The Body in the Room: Why People in Service Are Turning to Somatic Practice
For social workers, support workers, occupational therapists and everyone whose work is caring for others
Much of what happens in helping work never gets spoken. A client's shoulders rise before they answer. A young person goes still when a door slams. Your own chest tightens as you listen to a difficult story. These are nervous system signals, and learning to read them, in yourself and in others, may be one of the most valuable skills anyone in a caring role can build.
Why this matters to me
This blog was inspired by one of the women I support. We still work together today, and something she shared with me has shaped the way I think about this work.
She told me that what she often misses with support workers isn't kindness or good intentions. It's a sense of safety, and the skills and tools to create it. When she goes out into the community, a quiet worry sits underneath everything: if I panic in a public place, will this person know how to help me come back down? Too often, she doesn't feel confident they would.
Then she said something I'll never forget. She'd love to have me as her support worker more often, because she knows I have the tools to help her regulate if anxiety rises, while still gently supporting her to get out into the world.
For the past four years I've run a small anxiety and nervous system regulation group. We meet once a week, and some members join an extra session every fortnight. The changes I and their support workers have witnessed, in confidence, in calm and in people's willingness to step back into their lives, have been profound.
It made me wonder: what if every support worker had these skills?
Many people living with anxiety are working hard in therapy, and gradual, supported exposure to everyday situations is a core part of many anxiety treatments. Support workers are often the ones beside them when that exposure actually happens: at the shops, on the bus, in a busy café. Imagine if, instead of simply accompanying someone into the community, a support worker could recognise early signs of rising distress, help the person regulate in the moment, and guide them through the experience safely. Support work would become a genuine bridge between the therapy room and real life.
I believe these skills are not an optional extra. A sense of safety, and the practical tools to help someone regulate, are essential to this work if we truly want to help the people we support grow and heal. Without safety, the nervous system stays in protection mode, and growth is hard to reach. With it, people can begin to take the brave steps that lead to real change.
She continues to inspire me every time we work together, and her words are at the heart of why I directed my Mind Body Somatic Coaching certification towards this public.
This article looks at what the research says about somatic (body-based) practice, why breathwork needs to be individual rather than one-size-fits-all, and offers practical tools for yourself and the people you support.
Why the body matters in helping work
Helpers absorb what they witness. Secondary traumatic stress is increasingly recognised as an occupational hazard of working directly with people who have experienced trauma. In one survey of 282 master's-level social workers, 70% reported at least one symptom (Bride, 2007). Counsellors and therapists who sit with painful stories day after day face the same risk. That load often shows up in the body first: shallow breathing, tension, exhaustion, poor sleep.
Body awareness supports emotion regulation. Research shows clear links between reduced awareness of internal body signals (interoception) and difficulty regulating emotions (Price & Hooven, 2018). Noticing what's happening inside you is often the first step to managing it.
Your state affects your client's state. Studies of client–therapist pairs suggest that physiological synchrony, such as heart rate patterns moving together, reflects co-regulation, which supports connection and trust (Koole & Tschacher, 2016). The research is still developing, but it points to something many practitioners sense intuitively: a regulated practitioner helps create a regulated space.
What the evidence shows
Mindfulness and body awareness for practitioners. A meta-analysis of 38 randomised controlled trials found moderate reductions in anxiety, depression, distress and stress among healthcare professionals, with smaller improvements in burnout (Spinelli et al., 2019).
Interoceptive training for clients. Mindful Awareness in Body-oriented Therapy (MABT) teaches people to notice internal sensations to support self-care and emotion regulation. In its trials, clients who reached the sustained-awareness stage showed greater gains in interoceptive awareness and emotion regulation, and less distress, than those with briefer exposure (Price & Hooven, 2018).
Somatic trauma therapy. In the first randomised trial of Somatic Experiencing, 63 people with PTSD received 15 weekly sessions or waited, and SE produced large reductions in PTSD symptoms (Brom et al., 2017). A scoping review notes the evidence is still mixed in quality and more rigorous trials are needed (Kuhfuß et al., 2021).
Trauma-sensitive movement. After 10 weeks, 52% of women in a trauma-informed yoga group no longer met PTSD criteria, compared with 21% in a control group (van der Kolk et al., 2014).
