Somatic therapy
When you already understand everything and your body is still on alert
Some people come to my practice having done everything right.
They went to therapy. They understand where their problems come from. They can tell their story clearly and point to the moment something broke. They have read. They have done the work.
And yet the body keeps reacting as if none of that had happened. The heart races for no reason. Sleep doesn't restore. There is a tightness in the chest that won't let go, a stomach that closes up on Sunday night. Or the opposite: nothing shows up at all, just a kind of fog, as if you were watching your own life from the outside.
This is not a lack of willpower or intelligence. Understanding and the nervous system speak different languages. Somatic therapy works in the second one.
Your body has an accelerator and a brake
Much of what keeps you alive happens without your deciding it: your heartbeat, blood pressure, digestion, temperature, sleep. That is the job of the autonomic nervous system. Autonomic means exactly that: it doesn't ask your permission.
It has two main branches, and they are worth knowing by name.
The sympathetic branch is the accelerator. It switches on when you need to act: climbing stairs, running late for an appointment, swerving to avoid a car. The heart beats faster, breathing gets shorter, blood goes to the large muscles, the liver releases sugar and attention narrows to what matters. The adrenal glands release adrenaline and, if the demand goes on, cortisol. The whole organism gets ready to move.
To do that, it shuts down whatever isn't urgent. Digestion stops, tissue repair is postponed, desire drops, the immune system changes its priorities. It makes sense: nobody digests while running away.
The parasympathetic branch is the brake, and it is also home. Its main nerve is the vagus, which runs from the brainstem down to the abdomen and touches almost every organ on the way. When it predominates, the heart slows, saliva returns, the gut moves, tissues repair and deep sleep comes.
Digestion is parasympathetic. That is why, when you live on alert, the stomach is often the first thing to break down.
Neither branch is good or bad. You need both, and you need them to take turns.
And a third resource, the oldest one: shutting down
When the threat is too big and there is no way to run or fight, the organism has one last resource: to freeze. It is what an animal does when it plays dead. Blood pressure drops, the body goes limp or rigid, pain is dulled, everything feels far away.
The researcher Stephen Porges proposed that this response depends on an ancient branch of the vagus, different from the one that calms us, and that mammals also have a circuit that regulates the heart through other people: the face, the voice, the gaze. His model is still debated in academic circles. I use it because it describes very precisely what I see in my practice, not as a law.
What matters is this: shutting down is not weakness, and it is not a decision. It is a survival strategy. When it stays switched on, it is lived as tiredness that won't go away, disconnection, depression, brain fog, the feeling of not being fully in your own body.
Health is a rhythm
A healthy nervous system is not calm all the time. It rises when it needs to and comes down when the demand is over. Activation, discharge, recovery. Like a wave.
You can even see it in the heart. When you breathe in, the heartbeat speeds up a little; when you breathe out, it slows down. That variation from one beat to the next is one of the best measures we have of the vagus at work. In general, more variability is a better sign: it means the brake works, lets go and comes back on.
The psychiatrist Daniel Siegel coined the term window of tolerance for the range of activation within which we can feel, think and respond without falling apart. It is not a fixed point. It narrows with hunger and exhaustion. It widens in the company of someone we feel safe with. And it can be widened with practice, at any age.
Regulating the nervous system doesn't mean being calm all the time. It means having range: being able to activate, and being able to come back.
What happens when the rhythm is lost
When the demand never ends, or it ended on the outside but not on the inside, the wave turns into noise. The system gets stuck.
Stuck on the accelerator: anxiety, palpitations, light sleep that breaks at three in the morning, a clenched jaw, irritable bowel, high blood pressure, irritability, trouble resting without guilt.
Stuck in shutdown: tiredness that sleep doesn't fix, apathy, depression, numbness, slow digestion, disconnection, life seen from behind glass.
Both at once, which is more common than it seems: still on the outside, racing on the inside. It is like pressing the accelerator and the brake at the same time. The car doesn't move, but the engine is running at seventy kilometers an hour and overheating.
The neuroendocrinologist Bruce McEwen coined the term allostatic load for the wear and tear that adapting to stress again and again leaves on the body. You don't notice it from one day to the next. It builds up in the heart and blood vessels, in the metabolism, in immunity, in sleep, in the way the brain processes pain.
Seen this way, symptoms are not the damage itself. Often they are the way the organism contains an activation that found no way out.
You don't need to have lived through a tragedy
Somatic therapy was born to work with trauma, and that is still its firmest ground. But what underlies it, a nervous system that has lost its rhythm, is not exclusive to people who lived through something terrible.
It comes from an accident or a surgery. From a difficult birth. From years of work without a break. From a chronic illness, which is itself a sustained threat to the body. From growing up in a house where you had to be on guard all the time. From a culture that confuses speed with worth. Evil lives in the rush.
As a doctor I see it very often: the migraine that gets worse at the end of the quarter, the colon that flares before every trip, the back pain no test explains, the person who sleeps eight hours and wakes up exhausted, the autoimmune disease that flares after a loss. I'm not saying everything comes from the nervous system. I'm saying almost everything passes through it.
