The room was quiet. Not silent—there was a low hum of traffic outside, the whisper of leaves brushing the windowpane—but inside, a patient sat, eyes closed, gently shifting her weight from one foot to the other. Her therapist didn’t ask her to talk. Instead, she asked her to notice: the warmth of her body against the chair, the heaviness in her feet, the subtle pull of gravity on her spine.
It wasn’t mindfulness in the conventional sense. It wasn’t about returning to the present. It was about returning to the body.
“What do you feel in your skin?” the therapist asked. “What do you smell, right now?”
For patients with complex trauma, even these questions can feel disorienting. For many, the body is not a place of safety, but a memory vault of threats, fragmentation, and disconnection. Yet according to a new clinical framework by Dr. Ruth Lanius, it’s precisely this relationship, the sensory perception of the body, that may hold the key to healing.
Why This Book Matters Now
In her latest book, Sensory Pathways to Healing from Trauma: Harnessing the Brain’s Capacity for Change, internationally renowned psychiatrist and trauma researcher Dr. Ruth A. Lanius, along with co-authors Sherain Harricharan, Breanne Kearney, and Benjamin Pandev-Girard, presents a groundbreaking model that reorients trauma therapy through the eight sensory systems of the body.
Drawing from decades of neuroimaging research and real-world clinical practice, the book shows that trauma is not merely a cognitive or emotional wound—it is a sensory injury. And as such, it requires a sensory solution.
Each chapter explores one of the sensory pathways—vision, hearing, smell, taste, touch, proprioception, vestibular, and interoception—mapping how trauma disrupts them, and offering concrete, evidence-based tools to restore their functioning. With clear explanations, vivid case vignettes, and “Bridging to Practice” protocols at the end of each chapter, Sensory Pathways offers clinicians more than theory: it provides a tactile blueprint for rewiring the traumatized brain.
The Vestibular System — Restoring Inner Balance
When we think of trauma, we don’t usually think of balance. We think of flashbacks, panic, dissociation. But beneath those symptoms lies a disorientation that is both literal and neural: the body loses its sense of where it is in space. The ground, quite literally, feels unstable.
According to Sensory Pathways to Healing from Trauma, the vestibular system—the sensory system responsible for balance, motion, and spatial orientation—is often disrupted in trauma survivors, especially those with early developmental or chronic relational trauma.
“The vestibular system is the sensory foundation of safety,” the authors write. “It informs the brain: you are here. You are upright. You are held by gravity.”
What the Science Shows
Ruth Lanius and her team reference functional neuroimaging studies showing altered vestibular activation in individuals with PTSD and dissociative symptoms. In the traumatized brain, the right temporoparietal junction, cerebellum, and vestibular nuclei show underconnectivity, especially in patients with chronic derealization and a fragmented sense of self.
What this means is profound: trauma survivors may not only feel emotionally lost—they may literally feel out of place in their own spatial body map.
Bridging to Practice: Clinical Tools
The book offers clear, practical interventions therapists can implement immediately to stimulate and reintegrate vestibular processing:
- Grounding via Movement: Encouraging patients to gently sway, rock in a chair, or walk barefoot in figure-eights.
- Stability Exercises: Using slow head rotations, seated balance tasks, or wall-based stretching to enhance postural awareness.
- Vestibular Breath Synchrony: Coordinating slow, rhythmic movement (e.g., gentle head nods) with inhalation and exhalation to reinforce regulatory brainstem circuits.
These exercises are simple, but their impact is foundational. For clients with histories of neglect, abuse, or medical trauma—especially those prone to dissociation or chronic “floating”—the vestibular system becomes the first step back toward anchoring in the body.
A New Kind of Somatic Safety
Rather than relying solely on top-down strategies (like cognitive reframing), Sensory Pathways invites clinicians to begin with bottom-up neural repair through motion, sensation, and postural feedback.
It’s not about “thinking differently.” It’s about feeling gravity again.
