
Somatic simply means the body is involved. Every response your brain generates is felt somewhere physical: the chest that tightens before you have consciously registered anything is wrong, the stomach that drops, the shoulders that will not come down no matter how reasonable you are with yourself.
Working somatically means taking that seriously as information about what your nervous system is doing, rather than as a symptom to be talked out of.
Somatic therapy has come to mean something quite specific online: breathwork, movement, touch. Those approaches work with the state your nervous system is in right now, and they can be genuinely settling. I teach some of them myself, mostly in my book and programme, and some in sessions where they are useful. They are not the main work in a session, because settling a system in the moment will not change a system that has been reading danger for a long time.
The work I do in therapy sits at a different point in the sequence. Your brain generates a response, in a few hundredths of a second and below conscious awareness, and only afterwards does that response arrive as a thought, a feeling, or a sensation you can describe. By then it has already happened. This is why understanding a pattern often fails to change it: insight arrives at the end of the process, and the response was generated at the beginning.
So sessions with me are conversational, but the change work happens somewhere else. My main approach is BWRT®, which works directly with those automatic responses at the level where they were laid down. You will not be asked to relive anything in detail, and you will not need to hold a difficult memory in mind for long.
Anxiety and trauma are rarely only in the mind. They show up as tension that will not release, disrupted sleep, a stomach that reacts before you do, exhaustion that rest does not touch, and other sensations. Those symptoms are real, and they are part of the work rather than a separate problem to take elsewhere.
If persistent pain or long-standing physical symptoms are your main concern, there is more about that work on the chronic pain and physical symptoms page.
Alongside 1:1 therapy, I offer the NeuroSomatic Reboot™, a self-paced programme for persistent pain with direct support from me on WhatsApp.
The free initial consultation below is a conversation about you: what has been happening, what you have already tried, and what you would like to be different. You are welcome to ask about the programme or anything else, and I will give you my honest view of what would actually help, including when that is something other than working with me.
I work with anxiety and panic, trauma, PTSD and CPTSD, low self-worth, grief, relationship difficulties and life transitions.
Physical symptoms often travel alongside these, and they are part of the work rather than a separate problem.
I work online, via Doxy, and in person in my studio in Lisburn and in Belfast, University Street. Sessions are collaborative: we will spend time understanding what you are experiencing and why, and we go at a pace that feels manageable to you.
I am a psychotherapist with a PhD, an Advanced Practitioner and Accredited Trainer with The International BWRT® Institute, and I am trained in psychodynamic and somatic approaches.
Writing and talks featured in the Irish News, Psychreg, Queen's University Belfast, and the BWRT® Congress.




Dr Annalisa Manca Psychotherapy | BELFAST | LISBURN | © Copyright 2026 - All Rights Reserved