Sensory approaches in services. A Danish psychiatric unit that introduced sensory modulation significantly reduced restraint and seclusion, and staff training was described as crucial (Andersen et al., 2017).
How somatic skills support each role
Counsellors. Your presence is your main tool, so your own nervous system matters. Somatic awareness helps you notice when a client's story is landing in your body, such as a heavy chest, a tight throat or sudden tiredness, and use that as information rather than carrying it home. It also gives you gentle, body-based ways to help clients who struggle to put feelings into words, or who become overwhelmed when they try.
Psychologists. Somatic skills widen your options, particularly with trauma, where clients often feel disconnected from their bodies and talking alone may not reach the problem. Body awareness also helps you notice somatic countertransference in session.
Social workers. You often walk into homes and crises with little warning. A quick body check and a few slow breaths before a tense visit lower arousal. Noticing your own rising heart rate during conflict lets you slow your voice and posture, which helps de-escalate the people around you.
Support workers. Much of your communication is physical: tone, pace, proximity. Somatic skills help you read early signs of distress, offer calm co-regulation instead of reacting, and protect yourself from the cumulative strain of the role. They also let you do something powerful: support the therapeutic work a person is already doing. When you accompany someone into the community, you can help them stay within their window of tolerance, guide them through a moment of panic, and turn an outing into a safe, confidence-building step forward.
Occupational therapists. You already work with sensory processing and daily routines. Somatic practice deepens that work, especially in helping clients recognise signals like hunger, fatigue or rising anxiety that underpin independence.
Breath: powerful, but not one-size-fits-all
Breathwork is often presented as a universal fix. The research tells a more nuanced story.
Across 12 randomised trials with 785 adults, breathwork was associated with lower stress, though the effect was small to medium (Fincham et al., 2023a). One trial found five minutes a day of exhale-focused "cyclic sighing" improved mood and slowed breathing more than mindfulness meditation (Balban et al., 2023).
But the same breath can calm one person and unsettle another. Hyperventilation-style breathing can provoke panic and anxiety in vulnerable people, and people with acute stress disorders may be more likely to experience intrusive trauma memories during it (Fincham et al., 2023b). Research on intense breathwork commonly excludes people with panic disorder, heart or lung problems, epilepsy or pregnancy.
The practical takeaway is simple: there is no single right breath. A slow exhale may settle someone who is anxious and activated. Someone who is flat, shut down or dissociated may need gentle movement or orienting first. And some people find focusing on the breath itself distressing. The skill is not learning one technique, but learning to notice what this nervous system needs right now, and adjusting.
Consciousness navigation: a way of framing the skill
In Mind Body Somatic Coaching, we describe this skill as consciousness navigation: learning to notice where your attention and your state are at any moment, and to steer them with choice rather than on autopilot.
It rests on three capacities that align closely with the research above:
Noticing: tuning into body signals (breath, tension, heart rate, energy) before they escalate. This is interoception in practice.
Discerning: recognising which state you or your client are in (activated, shut down, or settled and present) and what might help.
Choosing: selecting a tool that fits the moment, whether breath, movement, orienting, sensory input or simply pausing, rather than applying the same technique to everything.
For people in service, this matters twice over: once for your own sustainability, and once for how you guide the people you support.
Tools for yourself
Three-point check-in. Three times a day ask: Where am I holding tension? What is my breath doing? What's my energy, 1–10? Track it for a week to see your patterns.
Match the breath to the state. If you feel wired, try a longer exhale than inhale. If you feel flat or foggy, try a few natural, slightly fuller breaths with gentle movement. If breath focus feels uncomfortable, skip it and use your feet or your surroundings instead.
Feet, seat, surroundings. Mid-session, feel your feet on the floor, your weight in the chair, and notice one object in the room. Five seconds, invisible to others.
Orienting after hard material. Slowly turn your head and let your eyes rest on a few neutral things around you. It helps signal to the body that you are here, now, and safe.
Discharge through movement. After a heavy session or visit, shake out your hands and arms, walk briskly, or press your palms firmly together for ten seconds.
Transition ritual. Mark the end of the working day physically: mindful handwashing, changing clothes, or a short walk before going inside.
Tools to use with clients (within your scope)
Invite, don't instruct. Offer choices: "Some people find it helps to feel their feet on the floor. Would you like to try that, or would you rather keep your eyes on something in the room?" Choice itself is regulating.
