The Body Keeps the Score — But What Do You Do About It? Practical Somatic Tools for Trauma Recovery

EMOTIONAL REGULATION & NERVOUS SYSTEM • April 13, 2026

LAST UPDATED: APRIL 2026

When Trauma Feels Like a Weight You Can’t Name

It’s 9:03pm on a Thursday. Nadia sits on the edge of her bed, dressed in soft gray leggings and an oversized sweater that swallows her frame. The room is quiet except for the faint hum of the air purifier. She presses her palms flat against her thighs, feeling a tightness beneath her ribs that tightens with each breath. It’s not pain exactly, but a deep, aching pressure that pulses like a silent drumbeat inside her chest, moving down her arms and pooling in her stomach.

She’s read Bessel van der Kolk, MD’s The Body Keeps the Score cover to cover. She knows trauma is stored in the body, that the nervous system remembers what the conscious mind cannot. But knowing this doesn’t soften the weight. It doesn’t tell her what to do with the trembling in her hands or the dizzy fog that clouds her focus every time a difficult memory bubbles up uninvited.

Nadia’s mind races, looping through the day’s meetings and emails, and the sharp words exchanged with her sister last week. Her body tightens, a visceral echo of the tension she always carries but rarely acknowledges. She tries to breathe deeply, to ground herself, but the familiar knot won’t loosen. It’s as if the trauma is encoded in her muscles and nerves, a silent language she’s never learned to translate.

She wonders: How do you help a body that won’t let go? How do you learn to listen to the signals of a nervous system that’s been on high alert for decades? And perhaps hardest of all—how do you begin to heal a body that remembers before the mind can understand?

What Is Somatic Memory?

When we talk about trauma, it’s tempting to focus on what happened or how we remember it. But trauma isn’t only a story locked in your mind; it’s a lived experience embedded deep in your body’s nervous system. Van der Kolk’s research demonstrated that traumatic memories often bypass the brain’s narrative centers and instead lodge in the body’s procedural memory systems.

This means that a particular sensation—a tightening in the chest, a sudden dizziness, or a muscle spasm—can be a somatic echo of trauma. It’s not a metaphor. It’s a biological imprint. These bodily memories don’t always come with words or images. They might show up as anxiety before a certain sound or a visceral freeze when someone touches your arm unexpectedly.

Somatic memory explains why trauma survivors often feel “stuck” in their bodies. You may be able to talk through your history, even understand it intellectually, yet your body reacts as if the threat is still present. That disconnect between mind and body is a hallmark of trauma’s footprint.

In clinical practice, I see this frequently with driven, ambitious women who appear composed and competent externally but carry a subtle, persistent charge in their bodies—like a low hum of tension under everything. Their bodies remember what their minds have tried to forget.

The Neurobiology of Trauma in the Body

Bessel van der Kolk’s synthesis of trauma neurobiology reveals the profound ways trauma rewires the brain and body. One of the key discoveries involves the default mode network (DMN), a system within the brain responsible for integrating memories, self-awareness, and the sense of continuity in your identity over time.

In trauma survivors, the DMN’s activity is often disrupted, causing fragmentation of experience. This disruption impairs your ability to place traumatic memories in the past and instead triggers bodily sensations and emotional states as if the trauma is happening now. This explains why a simple trigger—a smell, a sound, a posture—can activate intense bodily responses without conscious awareness.

Stephen Porges, PhD, neuroscientist and creator of polyvagal theory, adds critical insight into how the autonomic nervous system governs these somatic responses. His concept of neuroception—the nervous system’s subconscious detection of safety or threat—explains why your body might react before your mind can process what’s happening.

According to Porges, the autonomic nervous system operates hierarchically:

• Ventral vagal complex: The “safe and social” branch, supporting calm engagement and connection.
• Sympathetic nervous system: The mobilization system for fight or flight responses.
• Dorsal vagal complex: The shutdown or freeze system, activated in extreme threat.

In trauma, these systems can become dysregulated. The nervous system may default to hypervigilance or shutdown, making it difficult to return to the ventral vagal state that feels safe and connected. This dysregulation is often stored in the body’s musculature, breathing patterns, and posture.

Pat Ogden, PhD, founder of Sensorimotor Psychotherapy, emphasizes that trauma’s imprint is found in “action tendencies”—the impulses to move, flee, fight, or freeze that were interrupted during the traumatic event. These incomplete defensive responses create somatic tension and chronic dysregulation.