Core Theme: Interoception — Reclaiming the Felt Sense of Self
For many trauma survivors, the inside of the body is unfamiliar terrain. Some describe it as numb. Others, as overwhelming. The signals that should anchor us—heartbeats, hunger, breath—are scrambled or absent. Without access to those signals, self-regulation becomes guesswork. Emotions are difficult to track, and the boundary between the internal and external world can blur.
This is the work of interoception, and in Sensory Pathways to Healing from Trauma, Dr. Ruth Lanius and her co-authors argue it is the core of self-awareness—and the most fragile in trauma.
“Interoception forms the scaffolding of embodied identity,” they write. “When trauma disconnects the mind from the body, it is often interoception that is most disrupted—and most in need of reconnection.”
The Neurobiology of Interoceptive Disconnection
Neuroscientific studies cited in the book show that individuals with PTSD and complex trauma often have reduced activation in the insular cortex—the key region responsible for processing interoceptive signals such as breath, temperature, visceral tension, or pain.
This underactivation is especially pronounced in dissociative subtypes of PTSD. These clients may struggle to describe bodily sensations at all, or confuse interoceptive signals with danger (“My heart is racing, I must be dying”).
Lanius’s clinical insights suggest that restoring interoception is essential for regaining emotional regulation, building distress tolerance, and reestablishing a stable sense of self.
Bridging to Practice: Clinical Tools
Sensory Pathways offers specific, stepwise interventions to reawaken interoception without overwhelming clients:
- Tracking Internal Signals: Begin by helping clients notice one neutral sensation—such as warmth in their hands, or the feeling of a full bladder—without judgment.
- Body Map Drawing: Ask clients to visually sketch where they feel emotion, pressure, or movement inside the body, building sensory language and awareness.
- Heartbeat and Breath Synchronization: Use paced breathing while gently drawing attention to the heartbeat—not as a tool for relaxation, but as a way of building interoceptive tolerance.
These techniques are not about catharsis or emotional insight—but about restoring a basic sensory presence that trauma has silenced.
Interoception as Identity Reconstruction
The implications for therapy are profound. Lanius proposes that a stable, felt sense of internal state is a prerequisite for affect regulation, therapeutic alliance, and even memory integration.
When clients learn to reconnect with themselves—not just emotionally, but physically—they begin to rebuild a coherent sense of who they are.
“Healing begins,” the book insists, “not when we name the trauma, but when we can safely feel the self again.”
Reviews & Endorsements — A Quiet Revolution in Trauma Care
Even before its official release, Sensory Pathways to Healing from Trauma has been hailed as one of the most innovative trauma therapy texts of the decade. What sets it apart, reviewers note, is not just the depth of its science, but its clinical accessibility. It doesn’t just inform. It equips.
Dr. Daniel J. Siegel, in the book’s foreword, calls it “a comprehensive, useful, and fascinating tour through the sensory brain… offering practical clinical steps any therapist can harness.”
In early peer and practitioner reviews, the book is repeatedly described as “essential,” “transformative,” and “humbling.”
Dr. John Briere, author of Principles of Trauma Therapy, writes:
“This is an amazing book—ambitious, brilliant, and rooted in emerging neuroscience. It begs to be read, reread, and reflected upon by anyone working in trauma.”
Donna Jackson Nakazawa, journalist and author of The Angel and the Assassin, writes:
“We’ve never needed Lanius’s mind and heart more than we do now. This book is packed with cutting-edge, sensory-based healing practices—delivered with clarity and warmth.”
🧠 For Clinicians, by Clinicians
Unlike many academic texts, Sensory Pathways is structured for immediate use. Each chapter includes a “Bridging to Practice” section, where complex neurobiological material is translated into actionable tools: body-based assessments, sensory tracking protocols, and real-world therapeutic scripts.
Therapists who have previewed the book describe it as “a missing piece in trauma work,” particularly for clients who don’t respond to traditional talk therapy, cognitive processing, or exposure-based models.
“It made me rethink my intake sessions completely,” said Dr Oscar Rivas trauma-focused psychotherapist in Mexico. “Now I ask clients about their sensory world before we even talk about trauma history.”
Another EMDR-trained clinician called the book “a bridge between what we’ve sensed in our work and what science can now explain.”
