Somatic trauma therapy (Rothschild)

Domain IV · Body-oriented psychotherapy · Babette Rothschild · 1999

What it is

This is not a closed, manualised therapy. Rothschild (MSW, LCSW; a body psychotherapist since 1976, trained in Copenhagen) describes a set of principles and body-based tools that any trauma therapist can add to their existing model. Her publishers describe the techniques as "non-touch": the…

Format

• Rothschild gives no fixed number of sessions and no rigid phase manual. The sequence below follows her rule of brakes before accelerator, together with the ten foundations. The phase labels are; the content and the criteria for moving on are hers.
• Format. Individual, sitting or standing, talk-based with body awareness and simple movements woven in. No massage table and no therapist touch. Length depends on the client: building dual awareness "may take weeks, months, or years" (paraphrase of Rothschild 1999).

Who practises it, and how they are trained or regulated

• How change happens: Rothschild holds that trauma is kept as implicit, body-level memory and as autonomic nervous system (ANS) arousal. Recovery depends less on going back over memories than on the client learning to notice and regulate arousal, the "brakes", while keeping dual awareness: knowing that the past is past while feeling its traces in the present. Processing memories is optional. In the later work she…

Questions to explore with your client

• What drew you to it, and what are you hoping it will change?
• Is there physical contact? Was it explained beforehand, and do you feel free to say no or stop at any point?
• Does it involve intense or unusual breathing? Have you been told about the medical conditions for which that is not advised?
• Is it a group, retreat or community? How do they respond if someone wants to leave or raises a concern?
• How do you and the practitioner understand what is happening, in spiritual or cultural terms? Is that a source of comfort, worry, or both?
• Who runs it, and what training or registration do they hold?
• What actually happens in a session or meeting, and how often?
• What does it cost, and is there pressure to commit to more?
• How do you feel afterwards, in the hours and days that follow?
• Does it fit with, or clash with, the work we do here?

What practitioners of it watch for

• long silent sits that bring on flashbacks.
• mindfulness that heightens distress (see 4.22).
• relaxation exercises given to a frozen client, which can deepen the freeze.
• a client who believes they have to tell everything. Correct this explicitly.
• trauma that has not ended (ongoing abuse). Then safety comes first (Phase A).

When to involve someone else

• New or worsening physical symptoms, or advice to stop or change prescribed medication: involve the client's doctor or prescriber.
• Signs of coercion, isolation from family and friends, escalating costs or secrecy: discuss openly and consider safeguarding.
• A crisis or thoughts of suicide: follow your crisis protocol. In the US, call or text 988; in the UK and Ireland, Samaritans on 116 123.

Drawn automatically from the guide's own sections. Stay curious: neither endorse nor dismiss what the client values, and check anything that matters against the full guide and its sources. Not medical advice.