Somatic Movement Therapy for Pelvic Health
Authored by Dr. Maryssa Steffen, PT, DPT, Board-Certified Pelvic Health Clinical Specialist
“The white fathers told us: I think, therefore I am. The Black mother within each of us - the poet - whispers in our dreams: I feel, therefore I can be free.” - Audre Lorde
What is somatic movement therapy and how may it be applied to physical therapy and wellness?
Somatic practices are open structured, creative, and individual-centered.
They explore the principles of interoception, exteroception, and proprioception (more on these terms below!)
Research shows somatic approaches promote self-regulation and improve self authority or agency.
What does open structured and self evolving mean?
Your subjective experience is valuable material, and when attended to, can be a potent resource for regulating your nervous system, exploring your creative journey, or to simply enjoy lifting weights more!
You are an expert in your own needs and capacities, you are in the driving seat! How empowering, grounding, and thrilling. That is livin’!
What is interoception, exteroception, and proprioception?
These are bodily senses that shape perception and motivate movement:
Interoception is awareness of the internal body.
Exteroception is awareness of the external environment.
Proprioception is awareness of movement in space.
So what about physical therapy?
In physical therapy, distinct from, and complementary to, somatic psychotherapy, you will get a neuromusculoskeletal diagnosis and plan of care, and the treatments will include individualized movement or exercise prescriptions to support and transform your condition so you may move your body with more ease and pleasure. With a somatic approach, the emphasis is on “body awareness through reflection on movement habits, opening up movement capacity and developing self-directed or personal movement styles.”
Develop a practice of individualized exercises.
You are embark on your own movement education journey.
Stay present and mindful during movement. This practice can be deeply restorative, dynamic, and generative.
With consistent practice, unique to you and repeated over a period of time, your body gets conditioned in response to the repetitions.
You may experience spontaneous moments of pleasurable movement.
You affirm your own subjective experience.
Sensory exploration may replace fear or doubt as you learn to trust your body and your experience.
This is an embodiment practice and the “source of this process is love.”
What is embodiment?
Embodiment is awareness.
Awareness can be a stimulus for change.
Having awareness, agency, and options are liberating. When we move with more options, we have freedom.
To anticipate your question about, “Hey, I am already too aware of my body, that is why I am in pain!”- this can be caused by cognitive-emotional sensitization. When “emotions, attention, expectations, depressive thoughts, and catastrophic thoughts each enhance a descending facilitation this in turn sustains the process” of pain. This topic is too large for this blog, and is another condition we treat as part of a multidisciplinary team at Bodyful PT and Wellness. Stay tuned for part two where how we treat complex pain is explained!
How does Polyvagal Theory influence Bodyful treatments?
In polyvagal informed physical therapy, interoception can be used as a guide to explore the relationship between the body and emotions.
Read here about how visceral fascia mobilization can encourage your interoceptive sense.
Research shows that developing this greater awareness of the connection between bodily sensations and emotional states, “promotes listening more often to the body for insight,” and “participants [in the study] experienced their body more often as safe and trustworthy.”
When you slow down and listen, your body will tell you when to stop, when to change, when to say “no,” and when to say “yes.”
Understandably, however, slowing down and listening to your body can be frightening, especially if you have a history of traumatic holding patterns that are stored in your tissues and nervous system. There is much evidence to support that somatic and trauma-informed healing professionals can offer containers to dose your gradual return to self, to prevent overload and overwhelm, and to give your being the space needed to metabolize your story and its energy.
If this is your experience, you are not alone, and you are encouraged to seek support from a trauma sensitive professional, such as a psychotherapist, who uses trauma informed body based modalities as part of your guided care.
A summary of somatic approaches to movement:
Interoception is the perception of your gut, your emotions, and your physiology.
Exteroception comes from receptors in your skin and connective tissue, responsible for sensing touch, including pressure, heat, cold, potential damage to tissue, and vibration.
Proprioception is from receptors found in joints, ligaments, tendons, muscles, and the inner ear. This is the sense of your body in space and how you move and stay balanced.
You can deepen the interconnectedness of these sensory systems and improve your self awareness and body awareness. By engaging with these senses more often, playing with them, and practicing with others, you enrich the neural pathways for total body integration.
This awareness practice is typically more meaningful if you practice it in a social setting where others are simultaneously practicing their own embodiment.
Lastly, somatic approaches are not a destination or a goal. Somatic approaches to integrative transformation is a process and a practice.
Movement options are freedom.
With much practice over years, a lifetime, you are being with the layers that emerge, and the parts of you discovered.
Pelvic pain is caused by stress and the struggle to integrate all parts of yourself. The traumas, isolation, fear, shame, and dissociation are often stored for you in your pelvis, so that your mind can keep functioning and surviving.
When you are ready, your body is always there for you.
This practice is not a performance. You cannot fake it. There is no “correct” way to move.
Your body is yours, unique to you. When you track your felt material, you can try new movement behavior. You have the capacity to create more options and to be free.
If you are in the state of California, book a discovery call to learn more about our somatic approaches to physical therapy. We offer Telehealth and in person visits. Our office is located in Oakland, CA.
References
Meehan E and Carter B (2021) Moving With Pain: What Principles From Somatic Practices Can Offer to People Living With Chronic Pain. Front. Psychol. 11:620381. Doi: 10.3389/fpsyg.2020.620381
Pain Physician 2012; 15:ES205-ES213 • ISSN 2150-1149
