Levine, P. (1997) | References | Narcissus and the Child

What This Research Found

Peter Levine's Waking the Tiger presents a paradigm-shifting understanding of trauma as fundamentally a physiological phenomenon rather than a purely psychological one. Drawing on ethology (the study of animal behaviour), neuroscience, and decades of clinical observation, Levine developed Somatic Experiencing—a body-oriented approach that has helped thousands of survivors heal from trauma without having to relive traumatic events.

The biological basis of trauma: Levine observed that wild animals, despite facing life-threatening situations constantly, rarely develop the persistent symptoms humans associate with trauma. A gazelle that escapes a lion doesn't develop PTSD; it shakes and trembles briefly, then returns to normal grazing. Levine hypothesised that this natural discharge process—the trembling, shaking, and deep breathing that allows the nervous system to release mobilised survival energy—is what humans often interrupt or suppress. We override our instinctive responses through social conditioning ("don't make a scene"), rational suppression ("I need to stay calm"), or simple overwhelm. This interruption leaves survival energy frozen in the nervous system, creating trauma symptoms that can persist for decades. The amygdala—the brain's threat detection centre—remains on high alert, and stress hormones like cortisol continue flooding the system long after the danger has passed.

The concept of frozen survival energy: When facing threat, the body mobilises enormous physiological resources for survival: adrenaline surges, muscles tense, heart rate accelerates, breathing quickens. This is the fight-flight-freeze response. In Levine's model, trauma symptoms arise not from the threatening event itself but from the incomplete discharge of this mobilised energy. If the fight response was suppressed (you couldn't safely confront your narcissistic abuser), that fight energy remains locked in your muscles. If flight was impossible (you were a dependent child or financially trapped adult), that flight energy remains as chronic restlessness or dissociation. If freeze was overwhelming (the abuse was too much to process), that frozen state persists as numbness, disconnection, and collapse. The symptoms are the body's ongoing attempt to complete what was interrupted.

The felt sense and titration: Levine introduced specific techniques for working with trauma somatically. The "felt sense," borrowed from Eugene Gendlin's work, refers to the vague, pre-verbal quality of internal body experience—the "something" in your chest, the "tightness" in your throat. By attending to these subtle sensations without forcing, analysing, or narrating, survivors can gradually access and discharge trapped energy. "Titration" means working with small amounts of activation at a time, never overwhelming the system. "Pendulation" involves moving awareness between areas of activation and areas of resource or calm, teaching the nervous system that it can move through activation without becoming trapped in it. This approach is foundational to somatic experiencing as a therapeutic modality.

The completion of defensive responses: Levine's most practical insight is that the body knows how to heal if we allow it. The trembling, the impulse to run, the desire to push away—these are not symptoms to suppress but responses seeking completion. A survivor whose body wants to run doesn't need to actually run; they can allow the running energy to move through their legs while seated, completing the response neurologically without requiring external action. This completion allows the nervous system to recognise that the threat has passed and return to baseline, something that cognitive understanding alone cannot achieve.

How This Research Is Used in the Book

Levine's work appears in Narcissus and the Child to explain why narcissistic abuse creates such persistent physical symptoms and why body-oriented approaches are essential for full recovery. The book uses Levine's framework to validate survivors' somatic experiences and point toward healing approaches that address trauma where it actually lives.

In Chapter 12: The Unseen Child, Levine's concept of trauma stored in the body explains the physical toll that narcissistic parenting takes on children:

"Somatic symptoms are extensive and often misattributed. Levine explains that trauma is stored in the body, creating chronic muscular tension, digestive problems, and chronic pain."

This citation supports the book's argument that the effects of narcissistic abuse are not merely emotional or cognitive—they are inscribed in the body itself. The chronic tension from hypervigilance, the digestive problems from chronically suppressed emotions, the pain without clear medical cause: these are the body keeping score of experiences the mind may have minimised or denied.

In Chapter 21: Breaking the Spell, Levine's Somatic Experiencing is presented as a key healing modality for survivors:

"Somatic Experiencing, developed by Dr Peter Levine, works with the body's natural healing mechanisms. Rather than retelling trauma stories—which can retraumatise—the approach focuses on sensation: tightness in the chest, knot in the stomach, tension between the shoulder blades. By gently attending to these sensations, allowing them to move and discharge, the trapped energy of trauma releases."

The book also notes research showing "significant PTSD symptom reduction through somatic approaches, with some studies reporting up to 90% improvement," citing Brom et al. (2017). This positions Levine's approach as evidence-based rather than merely alternative.

