your work, you and your therapist will be getting you back into your body by creating fresh neural pathways. Known as neuroplasticity, you are literally altering the wiring of your brain for a more beneficial connection with your body. By getting away from words and avoidance you can take a guided trip shifting toward a deep understanding of your internal pain experience and your body’s ability to heal itself. You aren’t left in pain but led toward a deeper appreciation for your body’s power and innate harmony. 

Are you ready for relief and a higher level of self-knowledge and attunement? The resulting revelations and insight might make the journey through pain to this point worth it. Still, let’s ease your suffering and go gently forward. I am here for you.

If you are, considering somatic therapy, please contact me for a free consultation.

Reclaim your Body from Pain

Chronic Pain Relief Dr. Arielle Schwartz

When you sense and feel your body you are better able to take care of yourself. We are more likely to recognize if we feel hungry, thirsty, need to go to the bathroom, or need to rest when we are attuned to our sensations. Try it by taking a deep breath. Are you able to notice any areas of stiffness or discomfort in your body? Do you sense a desire to adjust your posture to better support your spine or to create a feeling of opening across your chest?

This may sound simple, but, truth be told, for many people it’s really not that easy…especially if you have a history of trauma or chronic pain. You might find it very difficult to tune into sensations. It might feel safer to avoid feeling your body because you never know when you might feel the next uncomfortable, aching, or burning sensation. Befriending the body takes time, especially if you feel as though your body has betrayed you. This post is one of a two-part series on attending to pain that guides you through tools to slowly, mindfully rebuild a connection to your body.

“If you have a history of trauma or chronic pain, you may need to relearn the art of listening to your body in a safe and slow manner. We begin by learning the role of the brain in pain, how trauma exacerbates chronic pain, and understanding the science behind why we need to move and breathe to heal.”
-Dr. Arielle Schwartz

Your Brain and your Pain

neurobiology of PTSD Dr. Arielle Schwartz

Acute pain is initially sensed in the body through nociceptors, the sensory receptors at the end of sensory neurons specifically organized to send pain signals to the spinal cord and brain. These neuronal connections extend into the limbic centers of the brain which attribute an emotional quality to the pain.

Sometimes there is a physical cause of chronic pain such as a bulging disc, arthritis, or an infection. It is important to recognize that not all health challenges can be changed, no matter how hard you try. Here, you can focus on self-compassion, surrender, processing your grief about living with pain, and pain management.

However, scientists also recognize that pain, like all of our life experiences, becomes stored as a memory, a procedural memory to be more precise. Procedural memories involve brain centers that retain the sequence of motor skills and actions. Over time, these neuromuscular pathways of pain become reinforced through myelination (the fatty coating that strengthens neuronal connections). Examples of procedural memories include riding a bike or tying your shoe. Once a procedural memory is learned you no longer need to think about it; our neural networks continue to repeat them on autopilot. Importantly, procedural memories can be resistant to change. in other words, chronic pain can start in the body but be maintained by changes in brain activity.

Why would we want to remember pain? Because the body is wired for self-protection. It is a protective response to remember previous injuries…so that we can protect ourselves in the future if we face a similar threat. However, this “pain memory” can set off false alarms in which we interpret a threat when, in fact, there is no danger or if there is a minor concern the pain response is stronger or out of proportion with the situation. Healing chronic pain involves learning how to reclaim relaxation through breath and movement…and your “pain memory” may just hold the key.

PTSD and Pain

Embodiment and Chronic Pain

Your pain is a connection to your past.

According to Mark Grant, author of Change your Brain, Change your Pain (2016), having a history of unresolved PTSD, especially childhood abuse, is associated with higher reports of chronic pain conditions including fibromyalgia. This may be linked to long-term holding of tension in your body to restrict vulnerable feelings. Holding muscular tension can help you avoid sensations…and as a result push away somatic reminders of a painful past. Or, if you live with chronic medical conditions, you may have had a history of unwanted or invasive medical interventions that have left scars on your soma and psyche.

Chronic pain can become a trauma that triggers a vicious cycle of more pain. If you have ever had a migraine or back pain you will know what I am talking about. The slightest feeling of a headache or a twinge in your back causes a fear response. How bad will it be this time? Will I end up in bed for days? Tension builds and you start to avoid anything that might trigger your symptoms. Your life starts to feel increasingly limited.

