Show Me the Steps

October 13, 2026 · Andree Patenaude

"Anyone who is result-oriented is going to have issues with therapy."

Amit*, a successful corporate accountant, took the time to share with me exactly what he thinks about the idea of going to therapy.

I sat across from him in a quiet cafe, curious about his perspective. Like many men, he expressed the concern that therapy is like a black box you can't see into.

"My whole life is evidence-based," he said, which makes sense for someone more comfortable with spreadsheets than feelings.

He elaborated: "If I go to a doctor, my bone is broken. I know exactly what they're going to do about it. I know the outcome.

"But with therapy, my mind is fixated on the method — I don't know what it's going to look like."

I sipped my oat milk latte. I was getting the sense that he already believed that therapy helps, he just didn't know how it would help.

"I 100% agree," he said, "therapy will help me. I just don't agree, or I don't align, with the approach overall.

"It's like, I know in my head that there is a problem which I have not been able to solve, and I know the problem has been there for a long time now."

He knew that thinking it over only got him so far, and it was incredibly frustrating that the same mind who could handle high-level corporate work, manage a team, navigate a whole new country… couldn't figure out how to help himself.

"In corporate, we generally say that if you give the same input and the process is the same, your output will always be the same. So either you change your input or you change the process. That's the only time you're able to get a different output."

He shifted in his seat. "I want to have control in the process. If not control, I want it to not be a black box. I want it to be a white box — I want to see inside and know the steps we'll follow."

I smiled, because I've heard this before from several male clients — that since therapy feels so open-ended, it just doesn't feel like it could truly solve anything.

An essential mindset shift

For people who are used to practical problem solving, it can be hard to commit to a process you can't see the shape of.

So many of us have been conditioned to treat ourselves like a problem to solve, so we end up trying to diagnose the exact issue so we can fix it.

Here's the reframe: Somatic therapy is more about following clues and breadcrumbs towards more depth, rather than having the roadmap clear at the start. As we go along, it becomes clearer what your body wants us to process. Oftentimes, your mind and your body might have different ideas about what needs resolving first.

That being said, inner work can feel daunting for some people, especially if you're the kind of person who usually sees 10 steps ahead, has a roadmap and a strategy for the outcomes you want to achieve in life.

So I asked him, "What would you need to know to feel more comfortable allowing yourself to explore more deeply than what your mind already knows?"

He already knew the answer.

"It's a slow process, right?"

"The trust will come when I am sure, before we even start. Even if you tell me it's step one, step two, step three… step two billion. Even if it takes years, I'm fine with that. But my brain would say, I want to know it now."

I think he has a point here — how can you commit to something that feels so unclear?

What happens in somatic therapy?

Every person is unique, so I can't describe what everyone's process will look like. However, what I can do is share with you the landscape of somatic work, some of the skillset you'll learn, and some milestones we'll work towards as you reach towards your goals.

Caveat: I'm not going to tell you that we can lay out every step. In fact, the somatic perspective has something to teach us here: that our thinking brain doesn't always have access to the information we're seeking — the thing under the surface that would really help.

Caveat: And even if we could rationalize every step, the body and subconscious mind will probably have other ideas. Even when we know what to expect, our unconscious defence mechanisms still kick in. Even when we know the technique, we could still not connect with the person offering it.

Before the first session

We have a brief consultation, so I can understand a bit about your goals and you can learn about how I work. If I can help and it's a good fit for me, I let you know — if it's not, I point you in the right direction towards someone who can help.

We book up to three sessions so you can feel it out before you commit to a standing spot in my calendar. We can work together weekly or bi-weekly moving forward once we both feel we're headed in the right direction.

The first session

First sessions are kind of like a meet-and-greet with potential for deeper work. My goal is to get to know you, informally assess your nervous system capacity, understand a bit about your trauma responses, and what you'd like to work on. I help you to understand what to expect from our process. Some people are ready to get right into it, others want to ease in. I lead us, but we follow your pace.

The goal of our work

The goal of our work together, in short: to build your nervous system's capacity to navigate your life and process sensory information below your conscious awareness so you react less to what happened in the past. Somatic work helps you to integrate the fragmented sensory information that keeps showing up as tension patterns and coping mechanisms, like shutting down or overthinking.

Capacity means you can let emotions and stress move through you without being overwhelmed, and you can return to a baseline. Dan Siegel calls this range the window of tolerance, and trauma therapists like Pat Ogden use it to pace the work.

