Sensorimotor psychotherapy

1. Introduction

Version followed: Sensorimotor Psychotherapy (SP) as taught by Pat Ogden's Sensorimotor Psychotherapy Institute: the three-phase model of Ogden, Minton & Pain, Trauma and the Body (2006), and its patient-facing companion Ogden & Fisher, Sensorimotor Psychotherapy: Interventions for Trauma and Attachment (2015). The full text of both books is not drawn on (tables of contents and the publisher's sample of the Spanish edition only). Step-by-step procedures here come from the authors' own teaching handouts (Ogden & Goldstein 2018), their videoconferencing chapter (Ogden & Goldstein 2020) and Janina Fisher's overview paper (c. 2009–2011). [uncertain: book-level detail]

SP is a body-oriented talking therapy for trauma and attachment problems. Ogden developed it drawing on Ron Kurtz's Hakomi method, the Rolf method, attachment theory, neuroscience and dissociation research [source: Buckley, BACP/SPI slides]. In SP's model, trauma and early relational experience persist as procedural habits: arousal patterns, unfinished defensive responses (fight, flight, freeze, submission), posture, gesture and orienting habits. These run whether or not there is a story attached to them, and talking about the trauma can reactivate them without resolving them [source: Fisher; Buckley]. Change comes when the client mindfully studies how present-moment experience is organised in the body, inside an attuned relationship, while arousal stays within the window of tolerance. The client then tries out new physical actions (grounding, alignment, boundary, reaching, completed defensive actions), and these reorganise the procedural encoding of the memory so that it feels "finally over". Re-living the event is not the mechanism [source: Fisher; Ogden & Goldstein 2018 masterclass handout]. SP works "bottom-up" (sensation, movement) as well as "top-down" (meaning, cognition), across three levels of processing: cognitive, emotional and sensorimotor [source: Ogden & Goldstein 2018 group handout; Ogden, Minton & Pain 2006 ch. 1 title]. The 2015 book says it is not a standalone, manualised treatment. It is meant to be used inside a therapeutic relationship and can complement other methods. Its authors say the method is fully learned only through the institute's training [source: Desclée sample of Ogden & Fisher 2015].

2. Framework

Phase-oriented treatment (three phases). SP adopts the classic phase-oriented model of trauma treatment [source: Ogden, Minton & Pain 2006, ch. 10–12 titles (English and German editions); Ogden & Fisher 2015 TOC; Ogden & Goldstein 2018 masterclass handout].

Phase	Goal	Typical content (from chapter titles and handouts)
1. Symptom reduction and stabilisation: "developing somatic resources for stabilization"	Regulate arousal, reduce symptoms, widen the window of tolerance, build the alliance	Psychoeducation (window of tolerance, animal defences, neuroception); body-sensation vocabulary; embedded relational mindfulness; inventory of survival and creative resources; somatic resources (grounding, core alignment, breath, somatic boundaries, centring, containment, self-soothing); building missing resources
2. Processing traumatic memory: "restoring acts of triumph"	Resolve unfinished orienting and defensive responses so the memory no longer drives dysregulation	Finding resources within the painful past; dual awareness of past and present; working with a small fragment of memory; restoring empowering (defensive) actions; sensorimotor sequencing; animal defences and emotion
3. Integration and success in normal life ("personality integration")	Change limiting beliefs and relational patterns; reconnect socially; intimacy; risk-taking	Attachment legacy; beliefs and the body; making sense of emotions; gait; boundary styles in relationships; proximity-seeking actions; play, pleasure and positive emotion; challenging the window of tolerance

Session count and format. None of the sources gives a fixed number of sessions or session length, and the 2015 book says outright that it is not manualised [uncertain]. Formats the authors describe: individual sessions; groups, where themes are explored through movement and members practise and teach each other new actions [source: Ogden & Goldstein 2018 group handout]; child, caregiver and family work with props [source: 2018 masterclass handout]; and videoconferencing [source: Ogden & Goldstein 2020]. Practical default: weekly individual sessions of ordinary length, with the phase lasting as long as the client needs [synthesis].

Typical within-session sequence [source: Fisher]:

The client begins talking. The therapist listens less to the content and more to the bodily and emotional responses that come with it.
The therapist tracks for unresolved activation (muscular, visceral, autonomic).
When activation appears, the therapist empathically interrupts the story.
The therapist helps the client set up dual awareness and orient to body sensation.
Somatic resources and mindful experiments reorganise the response.
Narrative and body are integrated.

Criteria for moving between phases.

Into Phase 2: the client can notice sensation without being flooded and can use at least some somatic resources to bring arousal back into the window. Intense memory or attachment emotion is approached only after the therapist has assessed that the client can regulate arousal [source: Ogden & Goldstein 2020]. Further readiness markers [synthesis]: the client can stay in dual awareness for several minutes, has reasonable daily stability (no current crises, safe enough living situation), and has a working alliance strong enough for repair.
Back to Phase 1 whenever a memory fragment pushes arousal outside the window. The 2015 book frames memory work as using a fragment intense enough to process but not enough to dysregulate [source: Desclée sample]. Treating the phases as non-linear and recursive is standard in phase-oriented trauma work [synthesis; uncertain whether stated as such in the SP texts].
Into Phase 3: traumatic reminders no longer trigger the old defensive pattern, and attention shifts to beliefs, relationships and positive emotion [synthesis based on chapter themes].
Patients reading the 2015 book should read its client orientation chapter (ch. 3) before other sections. The therapist should first read Section I [source: Desclée sample].

3. Guiding principles

The 2018 handout names five guiding principles: organicity, non-violence, unity, mind-body-spirit holism, and mindfulness/presence. These echo Hakomi, SP's parent method [source: Ogden & Goldstein 2018 masterclass handout; Buckley for the Kurtz lineage].

