Brainspotting Therapy: An Overview
THC Editorial Team September 13, 2021
- What Is Brainspotting Therapy?
- How Does Brainspotting Therapy Work?
- Conditions Treated by Brainspotting Therapy
- The Potential Benefits of Brainspotting Therapy
- The Effectiveness of Brainspotting Therapy
- Limitations of Brainspotting Research
What Is Brainspotting Therapy?
Brainspotting therapy, sometimes referred to as brainspotting, or BSP is a relatively new form of body-oriented psychotherapy designed to help people access, reduce negative symptoms associated with, and ultimately overcome trauma. Proponents of brainspotting believe that a person’s visual field, or where they look, can help facilitate the therapeutic process, similar to eye movement desensitization and reprocessing (EMDR).
What Is the History of Brainspotting?
Psychotherapist David Grand developed brainspotting therapy in 2003 in the United States after working with people who had experienced trauma related to the terrorist attacks in New York City on September 11, 2001.1 Grand’s background is in psychoanalysis, and he was trained in EMDR, a therapeutic technique based on the hypothesis that bilateral eye movement integrates the left and right hemispheres of the brain. He was also exposed to somatic experiencing (SE), a type of therapy that calls to mind the physical and emotional sensations of a traumatic experience in order for the individual to process it through the body and physically recover.
Grand used these techniques to create a therapeutic method called “natural flow EMDR,” which integrates brain and body. Grand monitored his clients’ physical cues through his work and made inferences about their corresponding brain processes. He developed this method shortly before the September 11 attacks and used it to treat people affected by that traumatic event.1
Grand happened upon the premise of BSP a few years later when a client’s gaze locked on a particular spot; while held there, she was able to dig deeper into her traumatic experiences than she had over the past year of natural flow EMDR therapy. Grand noted a “powerful eye reflex,” which, to him, indicated that there was something further to explore.1
Grand subsequently developed and created formal training for BSP. Since then, many mental health professionals have been trained to effectively incorporate brainspotting into their therapeutic approaches for a broad variety of mental health concerns.
How Does Brainspotting Therapy Work?
Researchers hypothesize that people who undergo traumatic situations store these experiences in specific areas of the brain and body.2,3 Studies have shown that people may experience adverse psychological, emotional, and physical effects when trauma is stored (or stuck/frozen) in the body rather than actively processed, relieved, or released. They have also suggested that frozen trauma may increase people’s vulnerability to disease.4 Brainspotting practitioners believe that the approach can be used as a tool to activate the body’s natural healing capacity to facilitate recovery from stored and unprocessed trauma.
Proponents of brainspotting hypothesize that unprocessed trauma is located in the subcortical region of the brain.2 Because activity in that region is biologically associated with people’s eyes, proponents believe specific points in a client’s visual field can help them access unhealed past traumatic content. Some practitioners believe that brainspotting works within the limbic system, which includes areas of the brain that affect thinking, impulse control, memory, and emotion.2
Brainspotting therapy relies on a process called dual attunement.2 In this process, a practitioner will pay close attention to developing the therapeutic relationship and relational attunement while simultaneously focusing on the individual’s gaze and physical responses.2 Brainspotting therapists have clients move their eyes to identify specific eye positions that help individuals identify, process, and release and heal various trauma-related symptoms. The essence behind BSP is that it uses the body’s natural ability to heal. A brainspot refers to the position of a client’s eyes that resonates with a traumatic memory.2
In a brainspotting session, the therapist will explain how trauma affects the body and mind, and clients are able to explore traumatic experiences in a safe space. Usually, a client will identify an issue that they would like to explore. The brainspotting therapist will then direct them to move and position their eyes in specific directions to help the individual target the source of the underlying adverse emotion they are experiencing. The therapist will ask the individual to track a slowly moving pointer across the visual field with their eyes. The therapist will watch for the person’s eyes to reach certain directional spots in which the eye position is believed to stimulate a painful memory or emotion. Usually, the client will indicate this subconsciously with a twitch or irregularity in their eye movement. Sometimes a client will detect the greater depth of feeling from a particular eye position before the therapist does and inform them.1
