This study assesses the efficacy of Somatic Experiencing for reducing symptoms of depression and anxiety in individuals living in a homeless shelter.

1. Assessing the efficacy of
Somatic Experiencing for
reducing symptoms
of PTSD

2. Is Trauma: Pathology or an
interruption on the path to
Resilience?
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3. “Nature has instilled in
all animals, including
humans, a nervous system
capable of restoring
equilibrium. When self-
regulating function is
blocked or disturbed, trauma
symptoms develop...”
Peter Levine
(Foundation for Human Enrichment, 2007)

4. Recovery, Resilience, and Chronic Symptoms
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6. Some evidence for innate resilience…
 60% of Dominant culture Americans
experience a traumatic event.
 8% of Dominant culture Americans meet the
criteria for PTSD.
 In a cohort of 911 survivors number of number
of positive emotions inversely correlated to the
development of PTSD (Fredrickson, 2001).
 Resilient individuals have habits that increase
resilience (Bonnano, 2004).

7. In this slide show we will
address these four questions…
• Why this study?
• Why this study now?
• How will the study be conducted?
• What this study could show?

8. Why this study?
 Most theories used for psychological
treatment start with the question, “How
does pathology develop?”
 Somatic Experiencing starts from the
questions: “What makes people resilient?
Why don’t more people develop PTSD,
trauma or other mental illness?”

9. Why this study? Cont...
 Paradigm Shift…3 levels: Resilience / affect
regulation, deterministic chaos,. Bodymind
 Over the last ten years there has been a growing
body of literature on resilience.
 Much of this literature matches the assumptions
underling Somatic Experiencing theory.
 Preliminary studies show indications of SE being
a short term effective treatment.

10. SE Studies: TFA (Trauma First Aid)
 Care Providers with Catholic Charities Post Katrina were given between
one and two sessions. (N= 142) (Leitch, 2006).
 Significant increase in resilience was found (Leitch, 2006).
 Significantly less severe symptoms then control (Leitch, 2006).
 Both control and experimental had an increase of symptoms at follow up
(Leitch, 2006).
 Tsunami Study: A few days after the session, 90% of participants showed
complete or partial improvement in reported symptoms (Leitch, 2007).
 A few days after the session, 84% of participants exhibited complete or
partial improvement in therapist observed symptoms (Leitch, 2007).
 All of the results should be interpreted with caution given the small sample
size and lack of an equivalent comparison group (Leitch, 2007).

11. Why this study now?
 There is a growing interest in clinician driven research.
 Initial studies of the SE model have indicated that even
one session can significantly reduce the development of
symptoms of PTSD.
 The full SE treatment modality has not yet been studied.
 SE is a short-term treatment and thus would fit the
current managed care model.
 The SE modality works with an individuals cultural,
personal and familial contexts to
increase psychological health.

12. Trauma affects the whole person:
Body-Mind-Relationships-Context…
 “All neurosis is are in essence
Men who committed
Middle class physioneurosis.” (Kardinair,
intimate abuse
individuals who 1941)
“Veterans…(diagnosed with experienced more
 “The four  “The body PTSD)…
experiencepsychophysiological changeskeeps the score.”
chronic trauma
adverse posttraumatic moredisorder are symptoms than
performed poorly than the
in childhood stress (Kolk, McFarlane, & Weisaeth,
both extensive andsample on a measure of verbal
comparison enduring.”
events are 250%PTSD 
(Herman, 1997)
1996).Bessal van der Kolk (1996)
nonabusive controls.
effects the whole significant
describes three
exhibiting affects changes 2005)
(Dutton,
Post-Traumatic Stress Disorder
learning,extreme stressless proficient in stress
more likely to to
 “Exposure
person: mind,physical psychobiological
is a“normal” brain,
body,
cumulative acquisition across repeated
reactivity
Smoke. 4600% self, history of childhoodlife…
reaction to and
an extraordinary
people at many a relationships–Chronic physiological
Women with levels of
exposures, greater sensitivity to proactive
more like to exhibited increased(Kolk, McFarlane, &
event pituitary-
functioning: Somatic, emotional, autonomic arousal,
abuse use
interference, andWeisaeth, – Heightened response to
cognitive,and autonomic responses
adrenal
1996).
more perseverative
I.V. drugs. (Fallite,charicterlogical”
behavioral,Al, 2000)
(Heim et and
1999) errors.” (Uddo, Vasterling, Brailey &
reminders of the traumatic
event and
(Kolk, McFarlane, & Weisaeth,
Sutker, 1993)
1996). –Hyperarousal in reaction
to intense but neutral
events.