Organicity. Trust that answers come from the client's own system. In practice: find out what the client wants, validate the wisdom of their current organisation, put them in charge of body awareness and action, and change your plan when something unexpected emerges [source: 2018 masterclass handout].
Non-violence. Do not push against defences or override them. Work with what the body does. The handout lists this principle without detail; the practical meaning here is [synthesis].
Unity. Collaborate. Say "we" and "us", let yourself be affected and share that judiciously, think aloud ("I wonder if…"), and suggest a focus rather than impose one [source: 2018 masterclass handout].
Mind-body-spirit holism. Link each thought or emotion to a movement, gesture or sensation, and the reverse. Join these elements together or separate them, depending on how much the client can integrate [source: 2018 masterclass handout].
Mindfulness/presence: embedded relational mindfulness. Mindfulness lives in the moment-to-moment exchange, not in set exercises: "Mindfulness is not taught through structured exercises or practices" (Ogden 2014, cited in the 2018 handout). The client reports experience aloud as it happens [source: 2018 masterclass handout; Ogden & Goldstein 2020].
Present-moment organisation over content. Be curious about how experience is organised now (sensation, movement, perception, emotion, thought), not only about what happened. Ask "what do you notice?" rather than "what do you think?" [source: Buckley; 2018 masterclass handout].
Regulation before processing; reorganise, do not re-live. Keep arousal inside the window of tolerance, and empathically interrupt when it leaves [source: Fisher].
Work at the edge of the window. "Safe but not too safe" (Bromberg, quoted in Buckley). Too much safety never reaches the dysregulated material; too little floods the client [source: Buckley].
Sensation before emotion when arousal is high. Set emotion aside until arousal settles, and track sensation [source: Buckley; Desclée sample on sensorimotor sequencing].
Procedural habits were once adaptive. Treat each limiting posture or defence as a survival resource before offering an alternative: "Every symptom has a purpose" (Ogden 2017, cited in the 2018 handout) [source: 2018 masterclass handout].
Different parts may react differently to a new action. Anticipate that a new action feels fine to one part of the self and threatening to another [source: 2018 masterclass handout].
Client control of body work. Tell the client they control every body-based intervention. Ask permission before frequent body questions, and invite them to say if a question feels uncomfortable [source: 2018 masterclass handout; Ogden & Goldstein 2020].
Therapist as interactive regulator. Use your voice, pace, energy, proximity and facial expression to regulate the client, and change them when the client dysregulates [source: Fisher; 2018 masterclass handout].
Attunement and repair. Match prosody and movement. When an empathic statement misses, correct course at once [source: Ogden & Goldstein 2020].
Neuroception and defences are instinctive, not weakness. Normalise dysregulation as instinctive activation, which reduces shame [source: Desclée sample; Fisher].
Titrate and use playfulness. Small doses, playful states and social engagement ease avoidance and hypervigilance [source: 2018 group handout].
Practise new actions. Change consolidates through repetition and experiential homework [source: 2018 masterclass and group handouts].
Adapt the method to the client, not the client to the method, including adaptations for dissociative clients [source: Desclée sample].

4. Intervention inventory

Organisation: A. Core relational and mindfulness skills (used in every phase); B. Phase 1 somatic resources; C. Phase 2 memory work; D. Phase 3 integration; E. Formats. All example therapist language is illustrative unless it is in quotation marks with a citation. Not covered: Hakomi-derived techniques sometimes linked with SP in secondary literature, such as "probes" and "taking over" a tension. They do not appear in the SP sources, so they are not described [uncertain].

Touch and consent (applies wherever touch or close physical contact appears below). The sources describe SP mostly as a no-touch method: Fisher presents its somatic work as needing no hands-on contact. Where contact does occur, it is light and mediated, for example the therapist holding a cushion for the client to push against [source: Fisher; Ogden & Goldstein 2020]. The sources set out client control and permission (the client controls all body interventions; ask permission for body questions; invite the client to say when something is uncomfortable) [source: 2018 masterclass handout; 2020 chapter]. The following steps are added [synthesis]:

Explain exactly what the contact would be: what, where on the body or prop, how long.
Ask, and accept a hesitant yes as a no.
Offer a no-touch alternative, such as a wall, an exercise ball, or the client's own hand.
Agree a stop word or gesture.
Check in during the contact and debrief afterwards.
Record consent in the notes.

Any touch requires specific SP or body-psychotherapy training and supervision. Check what your licence, employer and jurisdiction allow first. Never sexual or genital touch.

A. Core skills

A1. Tracking

Purpose / when: Continuous, from the first minute. Tracking yields the material for every other intervention and shows whether arousal is in or out of the window [source: Fisher; Buckley; 2020 chapter].
Steps:
1. Watch, alongside the words, for: subtle signs (skin colour, pupil or nostril dilation, trembling, micro-movements, breath changes); obvious ones (collapse through the spine, neck turning away, an arm pushing) [source: Buckley]; signs of hyperarousal (tension in jaw, arms, hands, legs, feet; alert immobility) and hypoarousal (flat affect, collapsed posture, slowed movement, decreased sensation) [source: 2018 group handout].
2. Note what changed in the body just after a particular word, memory or relational moment.
3. Decide whether to stay with the body, return to the narrative, or regulate [source: Fisher].
4. Also track for faulty neuroception (danger detected in a safe moment), overload, a need for movement or distraction, and readiness for integration [source: 2018 masterclass handout].
Example language (illustrative): (silently noted, then) "As you said his name, your shoulders came up a little."
Watch for: Tracking that tips into scrutiny. Shame-prone clients may feel watched, so name observations tentatively and sparingly [synthesis]. On video, ask the client to report what the camera cannot show (see E2).

A2. Contact statements (contact and labelling)

Purpose / when: Brief statements that name the client's present experience so the client feels met. They also turn attention from story to experience [source: Fisher, "contact and labelling"; 2018 masterclass handout: contact emphasising strengths and what regulates].
Steps:
1. Pick one observed element: a sensation, a movement, an emotion, or the sequence linking them.
2. Name it in a short, simple sentence, in a resonant tone, without interpreting [source: Fisher; 2020 chapter].
3. Watch the response. A softening or nod means it landed; a knitted brow means it missed, so correct course (A12).
4. Prefer contacting strengths and regulating moments over pathology [source: 2018 masterclass handout].
5. Once a pattern shows, label it, e.g. "the thought comes, then the stomach tightens, then you go quiet" [source: Fisher, pattern tracing].
Example language (illustrative): "Something just settled there." / "That thought brings a heaviness." / "Your breath got a bit deeper as you said that."
Watch for: Long or interpretive statements pull the client into thinking. Keep them short.

