Migraines look like a head problem, yet most people who live with them will tell you their whole body knows when a wave is coming. Temperature swings, neck tightness, watery eyes, a sour stomach, the sense that every sound is sharp and every light is a blade. What is happening is not just pain in the skull. It is an autonomic storm, a shift in the balance between sympathetic drive, parasympathetic shutdown, inflammatory signaling, and sensory gating. Somatic Experiencing, or SE, was built to help bodies renegotiate those states. Applied thoughtfully, it can reduce the intensity and frequency of migraines by easing the reflexes that push the nervous system into overload.
I have used SE within integrative mental health therapy for patients whose migraines resisted the usual combinations of triptans, magnesium, riboflavin, sleep hygiene, and avoidance lists. SE is not a silver bullet. It works best as one part of a coordinated plan that may include a headache specialist, physical therapy for cervicogenic contributors, nutrition changes, and in some cases prophylactic medication. But when you can calm the storm at the level of the body, everything else tends to work better.
The body’s alarms: why migraines behave like a whole-system event
Migraines are not just vascular constriction followed by dilation. Contemporary models blend neurovascular, neuroimmune, and network theories. The trigeminovascular system becomes sensitized, cortical spreading depression disrupts sensory processing, and brainstem nuclei that regulate arousal and pain gating go off rhythm. That science tracks with everyday signs. People with migraines often have a low threshold for sensory load on some days, then swing to relative resilience on others. Small stressors stack. One sleepless night plus a skipped meal plus a difficult conversation, and by late afternoon the nervous system is humming. The prodrome starts.
In SE terms, you could say the system tips into chronic sympathetic activation, high tone in neck and scalp musculature, then rebounds into a dorsal drop as the body tries to protect itself. Nausea, fatigue, the urge to withdraw, even depression after an attack, all fit within the polyvagal map. SE does not treat aura or vascular changes directly. It improves the organism’s capacity to move between states without getting stuck at the red line.
A quick primer on Somatic Experiencing
SE is a body based, bottom up approach to trauma therapy developed by Peter Levine. The central idea is that traumatic or overwhelming events can leave the nervous system in a loop of incomplete defensive responses. Rather than ask people to re tell their stories, SE guides them to track sensations, motor impulses, breath, and micro movements that reflect autonomic activity. The therapist helps the person oscillate between resource and activation, a process called pendulation, then supports tiny completions of stuck patterns. Over time the system finds more mid range, less all or nothing.
Migraines are not necessarily trauma, although trauma history is overrepresented among people with chronic pain. Even without explicit trauma, migraine attacks train the nervous system to expect danger. Anticipatory anxiety before a work presentation, the memory of last month’s three day attack, the neck that tenses when a child yells from the other room, these are associative learning processes. SE helps untangle those links and restores self trust in bodily signals. Within integrative mental health therapy, SE sits alongside cognitive skills, sleep regulation, and medical care, each supporting the other.
Mapping migraine phases to autonomic states
Most people can identify four broad phases, although not everyone experiences all of them each time. Prodrome, aura, headache, postdrome. Each has its own nervous system flavor, which suggests different SE tactics.
Prodrome often brings yawning, food cravings or https://www.amyhagerstrom.com/locations/delray-beach-fl aversions, neck stiffness, and difficulty focusing. I hear language like, I can feel the pressure building behind my right eye, or My upper back is bracing like I am about to lift something heavy. Autonomically, this can look like rising sympathetic tone layered over subtle parasympathetic shifts in the gut. In session, I will ask clients to track the earliest micro signs at home. How many yawns in an hour compared with your baseline. Does your right trap tighten more than your left when a meeting runs long. A small adjustment in posture, a longer exhale, a hand on the sternum while noticing warmth or coolness, can interrupt the ramp.
