What is the Bottom-Up Approach to reducing anxiety and the impact of trauma?

Written By Jinu Niki, LMFT

Have you heard of the “bottom-up approach” being talked about in social media and by mental health professionals? The bottom-up approach is a therapeutic strategy that focuses on changing physiological states and bodily experiences to influence mental and emotional well-being. It contrasts with the top-down approach, which starts with changing thoughts to affect emotions and behaviors. The largest difference might be that there is a lot more focus on the body and based on the understanding that emotional and psychological states are deeply connected to physical states. Here’s a more detailed explanation of what the bottom-up approach entails:

  1. Regulating the Nervous System:

    • Techniques are used to calm the nervous system and bring it out of a fight, flight, or freeze state into a more relaxed and present state. This can involve practices such as deep breathing, progressive muscle relaxation, or yoga.

  2. Sensory-Based Interventions:

    • Therapies often include activities that engage the senses, such as mindfulness, grounding exercises, or body scans. These practices help individuals become more aware of their physical sensations and how they relate to their emotions.

  3. Trauma-Informed Practices:

    • Many bottom-up approaches are used in trauma therapy, recognizing that trauma is stored in the body. Techniques such as Eye Movement Desensitization and Reprocessing (EMDR) and Somatic Experiencing focus on bodily sensations to process and release traumatic memories.

  4. Building Safety and Stability:

    • Before addressing cognitive aspects, the bottom-up approach often emphasizes creating a sense of physical and emotional safety. This can involve establishing routines, creating a safe environment, and developing self-soothing strategies.

If you want to learn about what techniques are used in bottom-up approaches, check out my next blog on “Techniques Used In Bottom-Up Approaches.”

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Jinu Niki, LMFT

Jin is a Licensed Marriage and Family Therapist with over 15 years of experience helping high-achieving individuals navigate anxiety, perfectionism, life transitions, and the lasting effects of familial trauma. She is passionate about creating a supportive, collaborative space where clients can gain insight, build resilience, and experience meaningful change.

As a Clinical Fellow and Approved Supervisor with the American Association for Marriage and Family Therapy (AAMFT), Jin is dedicated to mentoring and supporting the next generation of therapists. She is also a Certified EMDR Therapist, bringing specialized expertise in trauma-informed care and helping clients heal from experiences that continue to impact their relationships, self-worth, and daily lives.

Outside of her professional work, Jin is an avid traveler and food enthusiast who enjoys exploring new cultures, connecting with people from diverse backgrounds, and trying new restaurants and local cuisines wherever she goes. Jin believes that healing happens when people no longer feel driven by the need to prove their worth and can finally experience the freedom, confidence, and contentment that come from knowing they are enough.

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