Trauma is not only stored in our memories. It shows up in the body. People with post-traumatic stress disorder may experience muscle tension, a racing heart, changes in breathing, hypervigilance, numbness, dissociation, sleep difficulties, or a persistent sense of being on guard.
This is why effective PTSD treatment often involves more than talking about what happened. Trauma therapy involves paying attention to and working with the body’s sensations, nervous system responses, emotions, and patterns of protection.
As an EMDR-certified, trauma-informed Licensed Creative Arts Therapist, I often integrate EMDR, somatic approaches, and creative arts therapy to help clients work with trauma at both the cognitive and embodied levels.
What does PTSD have to do with the body?
When we experience a traumatic event, the nervous system responds to help us survive. The body may prepare to fight, flee, freeze, or protect itself in another way.
After the danger has passed, however, the nervous system can sometimes continue responding as though the threat is still present.
This can happen even when we consciously know that we are safe.
For example, someone may intellectually understand:
“My partner is not going to hurt me.”
Yet their body may tense when their partner becomes upset.
Someone may know:
“I’m an adult now. I’m not back in my childhood home.”
Yet their heart may race or their body may freeze when someone raises their voice.
These reactions do not necessarily mean that someone is choosing to overreact. They can be learned protective responses that developed in the context of overwhelming or traumatic experiences.
Why isn’t talking about trauma enough?
Talking about trauma can be an important part of therapy. Putting an experience into words can help us understand what happened, identify patterns, develop insight, and create meaning.
But trauma is not always experienced primarily through language.
Trauma response can show up as:
- A tight chest
- A clenched jaw
- Shallow breathing
- A stomachache
- Feeling frozen or unable to move
- Feeling restless or unable to settle
- Numbness or disconnection
- A strong urge to leave
- Difficulty making eye contact
- Feeling small or powerless
- People pleasing behaviors
- Perfectionism
- Automatically scanning other people’s facial expressions or tone of voice
A person may understand intellectually why they react this way and still experience the reaction in their body.
This is one reason trauma treatment can benefit from an embodied approach.
What does “working with the body” mean in trauma therapy?
Working with the body does not mean forcing someone to relive their trauma or trying to make them release trauma from their body.
In trauma-informed therapy, body-based work can be much more subtle.
We might slow down and notice:
What are you noticing in your body right now as you talk about… ?
Where do you notice tension?
What happens to your breathing when you talk about this experience?
Do you notice an urge to move toward something, move away, freeze, or become smaller?
What changes when you bring your attention to something that feels safe or comforting?
These observations can help us understand how the nervous system is responding in the present moment.
The goal is not to force the body to relax.
The goal is to develop greater awareness, choice, regulation, and connection with ourselves.
How does the nervous system relate to PTSD?
The nervous system plays an important role in how we respond to perceived danger.
When the brain detects a threat, the body can mobilize resources for survival. Heart rate, breathing, muscle tension, attention, and other physiological processes can change rapidly.
With PTSD, reminders of the original trauma can sometimes activate these protective responses even when the person is no longer in danger.
This can contribute to symptoms such as hyperarousal, avoidance, emotional numbing, intrusive memories, and heightened reactivity.
Trauma therapy can help people recognize these patterns and develop new ways of responding.
Rather than asking only:
“Why am I reacting this way?”
we can also ask:
“What is happening in my body right now?” “What is my body trying to tell me?”
and
“What does my nervous system need in this moment?”
How does EMDR work with the body?
EMDR, or Eye Movement Desensitization and Reprocessing, is a trauma therapy that does more than ask clients to verbally analyze their traumatic experiences.
In EMDR, clients may attend to aspects of a distressing memory while also noticing associated emotions, beliefs, physical sensations, and other experiences.
Bilateral stimulation is used as part of the EMDR protocol.
An important part of this process is noticing what happens internally as the memory is processed. A client may notice changes in body sensations, emotions, images, beliefs, or other aspects of the experience.
The goal is not to erase the memory.
Instead, EMDR aims to help traumatic experiences become less distressing and less connected to the sense that the danger is happening right now.
For some people, this can create a greater sense of distance from the past and more flexibility in how they respond in the present.
Why is body awareness important in trauma therapy?
Body awareness can help clients recognize their protective responses earlier.
For example, someone may learn to notice:
“My shoulders are tightening.”
“I’m holding my breath.”
“I suddenly feel very small.”
“I want to get out of the conversation.”
That awareness creates an opportunity for curiosity rather than automatically reacting.
Over time, clients can begin developing a different relationship with these responses.
Instead of:
“My body is betraying me.”
the perspective may become:
“My body is trying to protect me.”
That shift can be deeply meaningful.
The goal is not to eliminate every uncomfortable sensation. It is to develop more capacity to notice what is happening, stay connected to yourself, and choose what happens next.
How can creative arts therapy help with PTSD?
Trauma does not always come in words.
Sometimes an experience is easier to access through music, imagery, movement, drawing, rhythm, or other forms of creative expression.
This is one reason creative arts therapy can complement trauma treatment.
For example, a client might:
- Draw an image representing an emotion or experience.
- Choose or create music that reflects an internal experience.
- Use rhythm to explore activation or grounding.