Specifically, the “inside window method” refers to when a client becomes aware of the spot, from within, and the “outside window method” refers to when the spot is externally identified from the somatic stimulation of a client.2 The process of identifying charged emotions or spots helps inform the therapeutic practice so that the therapist can assist the client in knowing the primary areas of trauma to work on.2
When the client experiences the most troubling spots, they are encouraged to focus their vision in that specific position to elicit the response; simultaneously, they are encouraged to be mindfully aware of their experience and the feelings, memories, and thoughts that occur.2 Next, the therapist will help the client process the memories and feelings as the client experiences them through further exploration by talking or discussion. Brainspotting therapists believe this process helps clients become more attuned to their bodies and minds and more rapidly process the traumatic incidents from their past experiences. The trauma-resolution process is mindfully experienced so that the client’s “neural pathways” may be recuperated.2
Brainspotting, Conscious Awareness, and the Body
Brainspotting sessions require an enhanced awareness and acceptance of feelings experienced in the body. The client must be mindfully aware of their feelings, sensations, and cognition, whereas therapists must be aware of and attuned to the client’s condition through their eyes and their body.2
Although self-awareness is a basis for most types of therapy, some forms of therapy that emphasize mindful awareness are gestalt therapy, emotion-focused therapy, dialectical behavioral therapy, psychodynamic therapy, acceptance and commitment therapy, mindfulness-based cognitive therapy, mindfulness-based stress reduction, and other body-centered psychotherapies such as Somatic Experiencing.
What Conditions Are Commonly Treated by Brainspotting Therapy?
Brainspotting therapy is used to treat a variety of different conditions, including the following:5
- trauma and posttraumatic stress disorder (PTSD)
- addictions and substance abuse disorders
- anxiety disorders
- anger issues
- attention-deficit/hyperactivity disorder
- chronic pain
- chronic fatigue
- low self-esteem
What Are the Potential Benefits of Brainspotting Therapy?
Brainspotting is commonly used with people who have experienced physical or emotional trauma.
Some of the potential benefits of brainspotting include
- reduced trauma-related symptoms,5
- reduced anxiety,5
- recovery from substance abuse,5
- reduced pain and fatigue,5
- improvements in sports,6
- fewer flashbacks,7
- enhanced creativity,7 and
- lessened dissociation.7
Research has shown that people with anger issues may also experience an improved ability to manage their emotions.8
The Effectiveness of Brainspotting Therapy
Research into the effectiveness of brainspotting has been limited. However, some studies indicate that it might be particularly effective for treating PTSD and managing anger.
In a study comparing brainspotting with EMDR for treating people with PTSD, researchers found that brainspotting might be an effective alternative to EMDR for alleviating PTSD symptoms. Participants with PTSD were divided into groups receiving either three sessions of EMDR or three sessions of brainspotting; 23 participants were assigned to the EMDR group, whereas 53 were assigned to the brainspotting group. Before treatment, both groups rated their symptoms and then rated them again after completing the sessions. Both groups saw similar relief from symptoms, showing that brainspotting may have similar levels of effectiveness to the more established EMDR practice.9
In a clinical case study from 2017, a psychotherapist using brainspotting reported that it effectively helped reduce trauma symptoms in a client who survived an attack on the Bataclan theater in Paris. Three months after the client participated in a brainspotting session, he reported that the emotional and physical pain associated with his memories of the event had not returned, although the memories of what happened reappeared daily.10
A dissertation published in 2020 from Brandman University indicated that brainspotting might also effectively treat anger and irritability issues. The researcher asked 13 participants to complete a Patient-Reported Outcomes Measurement Information System Anger assessment before receiving brainspotting therapy. After receiving treatment, the participants again completed the assessments. Many of the participants showed a reduction in problematic anger following brainspotting therapy.8
Limitations of Brainspotting Research
Although there have been reports of improvements following brainspotting, the reports are mainly anecdotal.6 Few rigorous, peer-reviewed, and controlled studies have been completed on the efficacy of this therapeutic approach. Of the studies that have been completed, sample sizes were notably limited.11 In addition, few studies comparing the effectiveness of brainspotting versus established psychotherapeutic modalities such as cognitive-behavioral therapy have been conducted.