Healing trauma, then, requires more than talk therapy. It requires addressing the body’s stored memories and nervous system patterns. This is why somatic approaches—like Sensorimotor Psychotherapy, Somatic Experiencing (Peter Levine, PhD), and polyvagal-informed practices (Deb Dana, LCSW)—have become essential components of trauma recovery.

In my work with clients, I’ve seen how somatic healing unlocks nervous system regulation that words alone cannot. When a woman learns to track her body sensations, orient to safety cues, and complete interrupted action tendencies, she gradually reclaims a nervous system that had been hijacked by trauma.

This process isn’t simple or linear. It requires patience, titration, and a relational container that supports nervous system regulation. But it’s the pathway toward reclaiming your body and your life from trauma’s enduring legacy.

How Somatic Healing Shows Up in Driven Women

It’s 9:17pm on a Thursday when Nadia closes the hardcover copy of The Body Keeps the Score on her bedside table. The apartment is quiet except for the soft hum of the city outside her San Francisco window. She’s a 39-year-old startup executive, known for her razor-sharp intellect and unshakable composure in high-stakes meetings. Tonight, though, the calm façade cracks. Her chest tightens, a familiar heaviness settles in her stomach, and her breath feels shallow. She’s read about somatic memory and the body’s role in trauma recovery, but the question presses: “What do I actually do with this? How do I help my body when my mind is already exhausted?”

Nadia’s experience is emblematic of many driven women I work with. Their external lives read like success stories—leadership roles, advanced degrees, a track record of resilience. Yet beneath this surface, the body holds a different story. Trauma’s imprint isn’t just psychological; it’s physiological. The tension in Nadia’s chest and the constriction in her belly are somatic echoes of past relational wounds, stored in the nervous system and muscle memory.

What often surprises these women is how deeply disconnected they’ve become from their own bodies. The very qualities that propelled them professionally—their analytical mind, their capacity to compartmentalize—can become barriers to somatic healing. They may have intellectual awareness of trauma’s impact, but the felt sense, the visceral experience, remains elusive or overwhelming.

For Nadia, somatic healing begins with small, intentional acts. She notices the cold of her feet against the hardwood floor, the weight of her hands resting on her lap. These moments of grounding are not just mindfulness exercises; they are nervous system interventions. They invite her body to register safety, to descend the polyvagal ladder from a state of sympathetic arousal toward ventral vagal calm. But the process is rarely linear. Some days, the body’s signals feel like a tidal wave—unbearable and threatening. Other days, a gentle tremor or a sigh releases years of held tension.

Driven women like Nadia often report a paradoxical tension in somatic work: the body’s wisdom is undeniable, yet accessing it triggers activation that feels unsafe or destabilizing. This is where the clinical framework of titration and pendulation—concepts pioneered by Peter Levine, PhD, psychologist and developer of Somatic Experiencing—becomes critical. Rather than diving headfirst into body sensations, the trauma survivor learns to oscillate gently between activation and resource, allowing integration without overwhelm.

In my work with clients like Nadia, I emphasize that somatic healing is not about forcing the body to release trauma on a schedule. It’s about cultivating attunement to the body’s signals, building a window of tolerance that expands over time. This is especially important for women whose nervous systems have been conditioned to high vigilance and control. The drive to “push through” or “fix” somatic symptoms can replicate old patterns of suppression, reinforcing the very trauma cycle they seek to escape.

Somatic healing in driven women also intersects with the internalized pressure to perform. The body’s symptoms—tight shoulders, chronic headaches, digestive issues—are often minimized or ignored in favor of productivity. Nadia once told me, “If I admit that my body is struggling, I feel like I’m admitting I’m weak, that I can’t handle the pressure.” This internalized stigma is a somatic wound itself, a barrier to accessing the nervous system’s natural capacity for regulation and repair.

Another clinical dimension that distinguishes somatic healing in driven women is the role of the apparently normal part (ANP) and emotional part (EP), a concept outlined by Janina Fisher, PhD, psychologist and author of Healing the Fragmented Selves of Trauma Survivors. The ANP manages daily functioning, often suppressing or disconnecting from the EP, which holds the raw emotional and somatic experience of trauma. For driven women, the ANP’s competence is a double-edged sword—it enables success but perpetuates internal fragmentation.