A3. Framing a focus and thinking aloud

Purpose / when: To propose, not impose, where to work next; this is the unity principle in practice [source: 2018 masterclass handout].
Steps:
1. Offer a focus tentatively and check interest.
2. Use "we" and "I wonder if…".
3. Let the client choose which material to study now and which to set aside until arousal settles [source: Fisher, "choosing focus"].
Example language (illustrative): "I wonder if we could stay with that slump for a moment, rather than the story. Does that interest you?"
Watch for: Compliant yeses. Watch the body as well as the words for agreement.

A4. Embedded relational mindfulness and mindfulness questions

Purpose / when: The core change process. The client studies present experience aloud, with the therapist, instead of talking about it [source: 2020 chapter; 2018 masterclass handout].
Steps [source: 2020 chapter]:
1. Observe a visible cue.
2. Direct the client's awareness to it, asking them to stay with that sensation or feeling.
3. Ask a mindfulness question.
4. The client reports aloud what they notice, as it happens.
5. Give time, contact the report (A2), and ask again.
Example language: handout prompts "What do you notice in your body right now?", "Can you sense that right now?", "Just notice what happens inside", "Stay with it", "I want to make sure I get it" [source: 2018 masterclass handout; 2020 chapter]; Fisher's "What is happening right here, right now?" Avoid "why" questions; prefer "what do you notice?" to "what do you think?" [source: Buckley].
Watch for: Mindfulness is itself regulating, because curiosity tends to settle affect [source: Fisher]. If inward focus destabilises the client (rising panic, numbing, losing contact), switch attention to the room and environment or to a stabilising resource [source: Buckley].

A5. Directed mindfulness across the five building blocks

Purpose / when: To aim attention at elements the client usually ignores, especially posture and movement, so that attention can drive neuroplastic change [source: 2018 masterclass handout; Desclée sample ch. 8].
Steps:
1. Track which building block is most active: five-sense perception, body sensation, emotion, movement, or words, thoughts and beliefs [source: 2018 masterclass handout].
2. Choose the one most relevant to the goal. When arousal is high, that is usually sensation or movement rather than emotion or story [source: Buckley].
3. Direct attention there.
4. Follow how it links to the next element, then separate or join elements depending on the client's capacity [source: 2018 masterclass handout].
Example language (illustrative): "Let's leave the feeling to one side for a moment. Just notice the sensation in your hands."
Watch for: Clients who blur sensation and emotion ("I feel terrible in my chest"). Build vocabulary first (A6).

A6. Building a sensation vocabulary

Purpose / when: Early in Phase 1. Distinguishing sensation from emotion keeps arousal from escalating into helplessness [source: Buckley; Desclée sample ch. 10].
Steps:
1. Explain the difference between sensation (tingly, numb, fluttery, heavy, tight, warm) and emotion (sad, afraid) [source: Buckley].
2. Ask the client to describe one neutral area of the body with sensation words only.
3. Gradually describe activated areas the same way.
4. Offer a written word list as needed [synthesis].
Example language (illustrative): "If you set aside the word 'anxious', what is the actual sensation: tight, buzzing, hot, something else?"
Watch for: Alexithymic or numb clients may find nothing at first. Ask whether any area is less numb [source: 2020 chapter].

A7. Psychoeducation and engaging reluctant clients

Purpose / when: At the start, and whenever a client doubts body work. It builds confidence that the body is a useful target, and reduces shame by normalising fight, flight, freeze and submission as instinctive [source: 2018 masterclass handout; Fisher].
Steps [source: 2018 masterclass handout]:
1. Notice how the body takes part in the presenting problem.
2. Ask what the client wants to change.
3. Offer hope that body work can serve those goals.
4. Ask whether they want psychoeducation.
5. Reassure them that they control body interventions.
6. Elicit questions and concerns.
7. Normalise their physical pattern.
8. Demonstrate with your own body how somatic work might help.
9. Reinforce positively. Keep it brief, start early and repeat as needed.
Content: window of tolerance, with hyper- and hypoarousal; mobilising and immobilising defences; neuroception; three levels of processing [source: 2018 handouts].
Example language (illustrative): "When you froze, that was your nervous system protecting you. It wasn't a choice or a weakness."
Watch for: Lectures. Keep each piece tied to the client's own goal.

A8. Empathic interruption and re-orienting to the body

Purpose / when: When telling the story pushes arousal toward or beyond the edge of the window, e.g. the body tightens and breath goes shallow [source: Fisher].
Steps:
1. Gently interrupt the narrative.
2. Name the body change.
3. Invite the client to pause and orient away from the memory toward present sensation.
4. Regulate using voice, pace and somatic resources.
5. Return to the story only when arousal settles [source: Fisher].
Example language (illustrative): "Can we pause the story there? I notice your breath got very shallow. Let's just notice what's happening in your body right now."
Watch for: Clients who feel silenced. Explain beforehand that you will interrupt to protect them, not to stop them speaking [synthesis].

A9. Mindful experiments ("What happens when…?")

Purpose / when: To discover how experience is organised and to try alternatives, using comparisons and exaggerations [source: 2018 masterclass handout; Fisher].
Steps:
1. Pick a tracked pattern (e.g. slumped spine, head dropping with "it was my fault").
2. Propose a small physical change: lengthen the spine, lift the head, or exaggerate the collapse [source: Fisher].
3. The client tries it mindfully.
4. Ask what happens to sensation, emotion and thought, e.g. whether fear rises or falls [source: Fisher].
5. Compare with the habitual posture.
6. Keep, repeat or discard the change on the basis of what the client finds [source: Fisher].
7. Relational experiments: change distance or gaze (the therapist closing their eyes so the client controls "being seen", or moving chairs) and study the effect [source: Fisher].
Example language: "What happens when…" [source: 2018 masterclass handout]; (illustrative) "Let's try lengthening your spine just a little. What happens inside?"
Watch for: Any result is useful information; there is no right answer. Shame drops through curiosity, without verbal reframing [source: Fisher].

