Body-oriented therapy: what it is and who it can help

Sometimes you understand everything with your head, yet your body keeps living in alarm: shoulders up, shallow breathing, a knot in your stomach. At moments like these, talking alone may not be enough. Body-oriented therapy works with both words and sensations. I use it in my own practice, and here I explain how it works, who it suits and what is known about it.

What body-oriented therapy is

It is an approach to psychotherapy that pays attention not only to thoughts and feelings but also to how they show up in the body: in breathing, posture, muscle tension and movement. It is also called body psychotherapy or somatic therapy.

The idea is simple: stress and painful experiences leave a mark not only in our thoughts but also in the body’s habitual tension. Once you learn to notice these signals, you can work with them.

It is not massage and not physiotherapy. It is psychotherapy in which the body helps you understand and work through what is hard to put into words.

What happens in a session

A session starts with a conversation, like any other. Then I might suggest:

• Noticing sensations: where in your body you feel tension, warmth or heaviness right now, and what changes when you talk about something difficult.
• Working with the breath: noticing how you breathe and trying to breathe more slowly.
• Grounding: feeling your feet on the floor and your back against the chair, hearing the sounds around you. This helps you come back to the here and now when anxiety takes over.
• Posture and movement: noticing how you are sitting and trying a small movement that gives you more support or more freedom.
• Resources: finding a place or sensation in the body that feels calmer, and learning to return to it.

Usually we alternate conversation with short exercises, and after each one we talk about what you noticed.

Everything happens only with your consent. You stay fully clothed, nothing is forced, and there is no touch without your permission. You can say “stop” at any moment, and that is completely fine.

In my work touch is not needed at all: the main tools are attention, breathing and movement. That is why body-oriented therapy works well online too: you are at home, somewhere familiar, and I guide your attention.

Who it can help

• Stress and chronic tension, when your body does not relax even at the weekend.
• Anxiety and panic attacks: we learn to notice the first signals and calm the body.
• Physical symptoms linked to stress, once a doctor has ruled out illness.
• The aftermath of trauma, alongside other methods. Painful experiences often show up in the body: you jump at every sudden noise, freeze, or feel as if you are not quite in your body. Working with the body can help restore a sense of safety.
• Difficulty understanding your own feelings: the body often tells you before words do.

You don’t need to be good at “feeling your body” beforehand. Many people say at first that they notice nothing, and that is a perfectly good starting point: attention to the body develops gradually.

With severe depression, acute mental health crises or thoughts of harming yourself, the first step is help from a doctor, sometimes the same day. If you are in immediate danger, call 911.

What the research says

To be honest, the evidence for body-oriented therapy is growing but is still smaller than for CBT. A 2021 meta-analysis of 18 randomised controlled trials found that body psychotherapy moderately reduced symptoms and psychological distress compared with control groups. The authors note that the studies are few and very varied, and that larger, high-quality trials are needed.

Cognitive behavioural therapy (CBT) and EMDR have been studied far more, and the WHO recommends trauma-focused CBT and EMDR for PTSD. So I don’t offer body-oriented therapy instead of proven methods; I use it alongside them.

How I combine it with CBT and EMDR

• With CBT: we look at the thoughts that fuel anxiety, and body skills help calm the body in the moment, once a thought has already set the anxiety off.
• With EMDR: in the preparation stage we learn stabilisation techniques (grounding, breathing, a “safe place”), which help you stay in a state that feels safe during processing.
• Between sessions: short 2-3 minute exercises you can do at work or before bed.

The plan is always shaped around you: for one person body work is most of the session, for another just a small part.

Where to start

If you want to see how much stress has built up, you can take the PSS-10 (Perceived Stress Scale) test on this site. It takes a few minutes and does not give a diagnosis, but it is a good starting point for a conversation. If you would like to try body-oriented therapy, or simply have questions, book a free 15-minute intro video call. My sessions are held in Armenian or Russian, online or in person in Yerevan.