Name what you notice, gently. "I notice your breathing sped up when we talked about that. What's happening for you right now?" This builds body awareness without pressure.
Offer a menu, not a prescription. Grounding through the feet, holding a textured object, cool water on the wrists, a slow exhale, a stretch. Let the client discover what works for them.
Borrowed calm. Slow your voice, relax your posture and lengthen your exhale. Clients often settle alongside you without a word being said.
Build a personal regulation plan. Together, note what the client's early warning signs feel like in the body and which two or three tools help.
Watch for "too much." If a client becomes more agitated, spacey or disconnected during a body-based exercise, stop, orient them to the room, and return to talking. Less is often more.
Staying safe and within scope
Support workers can use grounding and co-regulation, but processing trauma belongs with qualified clinicians. Any touch requires consent, a clear rationale and alignment with service policy. Somatic self-care complements good supervision and reasonable caseloads; it doesn't replace them. Be cautious of any approach, including breathwork, that promises quick cures or a single technique for everyone.
The same principle applies to other body-based practices, such as cold and heat exposure. These can be powerful, but they need proper screening, informed consent and trained facilitation, especially for people with heart conditions, trauma histories or other health concerns.
Mind Body Somatic Coaching builds skills in self-regulation, body awareness and facilitation. It complements, but does not replace, clinical trauma therapy. If you hold a professional registration, check with your professional body how these skills fit within your scope of practice.
Where to go from here
Somatic skills are learnable, and they deepen with guided practice over time. Mind Body Somatic Coaching is fully accredited by the IICT (International Institute for Complementary Therapists). The course is open to anyone, and it was shaped with people in service especially in mind: counsellors, psychologists, social workers, support workers, occupational therapists and others whose work is caring for people.
The training offers a structured, supportive space to explore consciousness navigation, discover the breath practices that suit your own nervous system, and build practical body-based tools you can bring into your work. Graduates can practise as:
Somatic Movement Practitioner
Mind Body Practitioner
Somatic Breath Practitioner (Facilitator)
Somatic Life Coach
Thermal Exposure Facilitator
For those already working in helping roles, these qualifications can sit alongside your existing training, adding embodied skills to the knowledge you already have, both for your own wellbeing and for the people you support.
Whether or not you take a course, start small: notice your breath once today, and ask what it's telling you.
References
Andersen, C., et al. (2017). Applying sensory modulation to mental health inpatient care to reduce seclusion and restraint. Nordic Journal of Psychiatry, 71(7).
Balban, M. Y., et al. (2023). Brief structured respiration practices enhance mood and reduce physiological arousal. Cell Reports Medicine, 4(1).
Bride, B. E. (2007). Prevalence of secondary traumatic stress among social workers. Social Work, 52(1), 63–70.
Brom, D., et al. (2017). Somatic Experiencing for posttraumatic stress disorder: A randomized controlled outcome study. Journal of Traumatic Stress, 30(3), 304–312.
Fincham, G. W., et al. (2023a). Effect of breathwork on stress and mental health: A meta-analysis of randomised-controlled trials. Scientific Reports, 13, 432.
Fincham, G. W., et al. (2023b). High ventilation breathwork practices: An overview of their effects, mechanisms, and considerations for clinical applications. Neuroscience & Biobehavioral Reviews.
Koole, S. L., & Tschacher, W. (2016). Synchrony in psychotherapy: A review and an integrative framework for the therapeutic alliance. Frontiers in Psychology.
Kuhfuß, M., et al. (2021). Somatic experiencing: Effectiveness and key factors of a body-oriented trauma therapy: A scoping literature review. European Journal of Psychotraumatology.
Price, C. J., & Hooven, C. (2018). Interoceptive awareness skills for emotion regulation: Theory and approach of Mindful Awareness in Body-Oriented Therapy (MABT). Frontiers in Psychology.
Spinelli, C., Wisener, M., & Khoury, B. (2019). Mindfulness training for healthcare professionals and trainees: A meta-analysis of randomized controlled trials. Journal of Psychosomatic Research, 120, 29–38.
van der Kolk, B. A., et al. (2014). Yoga as an adjunctive treatment for posttraumatic stress disorder: A randomized controlled trial. Journal of Clinical Psychiatry, 75(6), e559–565.
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