A10. Therapist as interactive regulator; attunement

Purpose / when: Throughout, and especially during dysregulation [source: Fisher; 2018 masterclass handout; 2020 chapter].
Steps:
1. Match the client's prosody (timbre, volume, pace), eye contact, facial expression and movement to join them.
2. Then adjust your own tone, pace, energy, and the balance of information versus reassurance until the client settles [source: Fisher].
3. Use mirroring and modelling to show the next step [source: 2018 masterclass handout].
4. In distress, use soft non-verbal sounds and lean in [source: 2020 chapter].
Watch for: Your own window of tolerance. The therapist's capacity for affect sets what the client can safely express [source: 2020 chapter].

A11. Naming the relational field and modelling with your own body

Purpose / when: To bring implicit relational patterns into awareness [source: 2020 chapter].
Steps:
1. Name what happens between you (a shift in emotion, the client moving back as you lean forward).
2. When useful, share your own somatic response briefly as a model.
3. Ask what the client notices [source: 2020 chapter].
Example language (illustrative): "It looks like when I leaned in, you moved back a little. What do you notice?"
Watch for: Over-disclosure. Share "judiciously" [source: 2018 masterclass handout].

A12. Rapid repair of misattunement

Purpose / when: The moment a statement does not land (brow knits, body turns away) [source: 2020 chapter].
Steps:
1. Acknowledge the miss immediately.
2. Offer a tentative alternative.
3. Watch the body for resonance [source: 2020 chapter].
Example language: "That's not quite it, is it" [source: Ogden & Goldstein 2020].
Watch for: Small repaired mismatches are healthy: the source describes a match–mismatch–rematch cycle [source: 2018 group handout].

B. Phase 1: somatic resources

Somatic resources are physical actions that lower anxiety "just a little" and so let the client self-regulate without depending on reassurance [source: 2020 chapter]. The authors' list: body awareness, grounding, boundaries, breath, containment, self-soothing, movement, reaching, alignment, centring [source: 2018 handouts]. The 2015 book has chapters on grounding, core alignment, breath, a somatic sense of boundaries, and developing missing resources [source: Desclée TOC]. Where the sources only name a resource without giving steps, the steps below are marked [synthesis]. General rule for all of them: introduce, try in small doses, compare with the habitual pattern, repeat, then assign as homework.

B1. Resource inventory: survival and creative resources

Purpose / when: Opening Phase 1. Builds appreciation of strengths and maps what already regulates the client [source: Desclée TOC, ch. 13–14, "survival and creative resources", "categories of resources"].
Steps [synthesis following the chapter themes]:
1. Ask what has helped the client survive: people, places, activities, skills, spiritual and bodily capacities.
2. Separate survival resources (dissociating, withdrawing, staying hyper-alert) from creative resources (things that bring pleasure, competence or connection).
3. Honour each survival resource as once adaptive.
4. For each creative resource, ask how it shows in the body: posture, breath, sensation.
5. Note which resources are missing, e.g. no capacity to say no or to reach out, and target these later (B8, D3).
Example language (illustrative): "When you're out walking your dog, the time you said you feel most like yourself, what happens in your body?"
Watch for: Psychological resources have somatic correlates [source: Fisher]. Look for the posture of confidence as well as the words.

B2. Grounding

Purpose / when: For hyperarousal, floating or dissociation, and as a base for every later exercise [source: named in 2018 handouts and Desclée TOC ch. 16; Fisher mentions "feeling the ground under one's feet"].
Steps [synthesis; procedure not given in the text]:
1. Seated, feet flat on the floor.
2. Ask the client to notice the contact of feet with floor and of seat with chair.
3. Invite a gentle press of the feet into the floor and a release, repeated slowly a few times, noticing the legs.
4. Optionally stand, shift weight slowly side to side and front to back, and find the centre.
5. Ask what changes in arousal, breath and thought.
6. Close by asking which variant helped most, to be practised at home.
Example language (illustrative): "See if you can feel your feet on the floor. Press down just a little, then let go. What do you notice in your legs?"
Watch for: More presence, steadier gaze, deeper breath mean it is working. If attention to the legs brings up memories of being held down or of running, keep the effort minimal and stay in present-moment contact.

B3. Core alignment and posture

Purpose / when: Collapse, depression, shame, low self-esteem; habitual postures shape emotion and self-image [source: 2018 group handout; Desclée TOC ch. 17].
Steps [source: 2020 chapter, client example]:
1. The therapist models a collapsed posture and describes what it does to emotion, thought and self-esteem.
2. The therapist models an upright, aligned posture and describes the contrast.
3. The client compares the two in their own body and notices the differences.
4. Use an image to build the posture; in the source, the client used a lion's upright stance from a film.
5. Stand and walk with the aligned posture and report the experience.
6. Homework: practise the posture in a feared situation (in the source, a restaurant).
Example language (illustrative): "Let's both slump a little, then slowly lengthen up through the spine. What's different?"
Watch for: The client may need to return to the old posture to feel the difference; that is part of the work. Respect parts that find uprightness dangerous, for example if standing tall once drew criticism [source: 2018 group handout].

B4. Breath

Purpose / when: Shallow or held breath, constricted chest, anxiety during particular activities [source: 2020 chapter; Desclée TOC ch. 18].
Steps [source: 2020 chapter]:
1. Notice posture during the feared activity (in the source, using social media).
2. The therapist models opening the shoulders: draw elbows and arms back, expand the chest.
3. The client tries it and notices changes in spine, breath and sensation.
4. Homework: track posture and breath during the daily activity and journal thoughts and feelings.
Example language (illustrative): "Let your elbows draw back a little and notice what your breath does on its own."
Watch for: SP breath work here is gentle, coming from posture. It is not breath intensification. Do not instruct deliberately deep or fast breathing in clients prone to panic or hyperventilation [synthesis].

B5. Self-soothing: hand on heart

Purpose / when: Anxiety; building trust that the client can calm themself [source: 2020 chapter].
Steps [source: 2020 chapter]:
1. Position both people so torsos are visible.
2. Slowly bring a hand gently to the chest; the therapist can do it alongside the client.
3. Notice the effect on anxiety.
4. Repeat. Over time the client learns the feared outcome does not come, and confidence in self-soothing grows.
Example language (illustrative): "Just slowly bring a hand to your chest, if that feels okay. What happens?"
Watch for: Some clients feel self-touch as exposing or unfamiliar. Offer alternatives: a hand on the arm, holding one hand with the other, or holding a warm object [synthesis].

