What Is Somatic Therapy for Anxiety? A Maryland Therapist’s to Healing from the Body Up
We are more than our brains and anxiety is more than thoughts.
Here's something I say in my work with anxious clients fairly often, and it sometimes lands with a mix of recognition and confusion:
You've been trying to think your way out of something that isn't just happening in your thoughts.
If you've been dealing with anxiety for a while, you probably know a lot about it. You might have read about cognitive distortions. You might be able to name your patterns: the catastrophizing, the what-ifs, the 2am mental rehearsals. You may have tried journaling, or breathing apps, or podcasts, or sheer willpower. And you're still struggling.
It's not because you're doing it wrong. It's because anxiety doesn't live only in your mind. It lives in your body too. It’s in the tight chest, the held breath, the shoulders that haven't fully dropped in years, the stomach that clenches before a difficult conversation. And if we're only working on the thinking part of anxiety, we're leaving a significant portion of the problem untouched.
That's what somatic therapy is about.
This is the first post in a new series on body-based approaches to anxiety. In future posts, I'll get into nervous system basics, grounding techniques, breath and anxiety, and what hypnotherapy actually feels like from the inside. But let's start here: what somatic therapy actually is, why it matters for anxiety specifically, and what it looks like to work this way with a Maryland anxiety therapist.
What does “somatic” actually mean?
"Somatic" comes from the Greek word soma, meaning body. Somatic therapy, at its core, is therapy that includes the body as part of the conversation; not just as a side note, but as a full participant.
This might sound obvious. Of course your body is involved. But a lot of traditional talk therapy treats the body as more or less a vehicle for transporting your brain to the therapy session. The real work, in that model, happens in the thoughts and the words. Somatic approaches say: Hold up! The body is actually communicating something important, and we'd better listen to it.
This doesn't mean somatic therapy is some fringe, incense-and-crystals enterprise. (I say that with affection for incense and crystals, fwiw. I’m a sucker for all kinds of things that look, sound or smell nice.) The relationship between the body and emotional experience is a well-established area of research in neuroscience and psychology. The short version: your nervous system doesn't distinguish neatly between a physical threat and an emotional one. When anxiety is triggered , whether by a deadline, a difficult relationship, or an old memory, your body responds as though something actually dangerous is happening. Heart rate speeds up. Breathing becomes shallow. Muscles are braced. Digestion slows. Attention narrows. All good stuff if we need to fight or run away.
But here's the part that's really important for understanding why this matters for anxiety treatment: the body can stay in that alert, braced state long after the immediate trigger has passed. For a lot of people with chronic anxiety, the nervous system has essentially gotten stuck in a higher-alert setting. The baseline has shifted. The body is waiting for the next thing, all the time, even when things are technically fine.
Trying to talk a body out of that state is a bit like trying to convince someone who's been startled that they logically shouldn't be jumpy. The logic doesn't reach all the way down to where the jumpiness actually lives. That's not a character flaw. It's just how nervous systems work.
Why anxiety needs more than a cognitive approach
Don’t get it twisted: I love Cognitive Behavioral Therapy (CBT). I've used it for years, it has solid research behind it, and it works. Understanding how thoughts drive feelings and behaviors, and learning to interrupt unhelpful thought patterns is genuinely valuable work. You can read more about how I use CBT for anxiety here.
But CBT has limits when anxiety is living deeply in the body. Here's an analogy that I think captures it well.
Imagine your nervous system as a top quality smoke detector. It's doing its job: scanning for threats, sounding the alarm when it senses something potentially dangerous. Now imagine that this smoke detector has gotten, through years of practice, extremely sensitive. It goes off for steam from the shower. It goes off for toast. It goes off when you even walk into the kitchen with a lit candle. Birthday parties get dicey.
CBT gives you good tools for examining the evidence: Is this actually smoke? Is this a real fire? Nope, it’s toast again. The statistics on kitchen fires suggest this is fine. And that's useful! The logic can help. But it doesn't recalibrate the smoke detector itself. You still have a fire alarm that blares when you make toast. And you are getting real tired of cereal.
Somatic work is more about recalibrating. Teaching the nervous system (through experience, not argument) that it's safe to come down from high alert. That the present moment is more manageable than the alarm is indicating. That the body can unclench.
What somatic therapy looks like in practice
What can you notice, and change, from the inside out?
I suspect when some people hear "body-based therapy," they picture something that requires a yoga mat and a willingness to roll around on the floor (But also, yeah, I’m down for this too, with a background in Phoenix Rising Yoga Therapy). And I understand that hesitation. I've worked with a lot of skeptics over the years, and skeptics are completely welcome in my office, just as much as all the folks wanting to jump right into “the weird stuff”. I’m here for it all.
Here's what somatic work actually looks like in the context of anxiety therapy in Maryland with me:
It usually starts with noticing. Before we try to change anything, we get curious about what's actually happening in the body. Where do you feel anxiety in your physical self? Is it a tightness in the chest? A hollowness in the stomach? A vague tension in the jaw or shoulders? Many anxious people have been living so long in their heads that they've largely stopped registering what's happening below the neck. Just starting to notice, without judgment, without trying to fix it, is often meaningful in itself.