Somatic healing work invites the ANP and EP into dialogue, fostering integration rather than dissociation. Movement-based therapies such as Pat Ogden, PhD’s Sensorimotor Psychotherapy are particularly effective here, using body posture and action tendencies to access and re-pattern trauma responses. For Nadia, this means learning to notice how her shoulders hunch forward in anticipation of criticism, or how her breath constricts when conflict arises, and then gently experimenting with new, safer body patterns.

Ultimately, somatic healing for driven women is not about erasing the trauma imprint but about transforming the nervous system’s relationship to it. It’s a process of reclaiming the body as an ally rather than an adversary. Nadia’s story continues beyond the pages of her book, in the slow, patient work of feeling, releasing, and embodying safety.

The Neurobiological Dance of Somatic Healing

Understanding somatic healing requires a deep dive into the neurobiology that underpins trauma’s imprint and recovery. Bessel van der Kolk, MD, psychiatrist and trauma researcher, author of The Body Keeps the Score, emphasizes that trauma is stored not as a narrative memory but as somatic memory—encoded in muscle tension, autonomic arousal, and implicit bodily patterns. This somatic memory can be triggered by sensory cues long after the original event, often without conscious awareness.

Stephen Porges, PhD, neuroscientist and creator of polyvagal theory, provides the framework for understanding the autonomic nervous system’s role in somatic healing. His work describes how the nervous system shifts between three modes: the ventral vagal (social engagement and safety), the sympathetic (mobilization and fight/flight), and the dorsal vagal (shutdown and freeze). Trauma disrupts this balance, often locking the system in states of hyperarousal or hypoarousal.

Somatic healing aims to restore flexibility to this system. Deb Dana, LCSW, clinician and author of The Polyvagal Theory in Therapy, highlights the importance of co-regulation—the nervous system’s ability to “borrow” safety from another regulated nervous system. This is why somatic work is deeply relational, not just individual. The felt sense of safety in a therapeutic relationship can catalyze changes in autonomic regulation.

Peter Levine, PhD, psychologist and developer of Somatic Experiencing, advances the clinical techniques that harness these neurobiological insights. He introduces the concept of pendulation, the oscillation between states of activation and rest, allowing the nervous system to process trauma without overwhelm. Titration—the incremental exposure to body sensations—prevents retraumatization and supports integration.

Pat Ogden’s Sensorimotor Psychotherapy complements this by emphasizing movement and posture as gateways to implicit somatic memory. She outlines how action tendencies—automatic impulses to fight, flee, or freeze—can be tracked and gently completed or re-patterned. This body-based approach honors the wisdom of the nervous system and its role in healing.

Both/And: Understanding What the Body Keeps Is Not the Same as Knowing How to Help It Release

It’s a clinical truth that many driven women grasp intellectually: their bodies hold trauma. They’ve read the research, they’ve heard the talks, they resonate with the idea that healing must include the body. And yet, knowing this and knowing what to do next are two very different things.

Jordan is 42 and leads a nonprofit with a staff of 18. It’s 7:03pm on a Wednesday when she sits cross-legged on her bedroom floor, phone timer set for ten minutes of “somatic release” she found in an online video. She’s dressed in yoga pants and a soft sweatshirt, surrounded by candles. The instructions say to surrender to bodily sensations, to follow the felt sense wherever it leads. But Jordan’s breath catches, her mind races, and the sensations flood in like a storm. Instead of relief, she feels overwhelmed and panicked. She closes her eyes, tries to soften, but the body’s activation feels like a wildfire she can’t control.

Jordan’s experience is common: the paradox of somatic healing is that the body’s stored trauma is simultaneously the doorway to recovery and the source of activation that can feel unsafe. This is why clinical guidance, pacing, and relational containment are essential. The body’s wisdom needs a container, a guide, and a relational witness to move from dysregulation toward integration.

In my clinical work, I see this both/and dynamic play out frequently. The body is the scorekeeper of trauma—this is an unassailable fact. But how to translate that knowledge into safe, effective healing is a distinct clinical challenge. It requires nuanced understanding of the nervous system, the individual’s window of tolerance, and the interplay of psychological and somatic parts.

For Jordan, the path forward includes learning to pendulate gently between activation and rest, using somatic resourcing tools that anchor her in moment-to-moment safety. It means building a therapeutic alliance where her nervous system can borrow regulation and where her experience is held without judgment or pressure. It means recognizing that somatic healing is a process, not a quick fix.