Aura, when present, reflects cortical network changes. Visual flicker, zigzag lines, tingling, language glitches. SE will not turn off those phenomena mid stream, and I do not try to force that. The goal here is containment and reducing the stack of additional alarms. People can often soften their overall arousal even as the aura runs its course. Tracking the edges of the field of vision without straining, noticing a boundary like the weight of the body against the chair, and orienting to three stable sounds in the room, can keep the sympathetic surge from amplifying the headache that follows.
Headache phase is where many people feel least able to engage. Noise and light are intolerable. Vomiting risk is high if they move much. Here the SE stance is minimalist. Reduce input, allow protective withdrawal, and find micro doses of settling. Some clients can lengthen the exhale by a count or two without provoking nausea. Others find that pressing the soles gently into the mattress for five seconds, then releasing, decreases jaw clenching by a degree or two. Degrees matter. If triptan timing is helpful, we defer to it. SE should not delay evidence based abortives.
Postdrome, sometimes called the migraine hangover, can last a day or two. People describe brain fog, mood flattening, bowel irregularities, and a sensation like they have run a marathon. The nervous system is often in a dorsal tilt here, undersupplied with engagement energy. We titrate back into activity with careful pacing. This is a good window for SE work that re associates movement with safety, such as gentle head and neck tracking within pain free ranges, or standing for a minute by the window to orient to distance and natural light.
A clinical vignette from practice
A teacher in her late thirties came to me with three to four migraines a month, usually peaking on Sundays or the first workday after a holiday. MRI and labs were unremarkable. She had tried three preventives over three years, each helpful for a while, then less so. She noticed that complicated lesson planning, fluorescent lights, and raised voices set her off. She also carried a history of a car accident at nineteen with residual whiplash that flared under stress.
We built a short SE sequence she could use in the 12 to 24 hour prodrome window. It started with orienting to the room by noticing two colors and two sounds, then placing one hand over the sternum, one over the upper abdomen, and waiting for the first spontaneous sigh. She learned to track a specific sensation that reliably appeared early, a pencil eraser sized knot under the right skull base. Rather than stretching hard, which had failed her, she experimented with letting the left shoulder drop one centimeter while her eyes stayed soft. We did five to ten minute practices in session to teach her nervous system that change could happen without a big push.
We also ran a short course of the Safe and Sound Protocol, which is an auditory intervention informed by polyvagal theory. It filters music to emphasize frequencies of the human voice, which can cue the middle ear muscles and brainstem pathways associated with social engagement and calm. The research base is early and mixed, but in selected patients I have seen improved sound tolerance and lower startle. We screened carefully for sensory over responsivity and paused sessions when she reported a band of head pressure. Over eight weeks, her migraine days fell to about two per month and her use of abortives dropped by half. She still had bad days, and a head cold could set off a rough patch. But the Sunday night catastrophizing settled, and she felt she had levers to pull besides white knuckling.
Why somatic work belongs in migraine care, even without trauma
Trauma therapy may sound misaligned with a neurological disorder. In practice, SE is not only for trauma. It is a method for working with autonomic patterns. That said, trauma history does matter. People with early adversity show higher rates of chronic pain, irritable bowel, and migraine. The shared pathway is a sensitized alarm system. If the body learned that the world is unpredictable, it is more likely to brace, constrict, and over interpret signals. That background hum makes it easier for a sensory trigger to tip you into migraine.
When trauma history is present, SE helps avoid retraumatization from the very symptoms of migraine. For example, vomiting that repeats an earlier experience of medical neglect can become more than nausea, it becomes a memory cue. Carefully built pendulation, resourcing, and micro completing defensive impulses, such as pushing against a wall for a few seconds, gives the body a chance to resolve echoes of the past. Done well, this gentles the terrain on which migraine episodes occur.
The rest and restore protocol, and how I adapt it for migraine
People often ask about a rest and restore protocol. The phrase is used in different ways across programs, but the thrust is the same, practices that nudge the autonomic system toward ventral vagal engagement and healthy parasympathetic tone. For migraine, the details matter. Standard long breath holds can provoke dizziness. Aggressive stretching can spike neck pain. My version uses paced exhale focused breathing, soft palatal awareness, and orientation rather than intense bodywork.
