ADHD Therapies

Somatic Therapy: Understanding the ADHD Brain, Body & Trauma

ADHD brains may not linger on unpleasant issues, leaving somatic discomforts unaddressed. Somatic therapy for adults with ADHD begins with learning to be mindful of bodily sensations, which can eventually help reduce the intensity of high emotional arousal.

Young woman talking with a psychologist. Psychological counseling and therapy. Vector flat illustration.
Young woman talking with a psychologist. Psychological counseling and therapy. Vector flat illustration.

Somatic Therapy Explores the Mind-Body Connection

Today, most people recognize that there is some connection between their minds and their bodies. The field of somatic psychotherapy focuses on the feedback loop connecting mind and body, and the ways that one constantly informs the other.

Somatic therapists are attuned to physical sensations as talk therapists are attuned to thoughts and feelings. The holistic integration of body awareness with traditional psychotherapy was initially used to treat PTSD by focusing on the body’s sensations, rather than on reliving a traumatic event. Now, this approach has been expanded to help a wide range of people — including those with ADHD — release tension, fear, and anger that can compromise their functioning.

Somatic Therapy for Trauma

The ability to feel safe with others is central to a meaningful life, but that basic comfort can be elusive. Trauma expert Bessel van der Kolk, M.D., in his book The Body Keeps the Score, explores the fact that trauma leaves an indelible imprint on the body as well as the mind.

After a traumatic experience, the brain recalibrates the body’s early warning system in self-defense. Trauma survivors are generally hypervigilant, constantly scanning their environment for danger. So, even when the mind blocks or distorts distressing memories, as it usually does, the body remembers the threat exactly as it was experienced. When old fears are triggered, the body shifts into survival mode, derailing normal functioning. While the conscious mind may believe it can deny or minimize the memories, the body keeps score.

[Read About ADHD and Trauma: Untangling Causes, Symptoms & Treatments]

In teaching children with ADHD to control their impulses, many therapists use somatic techniques to help them become aware of and restrain the physical sensations associated with impulsivity and aggression. However, as people age, treatment usually becomes more intellectualized, with less attention to physical sensations.

Research shows that, compared to those without ADHD, those with ADHD are more likely to suffer migraines, digestive issues, muscle pain, and insomnia. Since most ADHD brains do not linger on unpleasant issues, somatic discomforts often remain unaddressed. Somatic treatment for adults with ADHD might begin with learning to be mindful of the sensations in their bodies. These sensations come when a trigger convinces the body that it is again under attack. The body raises the alarm and demands action.

ADHD and Trauma

Research suggests that, for many reasons, those with ADHD are more likely than others to have experienced trauma at some point in their lives, although they may not label it as such. It is generally not apparent that a physical complaint reflects an underlying emotion. Those with ADHD often disconnect from physical discomforts by numbing themselves with food, drugs, sex, risky behaviors, or by being workaholics. Somatic therapy offers greater physical and emotional control over the body’s uncomfortable responses to distress.

Somatic Therapy: 5 Key Coping Mechanisms

Here are some of the most common and easily learned interventions from somatic therapy that can reduce the intensity of high emotional arousal:

  • Deep “belly breathing” involves inhaling slowly through the nose, allowing the chest and belly to rise. Hold each breath for four seconds, then release it through the mouth for four seconds. By fully expanding the lungs, this technique counteracts the rapid, shallow breathing that accompanies panic, and calms the amygdala, the brain’s emotion processing center.
  • Progressive muscle relaxation involves sequentially tensing muscle groups as you breathe in, then relaxing them as you breathe out, beginning in the upper body and moving down to the toes. The process can be enhanced with positive imagery, like recalling the image of a happy place.

[Take This Test If You Think You Might Have Emotional Hyperarousal]

  • Yoga, dance, walking outdoors, tai chi, and other types of movement are great ways to reduce tension held in the body.
  • Meditation takes practice, especially for those with ADHD, but research identifies significant stress reduction following eight weeks of practice. Like the other techniques, it is a tool that enables improvements in mood, anxiety, and attention.
  • For urgent, short-term relief, petting a dog or cat has been shown to increase serotonin, dopamine, and oxytocin, and to reduce blood pressure, heart rate, and cortisol.

Finding a therapist who incorporates somatic therapy can allow you to spend less energy managing distress, leaving more energy to pursue a better quality of life.

Somatic Therapy: Next Steps

Ellen B. Littman, Ph.D., has been involved in the field of attention disorders for more than 30 years. She is a pioneer in the identification of gender differences in ADHD and the co-author of Understanding Girls with ADHD.

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