Complex post-traumatic stress disorder (CPTSD) can affect more than your thoughts and emotions. You might feel on edge, disconnected from your body, overwhelmed by physical sensations, or unable to relax even when you know you are safe.
Somatic therapy for CPTSD offers a body-focused approach. It can complement other forms of trauma treatment. You can develop greater awareness of physical sensations, regulation skills, and a sense of safety in your body.
At Well Behavioral Health, trauma treatment can incorporate body-based approaches. This is alongside evidence-based trauma therapies and skills for managing trauma symptoms. If you are looking for support with CPTSD, contact Well Behavioral Health today. You can learn more about available trauma treatment options and find out what level of care may fit your needs.
What is CPTSD?
Complex post-traumatic stress disorder, or CPTSD, describes a pattern of trauma-related symptoms. These can develop after prolonged, repeated, or interpersonal trauma. CPTSD includes the core symptoms associated with PTSD. This can include reexperiencing, avoidance, and feeling persistently threatened. It can also involve difficulties with emotional regulation, negative beliefs about yourself, and challenges with relationships.
CPTSD is a distinct diagnosis in the ICD-11. However it’s not a separate diagnosis in the DSM-5 used in the United States. In U.S. clinical practice, people who describe symptoms associated with CPTSD may receive a diagnosis of PTSD along with other conditions or symptoms.
Trauma can affect the way you respond to stress, relationships, memories, and situations that remind you of what happened. These responses may also have a physical component.
That’s one reason some people explore approaches that pay attention to both psychological and physical experiences during treatment.
What is Somatic Therapy?
Somatic therapy refers to therapeutic approaches that incorporate awareness of bodily sensations and physical experiences into mental health treatment.
Rather than focusing exclusively on thoughts or verbal descriptions of an experience, somatic approaches may help you notice things such as:
- Muscle tension
- Changes in breathing
- Heart rate
- Feelings of heaviness or lightness
- Temperature changes
- Restlessness or agitation
- Numbness or disconnection
- Physical sensations associated with emotions
- The urge to move, withdraw, freeze, or become still
The goal isn’t simply to focus on physical sensations. Instead, body awareness can become another way of understanding your responses. This can help with developing skills for managing distress.
Somatic therapy is sometimes described as a “bottom-up” approach. That’s because it pays attention to physiological and bodily experiences. That’ in addition to cognitive and emotional processes.
How Can Somatic Therapy for CPTSD Help?
Research examining somatic therapies as standalone treatments for CPTSD is still developing. There’s currently limited evidence showing whether body-oriented approaches provide additional benefits beyond established PTSD treatments. At the same time, trauma-informed movement and body-based practices may support general well-being. They can be incorporated into a broader treatment plan.
For that reason, somatic therapy for CPTSD is best understood as one potential component of personalized trauma care rather than a guaranteed or universal treatment.
1. Building Awareness of Physical Responses
Trauma responses can sometimes happen before you understand what’s triggering you. You may suddenly notice your heart racing, shoulders tightening, stomach discomfort, or an urge to leave a situation.
Learning to recognize these sensations can help you become more aware of what is happening in the moment. A therapist can help you explore these experiences without assuming that every physical sensation has a particular psychological meaning.
2. Developing Grounding Skills
Grounding involves using present-moment strategies to reconnect with your surroundings and establish a greater sense of stability.
For someone with CPTSD, grounding might involve noticing your feet against the floor, orienting to the room, paying attention to your breathing, or identifying sensations that feel neutral or comfortable.
These techniques can be particularly relevant when someone experiences intense emotional activation, dissociation, or feeling disconnected from the present.
3. Improving Emotional Regulation
CPTSD can involve difficulty managing strong emotional responses. You may feel overwhelmed quickly or have trouble returning to a calmer state after becoming activated.
Somatic practices can provide another way to notice escalating distress and practice regulation before it becomes overwhelming.
This does not mean that someone can simply “calm their nervous system” on command. Regulation is a skill that often develops gradually through repeated practice, therapeutic support, and learning what strategies work for the individual.
4. Rebuilding a Sense of Safety in the Body
After prolonged trauma, being in your own body can sometimes feel uncomfortable or unfamiliar.
Some people experience hypervigilance, while others experience numbness or disconnection. Body-focused therapy can create opportunities to notice physical experiences at a manageable pace.
The emphasis should be on choice and collaboration. A trauma-informed therapist should not pressure you to focus on bodily sensations that feel overwhelming.
5. Supporting Work With Dissociation
Dissociation can occur in people with trauma-related conditions. This may involve feeling detached from yourself, your surroundings, your emotions, or your body.
For some people, carefully paced grounding and body-awareness exercises can be useful parts of treatment.
However, dissociation can be complex. More intense body-focused exercises aren’t automatically appropriate for everyone. Treatment should be personalized based on your symptoms, history, stability, and goals.
Somatic Therapy Isn’t the Same as Trauma Processing
An important distinction is that body-based therapy and trauma processing aren’t necessarily the same thing.