13. Key concepts in SE Model…
 “Trauma is a natural normal part of life, not a
mistake, a disease or aberration.”
 “Bodymind designed to heal intense experiences”
 “Works within clients, ‘range of resilience’”
 “Verbal / cognitive content is used to track
activation not to access memories.”
 “SE model works with: Felt experience, physical
sensation, motor patterns, and cognitive processes.”
(Foundation for Human Enrichment, 2007)

14. Somatic Experiencing Model Tools for
Evoking Innate Righting Response
 Titration: Using the  Pendulation:
smallest amount of Inherent oscillation
activation possible to between Sympathetic
shift the system in a and Parasympathetic
contained way. activation.
 Resource: Evocation  Discharge: Release
of relaxation response, of high amounts of
empowerment, or arousal to return to
self-mastery. baseline resting state.
(Foundation for Human Enrichment, 2007)

15. (Foundation for Human Enrichment, 2007)

16. (Foundation for Human Enrichment, 2007)

17. Affect Regulation
 Affect Regulation: The ability to tolerate mange
and return to homeostasis after a range of
intensity of different emotional states.
 Self Regulation: The use of an affect regulation
tool to manage high levels of affect.
 Auto Regulation: Well established, automatic
or implicit regulation of affect.
 Co-Regulation: Regulation of affect through
relationship or inter-subjective relatedness
(Schore, 2008).

18. Affect Dysregulation
 Over Activated Sympathetic…
 Physical: Increase heart rate, difficulty
breathing, cold sweats, tingling,
muscular tension, exaggerated startle
response, difficulty with sleeping
 Mental/Emotional: Anxiety attacks,
rage outbursts, hyper vigilance, racing
thoughts, worry
(Foundation for Human Enrichment, 2007)

19. Affect Dysregulation
 Over Activated Parasympathetic…
 Physical: Low energy, exaughstion,
numbness, low muscle tone, poor digestion,
low heart rate, blood pressure, poor immune
function
 Mental/Emotional: Depression, dissociation,
apathy, disconnection in relationship, under
responsive
(Foundation for Human Enrichment, 2007)

20. How will this study be conducted?
 Between groups pre-test post-test matched control group design.
 Minimum N = 18 in each group ( N > 68 needed for optimum
power.)
 Population: A convenience sample of adults who are currently
living at COTS shelter.
 Matching Criteria: Years homeless, age, gender.
 Symptoms of depression operationalized as score on the Beck
Depression Inventory.
 Symptoms of anxiety is operationalized as score on STAI

21. How will this study be conducted? Cont.
Statistical Analysis:
 Repeated Measures Multivariate Profile
Analisys will be used to asses all
hypothesis.
 Descriminant Analysis will be used to
assess all hypothesis.

22. How will this study be conducted? Cont.
 Some questions that remain:
 Administering surveys two possibilities: A)
senior participant at COTS shelter receives
stipend, B) Find research assistants
(undergrad volunteers).
 Incentives for control group: A) Weekly
raffle, B) $5 per week per control group
member.

23. What could this study show?
 Whether and to what degree Somatic Experiencing is an
effective modality for reducing symptoms of trauma.
 The effects of interactions of other therapeutic modalities
such as: psychotherapy, case management, parenting
classes, mindfulness based programs etc.
 The number of sessions that creates optimal change from
Somatic Experiencing
 The type of Somatic Experiencing interventions that
correlate the best with change in symptoms.

