Healing From the Top Down and the Bottom Up

Have you ever noticed that even when you understand why you feel the way you do, your body doesn’t always get the message? Maybe you’ve told yourself, “I know I’m safe now” — yet your heart still races when something reminds you of the past. Or maybe you’ve worked through your anxiety in therapy, but your chest still tightens every time you walk into a certain situation.

That’s because healing doesn’t only happen in one direction.

For many people, talk therapy (a top-down approach) brings tremendous clarity and growth. Others find body-based practices (a bottom-up approach) help them release what’s been stuck for years. But what I’ve seen time and again is that true, lasting change often requires both working together.

Healing flows in two directions: from the mind to the body, and from the body back to the mind.

What Top-Down Healing Looks Like

When people think of therapy, they usually think of top-down healing. This approach focuses on using your thoughts, reflections, and conscious awareness to make change.

In a session, top-down work might include:

• Talking through your experiences.

• Naming emotions and patterns.

• Reframing old beliefs.

• Learning new coping strategies.

Top-down healing is powerful because it gives you understanding. You start to see the bigger picture of why you think and feel the way you do. For example, you might realize that the inner critic in your head isn’t really yours — it’s something you absorbed from childhood. Naming that truth can create incredible relief.

But here’s the challenge: just because your mind understands doesn’t mean your body has caught up. That inner critic may still cause your stomach to clench or your chest to feel heavy, even though you’ve worked hard to reframe it.

What Bottom-Up Healing Looks Like

Bottom-up healing starts with the body and nervous system. It recognizes that your body holds onto experiences, even when your mind can’t put them into words.

In therapy, bottom-up work might include:

• Breathwork to calm or energize the nervous system.

• Somatic practices like noticing sensations in your body.

• Brainspotting, which uses eye positions to access and release what’s stored below conscious thought.

Bottom-up healing is powerful because it reaches places that words can’t. You don’t have to retell every detail of your story for your body to let go of the weight it’s been carrying. Instead, your nervous system begins to regulate, and your body shifts into a calmer, safer state.

For example, someone who has lived with anxiety might find that after a bottom-up session, their chest feels lighter, their breath flows easier, and their body doesn’t react with the same intensity to stressors.

But here’s the challenge: just because your body feels calmer doesn’t mean your mind knows how to make sense of that shift or how to carry it into everyday life.

Why One Direction Sometimes Isn’t Enough

If you’ve ever felt like “I know better, but I still feel this way,” you’ve experienced the limits of top-down healing.

If you’ve ever felt calmer after yoga, breathwork, or meditation but found yourself falling back into old thought patterns, you’ve experienced the limits of bottom-up healing.

Neither direction is wrong. They’re both essential — but when used alone, they can leave part of you behind. Healing becomes deeper and more sustainable when the mind and body are invited to work together.

The Power of Bi-Directional Healing

When we combine top-down and bottom-up approaches, something shifts. It’s not just about thinking differently or feeling differently — it’s about both.

Here’s how it might look in practice:

• Top-down first, then bottom-up: A client talks through a stressful event and gains clarity about why it triggered them. Then, we use Brainspotting to help their body release the leftover tension. Their mind understands, and their body follows.

• Bottom-up first, then top-down: A client notices heaviness in their chest during Brainspotting. We stay with it until their body feels lighter. Afterward, they reflect on what the experience means, and new insights emerge. Their body shifts first, and their mind makes sense of it.

This two-way flow is what I call bi-directional healing. It’s the process of creating change that starts in one direction and integrates fully by moving through the other.

Why This Works for So Many People

Bi-directional healing works because it addresses the full picture of who you are. You’re not just a mind or a body — you’re both.

• For the overthinker: If you’ve ever felt stuck in your head, talking in circles, but still tense in your body, bottom-up work can help release what thinking alone can’t.

• For the feeler: If you’ve ever felt emotions flood your body but struggled to put words to them, top-down work can help you make meaning of what your body knows.

• For anyone feeling “stuck”: Combining both directions creates movement. Instead of staying caught in patterns, you begin to shift toward balance.

Clients often share that once they experience both directions together, things finally start to click. They don’t just know what needs to change — they actually begin to feel it happening.

What Makes This Different

Not every therapist is trained in both top-down and bottom-up approaches. Many offer incredible support in one direction, but their work may not fully bridge the two.

Because of my training in counseling, Brainspotting, and embodied therapies, I can guide clients through both pathways. That means in our work together, we don’t have to choose between talking it out or working with the body. We can do both — whichever direction feels most supportive in the moment.

What You Might Notice in Bi-Directional Healing

When mind and body begin to align, clients often notice:

• Feeling calmer and more grounded in daily life.

• Reacting less intensely to triggers.

• Letting go of tension they didn’t even realize they were holding.

• Gaining clarity that feels natural, not forced.

• Experiencing behavior changes that last, instead of slipping back into old patterns.

These shifts don’t happen overnight — but over time, the combined top-down and bottom-up approach creates momentum. You begin to feel different, not just think differently.

An Invitation to Healing in Both Directions

If you’ve ever felt like you know why you’re struggling but still can’t shake the physical feelings… or if you’ve released tension in your body but still wonder how to make sense of it… know that you don’t have to choose one path.

Healing isn’t about picking top-down or bottom-up. It’s about allowing both to work together, creating change that flows in both directions.

That’s the work I offer: a safe, supportive space where your story and your body’s wisdom meet. A space where you can talk it through and feel it through. A space where healing doesn’t happen in just one direction — it happens in every direction you need.

If you’re ready to experience what bi-directional healing can mean for you, I’d be honored to walk with you.