What is Brainspotting Therapy?

According to Theodora Blanchfield, AMFT, and Daniel B. Block, MD, at Very Well Mind, Brainspotting therapy is a type of alternative therapy that uses spots in a person’s visual field to help them process trauma. It accesses trauma trapped in the subcortical brain, the area of the brain responsible for motion, consciousness, emotions, and learning. This type of therapy was discovered in 2003 by David Grand, PhD, as an advancement of his work in Eye Movement Desensitization and Reprocessing (EMDR) therapy. Grand had observed a client getting “stuck” in one spot. While staying in this one spot, Grand observed her going deeper than ever before and Brainspotting was born.

One of the purported benefits of Brainspotting therapy over EMDR is that one does not need to “relive” the trauma in order to facilitate its release from the body. The Serenity Trauma Center stated that Brainspotting, for many, can be an ideal option when it comes to getting PTSD support. This option offers patients trauma therapy by accessing the sectors of the brain shrouded from one’s awareness. Using eye positions, therapists can detect optical movement in association with the traumatic memories sealed away in the brain.

When working with a brainspotting therapist for PTSD support, internal resources are enhanced that enable graceful yet deep processing work where attachments are concerned amidst traumatic energy and matter. Physical and mental healing is possible by stabilizing and regulating the brain’s hold on the body. PTSD support therapists who specialize in brainspotting use this approach to help patients tap into their deep emotions and repair the damage caused by trauma by working on the limbic system to influence various psychological components such as emotional well-being, long-term memory, impulse control, motivation, and cognition.

How Brainspotting Therapy Works

Brainspotting works on the theory that feelings from trauma can become stuck in the body, leading to both physical and mental ailments. It is believed that the brain’s memory of a particular trauma or incident is “reset” in the body and brain through Brainspotting. Grand described this “stuckness” as “frozen maladaptive homeostasis.” Our bodies are generally meant to be in a state of homeostasis, attempting to maintain a stable environment, but this particular kind of homeostasis is not helpful. Brainspotting accesses this and attempts to integrate this interrupted processing of the trauma.

It is one of a few types of emerging therapies focusing on the brain-body connection, including Somatic Experiencing and EMDR. Traditional talk therapy is known as “top-down” therapy. That is, traditional therapy tries to solve problems with the conscious mind. These brain-body therapies are known as “bottom-up” therapy, which aims to release the physical stress in the body, thereby leading to release the of emotional stress in the body as well. Brainspotting therapy works on the midbrain, which controls parts of the central nervous system that are responsible for processes such as vision, hearing, sleep, and motor control. When trauma occurs, this part of the brain typically goes into freeze mode to conserve resources for the body to be in defense mode. This is necessary if you’re, say, fighting a tiger, but is less helpful for psychological trauma—but our bodies can’t distinguish between the two.

Techniques

Although Brainspotting therapy is a bit more fluid and doesn’t have a set standard protocol, most sessions follow at least a general blueprint. Here’s how you might expect a session to go:

  • Although there is a therapist there guiding you, much of this is self-directed. You will start with some relaxing breathing and possibly listening to the bilateral sounds (music designed to move from one ear to the other) in headphones.
  • Once you have settled into a more mindful state, you will identify a place in your body where you feel the most distress and rank it on a scale of 1 to 10.
  • With the therapist’s help, you will then find your “brain spot,” or, where your eyes naturally focus on when the physical discomfort is the strongest. You will be guided to focus on this point by a pointer rod or the therapist’s finger, and they will help you identify the spot where you are becoming “stuck” and would like to work on it.
  • The therapist may take either an “Outside Window” or “Inside Window” approach. In the “Outside Window” approach, the therapist observes the client’s gaze and recommends a point; in the “Inside Window” approach, the client is the one identifying the point to process.
  • From here, you and the therapist will direct all your attention to the feelings coming up, as you stick with this one area of the body.
  • You will then take some time to process the whole experience of what came up and what it may mean.

At the end of the session, you will again rate your level of distress—typically it will be lower than it was when you started. Some people report feeling a sense of release either mentally or even physically, through a mild tingling sensation or mild shaking as though they have chills. Following the session, you may feel exhausted or more emotional than usual. Additionally, more difficult feelings may continue to surface. This is all part of the process, but if the feelings become too much to handle, reach out to your therapist or a crisis hotline if necessary.

What Brainspotting Therapy Can Help With

Though Brainspotting therapy is primarily focused on discovering and alleviating trauma, it can help many different types of issues, especially since trauma’s effects are so far-reaching.

  • Anxiety
  • Attachment issues 
  • Substance use
  • Posttraumatic stress disorder 
  • Chronic pain
  • Major depressive disorder 

Benefits of Brainspotting Therapy

In one small study, participants experienced a reduction in PTSD, anxiety, and depression symptoms within a few sessions. Other benefits:

  • Reduction in pain
  • Memories become less painful
  • Negative thought patterns are reduced
  • Better sleep
  • Increased energy

Effectiveness

Although research remains scant on this modality, one published research study (see below) found Brainspotting to be more effective than either EMDR or CBT—and patients even continued to get better following their treatment is over. All other treatment modalities showed patients’ symptoms returning at the 6-month follow-up. Hildebrand A, Grand D, Stemmler M. Brainspotting – the efficacy of a new therapy approach for the treatment of posttraumatic stress disorder in comparison to eye movement desensitization and reprocessingMediterranean Journal of Clinical Psychology. 2017;Vol 5:No 1 (2017).

Things to Consider

As Brainspotting is still somewhat new and considered somewhat of an alternative treatment, there is still little research on it and any possible long-term effects. In addition, although it does not require as much reliving the trauma as something like EMDR does, inevitably, you will be discussing painful memories and feelings, so it is best to be prepared for that and be sure you have adequate support and self-care practices afterward.

How to Get Started

Because Brainspotting is a type of therapy requiring specialized training, it is best to find a therapist who is certified in Brainspotting therapy. Brainspotting has a directory of therapists who are certified (which includes completing two courses and at least 50 hours of practicing Brainspotting on clients). Alternatively, you can search online directories of therapists to find ones who specialize in Brainspotting. Typically, Brainspotting treatment lasts for about 6 sessions, as opposed to EMDR, which may take up to 8 or 10 sessions.

This article is provided by Dr. Ralph Kueche (Child Psychologist). Dr. Kuechle is a Child and Adolescent Clinical Psychologist who specializes in treating children and their families who may be struggling with mood and behavioral issues. Learn more about Dr. Kuechle.