- Explore movement associated with tension, protection, or freedom.
- Use music and imagery to explore and express an emotion or part.
- Use creative processes as an outlet for self-expression and self-regulation.
Creative expression can provide another pathway into experiences that may be difficult to explain verbally.
For me, this is one of the strengths of integrating creative arts therapy with trauma treatment:
Music and creative experiences can help us access embodied experiences. Verbal processing can then help us stay with those experiences, explore them, and integrate their meaning.
Does working with the body mean you have to talk about your trauma?
Not necessarily.
Trauma therapy should be paced according to the individual’s needs and capacity.
You do not have to tell your entire trauma story immediately in order to begin therapy.
In fact, trauma-informed treatment often begins with establishing safety, stabilization, resources, and a sense of control.
This can be particularly important for people who become overwhelmed, shut down, dissociate, or feel disconnected when approaching difficult experiences.
Trauma therapy should not be about pushing through discomfort as quickly as possible.
It is about creating enough safety and stability to approach difficult experiences without becoming overwhelmed.
What is the goal of body-based trauma therapy?
The goal is not to make you feel calm all the time.
The goal is also not to eliminate every physical symptom.
Instead, trauma therapy can help you develop greater capacity to:
- Notice what is happening inside you
- Recognize protective responses
- Distinguish past danger from present circumstances
- Stay connected to yourself during difficult emotions
- Regulate overwhelming activation
- Develop a greater sense of choice
- Build experiences of safety and connection
- Process traumatic memories
- Integrate emotional, cognitive, and bodily experiences
Ultimately, the work is about helping the past become less present in your everyday life.
What if I know I’m safe, but my body doesn’t feel safe?
This is a common experience among people who have experienced trauma.
You may intellectually understand that you are safe while your body continues to respond as though something is wrong.
That does not mean you are failing at healing.
It may mean that your nervous system has learned a protective pattern that has not yet updated to the present.
Therapy can create opportunities for your mind and body to develop new experiences:
I can notice what is happening.
I can slow down.
I have choices.
I can stay connected to myself.
This moment is different from what happened before.
A note about trauma-informed pacing
Working with the body requires care.
For some people, focusing closely on physical sensations can initially increase distress or bring up overwhelming experiences. Body-based trauma therapy should therefore be individualized and paced carefully.
A qualified trauma therapist can help determine which approaches are appropriate and when.
The purpose of somatic and body-oriented work is not to overwhelm the nervous system. It is to increase capacity for awareness, regulation, connection, and processing while maintaining a sense of safety and choice.
PTSD treatment is more than remembering what happened
Trauma can affect how we think, feel, relate, move, breathe, respond, and experience ourselves.
That is why healing may require more than understanding the story.
Sometimes we need to listen to what the body has been communicating all along.
When we can approach those responses with curiosity rather than judgment, the body no longer has to be seen as the problem.
It can become part of the healing process.
Trauma happened in the past. Healing happens in the present—through new experiences of safety, connection, choice, and being able to stay connected to yourself.
Frequently Asked Questions About PTSD and the Body
Can PTSD cause physical symptoms?
Yes. PTSD can be associated with physical and physiological symptoms such as muscle tension, increased heart rate, sleep problems, hypervigilance, changes in breathing, gastrointestinal discomfort, and other stress responses. Physical symptoms can have many possible causes, so persistent or concerning symptoms should also be evaluated by a medical professional.
Why does my body react to trauma even when I know I’m safe?
The nervous system can learn to respond to reminders of danger. A person can consciously recognize that they are safe while their body still responds to cues associated with past experiences.
What is somatic therapy for PTSD?
Somatic or body-oriented trauma therapy incorporates awareness of physical sensations, movement, breathing, nervous-system responses, and other embodied experiences alongside psychological processing. Approaches vary, so it is important to work with a qualified clinician who uses methods appropriate for your needs.
Can EMDR help with physical symptoms of trauma?
EMDR includes attention to multiple aspects of traumatic memories, which can include physical sensations as well as emotions, thoughts, and images. Some people experience changes in their physical responses as traumatic memories become less distressing, although individual responses vary.
Do I have to talk about my trauma to heal?
Not necessarily in the way people sometimes imagine. Trauma treatment can involve verbal processing, but it can also incorporate stabilization, body awareness, imagery, creative expression, and other approaches. Treatment should be individualized and paced according to the person’s needs.
Can creative arts therapy help with PTSD?
Creative arts therapy can provide additional ways to explore and express emotions and embodied experiences through music, art, movement, imagery, and other creative processes. It can be integrated with other trauma treatments when clinically appropriate.
About the author
Wen Chang-Lit is a trauma-informed, EMDR-certified Licensed Creative Arts Therapist (LCAT) and board-certified music therapist and the founder of Integrative Creative Therapy. Her work integrates EMDR, somatic approaches, IFS-informed perspectives, and creative arts therapy to support adults working through trauma, complex PTSD, attachment wounds, and relational experiences.
She provides trauma-informed teletherapy for clients in New York and Texas.
If you are looking for an EMDR therapist in Austin, Texas, or a trauma therapist who integrates body-based and creative approaches, Integrative Creative Therapy offers a different way to approach trauma—one that makes space for the mind, body, emotions, and creative self.