Both knowing the body keeps the score and knowing how to help the body release are essential—and neither negates the other. They exist in tandem, a clinical tension that honors the complexity of trauma recovery.

The Systemic Lens: Why Western Medicine Still Treats the Body and Mind as Separate Problems

Zooming out from the individual woman’s somatic experience, it’s crucial to understand the systemic forces that shape how trauma and somatic healing are perceived and treated in Western culture. The entrenched dualism of body and mind in medicine and psychology creates a profound barrier to effective trauma recovery.

Western medicine’s historical separation of physical symptoms from psychological distress means that many driven women encounter a fragmented treatment landscape. They may see a rheumatologist for autoimmune symptoms, a psychiatrist for anxiety, and a therapist for trauma—and none of these clinicians may coordinate care that acknowledges how these symptoms intertwine at a somatic level.

Bessel van der Kolk, MD, highlights this limitation in The Body Keeps the Score: “The greatest source of suffering for people with trauma is that they are treated as if their problems are either physical or psychological, but not both.” This cultural split perpetuates the invisibility of somatic trauma and its consequences, leaving women like Nadia and Jordan to navigate a siloed system.

The biomedical model’s focus on symptom suppression rather than nervous system regulation can inadvertently reinforce a dissociative stance toward the body. Pharmaceuticals may mask somatic symptoms without addressing their root in trauma, and talk therapy alone often falls short of engaging the body’s procedural memory.

Moreover, the medical system’s emphasis on efficiency and objectivity can clash with the relational, slow, and nuanced work somatic healing demands. The time-intensive nature of somatic therapies, which prioritize safety, titration, and co-regulation, may be undervalued or inaccessible within insurance frameworks and clinical settings.

On a broader cultural level, the valorization of cognitive achievement and mental toughness among driven women creates additional systemic pressure to ignore or minimize bodily distress. Admitting to somatic symptoms can be stigmatized as weakness or distraction, compounding internalized shame and isolation.

Stephen Porges, PhD, and Deb Dana, LCSW, both advocate for integrating polyvagal-informed practices into mainstream healthcare to bridge this divide. Their work calls for systems that recognize the nervous system as the nexus of mind-body integration, and that prioritize relational safety as a foundation for healing.

Changing the systemic narrative requires cultural shifts that legitimize somatic experience, expand access to body-based therapies, and challenge the mind-body split that leaves so many women stuck in incomplete healing. Recognizing these systemic barriers is not about assigning blame but about contextualizing individual suffering and paving the way for systemic advocacy and reform.

For women ready to engage in somatic healing amid these systemic challenges, finding clinicians who understand and embody this integrative perspective is vital. Annie’s therapy with Annie offers precisely this—a trauma-informed, polyvagal-informed approach designed for driven women who want to work with their bodies, not against them.

The Body Keeps the Score — But What Do You Do About It? Practical Somatic Tools for Trauma Recovery

EMOTIONAL REGULATION & NERVOUS SYSTEM • April 13, 2026

How to Heal / The Path Forward

The recognition that “the body keeps the score” is a profound step in trauma recovery, but it often leaves women wondering: what now? Knowing that trauma imprints itself somatically can feel both validating and disorienting. In my work with clients, the real question isn’t just about understanding this truth—it’s about how to engage with the body safely and effectively to facilitate healing. This requires a nuanced, paced approach that honors the nervous system’s limits and capacities.

Healing somatic trauma is not a linear path or a quick fix. It’s a staged process that aligns closely with Judith Herman, MD’s trauma recovery framework, particularly Stage 2: Remembrance and Mourning, where the body becomes the site of deep processing. The body holds implicit memories—sensations, tensions, and action tendencies—that often surface before the conscious narrative can be accessed. Thus, somatic work is indispensable because traditional talk therapy alone cannot reach these layers.

Peter Levine, PhD, psychologist and developer of Somatic Experiencing, emphasizes the importance of “pendulation”—the nervous system’s natural oscillation between states of activation and calm. This oscillation allows the nervous system to process trauma without becoming overwhelmed. In practice, this means guiding clients to gently move between sensing the trauma activation in the body and returning to a felt sense of safety or resource. The goal is not to relive trauma in its full intensity but to titrate exposure, allowing incremental integration.

Deb Dana, LCSW, clinician and author of The Polyvagal Theory in Therapy, reminds us that healing also depends on co-regulation—the nervous system’s ability to borrow safety from another regulated nervous system. This is why relational safety, such as that found in therapy, is critical. You cannot fully rewire your nervous system in isolation. The presence of a calm, attuned other—whether a therapist, coach, or trusted support—provides the neurobiological foundation for your own nervous system to learn safety.

