Brainspotting therapy is a relatively new brain-body approach designed to help people access, process, and overcome trauma, emotional distress, and psychological symptoms by utilizing specific eye positions. Developed in 2003 by psychotherapist David Grand, PhD, this approach combines elements of eye movement therapies with focused mindfulness and somatic awareness to facilitate deep emotional processing.

While brainspotting shows promise in early research studies, it remains an emerging therapy with limited large-scale clinical trials compared to more established trauma treatments. Understanding its theoretical foundations, current evidence base, and potential applications can help individuals make informed decisions about whether this approach might be suitable for their mental health needs.

Table of Contents

  • What Is Brainspotting Therapy?
  • How Does Brainspotting Work?
  • The Development and History of Brainspotting
  • What Does Current Research Say About Effectiveness?
  • Who Can Benefit from Brainspotting?
  • What to Expect During a Session
  • Limitations and Considerations
  • Frequently Asked Questions
  • How Therapy Can Help

What Is Brainspotting Therapy?

Brainspotting (BSP) is a psychotherapeutic approach that uses fixed eye positions to help individuals process psychological trauma and emotional distress. The fundamental principle underlying brainspotting is that "where you look affects how you feel" — suggesting that specific eye positions can activate neural networks associated with traumatic memories and unprocessed experiences.

According to recent research, the therapist guides, through a pointer, the eyes of the client across the field of vision to find an appropriate eye position ("Brainspot") to "activate" the psychophysiological response to a traumatic memory. As opposed to EMDR, where the traumatic memory is the "target" of treatment, in BSP, the target is the visual point of activation. The purpose is thus to identify the Brainspot as this visual point that appears to promote the client's processing of the distressing or traumatic experience.

The approach integrates several therapeutic elements:

  • Focused mindfulness — maintaining awareness of internal experiences
  • Somatic awareness — attention to bodily sensations and responses
  • Dual attunement — the therapeutic relationship combined with neurobiological processing
  • Bilateral stimulation — optional use of bilateral sounds (BioLateral music)

How Does Brainspotting Work?

Theoretical Mechanisms

Brainspotting is theorized to work by accessing subcortical brain regions where trauma is believed to be stored. Pre-clinical work suggests the involvement of superior colliculus-mediodorsal thalamic-amygdalar pathways as potential neural substrates underlying clinical responses to EMDR. Further, a growing body of research demonstrating an intersection between the oculomotor and hippocampal memory systems suggests that eye position might play a crucial role in this relation.

The process involves several key components:

1. Eye Position and Neural Activation: The therapist helps identify specific eye positions that correlate with emotional activation or physical sensations related to the traumatic memory.

2. Subcortical Processing: By maintaining focus on a "brainspot," the therapy is thought to bypass the neocortex and access deeper brain structures involved in trauma storage and processing.

3. Dual Attunement: In Brainspotting therapy, the expression "dual attunement" refers to a process supposed to be both relational and neurological, through which the therapist continuously tries to remain connected to the therapeutic relationship, as well as to the client's brain-body response in therapy. According to this approach, the attuned, empathic, witnessing presence of the therapist promotes adaptive changes in the client.

4. Natural Processing: Unlike therapies requiring detailed verbal processing, brainspotting allows the brain's natural healing mechanisms to process trauma with minimal cognitive interference.

Session Structure

During a typical brainspotting session:

  • The client identifies a specific issue, memory, or physical sensation to focus on
  • The therapist uses a pointer or finger to guide the client's gaze across their visual field
  • When the client experiences increased activation (emotional or somatic), that eye position is held
  • The client maintains focused mindfulness on internal experiences while holding the eye position
  • Optional bilateral sounds may be played through headphones
  • Processing continues until the activation decreases naturally

The Development and History of Brainspotting

Origins and Evolution

David Grand, PhD, developed brainspotting in 2003 while working with trauma survivors, including those affected by the September 11 attacks. Therapist David Grand indicates he developed brainspotting in 2003 after working with 9/11 survivors and other patients. David Grand was previously trained in psychoanalysis in the 1980s and EMDR in 1993. He combined EMDR, psychoanalysis, and somatic experiencing into a modality he titled "Natural Flow EMDR," which became the precursor for brainspotting.

The discovery occurred during an EMDR session when Grand noticed that holding a client's eyes in a particular position led to significant emotional release and processing. This observation led to the development of a systematic approach for identifying and utilizing these "brainspots."

Current Status

As of 2024, brainspotting has grown significantly:- Although at least 6000 clinicians have been trained in brainspotting, with some sources reporting over 13,000 trained therapists

  • The approach is practiced internationally across multiple countries
  • Training programs are offered at various levels (Phase 1, 2, 3, and specialty trainings)
  • Professional organizations support ongoing education and certification

What Does Current Research Say About Effectiveness?

Research Findings

Current research on brainspotting shows mixed but increasingly promising results:

Comparative Studies with EMDR: A 2022 study published in the International Journal of Environmental Research and Public Health compared brainspotting with EMDR and other interventions. We explored the effects of a single 40-min session of Eye Movement Desensitization and Reprocessing (EMDR), Brainspotting (BSP), and Body Scan Meditation (BSM) in the processing of distressing memories reported by a non-clinical sample of adult participants. Design: A within-subject design was used. Methods: Participants (n = 40 Psychologists/MDs) reported four distressing memories, each of which was treated with a single intervention. EMDR, BSP, and BSM were compared with each other, and with a Book Reading (BR) active control condition, using as dependent measures, SUD (Subjective Units of Disturbance) and Memory Telling Duration (MTD) on a 4-point timeline: Baseline, Pre-Intervention, Post-Intervention, Follow-up. Results: SUD scores associated with EMDR, BSP, and BSM significantly decreased from Pre- to Post-Intervention (p < 0.001). At Post-Intervention and Follow-up, EMDR and BSP SUD scores were significantly lower than BSM and BR scores (p < 0.02).

