What is Somatic Tracking

Somatic Tracking is the primary therapeutic technique in Pain Reprocessing Therapy. It can be an effective tool for reducing nociplastic pain. It is a brain retraining technique that can be used with other therapeutic techniques. There are ways to increase its effectiveness and barriers that can get in the way.

What is Somatic Tracking?

Somatic Tracking is the primary technique in Pain Reprocessing Therapy (PRT). It is a brain retraining technique, so it needs practice to be effective. The purpose of somatic tracking is to change your relationship with your pain or other nociplastic symptoms. It has three main components: Mindfulness, Safety Reappraisal, and Positive Affect Induction.

What is the Purpose of Somatic Tracking?

Somatic Tracking is meant to bring more safety to your nervous system, correct misinterpretations that your brain has made, and start reducing the level of threat within your nervous system. By reducing the fear/danger/threat that your nervous system perceives and increasing the safety perceived, you can reduce your pain levels and your ability to cope with the pain.

Why Should You Do Somatic Tracking

Somatic Tracking is effective for nociplastic pain or the nociplastic component of mixed pain. It can reduce or eliminate nociplastic pain. It uses neuroplasticity to create changes in the brain (brain retraining), away from the fear associated with pain, while incorporating a sense of safety and understanding.

Neuroplasticity

Neuroplasticity is the brain’s ability to adapt and change in response to internal and external stimuli. It enables the brain to create new neural connections and alter the strength of existing ones. The following video does a good job of describing neuroplasticity:

Somatic tracking uses neuroplasticity to strengthen or write new neural networks around feelings of safety. It can help to rewrite our brain’s associations with pain and what causes it. We can use somatic tracking to reduce the amount of danger our nervous system perceives with different activities and behaviours to reduce or eliminate pain. By altering the neural networks in our brains towards safety and away from danger, fear, and threat, we can reduce the alarm of pain that it sends out for our attention.

Pain is an Output

Contrary to some people’s beliefs, pain is an output of the brain. You feel pain because the body interprets signals from different receptors as dangerous. Hence, the body sets off the alarm, which is pain in our bodies. When you have a paper cut, the pain you feel is due to signals sent to the brain by the damaged nociceptors in your skin, and the brain interprets that those signals show danger or threat. It’s good when the pain system works properly because we stop doing things that are likely to damage our bodies. Unfortunately, when the pain system is not operating properly, we can experience pain based on misinterpretations or extra sensitivity.

You feel pain because the brain has interpreted the signals coming from your body as something dangerous or that there is a threat somewhere. It can also be because it hasn’t received information that everything is fine now, so the alarm is no longer needed. This is why mirror therapy works for phantom limb pain. Pain is the result of the brain’s interpretation based on the data it has. Suppose you can change your brain’s interpretation of the sensations or lack of sensations, triggering the brain’s pain reaction. In that case, you can reduce or eliminate your pain. We are doing this with somatic tracking, retraining your brain to interpret the signals differently so it doesn’t trigger pain anymore.

Will Somatic Tracking Work for You?

Somatic tracking works for a variety of conditions and may work for you. It can be effective, although there are times when troubleshooting is necessary, and barriers need to be addressed.

How Do You Do Somatic Tracking?

Somatic Tracking has three main components: Mindfulness, Safety Reappraisal, and Positive Affect Induction.

Mindfulness

The first component of Somatic Tracking is Mindfulness. Mindfulness has many benefits for chronic pain and is relatively simple to learn. Although some people may struggle with it at first, there are usually ways to overcome the difficulties with mindfulness.

Benefits of Mindfulness for Chronic Pain

Mindfulness has several benefits for Chronic Pain:

• Mindfulness increases feelings of safety by deactivating the brain’s fear circuits.
• Regular mindfulness practice can help to reduce a person’s pain experience
• Brain images of mindfulness participants had less activation in the parts of their brains that manage pain messages
• Help people to focus their mind and body in the moment without judgment
• Enables people living with chronic pain to manage negative or worrisome thoughts about their pain.
• Being able to focus on noticing the breath and body sensations as being there just as they are, can help manage pain, as well as reduce depression and anxiety symptoms.
• Reduced rumination, stress, and emotional reactivity
• Better focus, cognitive flexibility, and working memory.
• Improved fear modulation, which is the ability to adjust your fear levels.

