What to Expect in Your Brainspotting Session
The field of psychotherapy continues to expand beyond what you may know as traditional talk therapy (think of the stereotype of laying on the sofa with the therapist sitting next to you, notepad in hand) by the development of what are known as brain-based therapies.
What are brain-based therapies?
A brain-based psychotherapy, also known as neuroscience-informed therapy or neurotherapy, deepens the practice of psychotherapy because it incorporates neuroscientific insights and knowledge into therapeutic interventions.
A brain-based psychotherapy works with the intricate functioning of the brain in order to enhance the effectiveness of mental health treatment. Brainspotting is one such brain-based psychotherapy.
Ok, so what is Brainspotting?
Brainspotting is a neuroexperiential model for psychotherapy, where it uses the connection between your visual perception and the brain’s subcortex in order to process emotional experiences, trauma and distress. Brainspotting can also be used for performance enhancement.
Brainspotting was founded by Dr. David Grand in 2003, who initially identified the concept of brainspotting while working with an athlete focusing on performance enhancement, and who also had been working with Dr. Grand on past trauma. While in this particular session, Dr. Grand had been performing EMDR with this client when he noticed his client’s eye bobble in an unusual way when he moved his finger in front of it. He then paused his finger in front of her eye which led to the client processing traumatic experiences that had not been previously touched upon in their work.
As a result of this revelation in the session, and subsequent and continued research and development, Brainspotting’s central concept of ‘where you look affects how you feel’ may be a psychotherapy that can help in your emotional healing.
What is a Brainspot?
As just mentioned, the concept behind Brainspotting therapy is ‘where you look affects how you feel.’ This means where you hold your gaze acts somewhat like a ‘portal’ that can activate a specific area of your brain connected with your experiences and memories, both positive and negative.
You already do this naturally. For instance, you may find yourself ‘staring off into space’ or looking in a certain direction while daydreaming, perhaps feeling emotions come up that catch you off guard. It is these particular spots, where you hold your gaze, that are called brainspots.
How does Brainspotting work?
Because there are 1-4 quadrillion connections in the brain, all facets of how brainspotting ‘works’ have not been identified. However, Brainspotting engages the areas of the brain whose role is associated with emotional regulation. The Brainspotting process is facilitated through dual attunement and embracing uncertainty by both the therapist and client.
How do attunement and embracing uncertainty work in Brainspotting?
In Brainspotting, dual attunement and uncertainty are interconnected. You cannot have dual attunement without embracing uncertainty and vice versa. Dual attunement refers to the relational connection and neurobiological connections within and between the therapist and client.
In a brainspotting session, therapists maintain a steady physical and emotional presence with their clients. The therapist bears witness to the client’s processing and maintains a supportive presence for the client as the client experiences a physical, emotional and/or verbal catharsis.
Dual attunement within the brainspotting session cannot develop without embracing and surrendering to uncertainty. Embracing uncertainty refers to being open and curious to what occurs during a Brainspotting session within the context of the therapeutic relationship. As I said earlier, there are 1-4 quadrillion connections in the brain. Neither the therapist nor the client can predict exactly which of these quadrillions of connections will be accessed in a Brainspotting session, and how they’ll be expressed through the client.
However, uncertainty does not mean chaos. In Brainspotting there is a frame, and the frame works with what the client brings into the session. This can be the issue the client wants to address as well as what the client feels and verbalizes, and the physical and emotional responses to the issue.
It is this holistic frame the client provides that the therapist mindfully receives and holds. As the therapist and client embrace and surrender to uncertainty, and stays curious, the therapist can bring in their expertise to help shape this frame with the client so processing may be optimized. This dynamic is what supports and expands the attunement.
What will my Brainpotting session look like?
Brainspotting therapy can occur online or in person. When you are in your session with your therapist, the therapist will ask you what the issue is that you would like to address. This can be any issue that you feel at that moment you would like to work on. I’ve had clients want to work on feeling aggravated after an argument with their spouse, and clients would want to work on a traumatic experience from childhood. You can decide on an issue prior to session and then shift to a different issue once in session. It is up to you.
Once you choose the issue you would like to work on and have provided the information about the issue you would like to convey, your therapist will ask you if you’re feeling “activated” around this issue. Activation in this case refers to any uncomfortable feelings, sensations or emotions that are occurring as you disclose (or not disclose) information about the issue.
