Top-Down & Bottom-Up Healing in Therapy
When we go through difficult experiences, stress, loss, trauma, or change, our mind and
body both respond. Therapy helps bring these two systems, thinking and feeling, back into
balance. We do this through Top-Down and Bottom-Up approaches.
Top-Down Techniques: Healing Through Awareness and Thought.
Top-down techniques work with your thinking brain, the part that names, analyses, and understands. They help you create insight and perspective, so you can respond to life’s challenges more clearly and calmly.
Examples of Top-Down work include:
– Cognitive Behavioural Therapy (CBT): noticing and reshaping unhelpful thoughts.
– Mindfulness: observing your thoughts without judgement.
– Psychoeducation: understanding how the mind and body respond to stress.
– Journaling or reflection: putting words to your inner experience.
Top-down therapy helps you:
• Recognise patterns and beliefs that cause distress
• Develop new, balanced ways of thinking
• Feel more in control and clear-headed
• Understand the “story” behind your emotions
Bottom-Up Techniques: Healing Through the Body
Bottom-up work starts with the body and nervous system, where emotions and memories
often live. It focuses on sensing and releasing what words can’t always reach.
Examples of Bottom-Up work include:
– Breathwork and grounding, calming or energizing the nervous system.
– Somatic Experiencing, noticing sensations, tension, and release.
– Movement and stretching, reconnecting to the body’s rhythm.
– Body scans and mindfulness of sensation, building safety and presence.
Bottom-up therapy helps you:
• Calm an overactive stress response
• Release stored emotion or tension
• Reconnect with your body’s signals
• Build resilience and inner safety
Why We Need Both
Healing isn’t just about thinking differently or feeling better, it’s about integration. Topdown and bottom-up techniques work together to create lasting change.
Top-Down = Understanding the story
🌬 Bottom-Up = Releasing what’s stored
Integration = Living with balance, clarity, and purpose
Together, they help you move from just surviving to fully living, grounded, aware, and
connected to your whole self.