what is top-down versus bottom-up processing?

A conversation with Yoga Therapist Lauren Albarella

All Parts is a newsletter for those who no longer want to force or fix their way through life. Our community space is called All Parts Home, where you have access to dozens of breathwork and movement practices, somatic explorations, educational workshops, and more to support self-compassion and curiosity. When you sign up for a membership, you automatically get a comped paid subscription to the All Parts newsletter.

Welcome back to the All Parts Collab Series!

Over the span of two months, I’ll be sharing 4 newsletters that I’ve written in collaboration with some of my favorite writers and fellow therapists. We’ll explore topics ranging from motherhood, to the intersection of yogic philosophy and psychotherapy, to defining what spirituality means for you, and the difference between top-down and bottom-up approaches to therapy.

This week we have someone who beautifully combines trauma healing with therapeutic yoga,

Lauren Albarella, C-IAYT

from

Yoga Therapy for Self-Healing

Lauren is passionate about helping women reconnect with their inner strength, resilience, and the deep sense of peace that is their birthright. Through a compassionate, holistic approach, she guides clients using yoga therapy to regulate the nervous system, ease anxiety, stress, and overwhelm, and cultivate greater self-compassion.

With nearly 2,000 hours of teaching and training, Lauren brings depth and experience to her work. She completed her foundational yoga therapy training with Breathing Deeply Yoga Therapy in 2021 and earned her advanced 875-hour certification in 2023. She also teaches at Kindred Flow Yoga and Odessa Healing Center, both in Cincinnati, OH and serves as a board member and teacher for Project Yoga, which brings yoga to underserved communities.

Before her career in yoga therapy, Lauren spent 13 years in the financial services industry, working in marketing and relationship management in New York City.

I was drawn to Lauren’s integrity and deep passion for this work, and I think that comes through really beautifully in our conversation about the importance of integrating both top-down and bottom-up processing.

First thing’s first, what is top-down versus bottom-up processing?

Eliza: Both top-down and bottom-up are ways of processing and healing that show us two distinct, yet complementary, pathways for integrating experiences and fostering regulation within ourselves.

Top-down processing relies on cognitive understanding and conscious meaning-making and problem solving to regulate emotions and behaviors.

Bottom-up processing, on the other hand, focuses on physiological and sensory experiences as the foundation for healing. Trauma is stored in the nervous system and expressed through body-patterns. Engaging the body’s felt sense helps to restore a sense of safety and regulation in the here and now, which helps to process past traumas stuck in the tissues of the body.

A lot of my clients come to me after years of top-down processing. They know the “what” and the “why.” They understand the stories and narratives and beliefs that are lodged in their psyches and bodies. They might understand intellectually that they grew up believing the learned narrative that they weren’t worthy of love, for example, but there is still a struggle to change behaviors and get out of those patterns. There might be a persistent sense of loneliness or physical tightness in their chest when forming close relationships that might feel like too much to overcome. In other words, their body still reacts as if they are unlovable.

Bottom-up emphasizes safety in the body as the cornerstone to healing. So going back to the example of unworthiness, when a person feels that sense of loneliness or tightness in the chest, this approach helps to build the capacity for which one can feel both safety and discomfort in the body. If we can allow those sensations to simply be there and witness them, we won’t get overwhelmed by them. Eventually they move and pass through.

Lauren: A bottom-up approach works through the body first—using movement, breath, and sensation to create shifts in emotions and thoughts. A top-down approach relies on thinking, reasoning, and problem-solving to process emotions and challenges. It focuses on changing thoughts first, expecting feelings and body responses to follow.

When someone is overwhelmed or stuck in rumination, a top-down approach often isn't effective because the nervous system is dysregulated. In these cases, a bottom-up approach can be more useful, helping to establish a sense of safety and calm before engaging in deeper reflection if necessary.

Why we need both

Lauren: Top-down approaches, such as reframing thoughts and cognitive strategies using reason and logic, can help change perspective and help with limited or distorted thinking. Bottom-up approaches, like breathwork, movement, and somatic awareness, help regulate the nervous system and restore a sense of safety via the body. They are both useful and can be used effectively in conjunction.

If we rely only on top-down processing, we might intellectually understand that we are safe and have cognitive-based coping strategies to utilize. However, the nervous system may still stay stuck in hypervigilance. If we rely only on bottom-up processing, we might calm our body, but without reshaping our mental patterns, we risk falling back into habitual fears and worries.

In yoga therapy, we work through the Koshic Model, which illustrates the human as existing in five layers. Body, breath, conscious mind, subconscious mind, and the "bliss" body. Balance within the conscious mind layer is said to be critical for maintaining balance in the other layers. There is no doubt about the power of the mind.