B6. Containment

Purpose / when: Feeling flooded, "spilling out", or sensing no edges [source: named only, 2018 handouts; Desclée sample says Section III covers containment].
Steps [synthesis; not described in the text]:
1. Invite the client to cross their arms or place both hands on their upper arms.
2. They notice the sense of their own edges.
3. Alternatively, wrap in a blanket (props listed in the 2018 masterclass handout).
4. Compare with before.
Watch for: Containment should feel holding, not trapping. Stop if it echoes restraint.

B7. Centring

Purpose / when: Feeling scattered, or lacking a sense of a core self [source: named only, 2018 handouts].
Steps [synthesis; not described in the text]:
1. Invite attention to the midline of the body: spine, or belly and chest.
2. Optionally a hand on the belly or sternum.
3. Notice the sense of a vertical axis, combined with alignment (B3).
4. Ask what this brings.
Watch for: Mark as optional. Some clients have little sense of the middle of the body and need grounding first.

B8. Somatic sense of boundaries (saying "no" with the body)

Purpose / when: Difficulty protecting oneself, setting limits, or differentiating from others. A somatic boundary comes from felt preferences, wishes, rights and safety, which is different from cognitive understanding [source: 2018 group handout; Desclée TOC ch. 19, 32].
Steps [source: 2020 chapter, client example]:
1. Create space for the full body, e.g. move chairs back.
2. Try physical "no" actions: tensing, facial expression, narrowing the eyes, hands raised palms outward.
3. Let the client find a more energetic action of their own; in the source, the client found stomping. Offer privacy options (online: muting, moving out of view).
4. Apply the practised "no" to real situations.
5. Optionally do a shared action, e.g. count to three and both say "no" loudly.
6. The client controls the volume and intensity throughout.
In person [synthesis]: the client can sense where the boundary feels right by asking the therapist to approach slowly and saying or gesturing "stop". The use of a rope to mark personal space is widely reported in SP training but is not described in the texts used; ropes are listed among props [uncertain].
Example language (illustrative): "Let's find what 'no' feels like in your arms. Try just raising your hands, palms out, and see what happens."
Watch for: Freeze, collapse or a voiceless "no" show the immobilising defence. Go smaller. Anger may appear and can energise the action. Make sure arousal stays inside the window.

B9. Movement, proprioception and deep pressure

Purpose / when: Dysregulated arousal, sensory processing difficulties, restlessness, and for children: strong movement and deep pressure can organise and calm [source: 2018 masterclass handout].
Steps:
1. Offer options and let the client, or child, choose: pushing a therapy ball, wrapping in a blanket or body sock, throwing a ball, pillow play. Props are from the 2018 masterclass handout.
2. Track the effect on arousal.
3. Stop at signs of over-activation [synthesis on steps].
Watch for: Rough play, clumsiness or stiffness may signal proprioceptive needs [source: 2018 masterclass handout].

B10. Developing missing resources

Purpose / when: Once B1 shows a gap (no reaching, no boundary, no alignment, no capacity for pleasure) [source: Desclée TOC ch. 20].
Steps [synthesis]:
1. Name the missing action.
2. Find a moment in the client's life, or an image, where it existed even slightly.
3. Embody it in a small form.
4. Practise it in session, then as homework.
5. Expect resistance from parts that learned the action was dangerous (D5).

B11. Working with limiting procedural habits

Purpose / when: Chronic postures or gestures that maintain old beliefs, e.g. the head tilted to one side [source: 2018 masterclass handout].
Steps [source: 2018 masterclass handout]:
1. Teach new actions first (alignment, grounding, breath).
2. Identify the limiting habit as a survival resource.
3. Acknowledge its adaptive purpose; in the source example, keeping the head to the side may have prevented attention or criticism.
4. Have the client teach the habit back to you, owned as their resource.
Example language (illustrative): "Can you show me how to do that head tilt? I want to understand how it helped you."
Watch for: The habit softening on its own once it is respected.

B12. Orienting habits

Purpose / when: Automatic patterns of attention, e.g. scanning doors, eyes down, narrowed field [source: Ogden, Minton & Pain 2006 ch. 4 title; Desclée sample, ch. 6: patients identify automatic orienting patterns and try changing them].
Steps [synthesis beyond the sample's one-line description]:
1. Track where the eyes and head go.
2. Contact the pattern.
3. Invite the client to orient slowly to the room: look around, name three things, notice that the room is safe now.
4. Experiment with a different orientation, e.g. raising the eyes, and compare.
Watch for: Slow, deliberate orientation to the present environment is also the fallback when inward focus is destabilising [source: Buckley].

C. Phase 2: processing traumatic memory

Only after Phase 1 readiness (section 2). Throughout, the aim is to reorganise the memory's procedural encoding, not to re-live it. Arousal stays at the edge of the window, never far beyond it [source: Fisher; Buckley; Desclée sample].

Screening before active defensive or movement work (the sources name only regulation-based readiness; the rest is [synthesis]):

Physical: pregnancy; cardiovascular or respiratory illness; epilepsy; recent injury or surgery; musculoskeletal pain affecting pushing or stomping. Adapt the action to a small, low-effort form, or get medical advice.
Psychiatric: psychosis; severe dissociation, especially dissociative identity disorder without stabilisation; active suicidality or recent self-harm; current abuse or an unsafe living situation; recent trauma without stabilisation. Stay in Phase 1.
SP is not cathartic discharge. Vigorous action is allowed only while the client remains mindful and within the window [source: Fisher; Buckley].

C1. Finding resources in the painful past

Purpose / when: Opening memory work. Locate what helped, even slightly, during or around the event: a moment of resistance, someone who helped, a place of refuge [source: Desclée TOC, ch. 21–22].
Steps [synthesis following chapter titles]:
1. Before details, ask what helped the client get through.
2. When a resource is found, have the client sense it in the body now.
3. Contact it and anchor it with posture or breath.
4. Use it later as a return point.
Example language (illustrative): "Before we go into what happened, what helped you get through that time, even a little?"