That is why this work can accompany any medical treatment. It doesn't replace it. It gives the body better conditions to do what it already knows how to do: digest, sleep, repair, defend itself.
What animals do
Wild animals live under constant threat. An impala is chased, caught, nearly eaten, and if it survives it goes back to grazing. It doesn't develop insomnia. It doesn't avoid the place.
When a deer is startled and finds out there is no danger, it first trembles. A small tremor that starts in the neck, moves down through the chest and ends in the legs. Then it goes back to eating.
That tremor is not a symptom. It is the nervous system finishing the discharge of the energy it mobilized to defend itself. Peter Levine describes it in his book Waking the Tiger. We have the same mechanism. What we have lost is permission to use it: we were taught to hold it in, not to tremble, to keep going.
How somatic therapy works
Almost every therapy works from the top down: from the idea to the emotion and, with luck, to the body. This one goes the other way. It starts with sensation: the weight of your body on the chair, the warmth in your hands, the lump in your throat. From there, little by little, emotion, images and, in the end, meaning appear.
Safety first, then the hard part. Before we go near what hurts, we look for what already works in you: a place in the body where there is calm, a person, a memory, a landscape. The nervous system doesn't open because it is asked to. It opens when it feels safe.
Little by little. It is not about opening the wound all at once, but about getting a little closer, noticing what happens and coming back to what holds you. Back and forth. Each round reminds the body of something it had forgotten: that it can activate and come back. Often you get there faster by going slower.
Letting the body finish. When activation finds a way out, the body shows it: a slight tremor, warmth rising, a breath that suddenly goes deep, a rumbling stomach, the urge to cry or to laugh. It is the same mechanism as the deer. We don't provoke it or force it. We give it space and time.
And there is something no technique replaces: the relationship. Nervous systems regulate each other, through the voice, the gaze, the rhythm of breathing. Nobody learns to calm down alone; we learned it, or didn't, in someone's arms. It's not only about knowing; it's about feeling, and being felt.
What a session is like
We sit and talk, as in any therapy. The difference is where we put our attention. At some point I will ask you something that may sound strange the first time: and where do you feel that?
You don't need to know the answer. Many people feel almost nothing at first, or only feel the problem. That is information too, and a good place to start.
Sometimes we also work with movement: a posture that wants to change, a gesture that was left unfinished. Always at a pace you can sustain. You can stop at any moment: being able to say no is part of the treatment, not an interruption of it.
Sessions last 60 minutes, in person in Tepoztlán or online by video call, in English or Spanish.
What it is not
You don't need to relive what happened. Or tell all of it, or remember it clearly. We can work with what the body registers even when memory has gaps.
It is not catharsis. It is not about getting everything out, but about building the capacity to feel without being overwhelmed. A big, dramatic discharge almost always means we went too fast.
It is not relaxation. Relaxing is a result, not an instruction. Telling someone on alert to relax usually puts them more on alert.
And it is not fast, and it doesn't promise cures.
Who it may not be for, or not yet
If you are in a situation of current danger, the first step is not therapy, it is safety. If there is an active psychiatric condition being treated with medication, this does not replace it; it can accompany it, in coordination with whoever is treating you. And if you are looking to get rid of a symptom in three sessions, this probably isn't it. This work goes to the root, and the root takes its time.
Frequently asked questions
What is somatic therapy?
It is a therapeutic approach that works with the body's sensations to help the nervous system come out of the chronic activation left by trauma and stress, and recover its natural rhythm between activity and rest.
Does it help if I haven't been through trauma?
Yes. The same mechanism is behind a lot of anxiety, insomnia, digestive problems, chronic pain and exhaustion. You don't need a terrible story to have a nervous system that has lost its rhythm.
Do I have to tell or relive what happened to me?
No. We work with what the body registers, at your pace, without reliving the event or narrating it in detail.
Is there scientific evidence for it?
Research on somatic trauma therapies is young. There are studies with promising results in post-traumatic stress, and more are needed. What is well documented is the physiology it rests on: how sustained stress affects the heart, digestion, immunity and pain. I would rather tell you that than sell you certainties science doesn't offer yet.
Are sessions online or in person?
Both. I see people in person in Tepoztlán, Morelos, and online by video call. Each session lasts 60 minutes, in English or Spanish.
How many sessions will I need?
It depends on each person and what they bring. I don't work with a fixed number of sessions or promise results within a timeframe. In the first session we look together at what makes sense for you.
Does it replace psychiatric medication?
No. It can accompany psychiatric treatment, in coordination with whoever is treating you. I never suggest stopping or changing a medication.
Who leads the sessions?
I do, Juan Moller: medical doctor and homeopath from the Universidad del Valle de Atemajac, with three years of training in somatic trauma therapy, and Gestalt psychotherapist from the Escuela de Gestalt Viva Claudio Naranjo. More about me.
Getting started
If any of this sounds familiar, we can talk. In the first session we look together at what is happening in your body and what makes sense to do. No rush.