Flow Notes: December, 2025
When Insight Isn’t Enough: The Case for Bottom-Up Therapy
When Knowing Better Doesn’t Help You Feel Better
Insight breeds understanding, maybe even self-compassion, but not necessarily freedom.
For many people who are 'too aware for their own good,' that awareness can start to feel like a trap. They can predict their triggers in advance and still feel powerless when they hit.
The self-observation that once felt like progress becomes surveillance; every reaction analyzed and replayed, every emotion intellectualized, every coping attempt judged.
Awareness, without integration, turns into just another performance of control. It’s exhausting, and it backfires because your nervous system can’t be talked or managed into safety.
Many people know why they struggle but can’t stop feeling the same way. The reason is simple:
Your mind learns one way, but your body remembers another.
And when your mind and body are at odds, your body is always telling the truth. Not necessarily about the facts of the situation, but about the state of the union
A Lawn Care Analogy I’m By No Means Qualified to Make
I’ve never had a lawn. And my grass pollen allergy testing triggered anaphylaxis. But hear me out…
Imagine you have a dead patch in your lawn.
You’ve tried raking, reseeding, fertilizing, and it just won’t thrive.
So, you dive deeper and experiment with compost, mulch, and watering schedules.
Then, after months of effort, you bring in an expert.
They test the soil, inspect the drainage, and finally discover the real problem: buried debris left from old construction work under the surface.
The roots can’t grow because they’re blocked by what’s underneath.
Now you have insight.
You understand why the grass won’t grow.
Problem solved?
Mmm, no.
The lawn won’t recover until you dig up what’s been buried beneath.
Once the old, abandoned materials are cleared out, the strategies you worked so hard to master finally start working—and they feel almost effortless.
That’s the difference between top-down and bottom-up therapy approaches.
Top-down work helps you understand the symptoms and teaches you strategies to manage them.
Bottom-up therapy helps you excavate what’s buried beneath the surface. It clears out the old material so the tools and skills you already have can finally take root.
Top-Down vs. Bottom-Up Approaches Explained
Top-down therapy starts with the thinking brain. It helps you reduce attachment to distressing thoughts, analyze patterns, reframe unhelpful interpretations, use coping skills, and figure out how to take action.
All of this has a place.
For people who are just starting to ‘do the work’ or seeking temporary support for life stressors, this approach can be powerful.
However, many patterns live below the realm of logic.
They aren’t stored as thoughts; they’re stored as feelings, sensations, and reflexes.
They’re the nervous system’s best guesses about what’s safe, what’s dangerous, and what you must do to stay connected, accepted, and worthy.
Those lessons got wired in through experiences that taught your body how the world works and what’s required of you.
And honestly—thank the lawd they did! They were your best or only options at the time.
The trick is, they keep running (sometimes not-so-quietly) in the background, long after they’ve outlived their usefulness, shaping your sense of self and how you move through relationships.
That’s why you can know better and still feel powerless to do better.
Bottom-up therapy works differently.
Instead of trying to logic your way out of your reactions, it helps your whole system update to the present.
The goal isn’t to suppress feelings or lawyer yourself out of them; it’s to help your nervous system release old burdens that no longer serve you.
Once the scaffolding that held up your distressing thoughts, automatic reactions, and unhelpful beliefs is dismantled, those top-down skills you worked so hard to learn finally start working naturally.
Top-Down vs. Bottom-Up Approaches Explained
Think: Magic School Bus, not neuroscience PhD
When something overwhelming happens, your brain stores two types of memory:
Autobiographical memory: the story of what happened.
Emotional memory: how your body and emotions responded, and the lessons they took from it.
Lessons like I’m fundamentally flawed, I’m too much, or I’m all alone.
Those emotional memories live in the subcortical (emotional) parts of the brain; the ones responsible for survival, not logic.
They form what’s called implicit learning: the automatic rules your nervous system built to keep you safe.
Over time, those learnings become patterns like perfectionism, people-pleasing, or shutting down when you feel criticized. These patterns can’t be changed through logic or insight, because they weren’t created there.
You can’t reason your way out of something your body learned through experience.
Bottom-up therapy approaches work by helping you access those emotional memories directly, in a safe and structured way, so your brain can update them through a process called memory reconsolidation.
When your system recalls a painful memory while also recognizing, “I’m safe and supported enough right now,” the old emotional charge dissolves.
The memory stays, but it no longer carries the same distress or meaning.
Your brain is eager to rewrite the old emotional learnings. It just needs a vehicle.
Let me tell you why Accelerated Resolution Therapy™ (ART) is my favorite one.
Why I use Accelerated Resolution Therapy (ART)
Accelerated Resolution Therapy is a short-term, evidence-based intervention that helps your brain re-code distressing memories quickly and gently.
Using calming eye movements and guided imagery, ART helps your nervous system update old emotional memories, so the facts stay the same, but the pain no longer runs the show.
I’ve trained in and experienced many bottom-up approaches myself—like Internal Family Systems (IFS), somatic psychotherapies, and EMDR. Each one can create real change in its own way.
What I love about ART is how efficient and humane it is.
Many trauma-focused therapies require repeatedly telling or reliving the story to desensitize yourself. While they can absolutely work, in my experience, that process can be inherently painful and draining.
With ART, you don’t have to share details out loud or even say what the memory is about for it to work.
We briefly open the “emotional learning container” to change what’s stored there. That moment of intensity usually lasts only 1-3 minutes of the full two-hour session and includes built-in pauses for grounding and regulation, so you never stay in distress for long.
Other bottom-up approaches, like EMDR or Somatic Experiencing, can take 6–15 sessions to reach full resolution, sometimes more with complex trauma (think growing up with repeated rejection, never feeling seen, or walking on eggshells).
Accelerated Resolution Therapy (ART) condenses the same neurological process into as few as one to three sessions by working efficiently with memory reconsolidation—helping your brain and body integrate change faster.
ART is designed to prevent overwhelm. The protocol includes intentional pacing, grounding breaks, and visualization tools that regulate your nervous system throughout the entire intensive.
You spend far more time visualizing positive or neutral imagery than revisiting pain.
The ART process doesn’t just remove distress, it replaces painful snapshots with representations of safety, strength, or peace that you choose.
Clients often describe walking away feeling lighter, clearer, and genuinely relieved, rather than wrung out and emotionally exhausted.
It’s focused, efficient, and solution-oriented—ideal for people who’ve done a lot of work already and are ready to feel the difference, not just understand it.
When Healing Starts to Flow
So, if you’ve read the books, practiced the skills, gained the insight, and still find yourself stuck, you’ve probably realized the solution isn’t about adding more tools.
It’s about helping your body catch up to what your mind already knows.
Bottom-up therapy doesn’t just explain why you react the way you do; it helps your system stop reacting like it’s still in the same story.
It helps your body register that things are different enough now—that you have more options, more support, and more agency than before.
When your body stops bracing for what already happened, you stop living in defense mode.
You can think clearly, speak honestly, and stay present without managing every moment.
The overthinking quiets. The guilt loosens. The effort eases.
That’s the difference between awareness and integration.
Healing isn’t about feeling “safe” all the time.
It’s about expanding your capacity to move through life with enough self-trust to know you can manage without being ruled by the protective patterns created for a different time, a different version of you.
Insight explains the story. Bottom-up work rewrites the ending.