TLDR: Your brain and body are predicting how you'll feel based on what has happened in the past — what researcher Anil Seth calls interoceptive inference. This shows up as physical sensations: the knot in your stomach, the clench in your jaw, the pressure in your chest. Your body is reacting to old experiences as if they were still happening. Our work is helping it learn that they're over.

That's the destination. The steps below are how we get there.

The phases

The following are some phases you might experience over time as we go deeper in our process. Think of these phases like steps, except they're less of a checklist and more of an important sequence and cycle. We will return to certain phases multiple times.

Sometimes these phases show up over the course of months, but they can also all show up in one session.

Who you work with matters

The therapeutic relationship is one of the strongest predictors of how therapy goes, a finding that holds across many studies. So finding a good fit is essential. You'll know if it feels right.

As we go along, I check in with you about how our process feels, and we adjust where needed if something doesn't feel right to you.

Learn how it all works

Most of my clients like to know how things work. Me too.

As we go along, I share with you the information you need to understand what we are doing and why. I sprinkle in some science so the puzzle pieces fit more easily.

Feeling is a skill

You will learn how to work with the feelings and sensations you experience, without having to tell the whole story, without having to do it alone.

We will do practices that you can take into everyday life to navigate your emotions and stress patterns.

Each session, we will talk about what is shifting for you, what questions you have, and where we need to go next.

Making embodiment safer

Your body holds memory in the form of fragmented sensory experiences. Ulrich Lanius writes that somatic memory is an essential part of traumatic memory, much of it nonverbal and stored implicitly.

I guide you in experiential practices to reconnect with your sensations, emotions, and senses, and help you to notice how your body is bracing: the clench you feel in your jaw every time you've struggled to express yourself, or the way your shoulders creep up when you talk about something that makes you anxious.

Many people feel disconnected from their body, or uncomfortable in their own skin, and that makes sense especially if you experience chronic pain, complex trauma or have learned that your emotions are unsafe. Psychiatrist Ruth Lanius describes a brain–body disconnect as part of the lived experience of trauma. We will spend time helping you get back into connection with your body and your emotions.

Somatic processing & release

The tension in your jaw can be thought of as a body memory, a pattern that was created at some point when it was needed.

Together we explore these patterns, oscillating between things that feel good and resourceful to you, and things that feel more challenging.

I help you go to the challenging places that are hard to access alone, like shame, anger, or guilt.

And I also help you remember what the positive things feel like, too. Like freedom, or comfort, or warmth.

[Insert diagram here: "resource and challenge loop · two lobes"]

Peter Levine, who developed Somatic Experiencing, calls this back-and-forth pendulation, and working in small doses titration. Unlike exposure therapy, Somatic Experiencing doesn't require retelling the whole story.

When you are somatically processing, you may feel flashes of hot/cold, tingling, strong emotions, expansion, burping, yawning, etc.

Bringing thinking back in

The fragmented sensory experiences begin to integrate at a higher level of processing, and you are able to make new meaning from your life experiences.

We keep track together over time to know what's changing, and we celebrate your wins!

What actually happens in a session?

A lot of the time we're trying to change how we feel by thinking about it. But we can also change how we think by giving your brain new inputs, and that means working with our senses, not just our emotions. This is called working from the bottom up. The term is used in Pat Ogden's sensorimotor psychotherapy, and psychiatrist Ruth Lanius's research looks at how sensory input shapes emotion regulation and attention after trauma.

Your nervous system is essentially predictive. It's already predicting what will happen, and it can rev you up or shut you down — the two patterns psychiatrist Ruth Lanius has mapped in brain-imaging studies of trauma — before you even decide how you want to act.

That's why thinking harder doesn't always change things — in order to access our survival system, we need to get below the thought patterns. So we start with your sense of safety and survival responses.

Here's the order and why it matters in somatic work.

1. Settle the system. We build a trusting and safe enough environment for you to go deeper with yourself. This looks like learning how you think, what kinds of techniques land with you, and where you are at in your nervous system. Nothing hard happens yet.

2. Notice what your body is doing. The clench in your jaw when you've struggled to express yourself, the way your shoulders creep up when you feel anxious. We're collecting information that thinking can't get to: what tightens, where, and when.

3. Move toward it in small doses. We oscillate between things that feel good and resourceful to you and things that feel more challenging, without you having to tell the whole story. As long as you can integrate it and it's not too overwhelming, your brain and body want to integrate.

4. Let the body update. My job is to help your brain understand that the physical experience is over and processed, so that the memory can be stored in a different way. We can also work forward. If flying scares you, we imagine getting on the plane and notice whether your heart starts racing or your stomach drops, and I support your nervous system to say, "okay, no, actually this is safe."