From Circuits to Sensation
For over two decades, Dr. Ruth A. Lanius has helped define the neurobiological language of trauma. A professor of psychiatry at Western University in Ontario, Canada, she’s perhaps best known for her groundbreaking fMRI studies on PTSD, which revealed how trauma disrupts large-scale brain networks—particularly the default mode, salience, and central executive systems.
Her research gave clinicians the first glimpses of what many trauma survivors could only describe metaphorically: “I’m not myself,” “I’m floating,” “I feel like I’m watching my life from outside.”
It was Lanius who mapped the neural correlates of dissociation, showing that in traumatized brains, the medial prefrontal cortex becomes inactive, the insula disconnects, and regulatory systems become unstable. Her studies confirmed what therapists had long sensed: trauma isn’t just remembered—it is re-lived, encoded, and often biologically avoided.
But Sensory Pathways to Healing from Trauma marks a turning point in her clinical arc.
Where her earlier work zoomed in on cognitive and affective dysregulation, this book pivots downward—into the body. Into the sensory roots of identity, safety, and therapeutic change.
“Our senses are the portals to embodied awareness,” Lanius writes. “Without them, we cannot know ourselves in space or in time.”
A Paradigm Shift: From Top-Down to Bottom-Up
Lanius’s co-authors—Sherain Harricharan, Breanne Kearney, and Benjamin Pandev-Girard—reflect this shift too: all are clinical researchers working at the intersection of neuroscience, somatics, and trauma therapy. Together, they bring a depth of experience working with war veterans, survivors of interpersonal violence, and those navigating the long shadow of developmental trauma.
The move from brain scans to sensory protocols is not a departure—it’s an evolution. It suggests that the next phase of trauma therapy will not only be neurobiologically informed—but sensorially integrated.
“Healing,” Lanius argues, “doesn’t begin in the cortex. It begins in how we smell, breathe, see, touch, and move through the world.”
Lanius, R. A., Harricharan, S., Kearney, B., & Pandev-Girard, B. (2024). Sensory pathways to healing from trauma: Harnessing the brain’s capacity for change. The Guilford Press.
https://www.guilford.com/books/Sensory-Pathways-to-Healing-from-Trauma/Lanius-Harricharan-Kearney-Pandev-Girard/9781462556915
Lanius, R. A., Frewen, P. A., Tursich, M., Jetly, R., & McKinnon, M. C. (2015). Restoring large-scale brain networks in PTSD and related disorders: A proposal for neuroscientifically-informed treatment interventions. European Journal of Psychotraumatology, 6(1), 27313.
https://doi.org/10.3402/ejpt.v6.27313
Lanius, R. A., Bluhm, R. L., Coupland, N. J., Hegadoren, K. M., Rowe, B. H., Théberge, J., … & Brimson, M. (2010). Default mode network connectivity as a predictor of post-traumatic stress disorder symptom severity in acutely traumatized subjects. Acta Psychiatrica Scandinavica, 121(1), 33–40.
https://doi.org/10.1111/j.1600-0447.2009.01391.x
Siegel, D. J. (2024). Foreword. In R. A. Lanius et al., Sensory pathways to healing from trauma (pp. vii–ix). The Guilford Press.
Briere, J. (2024). Endorsement review of Sensory pathways to healing from trauma. The Guilford Press. Retrieved from https://www.guilford.com
Nakazawa, D. J. (2024). Endorsement review of Sensory pathways to healing from trauma. Booktopia. Retrieved from https://www.booktopia.com.au
Lanius, R. A., Vermetten, E., Loewenstein, R. J., Brand, B., Schmahl, C., Bremner, J. D., & Spiegel, D. (2010). The dissociative subtype of PTSD: Rationale, clinical and neurobiological evidence, and implications. Depression and Anxiety, 27(8), 701–708.
https://doi.org/10.1002/da.20767
Lanius, R. A., Rabellino, D., Boyd, J. E., Frewen, P. A., & McKinnon, M. C. (2017). The innate alarm system in PTSD: Conscious and subconscious processing of threat. Current Opinion in Psychology, 14, 109–115.
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