Anxiety and depression involve interactions among thoughts, emotions, behavior, and physiological processes. During periods of heightened stress, some individuals experience increased alertness, muscle tension, rapid breathing, or difficulty concentrating. Others may experience emotional numbness, withdrawal, or disconnection. These experiences are sometimes described using the window of tolerance, a clinical framework for understanding how changes in arousal can affect emotional regulation and our ability to respond to everyday challenges.
Somatic tools, or body-based practices, offer one way to work with these experiences. Techniques involving breathing, movement, sensory awareness, and comforting physical sensations may help some individuals manage distress and reconnect with the present moment. Research on slow breathing and relaxation training suggests that certain body-based approaches can reduce anxiety and influence physiological arousal, although individual responses vary (Manzoni et al., 2008; Zaccaro et al., 2018).
Understanding the Somatic Approach
Somatic approaches recognize that psychological experiences are closely connected with bodily sensations and physiological responses. Stress and trauma can influence muscle tension, breathing, sleep, autonomic activity, and awareness of internal bodily sensations. Although people sometimes describe trauma as being “stored in the body,” this expression is better understood as a metaphor for the lasting physiological and emotional effects of traumatic experiences rather than a literal description of how memories are stored.
When distress makes cognitive strategies difficult to access, body-based practices may provide an alternative starting point. By gently attending to breathing, movement, or physical sensations, individuals may find opportunities to reduce distress and regain a sense of stability. These practices can complement cognitive and other evidence-based psychotherapies rather than replace them.
Somatic Tools for Regulating the Nervous System
The following body-based practices may help individuals manage physiological arousal, increase present-moment awareness, and respond more flexibly to emotional distress. Their effectiveness varies, and no single technique is appropriate for everyone.
1. Grounding Techniques
Grounding practices direct attention toward the present environment or physical sensations. Some individuals find them helpful when experiencing anxiety, emotional overwhelm, or feelings of disconnection.
5-4-3-2-1 Sensory Awareness: Identify five things you can see, four things you can touch, three things you can hear, two things you can smell, and one thing you can taste.
Feet on the Floor: Pressing the feet firmly against the ground and noticing sensations helps anchor the body in the present.
Holding an Object: Holding a weighted or textured object, such as a stone or piece of fabric, can offer a tangible focus point.
2. Breathwork for Regulation
Breathing practices can influence autonomic activity and may help reduce physiological arousal. A systematic review found that slow breathing was associated with changes in heart-rate variability and improvements in several measures of psychological well-being, although the underlying mechanisms remain under investigation (Zaccaro et al., 2018).
Box Breathing: Gently inhale for four counts, pause for four counts, exhale for four counts, and pause for four counts. Shorten or omit the pauses if breath-holding feels uncomfortable.
Extended Exhale Breathing: Inhale comfortably for approximately four counts and exhale for approximately six counts. Adjust the rhythm to avoid strain, dizziness, or air hunger.
Belly Breathing: Place a hand on the abdomen and notice its natural movement while breathing slowly and comfortably. Avoid forcing unusually deep breaths.
Breathing exercises should feel manageable rather than forced. Some individuals, particularly those experiencing panic symptoms or trauma-related distress, may find deliberate attention to breathing uncomfortable. If this occurs, return to natural breathing or choose another grounding practice.
3. Movement-Based Techniques
Gentle movement can provide an opportunity to notice bodily sensations, reduce muscle tension, and redirect attention toward the present moment. Movement-based relaxation practices may help manage anxiety, although their effects depend on the specific technique and individual circumstances (Manzoni et al., 2008).
Shaking: Gently shaking the hands, arms, or legs may provide a way to release muscular tension or redirect attention toward movement. However, there is insufficient evidence that shaking literally discharges adrenaline or resets the nervous system.
Somatic Stretching: Slow, comfortable stretching can encourage awareness of bodily position and sensations while potentially reducing muscle tension.
Walking or Rocking: Gentle rhythmic movement, such as walking or rocking in a chair, may provide a comforting sensory experience and help some individuals manage distress.