Sometimes, it can feel safer to not feel anything. But, numbness comes with a cost.

Movement Suppression and Pain

EMDR Therapy and Somatic Psychology Dr. Arielle Schwartz

In response to any threat, real or perceived, we engage the sympathetic nervous system which releases cotisol to initiate a fight or flight response. This high arousal will bring forth changes in respiration, digestion, body temperature, blood pressure, and muscle tension. Ideally, we can allow this “energy” to move us and we can respond by shaking the body, conscious breathing, and moving the arms and legs.  Movement helps your nervous system return to homeostasis, a state of relaxation and ease facilitated by the parasympathetic nervous system.

However, we live in a culture of stillness and many of us have learned to override our body’s natural impulses for movement. We suppress our sensations, emotions, and movement impulses. Suppression of movements inhibits our ability to resolve the nervous system activation into homeostasis and interferes with our ability to access the parasympathetic relaxation response. As a result, our muscles retain low levels of incomplete movements in the form of passive tension that is held without conscious awareness.

Alan Fogel, author of the book, Body Sense (2009) identifies that long-term suppression of movement impulses has consequences on health such as chronic pain, higher levels of cardiovascular disease, higher blood pressure, higher rates of gastrointestinal diseases, respiratory diseases such as asthma, and serious autoimmune disorders. In short, when we suppress movement impulses we impede our capacity for natural healing. What we cannot feel, we cannot heal.

Chronic Pain Relief

From a somatic therapy perspective, healing involves developing tolerance for sensations and reclaiming healing movements or movement sequences. We increase sensory awareness by developing a capacity to stay with painful emotions and sensations without judgment. Fogel calls pain your body’s “wake-up call.” I invite you to think of pain as an opportunity to reclaim healing movement impulses that were suppressed (sometimes many years ago).

Lack of movement, emotional stress, physical injury and historical trauma can lead to the stickiness or hardening of fascia. Fascia, also known as connective tissue, is a fibrous web that extends into every structure and system of your body. Fascia plays a key role in transmitting hormones (e.g. adrenaline, estrogen, insulin, thyroid hormones, oxytocin) and neurotransmitters (e.g. serotonin, dopamine, GABA, acetylcholine) throughout your body. Thus we see that fascia is deeply intertwined with the nervous system, endocrine system, and immune system.

Overtime, the hardening of the fascia can build up and is associated with vicious cycles of chronic pain, systemic inflammation, histamine intolerance, fibromyalgia, and chronic fatigue syndrome (myalgic encephalomyelitis). The good news is that mindful movement, deep breathing, and massage all help to melt the fuzz and rehydrate your fascia…Read more in part-two on how therapeutic yoga can help you find relief from chronic pain.

Therapeutic Yoga for Trauma Recovery

Therapeutic Yoga for Trauma Dr. Arielle Schwartz

This book introduces you to the power of the yogic philosophy and offers a variety of accessible yoga poses and breathing practices that will allow you to:

  • Nourish your nervous system
  • Reconnect with your body
  • Ground yourself in the present moment
  • Release unresolved patterns of fight, flight, freeze, or faint
  • Widen your ability to tolerate emotional discomfort
  • Develop a felt sense of resilience
  • Anchor yourself in self-love
  • Strengthen a

    connection with and trust in your body

  • Create a personalized yoga practice for your own self-care

About Dr. Arielle Schwartz

Therapeutic Yoga for Trauma Recovery Dr. Arielle SchwartzPhoto Credit: Jes Kimak

Arielle Schwartz, PhD, is a psychologist, internationally sought-out teacher, yoga instructor, and leading voice in the healing of PTSD and complex trauma. She is the author of five books, including The Complex PTSD Workbook, EMDR Therapy and Somatic Psychology, and The Post Traumatic Growth Guidebook.

Dr. Schwartz is an accomplished teacher who guides therapists in the application of EMDR, somatic psychology, parts work therapy, and mindfulness-based interventions for the treatment of trauma and complex PTSD. She guides you through a personal journey of healing in her Sounds True audio program, Trauma Recovery.

She has a depth of understanding, passion, kindness, compassion, joy, and a succinct way of speaking about very complex topics. She is the founder of the Center for Resilience Informed Therapy in Boulder, Colorado where she maintains a private practice providing psychotherapy, supervision, and consultation. Dr. Schwartz believes that that the journey of trauma recovery is an awakening of the spiritual heart.