How brainspotting is different from EMDR and other trauma therapies

Considering adding brainspotting therapy to your clinical toolbox? Or, maybe you’re just curious to know what brainspotting is and how it works.

In this article, we’ll cover what brainspotting is and the differences between brainspotting vs. EMDR (eye movement desensitization and reprocessing therapy).

Why brainspotting became my preferred treatment modality

Trauma-focused treatment modalities continue to evolve, with an increasing number of clients specifically seeking evidence-based approaches to address both acute and developmental trauma.

The National Center for PTSD reports that 6% of the population will meet criteria for post-traumatic stress disorder (PTSD) at some point in their lives, with women (8%) twice as likely as men (4%) to develop the disorder.

As clinicians, we recognize that a substantially larger percentage of our clients present with subclinical post-traumatic symptoms that respond well to trauma-informed interventions.

Many practitioners hesitate to specialize in trauma work due to valid concerns about vicarious traumatization and compassion fatigue.

With approximately 50% of mental health professionals reporting burnout symptoms, those of us therapists working with trauma must intentionally implement self-care practices and select treatment modalities that mitigate the risk of secondary traumatic stress.

I was one of those trauma therapists who succumbed to burnout.

Ten years ago, I closed my private practice. Then, I reluctantly returned in the summer of 2020 to “do my part” during the global COVID-19 pandemic.

Fortunately, I had experienced brainspotting therapy as a client a few years earlier.

Even though I hadn’t planned to return to private practice, my professional curiosity led me to complete the foundational Phase I brainspotting training after experiencing its clinical efficacy from the client perspective.

Prior to this, my practice had incorporated various trauma treatment protocols, including prolonged exposure, cognitive processing therapy, and parts work.

Upon returning to clinical work, I implemented brainspotting as my primary trauma intervention.

The unexpected benefit was how much this modality reduced my own clinical fatigue while maintaining—and often enhancing—therapeutic outcomes.

It has since remained my treatment approach of choice for trauma processing.

What is brainspotting?

“Where you look affects how you feel.” -David Grand, Ph.D.

Brainspotting is a brain-based trauma therapy, developed by David Grand, Ph.D. in 2003.

At that time, Grand was an EMDR therapist working with back-and-forth eye movements to help a client process trauma.

The client was a professional ice skater, and they had been periodically working on performance enhancement as well, addressing mental blocks to physical performance.

A primary focus of the performance work was this client’s inability to successfully complete a “triple lutz” jump in competition.

They had been working together for quite some time, but on this particular day, Grand noticed that as the client slowly moved her eyes back and forth horizontally, her eyes “wobbled” and stuck in one spot.

Although the EMDR protocol called for keeping the eyes moving, Grand followed this unusual body signal and simply held space for her while she held her eyes on that one spot.

Over the course of that session, she processed a cascade of traumas, some of which they hadn’t previously treated. Some had been treated, but a deeper layer emerged that day.

He stayed attuned with her as they both made space for the traumas to process.

Grand was astonished by the amount of material and the gentle swiftness with which it processed and resolved.

The next day, the client called to inform him that she had successfully completed a triple lutz! The performance block has never returned. He knew he was on to something important.

Over the last 22 years, Grand has trained thousands of therapists, and brainspotting has swiftly found its place in the vanguard of brain-body therapies available today.

Brainspotting therapy has a few unique characteristics that set it apart from other trauma therapies.

The uncertainty principle

David Grand bases the work on a fundamental concept: the uncertainty principle.

Borrowed from the field of quantum mechanics, the uncertainty principle states that we cannot know certain properties of a particle with perfect accuracy.

Grand applies this principle to the human mind: in an organ estimated to contain 100 billion neurons and 100 trillion neural connections, it’s impossible for us to know for certain how healing happens.

If we can’t possibly know what our client needs, we get to move into a position of curiosity and follow cues from our clients.

By “staying in the tail of the comet,” we allow our client’s brain and body to lead the way to healing.

The uncertainty principle frees the clinician from the expectation that they will be the one providing the “right” healing interpretation or treatment protocol.

I bring this principle into every moment of my sessions. As I talk with a client about an upsetting issue, I might (and often do) suggest brainspotting therapy to my client, but I never assume it’s what they need in order to heal, and they are free to decline.

Once a client begins brainspotting in our session, I focus solely on following my client’s physical sensations and other cues, such as blinking or swallowing. I maintain an attuned curiosity, noting these cues without needing to know what they mean. The client becomes the “head of the comet” and I the tail, following them wherever the process takes us.

For instance, we might sit largely in silence for most of our session, but, by no means, does that mean there’s nothing happening. To the contrary, some of the busiest and fastest-moving sessions are ones in which very little is spoken. The mind moves at warp speed and often veers off into seemingly unrelated memories or thoughts.

By maintaining a stance of mindful curiosity and staying in the tail of the comet, I’ve found that what might seem unrelated often leads us to core traumas or memories that unlock something important for the client.