A typical five minute sequence looks like this. Sit with spine supported. Let your eyes land on something neutral in the middle distance. Exhale through pursed lips a second or two longer than your inhale, no forcing. Place a fingertip lightly at the notch of the collarbones and sense movement there as you breathe. Name one sensation that feels neutral or pleasant, warmth in the hands, contact of the thighs with the chair. Without moving your head, let your eyes sweep the room slowly left to right, then back to center. If the neck feels safe, turn the head a few degrees right and left, staying well inside pain free range. End by feeling the weight of your feet or the length of your spine.
That small arc, repeated once or twice daily on migraine free days, trains the system to find middle gears. Over weeks, many people notice that their prodrome arrives with less velocity. They still need their medications and boundaries around sleep and nutrition, but their body has more slack in the line.
The Safe and Sound Protocol, when to try it, and when to skip
The safe and sound protocol can be useful for people with sound sensitivity, hypervigilance, and difficulty settling in busy environments. It is not specific to migraine, and robust randomized data are limited. In practice, I consider it for patients who report that chaotic audio environments, cafeterias, gyms with thumping music, or family noise at dinner are reliable triggers. I avoid it during an active migraine cycle and in clients with a history of destabilization with auditory exposures. Sessions are brief, ten to thirty minutes, with the option to stop at any hint of headache pressure, tinnitus flare, or dissociation. Used conservatively within integrative mental health therapy, it can reduce the background burden of sensory threat that primes the pump for attacks.
Practical in session work that reduces migraine load
Here is a condensed progression I often use across early SE sessions with migraine patients. It is not a script. It is a scaffold that adapts to the person.
- Begin with orientation. Identify three visual anchors at different distances, then three neutral sounds. Track any shift in breath or muscle tone. Add interoceptive tracking. Invite attention to one small area that feels easiest. Let sensation change without steering it. If intensifying, return to visual anchors. Work with micro movements. Encourage a slow, tiny nod, side tilt, or shoulder drop, staying under the pain threshold. Pause to notice rebound sensations. Introduce pressure and release. Press the hands lightly into the thighs for five seconds, then stop and feel what lets go. If jaw tightens, bring gentle awareness to the hinge and invite it to soften by a degree. Close with boundary and support. Lean the back into the chair, feel the head held by the headrest or hands, and let the eyes settle on something that cues safety.
We may spend entire sessions in the first two steps if the person’s system is highly reactive. Faster is not better. The test is whether daily life starts to feel a little wider.
Home practices that respect migraine physiology
Outside the office, small daily actions shift the baseline. People succeed when practices are simple, time bound, and kind.
- Do two five minute rest and restore sessions on days without headache, ideally mid morning and late afternoon, not right before bed if sleep is fragile. Use a prodrome interrupt. At the first yawn cluster or neck stiffness, orient to the room, lengthen the exhale by a second, and step outside for a minute of distance vision. Track one metric for four weeks. Choose either total migraine days, abortive doses, or time from prodrome to peak. Simplicity encourages adherence. Protect neck neutrality. Set screens at eye level, use a pillow that keeps the neck in line with the spine, and limit end range neck rotations during flare windows. Create sensory pockets. Keep one dim corner or a pair of tinted glasses and soft earplugs accessible to reduce stack when environments are loud or bright.
These are not cures. They are ways to drain the bucket so that inevitable stressors do not overfill it.
Measuring progress without the trap of perfection
Migraine comes in clusters. Improvements are rarely linear. I tell clients to evaluate change in 8 to 12 week windows, not day to day. Useful markers include a drop in attack frequency, a 20 to 30 percent reduction in peak intensity, faster recovery in the postdrome, fewer missed workdays, or lower anticipatory anxiety. Sometimes the earliest sign is a subtler one. People stop rearranging their whole week around fear of the next hit. They book a dinner with friends and trust that if a migraine comes, they have tools.