The book draws on Levine to explain why narcissistic abuse creates specific body patterns: "Chronic hypervigilance—scanning for the narcissist's mood shifts—has locked the nervous system in high alert. Suppressed authentic expression has created muscular armouring—tension patterns that literally hold back words never spoken, tears never shed, screams never released. Disconnection from their own needs has created dissociation from body signals—hunger, exhaustion, pain, pleasure all muted or absent."

Why This Matters for Survivors

If you experienced narcissistic abuse, Levine's research provides both validation and a pathway to healing that speaks directly to what your body has endured.

Your body's symptoms are not weakness—they are wisdom. The chronic tension, the startle responses, the way your body braces when you hear a certain tone of voice: these are not character flaws or evidence that you're "too sensitive." They are your nervous system's intelligent response to chronic threat. Your body mobilised survival energy to protect you, and that energy remains active because it was never allowed to discharge. The hypervigilance that exhausts you was once necessary for survival. The freeze states that numb you were your body's last-resort protection when fight and flight were impossible. Levine's work says: your symptoms make sense. They are the body's unfinished business, not proof of brokenness.

You can heal without having to relive the trauma. This is perhaps Levine's most liberating insight for survivors of narcissistic abuse, especially those whose memories have been confused by gaslighting. Traditional trauma therapies often require detailed recall and processing of traumatic events. But Levine's approach works with present-moment body sensation, not historical narrative. You don't have to prove what happened or have perfect recall. You don't have to construct a coherent story that might have been systematically undermined by years of reality distortion. You simply have to notice what your body is experiencing right now and allow it to complete its interrupted responses. The body doesn't need a narrative to heal; it needs permission to finish what it started.

The frozen parts of you can thaw. Many survivors of narcissistic abuse describe feeling numb, disconnected from their bodies, unsure what they feel or want. This dissociation was protective: when the emotional environment was too threatening, disconnecting from sensation reduced suffering. But now, that protective freeze may be preventing you from feeling alive. Levine's work offers a gentle path back into the body. Through titrated exposure to sensation—small, manageable doses of feeling—the frozen places can begin to thaw. You don't have to flood yourself with overwhelming emotion; you simply begin to notice what you notice, pendulating between activation and calm, teaching your nervous system that feeling is safe again.

Your body can learn that the danger has passed. The fundamental problem in Complex PTSD is that the nervous system remains calibrated to a threat that no longer exists. Your alarm system, perfectly adapted to detecting a narcissist's shifting moods, now fires at every ambiguous cue. Levine's approach helps complete the survival responses that kept your system activated, allowing it to finally register that the threat has ended. When the fight energy in your arms is allowed to complete, when the flight energy in your legs can discharge, when the freeze in your core can release—your nervous system can update its threat assessment. This is not about thinking differently; it's about the body receiving the information that the danger has passed through its own completion of response.

Clinical Implications

For psychiatrists, psychologists, and trauma-informed healthcare providers, Levine's framework has significant implications for assessment and treatment of narcissistic abuse survivors.

Assessment must include somatic presentation. Many survivors of narcissistic abuse present with physical symptoms: chronic pain, fibromyalgia, gastrointestinal disorders, autoimmune conditions, chronic fatigue. These may be the body "keeping score" of unprocessed trauma. When medical workup is inconclusive, consider trauma history, particularly adverse childhood experiences. Levine's framework suggests that these symptoms may represent frozen survival energy seeking discharge rather than discrete physical pathology. This doesn't mean the symptoms aren't real—they are profoundly real. But it suggests that treatment may need to address the underlying somatic trauma, not just the symptomatic presentation.

Stabilisation requires nervous system capacity, not just cognitive insight. Before trauma processing can proceed safely, the client must develop capacity for self-regulation. In Levine's terms, this means expanding the window of tolerance—the zone in which the nervous system can remain regulated while engaging with activating material. For survivors of narcissistic abuse with narrow windows (easily overwhelmed or easily dissociated), build resources first: grounding techniques, containment imagery, the capacity to pendulate between activation and calm. Rushing to trauma processing with an unresourced client risks flooding and retraumatisation.

Consider titration in all therapeutic work. Levine's concept of titration—working with small amounts of activation at a time—applies beyond formal Somatic Experiencing. In any trauma therapy, monitor activation levels. When a client's breathing changes, when they shift posture defensively, when their narrative becomes fragmented or dissociated, they may be exceeding their window of tolerance. Slow down. Return to resources. Work with smaller pieces. The goal is not to break through defences but to help the nervous system expand its capacity for processing without overwhelm. Survivors of chronic relational trauma often need gentler titration than those with single-incident trauma.

