Somatic Therapy in a Post-Covid World

How the heck does body-centered therapy work virtually?

Like so many of us, since around April 2020, my work has been completely remote. I went from meeting people in my office to befriending the megalith Zoom, from perceiving the full bandwidth of face, body language, hand motions, tension, and emotional energy to heads in boxes, occasionally interrupted by cats. A whole lot of psychotherapy has gone remote since the pandemic began, as the subsequent mental health crisis caused both an increase in demand and a huge rise in video platforms for therapists. But even so, the particular therapy I do brings special challenges when moving from real to virtual space.

I practice Somatic Therapy, and my initial training was in a modality called Rubenfeld Synergy Method, a technique involving both talk and touch. Clients would lie on a massage table, and the therapist—me—would gently touch the client, encourage subtle movement, and seek to engage the client in a conversation with their body’s messages.

The idea was, and is, to connect the body, mind, emotions and spirit, and help people move through stuckness and emotional pain using the body as a starting place. If movement can be freed, the theory goes, if the body can be attended to and feel heard, feel ease, feel relaxation or joy or relief, then issues of mental and emotional health can begin to move as well.

I still find these ideas to be both powerful and self-evident, and the techniques I was certified in ten years ago this month continue to be effective, revolutionary, and deeply moving to work in. But two things happened along my journey to how I’m practicing now, and they both are integral to how I now engage with my clients. In a strange way, in fact, my move to virtual as a result of the pandemic has had some valuable follow-on effects to the much earlier change I made, which was about how I was working with touch.

Every therapist has a niche, or at least, there are clients who tend to gravitate more toward some therapists than others. When I set out, I sought to attract folks who had marginalized gender and sexual identities and relationship structures, as I had considerable experience and comfort with such folks. But as time went on, I also recognized another trend in the clients who came to see me: complex trauma.

Because my training was so focused on touch and especially on “getting to the table,” which is to say, going into the touch work rather than remaining talking in chairs for too long, I had some early experiences in my practice of rushing people to the table who were not ready for touch work in any way. Imagine a person who’s been traumatized in some way, whether by a single horrific event or over years of abuse or neglect, and then imagine being a stranger seeking their trust who wants to try healing them using touch. Now add the fact that that person is being asked to lie on a table while this stranger stands over them and puts their hands on them.

Now granted, these folks came to me wanting this type of work. Every move is done with consent, checked for again and again. Certain body parts are off limits. Everyone keeps their clothes on. And, for some clients, the touch work can be incredibly transformative for unlocking and moving traumatic history.

But what I found was that for most people who came to talk to me, just establishing trust with a stranger was enough of a hurdle to start with. Going into the touch work too soon tended to be triggering for some people, often into a kind of freeze response where the client wouldn’t even be aware of their distress. Talking gently and openly, on the same level, while acknowledging the power dynamic that is already in place between therapist and client, is a thing I started to take my time doing—for as long as it took. Some clients, I never got to the table at all.

At the same time, I deepened my studies and knowledge in work with trauma. And I used all the tools I had learned to use the body as a resource, without putting my hands on people very often. I had to show them, instead, how to get in conversation with their own nervous systems.

And sometimes, even that is a challenge: I had a client for a while who would dissociate when she was asked to bring her attention to her feet, or to her breath. For people who have spent a lot of time trying to escape the terrible realities their bodies have lived through, connecting with the body can be painful, even impossible, without a lot of patience and gentleness.

So when the pandemic hit, I was actually fairly well placed to go remote. I know how to watch for changes in breathing and gently point them out. I know how to track eye contact, shoulder tension, changes in hand positioning and facial expression. I know how to bring someone back to ground when I can see—or when they tell me—that they’re dissociating. And I know how to direct people to look inward, describe their sensations, notice what their bodies are trying to tell them as they speak about their trials. All of this is still very possible using video, and besides that, video carries another advantage.

Especially for people with trauma histories, getting help that they don’t have to jump through a lot of hoops for is incredibly valuable. It’s quite enough work, in this country, to find a therapist with availability whom you can afford and who is a good match for you. The process we make people go through to find good help, when sometimes they’re already drowning, is criminal. So if I can also make it so that a client doesn’t have to get dressed, go out, drive or navigate public transit, find parking or walk a great distance, deal with all the stress of a commute to get somewhere that’s meant to give them relief from stress—I appreciate being able to do that.

Plus, I like the cats, and they seem to help my clients, too.