Relapses happen. Travel, illness, hormonal shifts, or a string of late nights can push the system back to higher sensitivity. This does not erase gains. It highlights where to strengthen supports. Often a brief return to session based SE, a few days of disciplined sleep and hydration, and timely use of abortives settles the pattern again.
The role of physical contributors and what SE does about them
Neck and jaw tension are not innocent bystanders in migraine. Cervicogenic pain can feed the trigeminal system. Bruxism during sleep, a history of whiplash, or a workstation that keeps the head forward all day, magnify the signal. SE interfaces well with physical therapy by helping clients perform exercises inside a tolerable window. If a therapist prescribes deep neck flexor training, we might precede it with gentle orienting and end with a minute of supported rest to prevent a post exercise spike. For temporomandibular issues, micro awareness of jaw hinge position and a soft tongue resting posture, tip on the alveolar ridge, can reduce clenching reflexes without forcing the mouth open.
I watch for subtle red flags. Unilateral neck pain with neurologic changes, sudden change in headache pattern, worst headache of life, fever, or visual loss outside a familiar aura pattern warrant urgent medical evaluation. SE is not a substitute for medical safety netting.
Medication and SE, not either or
A common worry is that body based therapies ask people to minimize medication. That is not good migraine care. The evidence for triptans, gepants, ditans, and in some cases CGRP monoclonal antibodies is strong. What SE does is reduce reliance on rescue dosing and increase the effectiveness of preventives by lowering background arousal. When someone worries about medication overuse headache, we coordinate with the prescriber to set a ceiling on abortive days per month, usually under ten, while building practices that keep them from reaching that ceiling. It is also reasonable to trial magnesium glycinate, riboflavin, or coenzyme Q10 in collaboration with a clinician, but I do not stack supplements without a plan. People deserve clarity, not full spice racks.
When SE is not the right front door
There are cases where SE is not the first move. Severe depression with psychomotor retardation, active substance withdrawal, untreated sleep apnea, and unstable medical conditions need attention before or alongside somatic work. Some clients find interoception intolerable at first. For them, external orientation, nature based attention, or highly structured cognitive strategies can build tolerance. Others respond better to biofeedback or neurofeedback to start, then layer in SE once they trust bodily signals again. Good care meets the person, not the model.
Building a personalized plan
The strongest plans tend to have four threads woven together. Medical, somatic, behavioral, and environmental.
Medical care lines up abortives, considers preventives if the monthly day count is high, and screens for comorbidities like sleep disorders or anemia. Somatic work through SE targets autonomy over state shifts and reduces reflexive bracing. Behavioral rhythms support sleep, movement, and regular meals, not as rules to fear, but as scaffolding. Environment covers light, sound, ergonomics, and social load. It is common to fine tune over months. An initial sequence that looked perfect on paper might leave out one key school pickup stressor. Test, learn, adjust.
I think of migraine as a negotiation with a sensitive and intelligent system. It does not respond well to force. It does respond to respectful experiments, repeated often, in small doses. Somatic Experiencing gives a language for those experiments. Track the early signals. Resource what is already steady. Touch activation, then return to safety. If you do that a few minutes at a time, most days, the autonomic storms come less often, and when they do arrive, they pass with less wreckage. That is not magic. It is consistent attention to how bodies find their way back to balance.
Address: 550 SE 6th Ave, Suite 200-M, Delray Beach, FL 33483
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Amy Hagerstrom Therapy PLLC provides somatic and integrative psychotherapy for adults who want mind-body support that goes beyond talk alone.
The practice serves clients throughout Florida and Illinois through online sessions, with Delray Beach listed as the office and mailing location.
Adults in Delray Beach, Boca Raton, West Palm Beach, Fort Lauderdale, and nearby communities can explore support for trauma, anxiety, chronic stress, burnout, and midlife transitions.
Amy Hagerstrom is a Licensed Clinical Social Worker and Somatic Experiencing Practitioner who works with clients in a steady, nervous-system-informed way.