5. Bring thinking back in. Your higher processing centres make sense of experiences that were too overwhelming to process before. This is where bottom-up and top-down meet. What you do between sessions, whether that's journalling or a nap, helps it land.

How you'd know it's working

"It's not like you can give me a before and after picture," he said.

So true. It's hard to even talk about 'outcomes' in therapy — especially because the therapeutic relationship is one of the strongest predictors of how therapy goes. (And also because of confidentiality, I can't share with you the success stories that make my heart explode.)

But in the spirit of the white box, here are a few ways you might know it's 'working':

• Something happens that would usually trigger you, but this time, you feel neutral.

• The activation is quieter, or after you got mad, instead of spending two days frustrated, you came down after an hour.

• You let yourself have emotions without them overwhelming you. That feeling that maybe you could use a cry? It feels like relief now, not failure.

• You're proud of yourself, because you just set a boundary when usually you would have gritted your teeth and said 'okay.'

• When conflict arose with your partner or kid, you stayed in the room instead of shutting down and going quiet.

• You have tools in your belt for when that familiar anxious feeling arises — and they work.

What therapy can't promise

Therapy can't promise anything. Rather it's a dedicated space and time for you to learn more about yourself, process what's held subconsciously, and receive support for what you're going through. It's a quiet room and someone you can talk to who won't judge what you have to say.

"Suffering is very, very personal. No matter what people say, it is you who gets yourself out of it. You can have somebody to talk to, but how you deal with it — I feel like that's just you."

If you've ever sat up at night trying to think your way out of anxiety, or tried to research your way out of feeling the way you do, you know that it's very, very hard to figure it out by yourself. Therapy is having someone to help you go to those harder places, knowing you have the support and skillset to do so.

Show me the steps

The cafe was about to close. As we walked outside to the overcast parking lot, we stopped for a final moment.

"The most important thing you can do is be really clear, upfront, about the method and the outcome. That's the only way to reach people."

I told him I liked what he'd said earlier: even if I told him it was step one, two, three, all the way to step seven billion, he'd be fine with that, as long as he knew there were that many steps.

"Yes," he said. "I don't care if it's just before I die. I'd want it to be known beforehand."

People instinctively know that therapy takes time and that there are no guarantees — and still we're drawn to those spaces that help us explore our inner selves, that give us hope to be more connected and more grounded in ourselves.

Don't be fooled: therapy is hard work.

And the part of you that wants to know every step before you begin? It's not in the way. It's welcome here.

But, in a world where productivity is forefront in our mind, it can actually be nice to have one hour a week where you don't have to accomplish anything but be yourself.

*Amit is a pseudonym.

Where this comes from

Sources and further reading for the ideas in this piece.

• Peter Levine, Waking the Tiger (with Ann Frederick, 1997) and In an Unspoken Voice (2010), via a review of both

• Danny Brom et al. (2017), Somatic Experiencing for PTSD: a randomized controlled outcome study, Journal of Traumatic Stress

• Somatic experiencing: effectiveness and key factors of a body-oriented trauma therapy, a scoping review (2021), European Journal of Psychotraumatology

• Ruth A. Lanius et al. (2010), Emotion modulation in PTSD: clinical and neurobiological evidence for a dissociative subtype, American Journal of Psychiatry

• Ruth Lanius and colleagues (2017), Dynamic causal modeling in PTSD and its dissociative subtype, Human Brain Mapping

• Ruth A. Lanius (2020), The sense of self in the aftermath of trauma: lessons from the default mode network in PTSD, European Journal of Psychotraumatology

• Ruth A. Lanius, Sherain Harricharan, Breanne E. Kearney & Benjamin Pandev-Girard (2025), Sensory Pathways to Healing from Trauma, Guilford Press

• Ulrich Lanius, "The Bottom-Up Processing Protocol," book chapter

• Pat Ogden, Kekuni Minton & Clare Pain (2006), Trauma and the Body: A Sensorimotor Approach to Psychotherapy, W. W. Norton

• Daniel Siegel, The Developing Mind (1999), for the window of tolerance, via this overview

• Anil K. Seth (2013), Interoceptive inference, emotion, and the embodied self, Trends in Cognitive Sciences

• Christoph Flückiger, A. C. Del Re, Bruce Wampold & Adam Horvath (2018), The alliance in adult psychotherapy: a meta-analytic synthesis, Psychotherapy