However, the real power comes when we integrate both. By tuning into bodily sensations with curiosity and understanding while also offering the mind tools to shift out of negative thought patterns, it is possible to cultivate a real and lasting sense of safety. It's a skill that can be learned and profoundly empowering—understanding how to work with both the body and mind gives us the tools to navigate life's challenges with greater resilience and ease.

Eliza: In the psychotherapy world, there seems to be two really distinct camps of practitioners who are more top-down approach based, and practitioners who are solely bottom-up focused, without much overlap. For years the gold-standard of psychotherapy was CBT, which is a top-down approach. We’re now starting to see a shift to more body-based approaches like Somatic Experiencing to help integrate the body into our awareness.

But I totally agree Lauren, it’s been my personal and professional experience that we need both…all of it. I love that you pulled the koshic model into this! In my seasonal 15-day practice we use the koshic model to explore all parts of ourselves; where we might need to pay a little more attention, where we might be spending too much time and attention.

Lauren: Eliza, it’s wonderful that you're incorporating the kosha model into your program —it’s such an intelligent and useful framework for understanding the human experience.

I completely agree that more practitioners on both sides are beginning to recognize the power and synergy between approaches. I’m also seeing more traditional talk therapists refer clients to body-based practitioners or integrate bottom-up strategies into their work.

That said, I want to clarify that in my case, as a yoga therapist and not a licensed mental health professional, I always ensure my clients have access to a psychotherapist and/or psychiatrist, depending on their individual needs.

Eliza: Thank you for that clarification, Lauren! I so appreciate your integrity of upholding your scope of practice.

How integrating top-down and bottom-up processing looks in our work:

Lauren: I was having a conversation with a client recently who was caught in rumination and struggling with difficult emotions.She was going through a lot of life challenges—potentially serious surgery and the urgent need to find new housing.

During our session, she was physically present but mentally elsewhere, becoming easily distracted and lost in worry. She would blurt out her concerns as we sat together: "I don't know how I am going to find a new apartment," while she gazed out the window. Intellectually, she knew that in that very moment, she was safe. But she was struggling to feel secure in her body, and her mind was clearly in overdrive. Any cognitive-based coping strategy was moot in that instance.

I asked her to describe her body sensations associated with worrying. She looked at me with confusion, and at first, she struggled, using words like "stress" and "overwhelm" but without identifying physical sensations. It is common for people who often disconnect from their bodies to be unable to find the words to describe what they are feeling. But the body communicates through sensation, and if we lose the ability to tune into it, we also lose the ability to regulate and return to a place of real safety.

I gently offered sensation-based words for her to explore: "tightness," "tingling," and "fluttering," hoping to hone in on what her body was experiencing. She could sit briefly with that sensation, which quieted her mind. I thought it would be helpful for us to continue to explore this "bottom-up" process.

For my client, dissociation and rumination were keeping her stuck. After briefly exploring the sensation associated with worry and fear, we switched gears and into some asana (yoga postures) where she could notice physical sensations related to movement. I invited her to feel her feet on the floor, to sense the muscles in her back engaging as she sat up a little straighter. We did some simple "sun breaths," inhaling as the arms lifted and exhaled as they came back down. She began to notice the feeling of her arms moving through space, the stretch in her shoulders, the expansion of her ribs. She became more settled and at ease. Her breathing visibly slowed and deepened.

Eliza: That is so beautiful that you were able to guide your client into more embodied awareness, Lauren! I loved reading how you guided her into more sensation-based language and awareness rather than just surface level interpretations of what’s happening in the body like “stress.”

I’m constantly inviting my clients to dance between top-down and bottom-up processing. Sometimes we’ll spend a full session just doing somatic work, which is of course more bottom-up (i.e. getting into sensation and simply noticing, similar to how Lauren guided her client back into her body). This is necessary and helpful if we are dealing with a sensation or stuck pattern in the body that has no known origin, or if there is a pre-verbal or impact trauma that the client does not and cannot cognitively remember.

Other times we’ll spend entire sessions oriented around stories, narratives, beliefs, and behavioral patterns that the client needs to unpack or understand better.

Most often, however, it’s a combination of the two, which I love! I always really struggle when someone asks me what a session looks like, so I won’t try to explain it here. But there is something magical that happens when a client can click into the parts of themselves that they’ve been ignoring and glean insight from those parts, befriend those parts, and then eventually learn to love those parts. Whether that be sitting with the sensation of fear that has kept them frozen for years, or realizing that a mental burden they’ve been carrying is not theirs to hold anymore.

It’s all part of the process.

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