Many people come to my practice after having meaningful experiences with Cognitive Behavioral Therapy (CBT). They’ve gained insight, learned helpful tools, and often understand their patterns very well.
And yet, something still feels stuck.
A common question I hear is:
How is somatic therapy different from CBT—and can they work together?
This article offers a grounded, trauma-informed way of understanding the differences.
What CBT Does Well
CBT is often described as a top-down approach to change. In its classic model, thoughts influence emotions, and emotions influence behavior. By identifying and modifying unhelpful thought patterns, CBT can reduce distress and support behavioral change.
CBT is well supported by research and can be highly effective for concerns such as anxiety, depression, and habit change—especially when a person’s nervous system is relatively regulated and the patterns being addressed are accessible through conscious awareness.
For many people, CBT provides:
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Insight and self-understanding
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Practical tools and coping strategies
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Increased agency and choice
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Symptom relief in day-to-day life
For these reasons, CBT is an important and valuable modality.
Where CBT Can Reach Its Limits
Some experiences don’t originate in conscious thought.
Trauma, chronic stress, and early relational patterns are often encoded in implicit memory and the autonomic nervous system—outside of language and deliberate cognition. People often describe this as:
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“I know I’m safe, but my body doesn’t feel safe.”
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“I understand why this happens, but it still does.”
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“My reactions feel automatic.”
These responses are not failures of insight. They are protective biological responses that activate before thinking is available.
When this is the case, asking the mind to override the body can feel frustrating—or even re-traumatizing.
The Somatic, Bottom-Up Approach
Somatic therapy works from the bottom up.
Rather than starting with thoughts, we begin with:
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Sensation and body awareness
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Nervous system states
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Breath, posture, and movement
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Subtle cues of safety, activation, or shutdown
Instead of asking “What are you thinking?”, we might explore “What is your body experiencing right now?”
As the nervous system begins to feel safer and more regulated, emotional and cognitive shifts often arise naturally, without force.
Inside-Out Change
A simple way to understand the difference:
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CBT: Change thoughts → influence emotions → guide behavior
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Somatic therapy: Restore nervous system regulation → emotions settle → thoughts and behaviors shift organically
Both approaches aim for relief, clarity, and choice. They simply start in different places.
When the body changes, the mind often follows.
How My Work Relates to CBT
I do not formally practice CBT, but my work is CBT-informed and often complementary.
As clients become more regulated and embodied, they frequently experience increased clarity, reduced reactivity, and a greater capacity to make aligned choices—without needing to push or override themselves.
This is one reason I often receive referrals from licensed therapists when talk therapy alone hasn’t fully landed.
My role is not to replace psychotherapy, but to support layers of experience that cognitive approaches may not always reach.
Scope and Collaboration
I am not a licensed psychotherapist. My work is best described as complementary, trauma-informed somatic healing. Some clients choose to work with me alongside a licensed therapist, while others seek somatic support after years of talk therapy.
Healing does not need to be either/or. Often, it is both/and.
When Somatic Therapy May Be Especially Helpful
Somatic work may be particularly supportive if you:
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Feel stuck despite insight and self-awareness
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Experience chronic anxiety, overwhelm, or shutdown
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Have a history of trauma or early relational stress
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Notice strong bodily reactions that don’t respond to reasoning
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Want change that feels integrated and sustainable
Final Thoughts
CBT helps us understand ourselves.
Somatic therapy helps us feel safe enough to change.
When change happens on the inside, thinking, feeling, and action naturally shift.
Colleen Godfrey
Integrative Somatic Therapy & Embodiment
Minneapolis–St. Paul
Research & Selected Sources (click to expand)
This work is informed by research in neuroscience, trauma psychology, and embodied awareness.
The following peer-reviewed and foundational sources are provided for readers who wish to explore further.
- Hofmann, S. G., Asnaani, A., Vonk, I. J., Sawyer, A. T., & Fang, A. (2012).
The efficacy of cognitive behavioral therapy: A review of meta-analyses.
Cognitive Therapy and Research.
Read - van der Kolk, B. (2014).
Trauma, the body, and implicit memory.
Read - LeDoux, J. (1996).
The emotional brain: The mysterious underpinnings of emotional life.
Read - Porges, S. W. (2011).
The polyvagal theory: Neurophysiological foundations of emotions, attachment, communication, and self-regulation.
Read - Schore, A. N. (2012).
The science of the art of psychotherapy.
Read - Mehling, W. E., et al. (2011).
Body awareness: A phenomenological inquiry into the common ground of mind-body therapies.
PLoS ONE.
Read