The therapeutic relationship provides co-regulation. Levine emphasises that humans are social nervous systems; we regulate each other. For survivors of narcissistic abuse whose primary relationships provided dysregulation rather than safety, the therapist's regulated presence is itself therapeutic. Your calm nervous system helps regulate the client's dysregulated one—a process Stephen Porges calls "neuroception of safety." This has implications for therapist self-care and supervision: you cannot offer regulatory presence if your own system is chronically activated. It also suggests that session frequency matters; more frequent contact may provide the co-regulatory experiences the client's system needs.

Body-based approaches may succeed where talk therapy plateaus. Some survivors respond well to cognitive approaches and stabilise at a functional level but remain symptomatic. Chronic tension persists, sleep remains disturbed, hypervigilance diminishes but doesn't resolve. Levine's framework suggests that incomplete discharge of frozen survival energy may account for this plateau. Referring for adjunctive body-based work—Somatic Experiencing, sensorimotor psychotherapy, or trauma-sensitive yoga—may address what cognitive approaches cannot reach. Many therapists find that integrating basic somatic awareness into their existing practice deepens outcomes without requiring full SE training.

Broader Implications

Levine's work extends beyond individual treatment to illuminate patterns that affect families, institutions, and society at large.

The Intergenerational Transmission of Trauma

Traumatised nervous systems cannot provide the regulated co-presence that children need for healthy development. A parent whose body carries unresolved trauma—chronic hypervigilance, hair-trigger startle, dissociative absences—transmits that dysregulation to their children, regardless of conscious intentions. Levine's framework explains intergenerational trauma not as mysterious transmission of memory but as the practical consequence of dysregulated nervous systems raising children in dysregulated environments. This dynamic is central to understanding the narcissistic parent whose own unhealed wounds shape the next generation. Children learn to mirror their parents' nervous system states. They absorb the message that the world is dangerous, that bodies cannot be trusted, that activation must be suppressed rather than discharged. Breaking this cycle requires healing the parent's trauma—allowing their nervous system to discharge frozen energy and model regulation—before or alongside interventions for the child.

Relationship Patterns in Adulthood

Survivors of narcissistic abuse often find themselves in relationships that replicate familiar dynamics—what clinicians recognise as trauma bonding. Levine's framework helps explain this through the body's role in attraction and attachment. A chronically activated nervous system may experience calm as unfamiliar and therefore threatening; the regulated partner feels "boring" while the unpredictable one feels "exciting." Conversely, a nervous system accustomed to freeze states may seek partners who create enough activation to feel alive. The body's habitual states shape whom we're drawn to and what we tolerate. Recovery involves not just cognitive awareness of unhealthy patterns but somatic reorganisation—teaching the body that regulated relationships are safe, that calm is not a prelude to abandonment or attack.

Workplace and Organisational Dynamics

Survivors of developmental trauma often struggle in workplace environments that trigger early body memories. The boss whose raised voice reactivates the child's terror. The performance review that triggers dissociation. The open office plan that denies the hypervigilant system any sense of safety. Levine's work suggests that these reactions are not overreactions but accurate readings by a nervous system trained in a different context. Organisations that understand this can design trauma-informed workplaces: private spaces for regulation, predictable communication, management practices that don't inadvertently recreate abusive family dynamics. The nervous system seeks safety; environments that provide it allow survivors to function closer to their actual capacity.

Educational Settings

Schools interact with children whose nervous systems may carry significant trauma. Levine's framework suggests that behavioural problems often reflect nervous system dysregulation rather than willful defiance. The child who "can't sit still" may have a body full of unresolved fight-or-flight energy. The child who "zones out" may be in freeze response triggered by something in the classroom environment. Trauma-informed education recognises these somatic states and responds with regulation support rather than punishment. Movement breaks, calm-down corners, teacher attunement to nervous system cues—these interventions address the body's needs rather than demanding the child override biological imperatives through willpower alone.

Medical and Mental Health Treatment

Levine's work has implications for how healthcare systems approach traumatised populations. Medical procedures can be retraumatising for survivors whose bodies already associate loss of control with danger. Mental health intake processes that require detailed trauma history before establishing safety may exceed the client's window of tolerance. The common practice of requiring patients to remain still during examinations contradicts the body's need for defensive mobility. Trauma-informed healthcare considers the nervous system's needs: explaining procedures in advance, offering choices where possible, attending to somatic cues of distress, and recognising that "difficult" patients may simply be terrified bodies attempting self-protection.