24. References cont. pg 1 of 3
Duttot, D. (2005). Trauma symptoms and PTSD-like profiles in perpetrators of
intimate abuse Traumatic Stress
Eisenberg, N., Guthrie, K., Fabes, R., Reiser, M., Murphy, B., Holgren, R. Masak,
P., Losoya, S. (1997). The relations of regulation and emotionality to
resiliency and competent social functioning in elementary school children.
Child development, 68, 295-311
Felitti VJ, Anda RF, Nordenberg D, Williamson DF, Spitz AM, Edwards V, Koss
MP, et al JS. (1998). The relationship of adult health status to childhood
abuse and household dysfunction. American Journal of Preventive
Medicine. 14, 245-258.
Fredrickson, B., Mancuso, R., Branigan, C., Tugade, M., (2000).The Undoing
Effect of Positive Emotions Motivation and Emotion, 24
Fredrickson, B., Tugade, M., Waugh, C., Larkin, G. (2001). What good are
positive emotions in crisis? A prospective study of resilience and emotions
following the terrorist attacks on the United States on September 11th,
Journal of Personality and Social Psychology. 84(2), 365-376
Foundation for Human Enrichment (2007) Somatic Experiencing: Healing Trauma, Training Manuel
Herman, J. (1997). Trauma and recovery: The aftermath of violence from
domestic abuse to political terror. Basic Books.
Heim, Newport, Heit, Graham, Wilcox, Bonsall, Miller, Nemeroff, (2000).
Pituitary-Adrenal and Autonomic Responses to Stress in Women After
Sexual and Physical Abuse in Childhood JAMA. 284, 592-597.

25. References cont. pg 2 of 3
Hulnick, M. (1996).Victim-to-perpetrator process: Effect of trauma on
incarcerated adult male sex offenders, Boston College
Kolk. B., McFarlane, A., Weisaeth, L., (1996). Traumatic stress, Guilford Press,
Ny: New York
Leitch, L. (2007). Somatic Experiencing Treatment With Tsunami Survivors in Thailand:
Broadening the Scope of Early Intervention. Journal of Traumatology,13(4) 11-20.
J
Leitch, L. (2006). Hurricane Katrina Projects: Findings Foundation for Human Enrichment.
Manuscript submitted for publication
Luthar, S.(2003). Resilience and Vulnerability: Adaptation in the Context of
Childhood Adversities, Cambridge University Press
Porges, S.W., Doussard-Roosevelt, J.A., & Maiti, A. K. (1994). Vagal tone and
the physiological regulation of emotion. In N.A. Fox (ed). Emotion
Regulation: Behavioral and Biological Considerations. Monograph of the
Society for Research in Child Development, 59 (2-3, Serial No. 240), 167-
186.
Porges, S. (2002). Neuroception: A subconscious system for detecting threats,
Zero to 3 Schore, A. (2003). Affect Regulation and repair of the self, Norton &
Company

26. References cont. pg 3 of 3
Tugade, M., Fredrickson, B., & Barrett. L., (2004). Psychological Resilience and
Positive Emotional Granularity: Examining the Benefits of Positive
Emotions on Coping and Volume 72 Issue 6 p. 1161-1190. Journal
Personality.
Uddo, M., Vasterling, J., Braily, K., & Sutker, P. (1993). Memory and attention in
combat-related post-traumatic stress disorder (PTSD). Journal of
Psychopathology and Behavioral Assessment
Valentine, L., Feinauer, L.(1993). Resilience factors associated with female
survivors of childhood sexual abuse, The American Journal of Family
Therapy.
Schore, A. (2002) Dysregulation of the right brain: a fundamental mechanism of
traumatic attachment and the psychopathogenesis of post traumatic stress
disorder (36: 9-30) Australian and New Zealand journal of psychiatry
Schore, A. (2008). Quarterly study group on attachment theory. Alta Bates
Hospital, Berkeley: CA
Stern, D. (2006) The interpersonal world of the infant, Basic Books
Selvam, R. (2008) Somatic therapy treatments effects with tsunami survivors 14 (3), 103-119