C2. Dual awareness: past and present

Purpose / when: The precondition for any memory work. The client observes their body and emotions now while touching the past, so they are not overwhelmed [source: Fisher; Desclée TOC, ch. 23].
Steps:
1. Establish present-moment anchors: feet, chair, room, the therapist's face.
2. Briefly touch the memory.
3. Ask what happens in the body "here and now" as the client remembers "then" [source: Fisher].
4. Alternate between the memory and the present anchor.
5. If present awareness is lost, drop the memory and re-orient (A8).
Example language: "What is happening right here, right now?" [source: Fisher]; (illustrative) "As you remember that, can you also feel the chair under you?"
Watch for: Glazed eyes, losing contact with the therapist, speaking in the present tense of the trauma. These mean dual awareness is lost.

C3. Working with a fragment of memory; uncoupling

Purpose / when: To titrate. Process one small piece of the memory, enough to activate but not to dysregulate [source: Desclée sample, ch. 24]. Uncouple the memory from automatic arousal by turning attention from the event's details to the bodily response during recall [source: Fisher].
Steps:
1. Together choose a small fragment, e.g. the moment just before the event, or a single image or sound [synthesis on choosing].
2. The client touches it briefly.
3. Shift attention from content to body response: arousal, belief, emotion, or urge to move [source: Fisher, who asks whether recall brings any of these].
4. Work with whichever appears (C4, C5).
5. Let other material wait until arousal settles [source: Fisher].
Watch for: The narrative accelerating or spreading to other events. Slow down and return to the fragment.

C4. Restoring empowering defensive actions ("acts of triumph")

Purpose / when: When the memory carries an unfinished mobilising defence (fight, flight, calling out) or an immobilising one (freeze, shutdown, feigned death) that replaced an action that failed, was unavailable or was punished [source: 2018 masterclass handout; 2020 chapter; Buckley on "Acts of Triumph"; Ogden, Minton & Pain 2006 ch. 11 title].
Steps [source: 2020 chapter, client example; consent steps synthesis]:
1. Ask the client to describe the body during the memory fragment.
2. If numbness is present, ask whether any part feels less numb.
3. Direct mindful attention to any tension, since tension often precedes action.
4. Ask what the body wants to do, and wait for an impulse (e.g. arms wanting to push).
5. Let the movement begin slowly and mindfully, in small form first [synthesis].
6. Give resistance: in person the therapist holds a cushion for the client to push against. Remotely, or as a no-touch alternative, the client pushes a large exercise ball against a wall [source: 2020 chapter].
7. Encourage a full, vigorous push; anger can energise it and build a felt sense of empowerment [source: 2020 chapter].
8. Pause. Notice the aftermath in the body: strength, breath, spine, sensation.
9. Link it to meaning, e.g. "I can protect myself", and repeat if useful.
10. Close with grounding, then discuss.
Touch / consent: holding a cushion means body-to-prop contact close to the client. Follow the consent steps at the head of section 4: explain, ask, offer the ball-and-wall alternative, agree a stop signal, check in during and after [synthesis]. This requires SP training and supervision; check your licence and jurisdiction.
Example language (illustrative): "Notice the tension in your arms. If they could do what they want, what would that be? Let it start very slowly."
Watch for: Working: lengthened spine, fuller breath, reduced isolation, a more confident bodily sense of self-protection afterwards [source: 2020 chapter]. Not working: the push becomes mechanical or explosive with loss of mindfulness, or the client collapses afterwards. Go slower and smaller, and return to resources [synthesis]. Contraindications: see the screening list above.

C5. Sensorimotor sequencing

Purpose / when: Shock trauma and hyperarousal. Recalibrate the nervous system by completing unfinished orienting and defensive responses at the level of sensation and involuntary movement [source: SPI webinar page; Desclée sample, ch. 26].
Steps:
1. Set the trauma content aside [source: Desclée sample].
2. Direct attention to physical sensations and involuntary movements linked to hyperarousal, e.g. trembling, shaking, heat, small micro-movements [source: Desclée sample, Buckley list of tracked micro-movements].
3. Follow them moment by moment, with the client reporting aloud, until arousal settles back into the window [source: Desclée sample].
4. Further procedure [synthesis; procedural detail not in the texts]: keep a slow pace. Pause whenever sensation grows beyond the edge of the window and return to a resource. Allow involuntary movement without amplifying it. Let the sequence reach its own natural settling, e.g. a spontaneous deep breath, warmth, stillness.
5. Close by noticing the settled state and connecting it with the present.
Example language (illustrative): "Just let the trembling be there. Notice where it goes. No need to do anything with it."
Watch for: Content intruding, which escalates arousal. Gently return to sensation. If arousal keeps climbing, stop sequencing and regulate.

C6. Working with immobilising defences and animal defences

Purpose / when: Numbness, collapse, freeze or submission in memory work. Both the patient book and the authors say these respond better to body-based than to purely verbal or emotional approaches [source: Desclée sample, ch. 25, 27; 2018 masterclass handout].
Steps:
1. Psychoeducate: mobilising versus immobilising defences, and how a defence shifts when earlier ones fail [source: 2018 masterclass handout].
2. Recognise the body signals of the current defence.
3. Find the less numb area or the first tension (C4, steps 2 and 3).
4. Invite tiny movements such as finger lifts or foot pressing, which the source names as body cues [source: 2020 chapter body menu].
5. Build toward mobilisation only as tolerated.
Watch for: Hypoarousal deepening (flatter affect, slower speech). Raise energy with orienting, sitting up, and more animated voice and pace [source: Fisher on adjusting voice and pace; specific moves synthesis].

D. Phase 3: integration

D1. Accessing attachment memory through posture, then consolidating

Purpose / when: Phase 3 attachment grief and longing, once the client can regulate arousal [source: 2020 chapter].
Steps [source: 2020 chapter]:
1. Notice a body cue (e.g. a spinal slump).
2. Ask the client to exaggerate it; posture can help bring back related memories.
3. The client focuses on the memory image while holding the posture, which can intensify emotion.
4. The therapist stays present: non-verbal sounds, leaning in, soft eyes, attuned proximity.
5. Offer short empathic statements that include the body and watch whether they deepen or resonate.
6. Repair any misses.
7. After release, client and therapist embody an aligned posture and full breath together, paired with a new belief (in the source, "I do deserve love").
Example language: "the pain makes you just want to curl up" [source: Ogden & Goldstein 2020].
Watch for: The client being able to feel and stay in contact. If emotion overwhelms, return to C2.