Components of Mindfulness

• Observe – Notice your body sensations and what is coming through your senses (vision, hearing, smell, touch, and taste). Don’t cling to anything, but observe and let it be.
• Describe – Put words to what you observe. Describe the “who, what, when, and where” of what you are observing. Acknowledge the thoughts and feelings that come up and let them pass. For example, the thought “I can’t do this” has shown up.
• Participate – become one with whatever you are doing and throw your attention into the moment. Go with the flow of what is coming up for you.
• Nonjudgmentally – Observe, but don’t evaluate as good or bad. Acknowledge that difference between the helpful and harmful, the danger and safety, but don’t judge them.
• One-Mindfully – Be completely in the present moment. Focus on whatever you are doing and let go of distractions. If your mind wanders, gently bring it back to the task at hand.
• Effectively – Be mindful of your goals in the situation and do what is necessary to achieve them. Focus on what works and act as skillfully as you can in the situation you are in.

Mindfully Tracking Sensations

When you track sensations, you apply mindfulness to your pain. Usually, this focus is on several aspects, including the sensation’s location, quality, and intensity. Your descriptions can include metaphors, imagery, or other ways of representing what you are feeling.

Location

• Widespread or localized
• Left side, right side, or both sides
• Part of the body (hip, leg, hand, arms, etc.)
• Stays in one spot or moving around (straight, erratic, circular)

Quality

• Throbbing, piercing, stabbing, stinging, burning, shooting
• Knotted, cramping, spasming, vibrating, prickly
• Tingling, numb, blank, empty
• Warm, hot, cool, cold, icy, frozen, burning, pleasant, cozy, comfortable
• Light, heavy, uplifting, pulling in, sinking, drowning
• Constricting, protective, inflamed, solid, dense, supportive, compressed

Intensity

• mild, moderate, severe
• dull, intense
• intermittent, pulsing, or continuous
• delicate, damaged, hearty, coarse

Examples of the Mindfulness Component of Somatic Tracking

Here are a few examples of the mindfulness component of somatic tracking:

• I feel a sharp pain shooting down the inside of my left thigh; it is not moving but fairly intense.
• I have a dull, aching pain in my left shoulder. It’s a steady and moderate ache.
• I have a sharp, piercing pain running down my right leg. It’s intense, and there’s also tingling in the area.

Mindfulness Summary

The mindfulness component lets your brain know you are aware of your body’s sensations, reducing fear because you are not reacting to your pain with fear. It can be challenging to be authentically mindful when paying attention to something that feels like a threat or something inherently dangerous.

Safety Reappraisal

Safety reappraisal is the second component of Somatic Tracking and enhances the safety created by the mindfulness component. In this component, you reduce the threat level by correcting possible misinterpretations by the brain and sending safety messages to your brain to reassure it that you are safe and no harm will come from what you are doing.

Building Off the Evidence Indicating Nociplastic Pain

These questions can help you determine whether your pain is nociplastic and doesn’t represent a structural problem. You can also create corrective statements to convince your nervous system that the pain is unnecessary.

• Did your pain originate during a time of stress, or did it become significantly worse during a time of stress?
• Did your pain originate without injury?
• Was there a time when your pain significantly worsened?
• Are your symptoms worse for certain times of the day (first thing in the morning, middle of night, etc.) or the day of the week (weekend vs. weekday)?
• Do you experience worse pain after certain activities (not delayed onset muscle soreness) but not during?
• Does your pain disappear when you engage in joyful or distracting activities? Does your pain occur when you think about it or when someone asks about it?
• Do you have a large number of symptoms?
• Do your symptoms spread or move?
• Are your symptoms triggered by stress (get worse when you are stressed, when anticipating a stressful situation, or when thinking about a stressful situation)?
• Are some of the triggers for your symptoms have nothing to do with your body (such as trauma triggers, temperature, weather changes, etc.)?
• Does your pain not make sense functionally (pain patterns don’t follow muscles, bones, nerves, and connective tissue)?
• Do you have symmetrical symptoms (same symptoms on both sides of the body)?
• Are your symptoms triggered by light touch or other stimuli that would not normally cause pain?
• Are there times you can do the same activity without pain or less pain?
• Does your pain worsen when you feel certain emotions or deal with certain situations?

With the statements based on these questions, you are reassuring your brain that what is going on in your body is fine and there is no reason to be alarmed. This evidence is important so you and your nervous system can believe the safety reappraisal. It allows you to be authentic when communicating safety to your nervous system.

Creating Safety that Applies to Your Condition or Pain Disorder

Creating safety requires reassuring your nervous system and letting it know that you are safe and will not do any damage. For your nervous system to believe the safety messages, they must make sense according to your pain condition and what is happening in your body. Some examples may include:

• Telling your body that you have done this before without damage, you have done something similar, and nothing happened, or you have done the same thing at a different intensity, and it was fine. There is nothing to worry about. What I am doing is safe.
• Telling your body that there is nothing wrong with your body (only do this if there are no significant structural problems).
• Reassuring your brain that the sensations in your body are safe.

