Have you ever left a therapy session thinking "I understand all of this" but still felt tense, anxious, or on edge in your body? You can name what happened, you can talk about it calmly, but the moment something triggers you, your heart races or your stomach drops. As an online therapist based in North Berwick, I hear this a lot. And it's one of the reasons I've been drawn to working somatically alongside the cognitive model of trauma.

Cognitive approaches like CBT and EMDR are well evidenced and help a lot of people. They make sense of what happened, challenge unhelpful beliefs, and process difficult memories. But trauma isn't just a thought. It lives in the body too.

When something overwhelming happens, your nervous system reacts before your thinking brain catches up. That response, whether it's fight, flight, freeze, or collapse, can get stored in the body as tension, numbness, chronic pain, or a low level sense of threat that never quite switches off. Some people describe it as always waiting for something bad to happen, even when life feels relatively okay. For some, cognitive work alone doesn't fully reach those physical imprints.

Somatic approaches focus on body sensation, movement, posture, and breath. Rather than talking about an experience, we pay attention to what the body is holding and work with that directly. It's a bottom up approach rather than top down. And it draws on the understanding that the body often holds the key to what words can't quite reach.

Here's the thing though: these two approaches don't compete with each other. They work well together. The cognitive model helps us understand the trauma, identify triggers, and update the meanings we've attached to what happened. Somatic work helps the body complete what it started during the traumatic event, which can release stored tension and build a felt sense of safety that thinking alone can't always create.

In practice, this might look like noticing what happens in your body when we explore a difficult memory. Or slowing right down to pay attention to subtle physical sensations that signal something important is shifting. Breath work and grounding techniques also play a big part in helping regulate the nervous system, both in sessions and in everyday life.

Trauma recovery isn't a straight line, and no single approach works for everyone. But bringing the mind and the body into the work together gives people a much fuller toolkit for healing.

If you're curious about what an integrated approach might look like for you, get in touch.