Somatic Interventions
for Play Therapy with
Traumatized Children
Blackbird Family Therapy, Inc.
A licensed marriage and family therapy corporation.
Outline
• Introduction to Somatic Therapy
• Basics of Somatic Trauma Therapy
• When and Why to Use Somatic Work in Play Therapy
• How to use Somatic Interventions in Play Therapy
Blackbird Family Therapy, Inc.
Intro: What Is Somatic Therapy?
• Somatic therapy focuses on how emotions and memories
are expressed in the body.
• Emphasis is on how things “feel” rather than what one
thinks:
Client: “I know that I'm a good person, but I don't feel that
way.”
Therapist: “Where do you feel that way in your body?”
Client: “I feel it like a heaviness in my heart.”
Therapist: “What is it like to place your hand where it feels
bad?”
Client: “It feels a little better.”
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Intro: How does ST Work?
• Basic tools of somatic therapy include body
awareness and intentional use of the afferent
nervous system (from the body to the brain).
• Although rarely advertised as such, many
somatic interventions resemble behavioral
interventions such as progressive relaxation,
counterconditioning, affect tolerance, and
exposure therapy.
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Intro: What “else” is Somatic
Therapy?
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Dance
Athletics
Meditation (e.g. Vipassana)
Yoga
Getting up & Lying Down
Talking Funny
Patticake
Laughing
Skipping
Horse Lips
Blowing Raspberries
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Yawning
Napping
Rocking
Jiggling
Sighing
Patting
Humming
Squatting
Moaning and Growning
Stretching
Playful Retching
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Basics of Somatic Trauma Therapy
• Track conditioned physiological responses to
trauma in both therapist and client
• Intervene with a resource that allows body
awareness (because all trauma responses
involve a lack of body awareness)
• Teach client that s/he can handle similar
responses in the future (with kids, this often
done through modeling & attachment work)
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Basics: Responses to Trauma
• Fight – we prepare to confront a potential aggressor or
predator – anger, adrenaline, blood flow to muscles…
• Flight – we prepare to flee a potential aggressor or predator –
fear, adrenaline, blood flow to muscles…
• Freeze – in situations where fight or flight are either
impossible, or where these strategies fail, we freeze and
prepare to survive the trauma – dissociation, endorphin
release, blood flow to head and chest
Children, and even therapists, often go into some form these
responses when they are “triggered” by an internal or external
cue that reminds them of a trauma. Often, as compassionate
and empathic adults, we follow along with our clients
unconsciously as they are triggered.
Blackbird Family Therapy, Inc.
Basics: Freeze States
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Freeze states often appear as combination of
ANS & PNS symptoms, likely because the
body is simultaneously preparing for flight or
fight responses while also freezing
Like stepping on the gas and brakes at the
same time
Freeze states are more associated with people
who develop PTSD
PTSD symptoms resemble both the activation
of the SNS – hypervigilence, startled response,
as well as PNS – dissociation, numb feelings,
memory loss
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Basics: How To Pull Out of a Trauma
Response
• Bring awareness to your whole body, especially
your hands and feet
• Take slow, deep breaths, yawn
• Intensely look at something you can see “right
now”
• Do something fun or different with your body...
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Basics: What Does Somatic
Therapy Feel Like?
• EMDR Light Stream Exercise
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Basics: Other Ways to Pull Out of
Trauma Response
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Dance
Athletics
Meditation (e.g. Vipassana)
Yoga
Getting up & Lying Down
Talking Funny
Patticake
Laughing
Skipping
Horse Lips
Blowing Raspberries
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•
•
•
•
•
•
•
•
•
•
Yawning
Napping
Rocking
Jiggling
Sighing
Patting
Humming
Squatting
Moaning and Growning
Stretching
Playful Retching
Blackbird Family Therapy, Inc.
When to use Somatic Interventions
in Play Therapy
• With Yourself and Caregivers
• When a child is “stuck” in a PTSD reaction
such as fear, dissociation, or aggression –
usually the child is unable to express the theme
of the trauma in play
• To consolidate gains and resource
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When: Working with Yourself &
Caregivers
• “Put on your own air mask before putting on your
child's.”
• Learning to regulate your own nervous system as a
way of non-verbally teaching a child to do the same.