Dual attunement

Brainspotting creates the conditions to heal trauma, and to heal attachment injuries, through the practice of “dual attunement.”

John and Julie Gottman define attunement as “a special kind of listening” that builds and protects connection. It is our essential ability to recognize, understand, and respond to another person’s inner world.

Dual attunement is a practice of simultaneously maintaining neurobiological attunement and relational attunement, both in the therapist and the client.

Brainspotting encourages neurobiological attunement via the therapist’s practice of staying tuned in to their own neurobiological signals as well as the client’s. It also involves gently prompting the client to periodically tune into their own physical sensations as emotions arise during processing.

Over time, the client increases their ability to be with the physiological expression of their pain and discomfort—tightness in the chest, heaviness in the belly, constriction in the throat—and to recognize as the pain shifts, decreases, and even dissolves.

Relational attunement is the ability to accurately understand and respond to another person’s emotions without merging or becoming upset by them.

In a brainspotting therapy session, the therapist practices relational attunement by staying mindfully focused on the client’s emotional experience.

The therapist may not verbalize their attunement; communicating non-verbally with a sigh or a hand on the heart, for example, can be very effective.

While the client experiences that empathy by being relationally attuned to the therapist, the truly transformative attunement occurs through the client’s relational attunement to their own inner world.

Healing attachment injuries through brainspotting therapy

“Pain is inevitable; suffering is optional.” -Haruki Murakami

Trauma occurs in many people’s lives and pain occurs in everyone’s.

The brainspotting therapy process has shown me that what seems to cause suffering for so many trauma survivors is their relationship to their pain, which often mirrors their attachment injuries.

Although the term “attachment style” has become a self-diagnosis du jour in the popular culture (#attachmentstyles is tagged in over 268,000 Instagram posts as of this writing), it’s a bit of a misnomer. Insecure attachment is a relational “style” borne of attachment injuries, many of which are based in trauma.

Every day I see clients relate to their pain—and by extension, themselves—in much the same way they relate to others: either anxiously clinging to, worrying about, or compulsively avoiding the pain living in their brain and body. Some show signs of a disorganized inner attachment that can include pain-seeking behaviors like cutting and destructive dating.

Brainspotting rewires the client’s brain by processing and integrating trauma, and by giving the client a chance to relate to themself in a more secure, compassionate, curious, and ultimately loving way.

By attuning to my client while staying attuned to and responsible for my own inner experience, I am modeling compassionate, curious attunement, and by extension, teaching them to attune to themselves with the same compassionate curiosity.

As they practice this inner relational attunement, they become more facile at “being with” their experience, without clinging anxiously to it or pushing it away in avoidance.

The dual attunement process creates a reparative attachment experience for the client.

As they experience the attunement of a calm, secure, regulated nervous system (mine) while attuning to themselves and re-regulating their own nervous system through trauma processing and co-regulation, they begin to experience themselves as a safe, secure base for their own inner life.

Developing their own “internal secure attachment” is one of the most profound outcomes of brainspotting therapy.

Brainspotting vs. EMDR

Several studies have compared the efficacy of brainspotting vs. EMDR and found them to have similar outcomes. Both brainspotting and EMDR are brain-based, using the eyes to access and process traumatic material in the subcortical brain and favoring focused mindfulness over talking.

Differences between the two methods include the use of a focused eye position, often augmented by bilateral stimulation via bilateral music in headphones (brainspotting) versus sweeping the eyes back and forth across the visual field to produce bilateral stimulation (EMDR).

EMDR has a set structure that usually follows eight phases of treatment, while brainspotting intentionally avoids protocols or set structures, favoring the therapist’s intuition and attunement.

EMDR was developed earlier than brainspotting therapy and has a more robust research history behind it at the time of this writing. However, brainspotting has been the subject of several research studies and is gaining traction as an evidence-based therapy.

Learn more

If you’re interested in learning more about brainspotting therapy, visit the Brainspotting website and consider registering for a Phase I training.

Brainspotting training will give you all the tools you need to begin using brainspotting with your clients.

Sources

• How Common is PTSD in Adults? Retrieved from the National Center for PTSD website.
• Lin, L., Assefa, M., & Stamm, K. (2023) Practitioners are overworked and burned out, and they need our support. APA Monitor on Psychology.
• Zimmer, C. (2011) 100 Trillion Connections: New Efforts Probe and Map the Brain’s Detailed Architecture. Scientific American Magazine.
• D’Antoni, F., Matiz, A., Fabbro, F., & Crescentini, C. (2022) Psychotherapeutic Techniques for Distressing Memories: A Comparative Study between EMDR, Brainspotting, and Body Scan Meditation. International Journal of Environmental Research and Public Health.
• Hildebrand, A., Grand, D., & Stemmler, M. (2017) Brainspotting – the efficacy of a new therapy approach for the treatment of Posttraumatic Stress Disorder in comparison to Eye Movement Desensitization and Reprocessing. Mediterranean Journal of Clinical Psychology.

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