Why I use Somatic Experiencing Over EMDR for Complex Trauma
Both EMDR and Somatic Experiencing are evidence-informed trauma therapies that work at the level of the nervous system. Both can be effective.
The question I get asked often is why I tend to lean toward Somatic Experiencing in my clinical work, especially with complex trauma.
This is my answer to that question. It speaks to the clinical reasoning, what complex trauma actually is and why it often requires a different approach, and what I bring personally to these decisions as a neurodivergent clinician living with chronic illness.
What is the difference between single-incident trauma and complex trauma?
Single-incident trauma is what most people picture. A car accident, a medical event, one overwhelming moment with a clear before and after.
Complex trauma is different. It develops over time, often within relationships, environments, or systems where safety was inconsistent or absent. It is not just about what happened. It is about what was repeated, what was missing, and how the nervous system adapted in order to keep functioning.
For many neurodivergent people, those adaptations are often misunderstood. What gets labeled as avoidance, shutdown, or being “too sensitive” is frequently the nervous system doing exactly what it needed to do in environments that were not built with that system in mind.
Because of this, complex trauma is rarely stored as one clear memory. It shows up as patterns. Chronic activation or shutdown, sensory overwhelm, dissociation, relational sensitivity, or a persistent sense of not fully being in your body.
Why do standard trauma therapies fall short for complex trauma?
Many trauma therapies were developed with a more linear model in mind. Identify the event, process it, resolve it.
That model works well when there is a clear event and a nervous system that can stay within a manageable range of activation while processing it.
With complex trauma, that is often not what is happening.
There may not be a clear narrative. Trying to organize one can itself be overwhelming. For many neurodivergent people, experiences are not primarily stored or accessed through language. They may be sensory, visual, or pattern-based.
When therapy leans heavily on explaining or organizing cognitively, it can miss how the experience is actually held in the body.
This is not a limitation of the person. It is a mismatch between the approach and the nervous system.
Why I gravitate toward Somatic Experiencing for complex trauma
Somatic Experiencing meets the nervous system where it actually is.
Complex trauma is not just about memory. It is about ongoing patterns in the body. Activation, shutdown, dissociation, and difficulty staying within a workable range of experience.
Somatic Experiencing does not require starting with a clear story. It does not assume that insight alone will shift the response. It works directly with what is happening in the present.
For many of the people I work with, especially those who are neurodivergent or living with chronic health conditions, this is a more accessible place to begin.
It allows the work to follow the system, rather than asking the system to adapt to the method.
How does your own experience with chronic illness and neurodivergence inform your clinical choices?
Living with Autism, ADHD, Type 1 Diabetes, and Celiac disease means my relationship to my body is ongoing and non-linear.
There is constant tracking. Sensory input, energy levels, blood sugar, regulation, capacity. The body is always communicating, and not always in ways that are easy to translate into words.
It also means that pushing through is not always an option.
Because of that, I do not approach the nervous system as something to override or correct.
Somatic Experiencing respects variability. It allows for pacing, adjustment, and working with what is actually available in a given moment. That makes it a more sustainable approach, both personally and clinically, especially with complex trauma.
What does “titration” mean in trauma therapy and why it matters for complex trauma
Titration means working with small amounts at a time.
With complex trauma, the system often has a lower threshold for overwhelm. Going directly into the full intensity of an experience can lead to shutdown, dissociation, or increased activation rather than resolution.
Titration works differently. A small amount of activation, followed by a return to something more settled.
Over time, this builds the capacity to move in and out of experience, rather than getting stuck in it.
It is slower by design. But it is also more sustainable, especially for nervous systems that have been managing a great deal for a long time.
Why is going slowly in trauma work actually more effective than going fast?
Going fast can look like progress. It does not always create lasting change.
When the system becomes overwhelmed, it returns to the same protective patterns it has always used. The processing does not integrate. It just moves through.
Going slowly allows the nervous system to actually metabolize what is happening.
For neurodivergent systems in particular, pacing is not just helpful. It is necessary. It reduces overload, supports regulation, and allows change to build in a way that holds over time.
What does it mean to work with the nervous system rather than the memory of trauma?
Working with memory focuses on what happened.
Working with the nervous system focuses on what is still happening.
Complex trauma often lives in patterns that do not have a clear narrative. Sensory responses, relational reactions, shifts into shutdown or activation that happen faster than conscious thought.
Somatic Experiencing works with these directly. It does not require full access to memory. It follows the body and supports what is already trying to resolve.
This is part of why it can feel more accessible than approaches that require a clear, organized account of the past.
How does Somatic Experiencing pair with art therapy in your practice specifically?
Art therapy adds another layer of access, particularly for complex trauma and neurodivergent clients.
Not everything is verbal. Sensations, patterns, and internal states can take form through color, line, texture, or movement.
Art allows the experience to exist outside of language, where it can then be tracked and worked with somatically.
It also naturally supports pacing. The process slows down, becomes more tangible, and often feels more manageable than sitting with sensation alone.
For many people, having something external to hold or look at makes internal experience feel less abstract and more workable.
What I say to a clients who come in requesting EMDR
I do not view EMDR and Somatic Experiencing as opposites, and I do not discourage people from asking about EMDR.
EMDR can be a powerful modality, including for complex trauma, especially when it is adapted with careful pacing and preparation.
At the same time, I am more extensively trained in Somatic Experiencing, and that does shape how I approach the work. It is the modality I tend to orient toward first, particularly with complex trauma, because it aligns with how I understand the nervous system and how I have seen change happen most sustainably.
If a client comes in specifically requesting EMDR, I want to understand what is drawing them to it and how their system tends to respond under stress.
From there, we look at what feels workable.
Sometimes that means beginning with Somatic Experiencing to build capacity and regulation, especially when there is significant dissociation or overwhelm. From there, EMDR can become more accessible and effective.
Other times, EMDR is a reasonable place to start, and we move into it with appropriate preparation.
And if it becomes clear that a client would benefit from EMDR in a way that goes beyond my scope or training, I am transparent about that and can support them in finding a provider who specializes in it.
The goal is not to steer someone toward one modality, but to work in a way that is aligned with their nervous system and gives them the best chance at sustainable change.