• Winnicott and the “holding environment”
• Resolving attachment through connection to a safe
object vs. mirroring learned helplessness
• Mirroring statements vs. mirroring affect
• Learning to “unmirror” or break a trauma habit.
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When: Working with Caregivers
• After you teach a parent or caregiver to “put on
their own mask”, it can be helpful to teach them
to do the following both in session (if
applicable) and at home:
• Therapeutic Touch
• Stroking, soothing
• Hugging, rocking
• Coaching parent to stay present in their body
with child to model how to do so for child
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When: Attachment Work
Children always heal from trauma in the context
of a safe and secure attachment bond.
By strengthening the attachment bond, you are
working on the trauma itself.
You can train a caregiver to be able to handle a
traumatized child's emotional dysregulation as
well as questions about an event.
Play therapy that involves the caregiver, along
with somatic touch related interventions, are
best.
Blackbird Family Therapy, Inc.
When: A child is “stuck”
• Flight: a child is scared
• Fight: a child is angry
• Freeze: a child is scared and “frozen” or
spacey, can also be “over cooperative”
• The child is unable to express their situation in
play, and instead acts out their situation
“concretely” in relationship to you and others.
• The goal is to intervene to allow the child the
ability to use play to work through the trauma.
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When: Resource & Consolidate
Gains
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Resource: something that was not available to the
child at the time of the traumatic event that is
available now: strength, loving adults, ability to say
“no” and tell adults, etc.
Building and developing resources helps children feel
that they could handle the trauma if it happened
again
Resources can be internal: superheroes, good
feelings, and external, actual people.
Resources can be physical acts and sensations.
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How To Use ST In Play Therapy for
Trauma
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Identify the Trauma Response: Flight, Fight,
Freeze, through countertransference and/or
observation
Bring in a resource
Complete the trauma response and/or choose
a more appropriate one
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How: Working with Fear / Flight
Fear often mobilizes energy for us to run from a
situation, often in the legs, but also in the
muscles in general.
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How: Working with Fear / Flight
Completing the Response:
• Where do you feel the fear in your body?
• If in the legs, what would be like if we got up
and ran around with that energy in a circle?
Changing the Response:
• Yell “no” at the fear and push it away with your
arms.
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How: Fear: Resources
• Tell me about someone who could handle this
without being afraid? (Superheroes, family,
cartoon & video game figures)
 Draw a picture of this person, show me how
s/he acts
 Imagine that you are that person, how does
that feel in your body? Notice that feeling.
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How: Working with Aggression
Aggression often mobilizes muscles in the
shoulders, arms, and chest. There is often a
great deal of upper body readiness.
The goal is often to complete the response, so
the person can feel that they are able to protect
themselves and feel safe.
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How: Working with Aggression
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Pushing Away with Arms
Saying “no”
Patticake
Stomping feet
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How: Working with Freeze
• Freeze states show up as dissociation, lack of body
awareness, numbness, “going into your head”
• Freeze states often happen in combination with a flight or
fight response, like pushing on the gas and breaks at the
same time
• The goal is to bring the client back into body awareness,
and then complete a different response such as flight or
fight.
• Freeze states are associated with PTSD and are very
common with sexual abuse.
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How: Working with Freeze
• Activity of any kind is the key, as well as body
awareness. Almost any somatic exercise will
work with a freeze state.
• Jumping up and down, running around
• It can be nice to choose an activity that would
represent a different response or complete one,
such as kicking or pushing for aggression, or
running or walking for fear.
• Pleasant, fun, and goofy activities are good too.
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Final Exercise
• Pair up with one other person here who you don't
know
• Tell each other who each you used as your “difficult”
person in the last exercise
• Decide who will go first
• Each of you will choose an appropriate play therapy
somatic intervention for the other from the handout
• Take turns performing your assigned interventions
• Check in and see what happened.
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More Information
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You can download this presentation on the Web:
http://matthewlindgren.com/EMDR-classes-consultations/somatic-play-workshop.html
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The first activity with the light visualization is from the
very first part of the EMDR protocol, in which you
prepare clients for work by resourcing.
The activities for the final exercise are from
Embodying Well Being, by Julie Henderson.
The information about trauma responses and
physiology are from Somatic Experiencing trainings.
Blackbird Family Therapy, Inc.