Body, Touch and Table Work in Therapy
Elizabeth Muehlbacher, MSW, RSW, SEP, is a mental health therapist specializing in body-oriented and somatic practices. She incorporates concepts of Somatic Experiencing™, Compassionate Inquiry® and Polyvagal Theory. She actively pursues ongoing training and consultation in this specialized area of psychotherapeutic practice. Somatic Experiencing and touch work are described below to help you understand its role in resolving physical and emotional symptoms related to trauma/PTSD, chronic stress/fatigue, fear, anger, anxiety, shame, health conditions or complex syndromes, as well as in restoring boundaries, regulation, resiliency, empowerment, and a healthy sense of self.
Why Use Touch Work in Therapy?
All our earliest experiences surrounding concepts of nurture, soothing and bonding with our caregivers and other relationships begin with touch. Our bodies hold our implicit memories that we may not have access to in a more traditional talk therapy session. Some of our deepest and most profound experiences are held in the body from a young age, before we are developed enough to carry into our explicit memory recall. When we are little, our brain and nervous system cannot process certain aspects of trauma because we do not yet have the cognitive capacity to do so. Touch can be an essential part of the renegotiation process, especially when trauma is pre-verbal and words are not available.
What is Somatic Experiencing™ (SE)?
Somatic Experiencing™ (SE) is a naturalistic approach to the resolution and healing of trauma developed by Dr. Peter Levine, resulting from his multidisciplinary study of stress physiology, psychology, ethology, biology, neuroscience, Indigenous healing practices and medical biophysics. SE releases traumatic shock (“freeze”) and supports the body’s natural ability to regulate itself, which is key to transforming PTSD, chronic stress, and the wounds of emotional and early developmental attachment trauma.
SE is based upon the observation that wild prey animals, though threatened routinely, are rarely traumatized. Animals in the wild naturally regulate and discharge the high levels of energy arousal (fight/flight) associated with defensive survival behaviors and chronic stress. This provides animals with a built-in “immunity” to trauma and stress that enables them to return to normal in the aftermath of highly charged life-threatening experiences.
SE facilitates the completion of self-protective motor responses and the release of survival energy bound in the body, thus addressing the root cause of trauma symptoms, which can result in subtle or more intense experiences as the body discharges. This is approached by gently guiding clients to develop increasing tolerance for difficult bodily sensations and suppressed emotions, to not get overwhelmed.
SE employs awareness of body sensation to help people "renegotiate" and heal rather than re- live or re-enact trauma.
SE's guidance of the bodily "felt sense," allows the highly aroused or frozen survival energies to be safely experienced and gradually discharged.
SE “titrates” your experience (breaks it down into small, incremental steps) so that you can remain embodied and present, rather than evoking a mindless catharsis.
Note: Somatic Experiencing can be used with or without touch.
SE does not require you to re-tell or re-live the traumatic event; however, working through the trauma story can be done more safely using SE. It offers the opportunity to engage, complete, and resolve—in a slow and supported way—the body’s instinctual fight, flight, freeze, and collapse responses. Individuals locked in anxiety or rage then relax into a growing sense of peace and safety. Those stuck in depression gradually find their feelings of hopelessness and numbness transformed into empowerment, triumph, and mastery. SE catalyzes corrective bodily experiences that contradict those of fear and helplessness and seeks to restore a sense of aliveness and pleasure. This resets the nervous system, restores inner balance, enhances resilience to stress, and increases people’s vitality, equanimity, and capacity to actively engage in life. For more information: www.traumahealing.org
The Somatic Experiencing Trauma Institute states that Somatic Experiencing is neither a form of psychotherapy nor a bodywork technique, though it lends itself well to being integrated into these and other treatment modalities.
What is SE™ Touch?
SE Touch is applied with hands and occasionally with forearm or foot contact, and can also be offered indirectly, such as providing support through a cushion. SE Touch is done fully clothed and is not used to manipulate the body. SE Touch offers support to muscles, joints, diaphragms, and organs to support regulation and healthy functioning. Touch can be applied with the client in a seated position or lying face up on a table or standing during movement exercises.