D2. Embodying a new way of being (new beliefs)

Purpose / when: When a healthier thought appears, to give it a body [source: 2018 masterclass handout; Desclée TOC ch. 29 "beliefs and the body"].
Steps [source: 2018 masterclass handout]:
1. Notice when the healthy thought emerges.
2. Express it physically and/or find words for a new posture.
3. Embody it by walking, clarifying the physical changes.
4. Contrast the new posture with the old, then return briefly to the negative belief to sense the difference.
5. Homework: practise the new posture with the positive thought and integrate it with other parts of the self.
Example language (illustrative): "As you say 'I can stand up for myself', what does your body want to do?"

D3. Reaching out (proximity-seeking actions)

Purpose / when: Clients who stopped reaching because no one reached back, or whose vulnerability was ridiculed [source: 2018 group handout; Desclée TOC ch. 33].
Steps [source: 2020 chapter; 2018 group handout]:
1. Playfully mirror each other: move toward and away, lean in, reach with the eyes, then with the arms.
2. The client may watch the therapist model first.
3. Reach and explore the words and meaning that come with the reach (in the source, "I have help and I'm going to get through this").
4. Optionally each person reaches for a chosen support object (in the source, stones) and explores its weight and texture.
5. In person or in groups, "push-pull" dyadic movements integrate distance-seeking (lean away, push, look away) with proximity-seeking (lean toward, reach, receive support).
Example language (illustrative): "Let your hand reach out just a little. What happens? Are there any words that go with it?"
Watch for: Hesitation, a limp hand, or reaching with the palm down mean the old expectation is present. Contact it and explore. Do not push past it. Any hand-to-hand contact needs the full consent procedure [synthesis].

D4. Gait: moving through the world

Purpose / when: How a person walks shapes orienting and social engagement [source: 2018 masterclass handout; Desclée TOC ch. 31].
Steps [synthesis beyond B3 step 5]:
1. Ask the client to walk as usual and notice what happens.
2. Experiment with one change at a time: head up, arms swinging, a longer stride, eyes on the horizon.
3. Compare and report.
4. Practise the version that supports the goal, as homework.

D5. Parts work: "Every symptom has a purpose"

Purpose / when: When a symptom or part resists a new action, or parts conflict [source: 2018 masterclass handout].
Steps [source: 2018 masterclass handout]:
1. Stay curious about what the symptom or part is for, rather than being pulled into crisis.
2. Ask what it accomplishes.
3. Identify its function and the part it connects to.
4. Express appreciation, and invite other parts to do the same.
5. Explore whether parts can help one another.
6. Reassure the part you are not trying to remove it.
7. Ask whether it would "step aside" or "dial down".
8. Explore actions that integrate two or more parts.
Watch for: Abrupt state shifts suggest structural dissociation. Slow down and stabilise (section 5).

D6. Boundary styles in relationships

Purpose / when: Rigid, collapsed or inconsistent boundaries in relationships [source: Desclée TOC ch. 32; 2018 group handout].
Steps [synthesis]: Identify the client's habitual style using B8 experiments (does "no" come too fast, too late, or not at all?). Practise the missing variant, then rehearse with a real relationship in mind.

D7. Play, pleasure and positive emotion

Purpose / when: Expanding tolerance for positive arousal. Joy lowers thresholds for perceiving life as hopeful (Panksepp, cited) [source: 2018 group handout; Desclée TOC ch. 34].
Steps:
1. Notice and contact moments of pleasure and play.
2. Embody them in movement.
3. In groups, "Assisted Jump for Joy" pairs high-arousal positive emotion with others' physical and emotional support [source: 2018 group handout; detailed procedure not given].
Watch for: Positive arousal can trigger fear or shame in trauma survivors. Titrate it.

D8. Challenging the window of tolerance

Purpose / when: Late Phase 3. Deliberately take small risks to expand the window (the Modulation Model) [source: 2018 handouts; Desclée TOC ch. 35].
Steps [synthesis]: Choose a manageable challenge (a social situation, an assertive conversation). Plan which resources to use. Do it as homework, then debrief the body's response in session.

D9. Experiential homework

Purpose / when: End of most sessions, to practise new actions [source: 2018 group handout; 2020 chapter].
Steps:
1. Choose one action (a posture, push, reach, breath, or grounding).
2. Agree where and when to practise it, e.g. in the feared restaurant.
3. The client tracks the body and journals [source: 2020 chapter].
4. Review at the next session.

E. Formats

E1. Groups

Purpose / when: Groups in which members model, teach and practise new actions with one another, which helps generalisation [source: 2018 group handout].
Steps [source: 2018 group handout]:
1. Attend to both the somatic and the verbal narrative.
2. Identify group themes.
3. Track members' somatic signs related to those themes.
4. Work bottom-up, exploring themes through movement, posture and gesture.
5. Use embedded relational mindfulness.
6. Integrate beliefs, emotion and the somatic narrative.
7. Assign experiential homework.
Theme-to-action map [source: 2018 group handout]:
- Posture: assertion, self-esteem, depression.
- Reach and eye contact: connection, intimacy.
- Defensive mobilisation: freezing, helplessness, empowerment.
- Boundaries: preferences, differentiation, conflict.
- Group support for positive emotion: joy, play.
Watch for: Every member and the leader have their own window, and members regulate and dysregulate one another through face, voice and action [source: 2018 group handout]. Track the room as well as the individual.

E2. Videoconferencing

Set-up [source: Ogden & Goldstein 2020]:
- A consistent, quiet room for each person, with notifications off.
- Start with a brief quiet body scan to shift from doing to being.
- Use a large screen, not a phone. Use rolling chairs so you can move closer for the face and farther away to show posture and gait.
- Agree a default frame, e.g. head and shoulders.
- Check your own image so that gestures like pushing do not look distorted.
- Keep props at hand: balls, pillows, ropes.
Body menu: Give the client a list of cues to report that the camera may miss, e.g. tightness, tingling, finger lifts, foot pressing, heart-rate change.
Permission: Ask permission for frequent body questions.
Client control: The client can mute or move out of view during energetic work.
Dual attention to distraction: When devices pull the client's attention, have them observe the body while engaging the distraction (shoulders, stillness, breath), then apply breath work [source: 2020 chapter].

