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Developing Better Therapists: Integrating Somatics and Assessment

The field of Somatics has been growing exponentially in the four decades I’ve been a therapist. Somatics is defined as the integration of mind, body, and spirit. As humans, multiple complex feedback loops define our experience.

To become better therapists, we must be as much a generalist as a specialist.This means we need to have an understanding of how psychology is interacting with physiology at any given moment. We also need to be competent in working from both the top-down and the bottom-up world view.

Top Down: 

The nervous system follows the mind. Structure follows the nervous system.

Bottom Up: 

Structure informs the nervous system. The mind interprets the relevance of those afferent inputs. 

This is not an either/or scenario. This is the bi-directional feedback loop that defines our perceived experience. There are three main categories that relate to our lens of experience.


These are the neurological inputs that are both conscious and non-conscious. The conscious inputs are recognized as sensations.


This is the emotional context that results from stimulus from the structure and/or thoughts.


The mind is interpreting and responding to the environment. This interpretation is a combination of the field of awareness plus past experiences. 

As therapists, how we work with this bi-directional feedback loop defines the outcome of any interaction. Somatics generally starts with the bottom-up approach. We first calibrate a benchmark based on a client’s movement capacity. Some of the capacity metrics we can use are joint mobility and integration, kinetic chain integration, and coordination. Volume and work production metrics can only be evaluated after assessing the foundation. The most foundational element is the breathing apparatus

Tip: With clients that have chronic symptoms, start with the breathing apparatus. With clients that have acute symptoms, start with assessment of the involved structure and evaluate how the breathing apparatus is tied into the coping strategies.

As human beings we all have experienced varying degrees of trauma, both physical and emotional. The autonomic nervous system responds the same to both variants. Often, both occur simultaneously as the  mind interprets the occurrence of an event.

Let’s unpack the concept of an event. There are generally three phases to an event. The first being before the event occurs. These are neurological markers that are registered by the nervous system. Thoughts and emotions often take precedence over sensations. The emotional context of a person’s  thoughts prior to the event will be embedded in the neurological inputs at the occurrence of the event. This phase is defined by what is about to happen. 

Next, is the occurrence of the event. Here, the primary neurological markers are based on physical sensations and structural receptor inputs. The physical body affected by the event. This phase is defined by what is happening.

The third phase is after the event has occurred. This is the phase of evaluation. The mind is interpreting the context of the two previous phases. This phase is defined by what  just happened.

Let’s simplify the physiological process of how the nervous system registers and records neurological inputs. It’s a challenge to adequately qualify the complexity of how the autonomic nervous system is communicating with the different feedback loops of the brain centers. We can generally say that the neurological inputs are received in the limbic system to create a memory and association. These memories and associations will have both conscious and non-conscious attributes. As a survival strategy and depending on the severity of the event, the nervous system may deem it necessary to compartmentalize and repress the memory.

In addition to the neurological inputs that are received during the three phases of an event, the nervous system also creates a coping strategy to respond to those neurological inputs. That coping strategy is what leads to nervous system dysregulation. Dysregulation is when the stimulus from those neurological inputs creates a sympathetic response in the autonomic nervous system and the nervous system has lost the capacity to down regulate and restore a parasympathetic response. Here, the nervous system responds as if the event is still occurring.

Nervous system dysregulation is a result from both real and perceived trauma. Trauma, both conscious and non-conscious, repressed and compartmentalized, can be accessed through the breathing apparatus. Trauma, both physical and emotional, has a specific relationship to the breathing apparatus. 

The fundamental signature of trauma is a paradox to a normal parasympathetic breath. Under a normal parasympathetic breath the four main diaphragms are moving in sync. On the inhalation the diaphragms are moving downward, and on the exhalation the diaphragms are moving upward

During paradoxical breathing, the pelvic and thoracic diaphragms are either moving apart or they are moving towards one another. During a cough or a sneeze, the diaphragms are moving apart. If you have experienced sneezing while driving, you may have noticed that the eyes involuntarily close and there is temporary tunnel vision. These are autonomic responses. 

At the occurrence of the paradoxical sympathetic fear or trauma response, the autonomic responses are more profound for the nervous system. Here, the diaphragms are moving towards one another to create additional intra-abdominal pressurization to protect the organs. There is more occurring than the physical function, there are chemical signatures that relate to the somatic context of the event. Those signatures are encoded in memories and associations. Even if we do not have conscious awareness of those somatic inputs, our nervous system is responding to them. 

When a similar stimulus to a past event is encountered, the limbic system is looking for a reference to keep us safe. The past events and the coping strategies that were utilized at the time of that previous event come forward as a in the now real time solution for responding to the stimulus. This is how we are unconsciously hijacked from the present moment to our past. This is also why the mechanics of a properly responsive breathing apparatus is altered. The nervous system is seeking safety by moving away from the input that would stimulate the memory and association to a previous event.

Somatic inputs to the nervous system is one potent method of asking the nervous system if it has capacity to appropriately respond to those inputs.

We must use caution when we evaluate breath and breathing. If we overstimulate an individual’s nervous system, they may experience a limbic system response that is akin to re-experiencing a past trauma. The way we keep our client safe is a specific progression of breathing apparatus stimulus. This progression starts with qualifying the capacity to have a non-binary conversation with the nervous system. Then we evaluate the Intrinsic subsystem in both feedback and feedforward movement assessment strategies. It is important to note that we must be incremental and have a priority to the first tenet of DNA, Keeping the Container Safe.

This process is the first step in learning how to utilize and apply the DNA template. There are multiple layers of understanding that occur when we learn to apply The 5 Tenets, The 5 Essential Skills, and The 5 Primary Kinetic Chains. 

DNA helps to develop better Somatic Therapists because the integration of the template allows the therapist to access unresolved trauma in a safe container for their client’s nervous system. 

Demonstration Video

This video demonstrates a Top Down approach to nervous system dysregulation. A few things to consider. Movement is the most tangible benchmark. While a person’s experience is the most important, that subjective experience is not tangible. When we create a tangible experience we are also creating a more complete experience for the individual. Another important aspect to consider is that It is important to follow up with structural reinforcement after restoring appropriate nervous system response. This reinforcement needs to be incremental so as not to overstimulate the ANS which in turn would potentially undue the benefits of the initial nervous system tone down.

1 thought on “Developing Better Therapists: Integrating Somatics and Assessment

  1. Thanks Joseph for the introduction. This is really interesting material and I encourage physiotherapist allover the world and other Therapists to enroll for this course. First heard about from Your student Mutibwa Allan and to be honest, this changed my practice and the way I treat patients. Am yet to study the entire DNA course.
    All the best Joseph and I hope your do not RETIRE because some of us are just getting the information and would love to hear from you for many years and learn from you.

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