Rasika Karkare 
When most people think of therapy, they imagine a person sitting in a therapist's office talking one-on-one about their issues. While individual psychotherapy is well known, there are many other modalities of therapy that cater to different needs, identities, and experiences. This article explores three such approaches — somatic therapy, group therapy, and queer affirmative therapy — each offering a unique pathway to healing and growth.
What are Somatic Symptoms and Somatic Therapy?
The term 'somatic' comes from the Greek word soma, which means 'body'. Thus, somatic symptoms are those which are related to the body. Somatic symptoms can thus properly be defined as 'symptoms involving physical problems and/or concerns about medical symptoms.' Somatic symptoms can cause a lot of discomfort, leading to an overall reduction in one's quality of life. Hence, it is important to address somatic symptoms at the earliest.
Some examples of somatic symptoms are:
- Pain: this includes areas such as the chest, arms, legs, back, and abdomen.
- Neurological symptoms such as headaches, weakness, dizziness, and fainting.
- Digestive symptoms such as abdominal pain or bowel problems, diarrhoea, incontinence, and constipation.
- Sexual symptoms such as pain during sexual activity or painful periods.
Somatic symptoms can become a disorder when they interfere with your ability to live a normal daily life.
What causes Somatic Symptoms?
Somatic symptoms can be caused by several different factors, such as:
Genetic and biological factors, such as an increased sensitivity to pain
Family influence, which may be genetic or environmental, or both
Personality trait of negativity, which can impact how you identify and perceive illness and bodily symptoms
Decreased awareness of or problems processing emotions, causing physical symptoms to become the focus rather than the emotional issues
Learned behavior — for example, the attention or other benefits gained from having an illness; or "pain behaviours" in response to symptoms, such as excessive avoidance of activity, which can increase your level of disability
What is Somatic Therapy?
Somatic therapy is a type of body-centred therapy. This kind of therapy looks at the connection of the mind and body and uses both psychotherapy and physical therapies for holistic healing. Thus, it is unlike other standard types of therapies, such as CBT, which only focuses on the mind.
In addition to talk therapy, somatic therapy practitioners use mind-body exercises and other physical techniques to help release the pent-up tension that is negatively affecting your physical and emotional well-being. Apart from this, somatic therapy can also help people build a better mind-body connection, which can help them form positive habits, while also helping them improve their overall resilience.
Examples of somatic therapy include: breath work, meditation, visualization, massage, grounding, dance, and/or sensation awareness work, vocal work, Body-mind centring, Kinetic awareness, ayurveda, yoga, postural integration, reiki massage, acupressure.
When is Somatic Therapy used?
Somatic therapy can be used in both individual as well as group therapy settings. This type of therapy can be used to help address both physical and psychological symptoms of certain mental health issues, including:
- Stress
- Anxiety
- Grief
- Depression
- Addiction
- Trauma and abuse
- Problems with relationships
- Sexual function
NOTE: It is, however, important to note that you are in control of your experience with somatic therapy. Before you start working with a somatic therapist, you can speak with them about what techniques and approaches they like to use to see if you're a good fit. As for how these techniques work, they all have one thing in common, which is that they require you to connect with your body.
Somatic symptoms are a reminder of the deep relationship shared by our mind and body. The basic idea of somatic therapy is that resolving physical symptoms can help enhance mental and emotional well-being as well. Thus, somatic therapy can be an effective option for those who want to establish a healthy mind-body connection and are looking for something different as compared to regular talk therapy.
What is Group Therapy? How Does It Help?
While somatic therapy focuses on the individual mind-body connection, therapy can also be conducted in groups. In fact, group therapy is a well-researched form of treatment for various mental health issues.
Understanding Group Therapy
In simple terms, group therapy is a form of talk therapy where one or more therapists work with a small group of people. The size of the group can be anywhere between 5 and 15 members. The group is generally smaller, so each member of the group gets equal time and opportunity to speak. Some groups allow members to join at any time; they are called open groups, while other groups do not allow new members to join once the group sessions have started, they are closed groups.
What Happens In Group Therapy?
Like individual therapy, group therapy is held in a safe and confidential environment. The group therapist also helps members set goals that they wish to achieve through the group therapy process. The group sessions usually focus on a particular subject, behaviour, or condition like substance misuse, depression, anger management, chronic pain, social anxiety, grief, or low self-esteem. People in the group share their experiences related to that topic, while the therapist facilitates the group discussions.
The group usually meets once a week and the length of sessions varies from 1 to 2 hours, depending on the therapist, the participants and the issues being addressed. Some clients choose to attend only group therapy, while others attend group therapy along with individual sessions.
How Does Group Therapy Help?
Group therapy can be beneficial for multiple reasons. Research suggests that group therapy can be effective in the treatment of various mental health conditions, such as anxiety, depression, Obsessive Compulsive Disorders (OCD), etc. Sometimes group therapy is as effective as individual therapy. Some other benefits of group therapy are:
It Provides A Safe Space
Like individual therapy, group therapy also works on the ethical principle of confidentiality. The therapist works with other members to create a non-judgemental environment within the group so that each member feels free to express themselves.