Talk to your brain in soothing and reassuring ways. For example, you may speak to it like a child or a pet scared of a thunderstorm. Your nervous system sees danger and threats where there are none and needs to feel safer. Your primitive brain needs authentic feelings of love, care, and safety.

Examples of Safety Reappraisals:

Here are a few examples of the safety reappraisal component of somatic tracking:

• I am safe right now. Nothing I am doing is causing harm.
• While exercising: I have done this before without harm coming to me. It may be slightly more intense, but I am safe. It just feels a little different.
• When dealing with a trauma trigger that is triggering pain, I am safe. My past trauma is being triggered, but I am in no danger right now. The danger is in the past. I am safe where I am in the present.

Positive Affect Induction

Positive Affect Induction is the third and final component of Somatic Tracking. It involves instilling a calmer and more relaxed state that will increase a sense of safety within the nervous system and reduce feelings of fear. You may achieve this through imagery, gentle curiosity, stories, humour, or techniques from other modalities that help relax you. The focus here is getting you or keeping you in a calmer and more relaxed state, which may differ depending on whether it is self-led or professional-led.

A guide and worksheet are available at the bottom of this blog.

When Should You Not Do Somatic Tracking

If the threat level that your nervous system is experiencing is too high, you are more likely to do harm than good. Different people can tolerate different pain levels (some have become used to higher pain levels). Suppose your distress level is above a 5 on a 0-10 scale (with 0 being neutral and 10 being the worst you can imagine). In that case, you should probably not do somatic tracking. This doesn’t mean you won’t be able to do somatic tracking, but you might need to use tools and techniques before to reduce your distress. Some EMDR resourcing skills (Safe place, container, circle of love), DBT distress tolerance (self-soothing, improve the moment), DBT emotion regulation (check the facts), somatic techniques (soothing touch, polyvagal), and self-compassion/mindfulness skills may be able to help you in this area.

Remember that for somatic tracking to work, your nervous system needs to be able to either learn or believe the safety messages that you are communicating to it. Suppose you are telling it that you are safe, but your nervous system senses way more danger than safety. In that case, you will likely do more harm than good because you may be teaching your nervous system that you can’t be trusted. This is why it is so important to pay attention to your threat and safety levels before you start somatic tracking. If you are struggling to get your nervous system to a less distressed state or need more guidance, consider seeing a therapist experienced in Pain Reprocessing Therapy.

What Are Some of the Barriers to Somatic Tracking Being Effective?

Sometimes, you don’t realize that you are engaging in behaviours or having experiences that are holding onto the pain. The following are a few barriers that may be keeping somatic tracking from being effective.

Pressure/Intensity

Your nervous system can interpret pressure and intensity as threatening, so the more intensely you do Somatic Tracking, the less effective it is. This can be hard for those who are worried about doing it right or focused intensely on what they are doing because those worries can make it less effective.

Unprocessed Trauma

Unprocessed trauma can hold onto pain. Things that would otherwise be safe could be interpreted as threatening due to trauma. Sometimes, trauma needs to be processed and integrated for somatic tracking to work. Some trauma therapies include EMDR, Flash Technique, Somatic Experiencing or other somatic therapies, and Cognitive Processing Therapy.

Suppressed Emotion/Memories

Suppressed emotions and memories can hold pain, and in order to release the pain, you need to release the emotions. This can be done through various types of emotion work (Emotional Awareness and Expression Therapy, AEDP) or EMDR.

Certain Core Beliefs

Core beliefs are deeply held beliefs that inform how people see themselves and the world. They have a significant influence on people’s perceptions and decision-making. They can come from what we learned as we grew up, trauma or what we learned due to our life experiences. Patterns of intensity, not being good enough, perfectionism, and having to be in control are due to various core beliefs. Core beliefs can be positive, negative, or neutral. Some core beliefs can interfere with somatic tracking, while others can enhance somatic tracking. Fortunately, core beliefs can be changed.

Some therapies that can be effective for changing core beliefs include Cognitive Behaviour Therapy (CBT), Dialectical Behaviour Therapy (DBT), EMDR, Schema Therapy, and Acceptance Commitment Therapy.

Conclusion

Somatic tracking can be an effective brain retraining tool for nociplastic pain. You can personalize it to increase its effectiveness. There are also barriers that you may have to troubleshoot and address to improve the effectiveness of this excellent resource for reducing or eliminating nociplastic pain.