Titration and Pendulation: Helping the Body Process Trauma Gently
- Isaac Bailey
- 7 days ago
- 4 min read
I recently attended a trauma-focused professional development workshop facilitated by Peter Levine: trauma is not only something we remember, it is also something the nervous system can continue to respond to in the present.
For many people, trauma shows up less as a clear narrative and more as a felt experience: tension, numbness, agitation, shutdown, startle responses, or an ongoing sense of being “on edge.” When we work with trauma through the body, the goal is not to force anything to happen. It is to support the nervous system to do what it naturally wants to do, move from stuck activation or shutdown toward greater regulation and choice.
Two core practices discussed in the workshop were titration and pendulation. Both offer a structured, safer way to approach traumatic activation, especially when the body has learned to protect itself through overwhelm, dissociation, or hypervigilance.
Why the body matters in trauma work
Trauma can leave the nervous system organised around protection. Even when life is stable now, the body may continue to react as if danger is close. This can look like:
persistent anxiety or a racing mind
chronic tension, jaw clenching, headaches, gut discomfort
sleep disruption, sudden spikes of panic, or emotional flooding
numbness, disconnection, or “going blank”
difficulty trusting safety, even in supportive relationships
A body-informed approach pays attention to these responses without judgement. Rather than pushing for catharsis or detailed retelling, it asks: What is happening right now in the body and what does the nervous system need to stay within a tolerable range?
Titration: working in manageable doses
Titration is the practice of approaching trauma-related sensations, memories, or emotions in small, manageable increments, in “doses” that the body can integrate.
This matters because, for many survivors, trauma processing can swing toward extremes:
too much too fast (flooding, panic, shutdown), or
avoidance that keeps everything locked away (stuckness, numbness, repeating patterns).
Titration offers an alternative: paced contact with difficulty, with frequent returns to stability.
In practice, titration might sound like:
“Let’s stay with that sensation for just a few seconds, and then come back to your breath or your feet.”
“Notice the edge of it, where it’s mild, rather than going straight to the worst part.”
“We’ll touch it lightly and check what your body says next.”
The underlying principle is straightforward: the nervous system integrates best when it is not overwhelmed. Small steps build confidence, capacity, and a felt sense of control, especially for clients who have learned that strong feelings are dangerous or unmanageable.
Pendulation: moving between distress and regulation
If titration is about dose, pendulation is about movement. It involves guiding attention between states of activation (distress) and states of settling (regulation), so the nervous system can restore balance.
Many trauma symptoms involve being stuck:
stuck “on” (fight/flight)
stuck “off” (freeze/shutdown)
stuck oscillating without relief.
Pendulation helps the system practise flexibility again. Rather than staying in distress until it becomes unbearable, we intentionally include moments of resourcing and ease.
This can look like:
noticing a tight chest… then noticing the support of the chair
feeling sadness arise… then orienting to the room and tracking breath
sensing agitation… then finding a grounded place in the body (feet, legs, back)
Over time, this back-and-forth can teach the nervous system something important: I can be with discomfort and still come back to safety.
Reading the body’s cues: the “small signs” that matter
A significant part of effective somatic work is learning to track subtle cues that suggest the body is processing, often quietly.
In the workshop, we focused on noticing signals such as:
softening in the face, shoulders, or belly
warmth spreading through the chest or limbs
a deeper breath or spontaneous sigh
gentle trembling, vibration, tingling, or “buzzing”
a sense of grounding, weight, or settling
These are not things to chase or force. They are information. They can indicate shifts in autonomic state, small movements toward regulation, completion, or integration.
Tracking cues also supports pacing. If a client’s breath becomes shallow, their gaze fixes, their body goes rigid, or they report feeling far away, those are signs the system may be approaching overwhelm. That is often the moment to slow down, resource, and stabilise, not push through.
Strengthening safety anchors: building embodied steadiness
A key takeaway was the importance of safety anchors—internal or external experiences that reliably support a sense of calm, steadiness, and groundedness.
Safety anchors are not just “positive thoughts.” They are felt experiences the body can access.
Examples include:
feeling the feet against the ground
noticing the support of the chair or wall
tracking the rhythm of the breath without changing it
orienting to the room (colours, shapes, light, sounds)
a memory of a safe place or a supportive person (when this is genuinely resourcing)
In therapy, we often work to expand these experiences:
make them easier to access
help them last longer
strengthen the client’s ability to return to them when activation rises
Over time, anchors become practical tools clients can use outside sessions—during triggers, conflict, or moments of high stress.
What this means in counselling sessions
For clients, these concepts translate into a few important differences in the therapy room:
We prioritise safety and pacing. Healing does not require reliving everything in full intensity.
The body is treated as an ally, not an obstacle. Symptoms become signals, not failures.
Choice and control are reinforced. Clients learn to approach, pause, and step back, on purpose.
Regulation is built, not demanded. We practise it, repeatedly, in small ways that add up.
This approach can be especially helpful for people with complex trauma histories, dissociation, persistent anxiety, or strong somatic symptoms, where traditional “talk only” methods may not fully reach what the nervous system is holding.
Closing reflection
My main reflection from this workshop is that effective trauma work is often quiet and incremental. Titration helps us approach difficult material in manageable doses. Pendulation helps restore flexibility by moving between activation and regulation. Together, they offer a respectful, body-informed pathway toward integration, without forcing the nervous system to do more than it can safely hold.
If you are curious about integrating these approaches into your practice, you are welcome to reach out.
