Somatic Experiencing: A Path to Healing from Long COVID

The term Long COVID is a syndrome that refers to the myriad of symptoms that continue or develop after the initial infection by SARS COV-2 (COVID-19) resolves.  When symptoms last for more than 3 months after the initial infection, then it is generally considered Long COVID. For many who experience Long COVID, these symptoms have lasted years.  While there are over 200 recognized symptoms under the umbrella of Long COVID, some of these symptoms can be severely disabling to include crushing fatigue and bewildering brain fog and cognitive dysfunction.  Understanding the reasons behind which some people develop this post-infectious syndrome has been confusing. Even more confusing to those who experience Long COVID, is that the initial infection that resulted in such disability was often mild or even asymptomatic. 

Long COVID is a complex condition with likely a variety of underlying dysfunctions that vary from person-to-person. In other words, Long COVID could be a different disease syndrome between people; similarly the effects vary greatly from person-to-person. While there has been significant attention to this new disease entity and researchers and clinicians alike are finding out more and more about the underlying pathophysiology and how to potentially help people improve their lives, there is still much that isn’t known, and even five years on, tthere aren’t many effective treatments.  Now, as the US government endeavors towards fiscal efficiency, governmental support towards Long COVID research will likely be reduced and may be thwarted.  Previously young, healthy people have now been disabled for years. Looking towards doctors and the medical system for answers on how to regain their lives and navigate this confusion, feels somewhat of a moral injury. 

I am a medical doctor trained in Internal Medicine and Infectious Diseases. During my Infectious Disease fellowship, I began to experience a post-infectious syndrome from having been reinfected with a parasite while working in Malawi.  What I experienced was truly disorienting and bewildering to me and clinically has many overlaps with what those with Long COVID experience. While I'm fully recovered now, the road to healing was bumpy.   

During the COVID-19 pandemic, I began my training as a Somatic Experiencing Practitioner which is typically a 3 year endeavor. Somatic Experiencing is a body based modality that aims to regulate the autonomic nervous system and to resolve the effects of traumatic experiences and chronic stress on the body.  Effectively, Somatic Experiencing navigates to the emergence of more capacity physically, physiologically, and emotionally.  During these years, I myself received Somatic Experiencing nearly weekly. It’s through my own experience of SE that I intimately understood the improvements on my own body’s emotional, physical, and physiological health.  I could too clearly appreciate how the impact of my own life’s events directly impacted my body’s reaction to the parasite that I had been infected with and the subsequent dysfunctional cascade which led to the development of disease. The training and my own experience of SE opened an entirely new perspective on the body, human experience, physiology, and how disease manifests.  Understanding human disease is often like a puzzle and the perspective learned through SE is a key piece in that endeavor. 

And as I gained a deeper feel of this perspective, Long COVID emerged and I was clinically observing the unfolding of this new post-infectious syndrome.   I’ve used these three perspectives of medical knowledge, the lens that Somatic Experiencing provides for me, and the knowledge gained from healing from a post-infectious disease state that is similar to what people with Long COVID experienced to synthesize what may supportive towards improving regulation and more functional capacity and decreased symptoms.   

I've observed that SE techniques can be incredibly valuable in helping people recover from and manage Long COVID symptoms.

Simply, my approach is to improve regulation and support the emergence of capacity in the body.

How Somatic Experiencing Can Help:

Long COVID’s effects on people’s bodies and experiences in the world  are supported in many ways by the techniques of Somatic Experiencing.  Below is a list of symptoms and disruptions that people with Long COVID have. I’ve used SE to address these symptoms directly with patients. I fully acknowledge that I cannot yet prove these explanations yet this is my experience clinically.  It is a goal of mine to be able to demonstrate both clinically and physiologically how the techniques of Somatic Experiencing can be supportive and therapeutic in healing from Long COVID.

The sessions that I provide specifically incorporate touch in an intentional way; this touch is nuanced to respond to the individual while I also aim to address some of the more global ways touch is helpful for most people with Long COVID.

• Autonomic Nervous System Regulation: Long COVID can cause the autonomic nervous system to become imbalanced often termed dysautonomia. This can result in a variety of symptoms including Postural Orthostatic Tachycardia Syndrome or POTS. Somatic Experiencing techniques work to help bring in regulation into the autonomic nervous system. 