Public Health Framework

Viewing trauma through Levine's somatic lens reframes it as a physiological condition with population-level prevalence and consequences. Childhood adversity creates dysregulated nervous systems that manifest as mental illness, physical disease, relationship dysfunction, and reduced productivity. The brain's neuroplasticity means that early intervention during developmental windows can prevent patterns from becoming entrenched. Prevention—supporting parents, reducing family stress, teaching children about their bodies and emotions, creating environments where natural discharge can occur—may be more cost-effective than treating entrenched trauma later. The societal cost of frozen trauma is measured in healthcare spending, disability payments, lost productivity, incarceration, and shortened lives. Investing in trauma-informed approaches across systems represents a public health intervention with potentially enormous returns.

Limitations and Considerations

Levine's work, while influential and clinically validated, has limitations that warrant acknowledgment.

The research base is growing but remains limited. While clinical outcomes support Somatic Experiencing's effectiveness, randomised controlled trials are fewer than for some other trauma treatments (such as EMDR or prolonged exposure). The 2017 Brom et al. study cited in Narcissus and the Child showed significant results, and additional studies have followed, but the evidence base is still developing. Clinicians should be transparent with clients about the state of the evidence while remaining open to approaches that may help where others haven't.

Individual differences in interoception matter. Levine's approach relies heavily on the client's ability to notice internal body sensations—the "felt sense." Some clients, particularly those with significant dissociation or alexithymia (difficulty identifying emotions and body states), may struggle to access this awareness initially. This doesn't mean the approach won't work, but it may require more groundwork to develop interoceptive capacity before proceeding. Clinicians should assess body awareness early and build this capacity rather than assuming it.

Translation from animal models requires caution. Levine's foundational observation—that animals discharge trauma naturally while humans don't—is compelling but involves some extrapolation. Animal nervous systems, while sharing core features with human ones, operate in simpler psychological contexts. The complexities of human trauma—meaning-making, relational context, developmental timing—add dimensions that animal models cannot fully capture. Levine's framework provides a useful starting point, not a complete account of human trauma.

Cultural considerations require adaptation. Concepts like the "felt sense" may be more or less accessible in different cultural contexts. Bodywork and attention to sensation may carry different connotations across cultures. Western assumptions about individual healing may not fit collectivist cultural frameworks. Clinicians must adapt Levine's principles to cultural context rather than applying them uniformly.

Historical Context

Waking the Tiger appeared in 1997, positioned at the intersection of several intellectual traditions that had been developing for decades. The body-oriented therapy lineage stretching from Wilhelm Reich through Alexander Lowen provided the foundation that trauma has somatic expression. Eugene Gendlin's work on the "felt sense" offered a method for accessing pre-verbal bodily knowing. Peter Levine's unique contribution was integrating these therapeutic traditions with ethological observation and emerging neuroscience to create a coherent theory of trauma as incomplete physiological response.

The book's publication came during a period of ferment in trauma treatment. While PTSD had been formally recognised since 1980, treatment remained dominated by cognitive and exposure-based approaches. Judith Herman's Trauma and Recovery (1992) had recently proposed Complex PTSD and emphasised the relational nature of trauma recovery. Bessel van der Kolk was conducting neuroimaging studies showing trauma's effects on brain structure and function. Into this context, Levine offered a specifically somatic framework—not just acknowledging that trauma affects the body, but proposing that the body holds the key to resolution.

The book was initially published by a small press (North Atlantic Books) and spread primarily through word-of-mouth and the growing community of body-oriented therapists. Over time, it achieved wider recognition as somatic approaches gained research validation and mainstream acceptance. Somatic Experiencing training programmes now operate worldwide, with over 60,000 practitioners trained. The core insight—that trauma is physiological and must be addressed somatically—has been repeatedly validated by subsequent neuroscience research, particularly Stephen Porges's polyvagal theory and van der Kolk's The Body Keeps the Score (2014), which explicitly builds on and cites Levine's work.

Today, Levine's framework is considered foundational to the field of somatic trauma therapy. His concepts of titration, pendulation, and completing defensive responses have become standard vocabulary in trauma-informed practice. The book remains in print, translated into over 25 languages, and continues to provide hope and direction for survivors decades after its publication.

Waking the Tiger: Healing Trauma

APA Citation