It involves the breath. Not in a "just breathe" way. That particular piece of advice, while well-meaning, can feel maddening when you're mid-anxiety spiral. But intentional breath work that specifically targets the nervous system's ability to slow down and settle. There's a reason the breath is at the center of almost every calming practice across cultures and centuries. It's one of the very few processes in the body that is both automatic and consciously controllable, which makes it a uniquely powerful lever. Plus, it’s also with you. You don’t to make an in-app purchase for it or remember to bring it with you.
It can include body awareness practices. This includes things like body scans, grounding through the senses, and attention to physical sensation. These can help bring you back to the present moment when anxiety has taken your mind somewhere else entirely. I wrote about some of these in the embodiment post in my mindfulness skills series.
It can include clinical hypnotherapy. This might raise an eyebrow. But hypnotherapy, done clinically, is one of the most effective body-based tools I have for anxiety because it works at the level of the nervous system and the subconscious, rather than asking the analytical mind to do all the work. I'll write more about this in an upcoming post in this series.
It is always paced to you. Working with the body in therapy needs to be carefully dosed. Moving too fast can feel overwhelming. The goal is never to flood you or push you past your capacity to stay present with what's coming up. We work at the edges of what's comfortable, not in the middle of overwhelm.
“Isn’t This just the same as relaxing?”
Nope. It’s an extremely fair question though. Here's the difference:
Relaxation is a state. It's the absence of tension, the feeling of being at ease. It's lovely when it happens, and it's a fine goal in itself. But relaxation doesn't necessarily change anything about how the nervous system is organized, or how quickly and strongly it responds to triggers, or what underlying beliefs and memories are driving the anxiety response.
Somatic therapy is working with the body toward lasting change in how you experience and process anxiety, not just in how you feel in a given moment. It's about building capacity. Not just calming down right now, but developing a more flexible, resilient relationship between your nervous system and the stressors in your life.
The results I've seen in clients who do this work are some of the most durable I've witnessed in over 20 years of practice. People who went from multiple panic attacks per week to occasionally having one. People who stopped white-knuckling through ordinary daily stress. People who told me they finally felt at home in their bodies again after years of bracing and vigilance.
Somatic approaches can be useful to anyone seeking relief from anxiety.
Who Benefits from Somatic Approaches?
Got a pulse? It’s you!! Just kidding. But most people with anxiety, in my experience, could really benefit from this. Here’s a few situations where I find somatic work particularly useful:
When anxiety is highly physical. If your anxiety shows up predominantly as physical symptoms (racing heart, digestive upset, chronic muscle tension, dizziness, that floaty disconnected feeling) somatic approaches are often where the most meaningful work happens.
When talk therapy has felt like going in circles. If you've spent time in therapy talking about your anxiety but not feeling like things are actually shifting, it may be that the work needs to involve the body more directly. Understanding your patterns isn't always enough to change them.
When anxiety seems to come from nowhere. Some anxiety isn't attached to clear thoughts or identifiable triggers. It just arrives, as a feeling, a physical state, a background hum of dread. Somatic work is well suited to this kind of free-floating anxiety because it works at the level of sensation and nervous system response, not just cognitive content.
When anxiety is connected to old experiences. The body holds the history of what we've been through, sometimes quite literally, in patterns of bracing, holding, hypervigilance, or shutdown. Somatic approaches can help address anxiety that has roots in past experiences, carefully and at a manageable pace.
Where this series is going
Over the next several posts, I'm going to take these ideas further:
How your nervous system works (in plain English, no jargon required), and why anxious nervous systems get stuck in high alert
Grounding techniques that actually work (and why they work)
The anxiety-breath connection, and how changing the breath changes the nervous system
What clinical hypnotherapy for anxiety actually feels like, from the inside
A self-compassion practice specifically for the body experience of anxiety
Each post will be practical, and each will connect back to real work I do with anxiety therapy clients in College Park and online in Maryland.
working with a maryland therapist who takes the body seriously
My approach to anxiety therapy has always been integrative. That means I don't plant a flag in any single method and stay there. I use CBT, mindfulness-based approaches, somatic and embodied healing practices, and clinical hypnotherapy because different people need different things, and most people need a combination. The body and the mind are not separate problems. They need to be worked on together.
If what I've described here resonates, and you're someone who has been trying hard to think your way out of anxiety without quite getting there, I'd love to talk. I offer a free 15-minute consultation call so we can see whether working together would be a good fit.
Sessions are available in person in my College Park, Maryland office, or online anywhere in Maryland. Contact me here, or call (301) 818-3978.
About the author, A MARYLAND ANXIETY COUNSELOR:
Beth Charbonneau, LCSW-C, is a Maryland therapist, specializing in anxiety therapy and treatment. With over 20 years of experience, she brings a holistic approach to calming the mind and body, and encourages her clients to feel empowered to find more joy in life. More information about her practice can be found on her website.