• Addressing "Freeze" States: Many with Long COVID experience a "freeze" state in their nervous system which can contribute to or exacerbate the symptoms of  brain fog and fatigue. SE techniques work to release this freeze state or shut-down/collapse state and helps to restore energy and clarity.

• Managing Overwhelm: SE works to address directly the feelings of overwhelm. There are many factors that contribute to feeling overwhelmed when having Long COVID; SE is beneficial to reducing the feelings of overwhelm that is common with Long COVID, allowing individuals to feel more grounded and in control.

• Reducing Body-Based Anxiety: Long COVID can increase anxiety, often felt physically. SE, including touch and myofascial release, can alleviate these symptoms and improve tissue coherence. Many with Long COVID experience anxiety significantly more or differently than they had prior to Long COVID; it seems that this is in-part mediated by inflammation and underlying disruptions of COVID rather than simply being an emotional reaction.  The anxiety is a Side Effect. People feel it in their bodies quite differently than they had previously. 

• Expanding the Window of Tolerance: People with Long COVID often have a very narrow "window of tolerance," meaning they are highly sensitive to various stimuli (food, emotions, exertion, etc.). SE helps to expand this window, making daily life more manageable and reducing symptom triggers.

• Post-Exertional Malaise & associated the associated fear: The fear of "crashing" after exertion is common in those with Long COVID. Crashes can occur after simple tasks or exertion, be them emotional, physical or cognitive exertion.  This can leave people bedbound for hours to days unable to do much of anything while awaiting their bodies to come out of the crash. The crashes themselves are overwhelming.  Through SE, people are better able to feel their limits beyond which they may crash, manage this fear, and prevent crashes. It also helps them to maintain more confidence as they increase their functional capacity.

• Reconnecting with the Body: SE helps people reconnect with their bodies and regain a sense of safety and trust in their physical experience.

• Navigating New Symptoms: New and unfamiliar symptoms can be frightening. SE cultivates curiosity and the capacity to experience these symptoms without panic, reducing hypervigilance.

• Addressing Viral (other pathogen) Reactivation: For many, Long COVID may involve the reactivation of dormant viruses and possibly the reactivation of other latent pathogens. It has been measured and observed that certain viruses reactivated during COVID-19 infection as well as in the Long COVID state. I’ve observed that especially for some of these infections, like Epstein Barr Virus which causes Mononucleosis, many individuals have had reactions around these previous infections.  And thus when they are reactivating, the body’s state dependent response to the reactions could also be brought in.  I’ve used SE to help rework the charge around the points of previous infections which could potentially help improve immune function and how the immune system is able to manage or control these infections moving forward.

• Gut Health: SE can improve gut symptoms and potentially support a healthier gut microbiome by regulating the nervous system including the enteric nervous system (or gut nervous system). While many have an increased awareness of how the health of the microbiome influences our health, it’s less often appreciated how too the enteric nervous system can influence the health of the microbiome. 

• Healing from the Trauma of Illness: Having a chronic, invisible illness like Long COVID can be deeply traumatic. SE provides tools to process this trauma, addressing feelings of confusion, rejection, and unsafety.

• The COVID-19 infection as a traumatic experience: The state of the body at the time of infection or reinfection is important to understanding how the immune system is able to recognize and to respond to the pathogen itself. For most who go onto develop Long COVID, there were already overwhelming experiences in their lives at the time of infection.  And also, many had to “push-through” when they were infected which essentially over-rode the bodies capacity to rest and address the infection itself.  It’s been observed that with increasing subsequent infections that the risk for Long COVID or symptomatology worsens. This makes sense viewing the infection as a trauma- when reminded of the trauma/s, the body again has a learned memory. Working with Somatic Experiencing by taking some of the charge away of these overwhelming experiences and then working through the moments around the infection or infections itself as another traumatic experience for the body, may help to bring the immune system into better regulation and respond to the COVID-19 virus in a way that it was unable to at the actual time of infection. 

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In essence, Somatic Experiencing offers a way to:

• Bring regulation, safety, and connection back into the body.

• Increase capacity to experience and process the many new symptoms without feeling overwhelmed.

• Address the underlying nervous system dysregulation contributing to Long COVID.

• Support the immune system and overall healing.

• Support the resolution of effects of the overwhelming experience of having developed a disabling illness

This approach recognizes the complexity of Long COVID and aims to empower individuals to navigate their healing journey with greater awareness and resilience.