Most of us have heard something along the lines of “It’s okay to talk about your feelings, don’t hold it in.”, or “Maybe you should talk to someone about how you’re feeling.” If you took the next step and have experienced a therapy session, your experience may have gone something like this.
You walk into your therapist’s office, sit on the comfy couch, and talk about all the things from the kids and your spouse to the road rage you experience daily. You leave with a sense of a lighter load but the next day or maybe a few hours later, you’re annoyed again. You begin to overthink and then enter the butterflies in your stomach, the random soreness in your shoulders, or the strange urge to go to the bathroom. You may have even talked to your Primary Care Physician about some ailments or symptoms that seem to linger or notice this for your children as well.
At times, we may be putting a band aid on the symptoms of a wound that lives deep within our body. We discover the interconnectedness of the mind and body when we talk about our emotions and explore where they live in the body. This leaves us to question if traditional talk therapy which is also referred to as a top-down approach to therapy, is enough to heal our emotional wounds. Exploring where our emotional wounds live within the body and the connection to our mind, is referred to as a bottom-up approach to therapy, or Somatic Therapy. Integrating traditional talk and somatic forms of therapy can provide a holistic approach to the therapeutic process, addressing the mind and body. Let’s explore what the differences are and how each approach or a combination may be beneficial for you or your child.
The top-down approach to therapy is when we talk about our experiences and trauma and is often coupled with Cognitive Based Therapy (CBT). This type of therapy helps us to recognize our thoughts, and emotions, and how they inform our actions. Mindfulness is usually recommended with talk therapy. Observing your thoughts and practicing strategies to reframe thought patterns, can mitigate a negative thought spiral which often leads to inconsistency in actions, outbursts, low self-esteem or feelings of anxiety and depression.
The bottom-up approach to therapy focuses on where we feel sensations in our body when thinking about stressors and trauma. Feeling bodily sensations is often referred to as Somatic Therapy. Stressors and trauma can disconnect us from our body but also attach themselves to certain areas within the body. The bottom-up approach helps to reconnect the mind with the body. For example, your chest may hurt when you think about the relationship with your mom or your child’s stomach is nauseated each time, they enter the cafeteria because they were constantly bullied last year at the lunch table. However, the connection between the thought and the bodily sensation may go unnoticed. When we ask ourselves “Where in my body do I feel this stressor or trauma?", we begin to heal at a deeper level that allows us to regulate and control the nervous system. Our nervous system usually takes on the majority of the physical manifestations (i.e. shortness of breath, chest pains, stomach aches) of stress, fear, and negative thought patterns. Yoga, deep breathing, grounding exercises, exploring nature, and meditation are techniques that can assist with the bottom-up approach.
Deciding which approach to therapy is right for you or your child can be discussed with a therapist. A holistic approach to therapy integrates strategies that address emotional wounds within the mind and body. Adults and children who have challenges with impulse control, flash backs, PTSD, and trauma may benefit from both approaches implemented progressively. For more information, please visit the resources below and stay tuned to more content on the Podcast, One Day You’ll Thank Me.
Katie Blythe, MSW, LCSWA, CHC
The Body Keeps the Score by Bessel Van der Kolk