Usually it comes when I’m driving on a busy road. I know I can pull over and get out of the car, but my body acts like it’s trapped. First I have tunnel vision. Next, my shoulders and torso bend beneath an invisible weight so heavy I can’t breathe. Then I feel like I’m going to pass out behind the wheel.
It happened 10 years ago, but I can’t leave that December afternoon in the past. Every time I get in the car, my nervous system takes me back — I’m in the passenger seat, bracing for a wreck, as my mom speeds down the icy highway.
I’m telling my therapist this story. Even though I’m sitting motionless on a couch, the same physical sensations flood my body, as if we’re still dodging patches of black ice on I-94.
“I feel like I’m going to faint,” I say. “Can we take a break from talking about this?”
“What happens when you take a deep breath?” My therapist’s voice softens as we make eye contact. “Do you notice anything changing in your body?”
I’m scanning the room for an escape hatch. But after a few inhales and exhales, and some comforting words from my therapist, my heart rate slows and the dizziness dissipates. I’m not gripped by the memory anymore. Instead, I’m present in it: actively thinking about what happened during that drive, but not so upset that I can’t talk about it.
The psychologist Pat Ogden developed sensorimotor psychotherapy in the 1970s, after noticing how trauma affected her clients physically and how much activities like yoga and dance enhanced their recovery. The technique employs mindfulness exercises to help trauma survivors do two things: learn how to control their physical responses to traumatic memories, and then start processing the trauma in therapy. You can’t work through trauma, Ogden’s method says, until you can bear to spend time with it.
My therapist first explained it as “completing the sequence” of trauma. Traumatic events automatically activate our fight-or-flight response. In certain situations, we can’t literally fight or flee from bodily or emotional harm. The physical sensations that accompany our reactions, like bodily pain or intrusive images, can then become hardwired in our brain. Reminders of that event, long after it’s over, can trigger the same physical sensations all over again. For example, someone who was physically abused might feel the sting of a phantom slap whenever they watch a fight scene in a movie.
“With sensorimotor therapy, we don’t encourage people to just retell their stories of trauma,” says Amy Gladstone, a clinical social worker and sensorimotor psychotherapy trainer. “Instead, we work through the memory together, paying attention to the level of activation in the body and working with the nervous system as it’s responding to the narrative.”
In treatment, patients describe how it feels, physically, to recall a traumatic event in the moment. They also work with their therapists to monitor how those sensations change over time. This exercise forces patients to take a step back and see their bodily trauma responses as temporary and malleable. It also helps relocate traumatic memories from the ancient brain stem to the frontal lobe, which governs rational thinking.
“During the traumatic event itself, the thinking brain goes offline,” Ogden tells me. “Sensorimotor psychotherapy is grounded in mindfulness; when a therapist helps a client stay aware of their internal experience and report back to us what they’re experiencing, the thinking brain can stay online.”
Mindfulness techniques also give patients a chance to rewrite the original traumatic event. This foundational principle comes from neuroscience: If the brain can learn to associate an old memory with new information, it can store it as a different, defanged memory. For instance, if someone wasn’t able to fight back during a mugging, a therapist might encourage her to yell “no” out loud or push against a wall during a therapy session. The goal is to notice a survivor’s impulses — “I want to make a fist with my hand” — and act them out in the safety of a therapist’s office.
Physically acting out traumatic memories can evoke dual awareness, the ability to observe yourself physically in the therapist’s office while simultaneously describing a traumatic memory out loud. In one sensorimotor session, my therapist asked how I feel when I talk about being in my mom’s car. “Panicked,” I told her. She asked me to be more specific, so I took a deep breath and scanned my body, head to toe.
My legs were buzzing with restless energy, almost aching to run. My therapist asked me to push against her hands with my feet and focus on the restless feeling, taking note of any sensory changes. Within a few minutes, the restlessness went away. My legs felt content in their stillness, no longer ready to flee. I felt like I was in charge of my body. For the first time, I began talking through the details of my trauma without glancing at the exit in desperation.
Pilot studies suggest that sensorimotor therapy comes with noticeable benefits for trauma survivors: It can reduce PTSD symptoms, like nightmares and panic attacks, and help clients stay in the present moment when triggers surface. Overall, the technique appears to help clients move beyond their physical responses to trauma and start tending to the underlying emotional injuries. While there haven’t yet been any empirical studies on sensorimotor therapy, experts say therapies like this one can be effective without randomized, controlled trials.
I only have five sensorimotor sessions under my belt, but I feel like they’ve made a difference. When I start to panic, especially behind the wheel, I can calm myself down enough to keep driving. Not only am I sleeping better, I’m also having less frequent, severe joint pain (a chronic issue I thought was entirely unrelated to my trauma). And I’m learning to understand “being present” in a new way, both as a concept and a bodily state. Inside my unclenched shoulders and my once-restless fingertips, I can feel what it means to live.
I can still smell the cigarette butts and worn leather in my mom’s car when I’m driving on busy highways. Sometimes I have to pull over to catch my breath and remind myself I’m safe. But I don’t feel defenseless anymore. Now I’m my own fixer, ready to handle crises — on the road and off.