Feelings of activation can also be positive. For example, if you’re working on performance enhancement, the activation can center around the positive feelings relating to the skill you want to build up.
Sometimes, activation can be detected by your therapist as you convey information about this issue. In that case, your therapist will state that they notice you seem to be activated and then ask to confirm if they’re correct.
When you confirm you’re feeling activated, your therapist will take what’s called a SUD. A SUD is a 0-10 scale that stands for “subjective unit of disturbance.” In this case, 0 = no activation, or neutral and 10 = the worst feelings of activation you can imagine. Your SUD is a tool to help your therapist understand your level of activation. There is no right or wrong and the scale may not need to be used at all.
What is an activation vs. a resource spot?
You can then collaborate with your therapist as to whether you would like to brainspot through an activation spot or a resource spot. An activation spot is a brainspot that is identified based on using your activation as a gauge and tuning in to a spot that further elicits the activation you’re feeling.
A resource spot, or adding a resource to finding a brainspot, is identified by relying on neutral/calm/less activating sensations. Adding a resource is like adding a buffer. You’re still processing the issue, but the ‘buffer’ helps to diffuse the impact of the processing if you’re starting from a more activated place. Multiple resources can be applied, if needed.
When I ask a client for their SUD, no matter the level they report, I usually offer the option of a resource spot. I have found that even with a lower SUD, a client still might want added resource(s). Or sometimes, making the offer helps the client to feel more comfortable with the process, and feel supported. A resource can be incorporated at any time during the brainspotting process.
What then?
It is at this point, depending on how a spot is chosen, the therapist may bring out a pointer. The pointer is a retractable pointer that is typically used for presentations. The pointer helps to identify and maintain a precise brainspot for the client to notice, or treat as a home base during the process if the client’s gaze naturally explores other spots.
There are multiple ways that a spot can be chosen. I won’t go into each method in detail, but will say in a broader sense that choosing a brainspot can be accomplished either by relying on the therapist’s observations or collaboratively between the therapist and client.
The client can also apply Bio-lateral music, through headphones/earbuds. Bio-lateral music is music that is experienced bilaterally where the music alternates left and right though the headphones/earbuds. Bio-lateral music can assist in the brainspotting processing, but is optional.
The therapist and client typically discuss and agree on which approach to take in finding a brainspot and applying Bio-lateral music for the issue being worked on.
Once a brainspot is identified, the client will gaze at it and start to process. The strength of dual attunement and embracing uncertainty become paramount here. Neither the therapist nor the client will know specifically where the processing will go, but both can feel that the client is being noticed, heard and supported.
In general, processing can bring up memories, images, feelings, emotions and/or body sensations of the deeply held (remember subcortex?) experiences that are informing the issue being worked on. The expression of these memories, images, feelings, emotions and/or body sensations in the presence of your attuned therapist allows for the client’s mind to engage its natural healing system.
Everyone processes differently. Some clients speak throughout the brainspotting process, others process in silence. Processing typically occurs in waves where there is an increase in feelings, emotions and body sensations and then a feeling of release or calm.
Clients lead the therapist here. The metaphor for this dynamic is that the client is a comet and the therapist is in the tail of the comet. The client leads the therapist to where the client needs to go and the therapist takes the ride with the client as the passenger only, not a backseat driver.
The therapist will check in with the client at points during the session. These points can be based on either an agreed amount of time, or through the therapist’s attunement with the client. When checking in the client is asked to notice where they began with the issue, and how they feel now (or their SUD, if used).
Check-ins become more frequent toward the end of the session to ease the client out of processing. Or, the client may decide they are at a place they would like to end processing for the session.
Coming to the end of the session
When the client is done processing or it’s the end of the session, your therapist will ask if it is ok to remove the pointer (if used). Once the client gives the ok to remove the pointer, the therapist may debrief with the client.
Like EMDR, the processing continues after a Brainspotting session. Clients are asked to notice any new insights, thoughts, memories or dreams. Clients can also be provided the option to contact the therapist before the following session, if needed.
That’s it!
That’s your Brainspotting session. When you return for your next session, you and your therapist will follow up on any insights, thoughts or shifts since your last session. You both can then collaborate on next steps…and brainspot another issue.