Pat Ogden, PhD, founder of Sensorimotor Psychotherapy, brings in the dimension of body-based action tendencies—those subconscious impulses to move, fight, flee, or freeze that may have gone unfinished during trauma. Somatic healing involves not only noticing these impulses but also completing or renegotiating them through movement, posture, and touch. This is how the body integrates trauma: through action, not just reflection.

Here is a clinically grounded path forward that integrates these principles:

1. Establish Safety and Resourcing: Before engaging trauma memories, your nervous system needs to feel safe. This involves cultivating internal and external resources—such as grounding techniques, safe places in imagery, and connection with supportive others. Orientation exercises like visual scanning can activate the ventral vagal social engagement system, fostering a sense of safety.
2. Increase Somatic Awareness Gently: Learning to track sensations without judgment builds your window of tolerance. This includes noticing physical sensations like tightness, warmth, or tension. The felt sense, as described by Peter Levine, is your body’s holistic internal experience of a situation, which can guide your healing work.
3. Pendulate Between Activation and Calm: Move gradually into trauma activation, then return to resourcing. This prevents overwhelm and promotes integration. For example, you might focus on a sensation of tightness for a moment, then shift to feeling your feet on the ground or your breath moving.
4. Complete Action Tendencies: Work with your body’s impulses to move, gesture, or express what was interrupted in the original trauma. This can be subtle—a small shake, a change in posture, or a sigh—or more overt movement, depending on your readiness.
5. Engage in Relational Healing: Healing is relational. Therapeutic relationships provide the co-regulation necessary for nervous system repair. This might include therapy with an EMDR-trained trauma specialist, somatic psychotherapy, or trauma-informed coaching. Online courses like my Relational Trauma Recovery Course offer structured support to deepen this work between sessions.
6. Integrate Mind-Body Approaches: Practices such as gentle yoga, breathwork, and bilateral stimulation (a component of EMDR) complement somatic therapies by enhancing nervous system regulation. These tools help restore the default mode network’s function, improving temporal integration and embodied self-awareness.
7. Be Patient and Compassionate with Yourself: Somatic healing is complex and often non-linear. You may experience fluctuations in symptoms, moments of progress followed by regressions. This is normal. Cultivating self-compassion, informed by Kristin Neff, PhD’s research, supports resilience and counters the inner critic that often sabotages recovery.

What often surprises clients is how subtle shifts in bodily awareness can ripple out into profound emotional and cognitive changes. The body is not just a container of trauma; it is also the gateway to healing. This work requires courage, curiosity, and a commitment to listening deeply to your body’s wisdom.

If you’re wondering where to start, I encourage exploring body-based practices within a safe, supportive container. My individual therapy and Relational Trauma Recovery Course provide that container, combining somatic tools with relational depth. You don’t have to do this alone.

Remember, understanding what your body keeps is not the same as knowing how to help it release. Healing is a process of reweaving safety into the fabric of your nervous system, one felt moment at a time.

“Healing is not about fixing what’s broken. It’s about befriending the parts of yourself that have been wounded and learning to live from a place of embodied safety.”

Warm Communal Close

Healing trauma held in your body is challenging, but you are not alone in this. What you’re experiencing is real, and it matters deeply. The body’s wisdom is waiting for you to listen, and with the right support, that listening can open the door to a new way of being—more grounded, more present, more connected to yourself and others.

Take gentle steps, honor your limits, and reach out when you need it. Whether through therapy, coaching, or courses, there are paths designed to meet you where you are. If you want to explore how somatic healing can fit into your life, I invite you to connect with me or explore the Relational Trauma Recovery Course. Your body has a story, and it’s ready to be heard.

With warmth and respect for your strength, Annie

Related Reading

van der Kolk, Bessel, MD. The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma. Viking, 2014.

Levine, Peter, PhD. Waking the Tiger: Healing Trauma. North Atlantic Books, 1997.

Dana, Deb, LCSW. The Polyvagal Theory in Therapy: Engaging the Rhythm of Regulation. W.W. Norton, 2018.

Ogden, Pat, PhD. Sensorimotor Psychotherapy: Interventions for Trauma and Attachment. W.W. Norton, 2015.

Medical Disclaimer

Medical Disclaimer