E3. Children, caregivers and families

Steps [source: 2018 masterclass handout]:
- Map the child's and caregiver's windows and how they affect each other.
- Work on co-regulation as well as self-regulation, and include caregivers (triadic framing).
- Keep the atmosphere playful and non-coercive, with the child in charge.
- Use props: pillows, therapy balls, body socks, fidgets, throwing balls, rope, blankets.
- Set challenges the child can succeed at within the window, and reinforce strengths.
- Support smooth transitions between states: mealtime, play, rest, bedtime.
Falling exercise for trust and interdependence is named, but its procedure was not given [uncertain]. Do not improvise trust-falls without training [synthesis].

5. Handling problems

Sources give some of these responses; anything not from a source is marked [synthesis].

Client reluctant or "not ready" for body work. Use the A7 sequence: link the body to the client's own goal, offer hope, demonstrate with your own body, and stress that they control every intervention [source: 2018 masterclass handout]. Start with something low-exposure: noticing the feet, a hand on the chest, posture comparisons done together. Let the client keep talking and weave in one body question at a time [synthesis].
Overwhelm or hyperarousal in session. Empathically interrupt the story. Shift from emotion and content to sensation. Orient to the room. Use grounding and your own slower voice and pace [source: Fisher; Buckley]. If arousal is still high, sit up, look around, name objects, and press the feet down [synthesis]. Next session, use a smaller fragment and more resource work [synthesis].
Hypoarousal, numbing, dissociation. Ask what is less numb, find tension, invite tiny movements [source: 2020 chapter]. Raise the energy of your voice and the interaction. Orient to the environment rather than inward [source: Buckley; Fisher]. With severe dissociation or parts switching, stay in Phase 1, use D5 parts work, and adapt per the dissociation guidance in the 2015 book [uncertain]. Consider a specialist referral [synthesis].
Stuck: nothing changes, the client only describes. Change the level of processing: from cognition to sensation, from emotion to movement. Run a comparison experiment (exaggerate vs. correct the posture) [source: Fisher; 2018 masterclass handout]. Check whether the target fits the client's own goal (organicity). Look for a part that needs the old pattern (D5) [synthesis on order].
Resistance to a new action, or a part objecting. Treat it as information: the action may feel acceptable to one part and threatening to another [source: 2018 masterclass handout]. Honour the old pattern as a survival resource and have the client "teach it" to you [source: 2018 masterclass handout]. Shrink the action to a micro-version [synthesis].
Shame at being looked at or tracked. Lower exposure: the therapist closes their eyes, changes distance or angle, and lets the client control being seen [source: Fisher]. Name observations tentatively and less often, and contact strengths [synthesis; 2018 masterclass handout on contacting strengths].
Client wants to tell the whole story. Validate. Explain that SP works with how the story lives in the body now, and that you will slow down to keep them within the window. Let them tell short pieces, pausing at body shifts [synthesis based on Fisher].
Client seeks catharsis (wants to scream, hit, "get it all out"). Explain that SP aims at mindful, regulated completion of actions, not discharge [source: Fisher; Buckley]. Slow any vigorous action and keep it mindful; screen first (section C) [synthesis].
Non-adherence to homework. Make homework one small, concrete action tied to a real situation the client chose [source: 2020 chapter on homework examples]. Practise it once in session. Ask what got in the way, tracking the body as they answer, since avoidance may be procedural [synthesis].
Ruptures and misattunement. Recognise them from body cues (a knitted brow, a pull back), name them at once, and offer a tentative correction ("That's not quite it, is it") [source: 2020 chapter]. For larger ruptures, name the relational shift between you and explore it mindfully (A11) [source: 2020 chapter]. Take responsibility for your part [synthesis].
Touch-related problems. If contact or a prop held by the therapist triggers fear, stop, re-orient, and switch to the wall or ball alternative. Debrief and record it. If the client asks for touch you are not trained or licensed for, decline warmly and explain why [synthesis]. Supervision is required for any touch.
Movement or memory work brings up new "memories". Stay with present experience. Do not interpret body sensations or postures as proof of particular past events, and avoid leading questions about abuse [synthesis].
Physical symptoms, pain or medical conditions. Body work is not treatment for physical disease. Refer for medical assessment of unexplained physical symptoms. Adapt or skip exercises with injury, pain, pregnancy, cardiac, respiratory or seizure conditions [synthesis].
Suicidality or self-harm emerging. Pause trauma processing and use standard risk assessment and safety planning, including lethal-means counselling about safe storage and removal. Return to Phase 1. SP sources do not set a protocol here [synthesis].
Therapist dysregulation. The therapist's window limits what the client can express [source: 2020 chapter]. Use your own grounding and breath in session, and take it to supervision [synthesis].
Cultural differences around eye contact, posture, voice and touch. Upright posture, direct gaze or a loud "no" may carry different meanings. Ask what each action means in the client's context before setting it as a goal [synthesis].
Online: cues are invisible. Use the body menu, ask more often (with permission), and move the camera or chair to show more of the body [source: 2020 chapter].

Sources

Sources:

Books and papers cited (main text not drawn on unless listed above):

Ogden, P., Minton, K., & Pain, C. (2006). Trauma and the Body: A Sensorimotor Approach to Psychotherapy. Norton. German edition: Trauma und Körper, Junfermann.
Ogden, P., & Fisher, J. (2015). Sensorimotor Psychotherapy: Interventions for Trauma and Attachment. Norton. Spanish 2nd edition, Desclée de Brouwer, 2019.
Ogden, P., & Goldstein, B. (2020). Sensorimotor Psychotherapy from a distance. In H. Weinberg & A. Rolnick (Eds.), Theory and Practice of Online Therapy (pp. 47–63). Routledge.
Fisher, J. (c. 2011). Sensorimotor approaches to trauma treatment. Advances in Psychiatric Treatment [uncertain: year and volume; manuscript ID dated 2009].
Siegel, D. J. (1999). The Developing Mind (origin of "window of tolerance", as cited by Ogden & Goldstein).

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