This practice is suited to people who want therapy that includes body awareness, emotional processing, and whole-person support in addition to conversation.
Sessions are private pay, typically 55 minutes, and a superbill may be available for clients using out-of-network benefits.
For local connection in Delray Beach and surrounding areas, the practice uses 550 SE 6th Ave, Suite 200-M, Delray Beach, FL 33483 as its office and mailing address.
To learn more or request a consultation, call 954-228-0228 or visit https://www.amyhagerstrom.com/.
For a public listing reference with hours and map context, see https://maps.app.goo.gl/VZTFSS2fq1YPv7Rs5.
Popular Questions About Amy Hagerstrom Therapy PLLC
What services does Amy Hagerstrom Therapy PLLC offer?
Amy Hagerstrom Therapy PLLC offers somatic therapy, integrative mental health therapy, the Safe and Sound Protocol, the Rest and Restore Protocol, and support for concerns including trauma, anxiety, and midlife stress.Is therapy online or in person?
The website describes online therapy for adults across Florida and Illinois, and some service pages mention limited in-person availability in Delray Beach.Who does the practice work with?
The practice describes its work as being for adults, especially thoughtful adults dealing with trauma, anxiety, chronic stress, burnout, and nervous-system-based stress patterns.What is Somatic Experiencing?
Somatic Experiencing is described on the site as a body-based approach that helps people work with nervous system responses to stress and trauma instead of relying on insight alone.What are the session fees?
The fees page states that individual therapy sessions are $200 and typically run 55 minutes.Does the practice accept insurance?
The website says the practice is not in-network with insurance and can provide a monthly superbill for possible out-of-network reimbursement.Where is the office located?
The official website lists the office and mailing address as 550 SE 6th Ave, Suite 200-M, Delray Beach, FL 33483.How can I contact Amy Hagerstrom Therapy PLLC?
Publicly available contact routes include tel:+19542280228, https://www.amyhagerstrom.com/, https://www.instagram.com/amy.experiencing/, https://www.youtube.com/@AmyHagerstromTherapyPLLC, https://www.facebook.com/p/Amy-Hagerstrom-Therapy-PLLC-61579615264578/, https://www.linkedin.com/company/111299965, https://www.tiktok.com/@amyhagerstromtherapypllc, and https://x.com/amy_hagerstrom. The official website does not publicly list an email address.Landmarks Near Delray Beach, FL
Atlantic Avenue — A central Delray Beach corridor and one of the area’s best-known local reference points. If you live, work, or spend time near Atlantic Avenue, visit https://www.amyhagerstrom.com/ to learn more about therapy options.Old School Square — A historic downtown campus at Atlantic and Swinton that anchors local arts, events, and community gatherings. If you are near this part of downtown Delray, the practice serves adults in the area and across Florida and Illinois.
Pineapple Grove — A walkable arts district just off Atlantic Avenue that is well known to local residents and visitors. If you are nearby, you can review services and consultation details at https://www.amyhagerstrom.com/.
Sandoway Discovery Center — A South Ocean Boulevard landmark that connects Delray Beach residents and visitors to coastal nature and marine education. If Beachside is part of your routine, the practice maintains a Delray Beach office and mailing address for local relevance.
Atlantic Dunes Park — A recognizable Delray Beach coastal park with boardwalk access and dune scenery. People based near the ocean side of Delray can learn more about scheduling through https://www.amyhagerstrom.com/.
Wakodahatchee Wetlands — A well-known western Delray destination with a boardwalk and wildlife viewing. If you are on the west side of Delray Beach or nearby communities, the practice offers online therapy throughout Florida.
Morikami Museum and Japanese Gardens — A major Delray Beach cultural landmark west of downtown. Clients across Delray Beach and surrounding areas can start with https://www.amyhagerstrom.com/ or tel:+19542280228.
Delray Beach Tennis Center — A public sports landmark just west of Atlantic Avenue and a familiar point of reference in central Delray. If you are near this area, visit https://www.amyhagerstrom.com/ for service details and consultation information.