4. Vagus Nerve and Autonomic Regulation
The vagus nerve contributes to the regulation of heart rate, digestion, and other autonomic functions. Some activities involving breathing, vocalization, or temperature changes may influence physiological arousal. However, it is important to distinguish established autonomic mechanisms from popular claims that particular exercises directly stimulate the vagus nerve or reliably produce relaxation (Panneton, 2013; Zaccaro et al., 2018).
Humming or Chanting: Gentle vocalization may provide a rhythmic focus and encourage comfortable breathing. Although some people find these activities relaxing, evidence that ordinary humming directly produces clinically meaningful vagal stimulation remains limited.
Gargling Water: Gargling may offer a sensory experience that some individuals find grounding. However, it has not been established as a reliable therapeutic method of stimulating the vagus nerve or regulating emotional distress.
Cold Water Splashing: Brief facial cooling may elicit aspects of the mammalian dive response, which involves both sympathetic and parasympathetic activity (Panneton, 2013). Because cold exposure can affect cardiovascular functioning, individuals with heart conditions, arrhythmias, or other medical concerns should seek appropriate medical guidance before attempting techniques intended to activate this reflex.
5. Touch and Self-Soothing Practices
Comfortable touch and gentle pressure may provide reassuring sensory experiences. Some individuals find these practices calming, although responses depend on personal preferences, sensory sensitivities, and trauma history.
Havening-Style Self-Touch: Gently stroking the upper arms or hands may feel comforting to some individuals. However, the specific therapeutic mechanisms and clinical effectiveness claimed for the proprietary Havening Techniques have not been established by the evidence reviewed here.
Weighted Blanket or Pressure Stimulation: A comfortably weighted blanket or gentle self-hug may provide a soothing sensation. A systematic review and meta-analysis found modest reductions in anxiety associated with weighted blankets, although the studies were relatively small and had methodological limitations (Zhao et al., 2024). Use only a weight that allows comfortable breathing and unrestricted movement.
Hand Over Heart: Placing a hand over the chest while breathing comfortably may encourage self-soothing and awareness of physical sensations. This practice should be understood as an optional grounding exercise rather than a proven method of activating a specific nervous-system response.
Integrating Somatic Tools into Daily Life
Somatic practices can be incorporated into daily routines as optional strategies for managing stress and increasing awareness of bodily sensations. Practicing when relatively calm may help individuals become familiar with techniques they can draw upon during more challenging moments.
However, consistency does not guarantee improved nervous-system regulation, and the evidence varies across individual practices. These tools may be most helpful when selected according to personal preferences, medical considerations, and therapeutic goals. They can complement cognitive approaches and other established treatments for anxiety, depression, and trauma-related concerns.
Conclusion
Stress, anxiety, depression, and trauma-related experiences can affect both psychological functioning and bodily sensations. For some individuals, body-based practices may complement cognitive strategies by providing opportunities to manage physiological arousal, increase present-moment awareness, and experience greater physical comfort.
Research supports certain approaches, including slow breathing and relaxation training, while evidence for other commonly recommended somatic practices remains preliminary or limited (Manzoni et al., 2008; Zaccaro et al., 2018). The goal is not to force the body into a particular state but to develop a flexible range of coping strategies that respect individual needs, preferences, and boundaries.
References
Manzoni, G. M., Pagnini, F., Castelnuovo, G., & Molinari, E. (2008). Relaxation training for anxiety: A ten-years systematic review with meta-analysis. BMC Psychiatry, 8, Article 41. https://doi.org/10.1186/1471-244X-8-41
Panneton, W. M. (2013). The mammalian diving response: An enigmatic reflex to preserve life? Physiology, 28(5), 284–297. https://doi.org/10.1152/physiol.00020.2013
Zaccaro, A., Piarulli, A., Laurino, M., Garbella, E., Menicucci, D., Neri, B., & Gemignani, A. (2018). How breath-control can change your life: A systematic review on psycho-physiological correlates of slow breathing. Frontiers in Human Neuroscience, 12, Article 353. https://doi.org/10.3389/fnhum.2018.00353
Zhao, Y., Zhang, Q., Liu, Z., Zhao, Z., & Zhu, Q. (2024). Safety and effectiveness of weighted blankets for symptom management in patients with mental disorders: A systematic review and meta-analysis of randomized controlled trials. Complementary Therapies in Medicine, 87, Article 103104. https://doi.org/10.1016/j.ctim.2024.103104