Some trauma treatments directly address traumatic memories, beliefs, and avoidance. These include Cognitive Processing Therapy (CPT), Eye Movement Desensitization and Reprocessing (EMDR), and Prolonged Exposure (PE). There’s strong research support among trauma-focused psychotherapies for PTSD.
Somatic approaches may instead focus on awareness, grounding, regulation, and physical experiences associated with trauma.
Depending on your needs, a treatment plan may incorporate multiple approaches rather than relying on one method.
For CPTSD in particular, clinicians may also consider symptoms involving emotional regulation, relationships, dissociation, and day-to-day functioning. Current evidence doesn’t establish that one treatment approach is universally superior for CPTSD.
What Does Somatic Therapy for CPTSD Look Like?
There’s no single somatic therapy session that looks the same for everyone. A session may involve talking about current concerns while also noticing what happens physically as you discuss a situation.
For example, your therapist might invite you to observe:
- Where you notice tension
- Whether your breathing changes
- What happens when you feel anxious
- What sensations feel comfortable or neutral
- Whether certain situations create an urge to move away
- What helps you feel more grounded
- How your body responds when you experience a sense of safety
A therapist may then help you practice a regulation or grounding strategy.
Importantly, this doesn’t require you to disclose every detail of your trauma or repeatedly revisit traumatic memories. The pace and focus of therapy should be determined collaboratively.
Somatic Therapy and Other Trauma Treatments
For CPTSD, somatic therapy may be most useful when integrated into a broader treatment plan.
Cognitive Processing Therapy
CPT is a trauma-focused psychotherapy that helps people identify and examine unhelpful beliefs related to trauma. It can address themes such as safety, trust, control, self-esteem, and intimacy.
EMDR
EMDR is another established trauma-focused psychotherapy. It uses structured procedures to help people process traumatic memories while attending to bilateral stimulation, such as guided eye movements or other forms of alternating stimulation.
Skills and Grounding Work
People with CPTSD may also benefit from learning practical strategies for emotional regulation, distress tolerance, grounding, and managing trauma-related symptoms.
These skills can be particularly useful when symptoms interfere with work, relationships, daily responsibilities, or participation in deeper trauma treatment.
Somatic Approaches
Body-based approaches can add another dimension by helping clients notice physical experiences and practice greater awareness and regulation.
The best combination depends on the person rather than the diagnosis alone.
Who Might Consider Somatic Therapy for CPTSD?
Somatic approaches may be worth discussing with a mental health professional if you:
- Experience strong physical reactions to stress or trauma reminders
- Feel disconnected from your body
- Experience hypervigilance or persistent tension
- Have difficulty recognizing when you are becoming overwhelmed
- Experience dissociation or feeling detached from your surroundings
- Want additional grounding and regulation strategies
- Prefer an approach that incorporates body awareness
- Have found purely cognitive approaches incomplete for your needs
These experiences don’t automatically mean that somatic therapy is the right treatment. An assessment can help determine which approaches are appropriate. A higher level of support may be beneficial.
When More Support May Be Helpful
Weekly therapy can be effective for many people. However, it’s not always enough when trauma symptoms are affecting daily life.
An intensive outpatient program (IOP) can provide more therapeutic support. This is while allowing you to remain at home and continue participating in many of your normal responsibilities.
Well Behavioral Health’s Trauma Program is a virtual trauma IOP. It’s for people experiencing PTSD, CPTSD, dissociative disorders, and co-occurring concerns. The program runs five days per week for three hours per day. It incorporates body-based approaches such as Somatic Experiencing and EMDR alongside Cognitive Processing Therapy and skills for managing dissociative and trauma symptoms.
This type of integrated approach can be useful for people who need more structure than weekly therapy provides.
Somatic Therapy at Well Behavioral Health
Well Behavioral Health takes a personalized approach to trauma treatment. That’s rather than assuming that one modality works for everyone.
Its trauma services can incorporate evidence-based trauma treatment, body-based skills, grounding, emotional regulation, and support for dissociative symptoms. The goal is to help clients develop practical tools while addressing the broader effects of trauma.
Well Behavioral Health also offers outpatient groups. Groups can complement individual therapy and psychiatric care, rather than replace them.
For people navigating both trauma and an eating disorder, Well Behavioral Health also offers an integrated trauma and eating disorder IOP track. This can include trauma-focused groups and somatic resourcing.
Finding the Right Approach for CPTSD
Choosing trauma treatment isn’t about finding the most popular modality. You don’t have to force yourself through an approach that doesn’t feel appropriate.
A clinician can help you consider your symptoms, treatment history, goals, current level of stability, and preferences.
You may benefit from a combination of approaches over time. For some people, treatment may emphasize stabilization and practical skills initially. For others, trauma-focused treatment may be appropriate earlier. The best plan is one that’s clinically appropriate and developed collaboratively.
If you are considering somatic therapy for CPTSD, you don’t have to determine the right treatment on your own. Reach out to Well Behavioral Health to discuss your symptoms, goals, and available trauma treatment options. A conversation with our admissions team can help you understand whether individual therapy, an outpatient group, or a more structured trauma IOP may be the right next step for you.
