As a psychotherapist trained in Somatic Experiencing, I work with clients whose distress shows up not only in thought and feeling but also in the body — in chronic tension, in shallow breath, in a persistent sense of being disconnected from themselves. For a long time, this somatic dimension of suffering has been sidelined in psychiatry. That is beginning to change. One of the more interesting developments driving this shift is the growing body of research on the fascial system: the connective tissue network that wraps around every muscle, nerve, organ and vessel in the body.
A recent review in Frontiers in Psychiatry draws together a growing body of evidence suggesting that fascia is not the passive packing material it was once thought to be. It is a highly innervated, dynamic system that plays a central role in how we sense ourselves from the inside out — and how we hold, or release, the imprint of stress and trauma.
What is the fascial system?
Fascia is a continuous, three-dimensional network of connective tissue that runs throughout the body. It has several distinct layers, each with its own function:
- Superficial fascia sits just beneath the skin and provides a gliding interface between the skin and the structures underneath.
- Deep fascia surrounds muscles and nerves and contains mechanoreceptors that contribute to our sense of movement and bodily position.
- Visceral and parietal fascia envelope the internal organs and body cavities, allowing them to move smoothly against one another.
What makes fascia clinically relevant for mental health is its sensory density. It contains hundreds of millions of nerve endings — significantly more than muscle tissue alone — which means it functions as a sophisticated sensory organ in its own right.
Fascia and interoception
Interoception is the process by which the brain reads the internal state of the body: heartbeat, breath, gut sensations, muscular tone. It underpins much of what we call emotion. When you “feel” anxious, sad or settled, you are in part reading interoceptive signals.
Because fascia is so richly innervated, it contributes substantially to this internal signalling. When the fascial network is healthy and able to glide and move freely, the information it sends to the brain is relatively clean. When it becomes stiff or restricted, the signal becomes noisy — and the brain’s internal model of the body becomes distorted.
This is one of the mechanisms thought to contribute to alexithymia, the difficulty identifying and naming one’s own emotional states that is common in clients with developmental trauma.
How chronic stress changes the fascia
Under prolonged sympathetic nervous system activation — the state we enter under chronic stress or unresolved trauma — the fascia undergoes real biological changes. Local vasoconstriction reduces blood flow to the tissue. Hyaluronan, the substance that allows fascial layers to glide, becomes more viscous. Over time, fibroblasts can differentiate into myofibroblasts, leading to structural densification of the tissue.
In plain language: the body becomes literally stiffer, and the stiffness is not random. It follows lines of habitual tension shaped by how we have learned to brace, hold and protect ourselves. Anyone who has watched a client walk into the consulting room with hunched shoulders and a guarded gait has seen the visible end of this process.
This biological reality has clinical consequences. Myofascial Pain Syndrome — characterised by tender trigger points and restricted movement — is strongly comorbid with anxiety and depression. The relationship appears to run in both directions: psychological stress changes the tissue, and the changed tissue helps maintain the felt sense of stress.
Why fascia matters in trauma therapy
For clinicians working with trauma, none of this will be entirely new. Practitioners trained in Somatic Experiencing and related modalities have long worked from the premise that the body holds what the mind cannot yet process.
What the fascial research offers is a clearer biological account of why this is the case. Trauma is not simply a memory stored in the mind; it is a pattern held in the tissues, the nervous system, and the connective web that links them. When we treat trauma as a purely cognitive problem, we miss a significant part of what is happening for the client.
This has implications for assessment as well as treatment. A client who reports feeling “numb”, “disconnected”, or “frozen” may be describing an interoceptive failure rooted partly in long-standing fascial restriction. A client who cannot identify their feelings may not be resisting therapy; their body may simply not be sending clear signals to be read.
Body-based approaches that support fascial health
Several modalities appear to support the health of the fascial system and, with it, the capacity for emotional regulation:
- Myofascial release uses targeted manual techniques to influence mechanoreceptors, reduce local inflammation, and restore gliding between tissue layers.
- Yoga combines rhythmic movement, breath and attention in a way that appears to support both fascial mobility and vagal tone — the latter being a marker of parasympathetic regulation often impaired in depression.
- Mindfulness and meditation practices support a shift away from chronic sympathetic activation, allowing the nervous system to settle and the tissue to follow.
It is important to be measured here. The clinical evidence for the fascial–psychiatric interface is still emerging. We do not yet have large-scale trials demonstrating that fascial work alone resolves anxiety or depression, and we should be cautious about overclaiming. What we do have is a converging picture from anatomy, neuroscience and clinical observation that suggests the body deserves a seat at the table in mental health care.
What this means for clients
If you are someone for whom traditional talk therapy has been only partly helpful, this material may be worth considering. The fact that your distress shows up in your body — in tension, gut symptoms, fatigue, or a sense of disconnection — is not a sign that you are doing therapy wrong. It is a sign that your healing may need to include the body as well as the story.
For those considering somatic work, it is worth seeking a practitioner who is properly trained in a recognised modality such as Somatic Experiencing, and who understands trauma, attachment and the therapeutic relationship. Body-based work and relational work are not alternatives; they belong together.
Toward a more integrated mental health practice
The shift toward an embodied psychiatry is overdue. For too long, the body has been treated as a vehicle for the mind rather than as part of the same system. The growing research on fascia is one strand in a broader correction. It reminds us that psychological distress is not floating in the head; it is inscribed in living tissue, and any account of healing that ignores this is incomplete.
In my own practice, this is not an abstract proposition. It shapes how I sit with clients, what I notice, and the pace at which we work. The body has its own timing, and good therapy respects that.
Frequently asked questions
Can trauma be stored in fascia? The phrase “stored in the body” is shorthand for a more specific process. Chronic stress and unresolved trauma appear to drive measurable biological changes in fascia — densification, reduced gliding, altered mechanoreceptor input — that contribute to ongoing dysregulation. It is more accurate to say that trauma shapes the tissue than that the tissue stores discrete memories.
Does fascial release replace psychotherapy? No. Body-based interventions appear to be most effective when they sit alongside relational, trauma-informed psychotherapy. The evidence base does not support fascial work as a standalone treatment for mental health conditions.
How does somatic therapy differ from talk therapy? Somatic therapy attends to the body’s signals — sensation, tension, breath, posture — as a primary source of information about a client’s state, rather than working predominantly through narrative and cognition. In practice, the two often overlap.
Who should consider somatic work? Somatic approaches can be useful for those working with developmental trauma, PTSD, chronic stress, attachment difficulties, and clients who describe being “in their head” or disconnected from their feelings. As with any therapy, the fit with the practitioner matters as much as the modality.
If you would like to work with a trauma-informed psychotherapist in Sydney, or are a clinician interested in deepening your practice through attachment- and somatic-informed training, you are welcome to get in touch.
Reference
Shah, S. M., Jahangir, M., Alhudaithi, G. S., Taneja, C., Alharbi, F. S., & Lin, X. (2026). Fascia’s role in the mind-body continuum: a novel target for integrative treatments in psychiatry. Frontiers in Psychiatry, 17, 1687288. https://doi.org/10.3389/fpsyt.2026.1687288