Self-Awareness
Group therapy is not only a place for interactions. But it can also contribute to increased self-awareness. Sharing your struggles and listening to others can help you reflect and gain insights into your own life, leading to personal growth.
Sense of Hope
This is one of the most important benefits of group therapy. The journey of healing can seem overwhelming and lonely, but joining a therapy group allows you to interact with others going through similar issues, which might reduce feelings of loneliness in recovery. When you see other group members making progress, it might also create a sense of hope and motivate you towards progress.
Shared Learning
Group therapy allows members to interact with others who are going through similar issues. Because everyone is going through similar struggles, group members can come together to find effective coping mechanisms and even learn from each other's experiences, leading to a shared learning experience.
Development of Social Skills
Groups require interactions from members. Thus, regular interaction with group members can help in the development of social skills such as effective communication, boundary setting, conflict resolution, etc. These skills are useful in other domains of life as well.
Group therapy is an effective form of treatment, as it not only offers the benefits of individual therapy, such as confidentiality and a safe space but also creates a collective environment where group members feel supported by each other. It also reduces feelings of loneliness and contributes to the development of self-awareness and social skills.
What is Queer (LGBTQIA+) Affirmative Therapy?
Just as group therapy creates a supportive collective space, certain modalities of therapy are designed to address the unique experiences of specific communities. We live in a heteronormative society where heterosexual relationships are considered a cultural norm, thus individuals who identify as LGBTQIA+ face consistent discrimination and marginalization. Living in an environment of stigma and discrimination often causes harm to the sense of self of a queer individual. All these stressors have a significant impact on their mental health. Queer Affirmative Therapy focuses on accepting and affirming the client's identity and sexual orientation.
Why is Queer Affirmative Therapy Needed?
Many people in India find it hard to come out of the closet and live according to their choice, due to the fear of non-acceptance and rejection. This makes it difficult for individuals from the community to find a safe space for themselves. Queer affirmative therapy helps them to open up to a therapist who not only understands their situation but also makes them feel accepted for who they are and who they want to be.
Queer Affirmative Therapy is a practice that holds a positive view of Lesbian, Gay, Transgender, and Queer persons, their identities, and their relationships. It also focuses on helping individuals to accept their uniqueness. Additionally, it can also address the impact of heteronormativity, transphobia, and homophobia on the people identifying themselves as a part of the community. Queer Affirmative Therapy also recognizes and addresses the intersection of power and privilege that exists across different social identities, which makes the therapy approach more inclusive.
Affirmative therapy focuses on validating the client's unique experiences of clients through verbal and nonverbal techniques. It also helps individuals to work on their fears and practice activities that encourage self-acceptance.
What does Affirmative Therapy look like?
Affirmative therapy begins even before the first session begins as an affirmative therapist is mindful of the therapy space, be it online or in-person. The therapist ensures that the therapy environment is welcoming and free of any signs or symbols that make the client uncomfortable. They declare their pronouns and ask for the client's pronouns too. They try to create a sense of safety in those 50 minutes to open up regarding vulnerable parts of their lives.
A Queer Affirmative Therapist is sensitive to how heteronormativity leads to unique stressors such as social isolation, discrimination and erasure in the life of a queer individual which harms their mental health. They focus on building trust by using inclusive language, reflecting and validating what the client says about themselves, their identity, and their experience.
Is being Queer Affirmative the same as being Queer Friendly?
The terms 'Queer-Affirmative' and 'Queer Friendly' are almost used interchangeably, but they can have very different meanings. A queer-friendly therapist may be accepting and non-discriminatory towards queer individuals, but they may not have the knowledge and expertise to support queer clients.
A queer affirmative therapist goes beyond acceptance and takes an active stance in supporting and empowering their clients. A queer affirmative therapist is self-reflective and actively works to deconstruct their own beliefs about the influence of cis-genderism and heterosexism in therapy, while also advocating for LGBTQIA+ communities outside the mental health system. They keep expanding their knowledge of Queer affirmative therapy through continued training and regular interactions with queer persons.
How to find a Queer Affirmative Therapist?
Although there are no objective measures to say if a therapist is Queer-Affirmative, there are a few ways to determine if a therapist is Queer Affirmative. They are:
- The therapist is certified and trained to practice Queer-Affirmative Therapy
- Have an open discussion with the therapist to check if they practice Queer Affirmative Therapy
- Most queer affirmative therapists mention that they are queer affirmative on social media platforms and websites. This is because they realise that it is very difficult for marginalised communities to find safe space and doing so makes therapy more accessible for their clients.
Conclusion
Therapy is not a one-size-fits-all process. Whether through somatic approaches that connect the mind and body, group therapy that fosters shared healing and learning, or queer affirmative therapy that creates a space of acceptance and empowerment, each modality offers unique pathways to well-being. One of the aims of therapy is to make every individual feel safe and free to express all aspects of themselves. While homosexuality has been decriminalized in India, individuals identifying as LGBTQIA+ still struggle with a lot of challenges, when it comes to gaining acceptance in the current society. Queer Affirmative Therapy aims at providing them with a safe space where they are not only heard but also accepted and seen for who they are. Exploring different therapy modalities can help you find the approach that best aligns with your needs, identity, and journey toward healing.
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