Some examples of when touch can be helpful are:
Identifying an area of the body for tracking internal sensations.
Supporting an area of the body to release tension or constriction.
Stabilizing a highly activated / dysregulated nervous system.
Containing and processing difficult emotions (e.g., feeling therapist’s hands on the outside of your upper arms to provide a sense of containment to reduce flooding).
Bringing awareness to an area of the body that feels disconnected or numb.
Engaging a reflexive action or defence to support completion / discharge of a response (e.g. pushing into a therapist’s hands to engage a frozen fight response).
Resourcing an individual with positive sensation or a healthy body function (e.g., pressure on the feet can enhance a sense of grounding).
Calming an anxiety response
Touch was incorporated in Somatic Experiencing by Dr. Peter Levine, and was further refined as a practice by Kathy Kain, MA, SEP, somatic and bodywork practitioner and senior faculty member with the Somatic Experiencing Trauma Institute (www.somaticpractice.net).
Disclosure and Consent
Touch will never be employed without discussion and verbal consent first. You have the right to choose touch work or refuse. Your practitioner will discuss ahead of time the recommendation of touch, if indicated, and you will have an opportunity to ask many questions. A refusal continues to be an option even if the work has begun. Your practitioner will verbally identify exactly the scope and practice of your work before, during and after sessions. It is your responsibility to communicate any effects of such treatments to your practitioner during and after sessions.
SE can result in a number of benefits to you, such as relief of traumatic stress symptoms, increased resiliency and resourcefulness. Like any other treatment, if may also have unintended negative side effects, such as sleep disturbance, frightening memories or unfamiliar/uncomfortable body sensations. Such reactions can be attended to in the course of our work together.
Elizabeth Muehlbacher, RSW, SEP, is registered to complete Kathy Kain’s specialized touch work training in 2025. However, she is fully trained in the use of touch in the context of Somatic Experiencing Certification. The certification process for this treatment includes 235+ hours of training over a 3 year period, 30+ hours of personal consultation and experiential work, as well as continued reading, studying and consultation. Her certification in Compassionate Inquiry, which is also somatically-focused, involves over 200 practice hours and an intensive 1-1 mentorship program.
Ethics of Touch
Consent is required when using touch-related techniques in therapy, and can be withdrawn at any time. Elizabeth will ask your permission to use touch and you have the right to decline or refuse touch without fear of wrong-doing or disrupting the therapeutic relationship, even if you previously provided consent. Elizabeth will ensure that you understand the nature and purpose of using touch. Elizabeth will explore with you and evaluate the appropriateness of the use of touch in your situation. She will also check in with you about your comfort level with regards to the location of touch, amount of pressure, length of contact, and her proximity to you both before and during each session.
Sexual touch of clients by therapists is unethical and illegal. Genital touching is not performed, nor do therapists use touch to sexually stimulate clients deliberately. Touch should not be used to foster dependency of the client on the therapist, and therapists are cautious about the potential to re-enact dynamics or trigger transference coming from early, vulnerable experiences/states. Clear boundaries are outlined prior to and during the use of touch in a manner that is not enmeshing, shaming or derogatory.
Touch is only used in your best interest to benefit your healing with respect for your self-determination, and never to gratify the personal needs of your therapist. Your needs and wishes take priority over any clinical or theoretical approach. You may request not to be touched at any time during therapy without needing to explain it, if you choose not to, and without fear of punishment. You might also change your mind about touch and decide that you feel comfortable receiving touch support in areas that were formerly uncomfortable.
Informed consent for body and touch-oriented approaches within therapy and counselling is essential and out of respect for your right to choice and self-determination. Consent must be given voluntarily, knowingly, and intelligently. Consent is active and you can change your mind at any time.
If touch work becomes an option in your therapy journey, you will be required to sign that you have read and understood the contents of this page prior to treatment. Thank you for understanding.