PTSD Treatment Outcomes: Research from 2023 in The Canadian Journal of Psychiatry found positive results: Paired sample t-tests after six brainspotting (BSP) sessions showed a significant [t(8)=3.67, P =.006] drop in posttraumatic stress disorder (PTSD) symptoms as measured by the PTSD checklist for DSM-5 (PCL-5). There were also small improvements in levels of functioning as measured with the Work and Social Functioning (WSAS) scale [t(8)=2.65, P =.03] and the Quick Inventory of Depressive Symptomatology (QIDS; Wilcoxon Signed-Ranks test: Z = −2.13, P =.03).

Clinical Trial Results: A 2024 study comparing brainspotting to treatment as usual (TAU) found: In general, TAU was better initially posttreatment, while Brainspotting showed more longitudinal benefits at the follow-up stage.

Therapist Perspectives:

Following up on anecdotal data that BSP is more flexible and easier to learn than EMDR by therapists, in 2021, we conducted a survey of N = 112 therapists attending BSP training (all had EMDR experience and most were using BSP in therapy). A total of 82% of surveyed therapists reported that, on average, clients responded "better" or "much better" to BSP versus EMDR; 82% also reported that BSP versus EMDR integrated more easily into other treatment approaches.

Evidence Limitations

It's important to note significant limitations in the current evidence base:- First and foremost, the data is lacking. Brainspotting launched in 2003, yet peer-reviewed studies are still few and small, often 20-60 participants. Most focus on PTSD; randomized controlled trials (RCTs) are limited, and almost none compare brainspotting head-to-head with established treatments like EMDR or prolonged exposure

The evidence base for brainspotting is limited; small pilot and comparative studies suggest possible benefits, but its theoretical foundations have not been empirically validated

  • Many studies have small sample sizes or use non-clinical populations
  • Long-term follow-up data is limited

Who Can Benefit from Brainspotting?

Primary Applications

Research and clinical reports suggest brainspotting may be helpful for:

Trauma and PTSD:

  • Post-traumatic stress disorder (PTSD)
  • Complex trauma
  • Single-incident trauma
  • Developmental trauma

Anxiety and Mood Disorders:

  • Generalized anxiety disorder
  • Depression
  • Panic disorder
  • Social anxiety

Other Conditions: Clinical practitioners report using brainspotting for:

  • Chronic pain conditions
  • Performance anxiety
  • Attachment difficulties
  • Grief and loss
  • Substance use disorders
  • Attention issues (ADHD)

Research on Specific Populations

Recent studies have examined brainspotting with various populations:

  • Veterans: Studies show promise for military-related PTSD
  • Women with severe PTSD: The preliminary efficacy and clinical applicability of Brainspotting among Filipino women with severe posttraumatic stress disorder
  • Test anxiety: Research on academic performance anxiety
  • Children: Emerging applications with anxiety symptoms in school settings

What to Expect During a Session

Initial Assessment

  • Discussion of presenting concerns and treatment goals
  • Explanation of the brainspotting process
  • Assessment of current distress levels
  • Identification of body sensations related to the issue

The Brainspotting Process

1. Activation: Focus on a specific memory, issue, or body sensation

2. Scanning: Follow the therapist's pointer to find the "brainspot"

3. Processing: Maintain eye position while observing internal experiences

4. Integration: Allow natural resolution and decreased activation

5. Closure: Discussion of the experience and grounding exercises

Session Frequency and Duration

  • Sessions typically last 50-90 minutes
  • Frequency varies based on individual needs (weekly or bi-weekly)
  • Number of sessions depends on complexity of issues
  • Some report significant change in 3-6 sessions, while others need longer treatment

Limitations and Considerations

Scientific Debate

The scientific community remains divided on brainspotting:

Concerns Raised by Critics:- Brainspotting is depicted as a clear pseudoscientific trauma treatment. Clinician characteristics and professional demands predict pseudoscience adoption

The authors of this thorough analysis (McKay D & Coreil A, 2024) concluded that brainspotting meets the criteria for a pseudoscience because it makes fantastic claims of outcome and has a built-in component that insulates the method from disconfirmation. Brainspotting is not an evidence-based treatment; furthermore, it is not grounded in any basic science that connects its purported mechanisms to neurobiological aspects of trauma

Professional Guidelines:- The American Psychological Association does not list brainspotting as a recommended intervention for PTSD under its clinical practice guidelines for mental health professionals

  • The APA's 2025 Clinical Practice Guideline for PTSD recommends evidence-based treatments such as cognitive processing therapy, prolonged exposure, and conditionally recommends EMDR

Important Considerations

1. Limited Research Base: Compared to established treatments, brainspotting has fewer rigorous studies

2. Theoretical Questions: The exact mechanisms remain unproven

3. Training Variability: Quality may vary among practitioners

4. Not First-Line Treatment: Currently not recommended as primary treatment by major organizations

5. Individual Response: Results vary significantly between individuals

Frequently Asked Questions

How is brainspotting different from EMDR?

While both use eye positions, key differences include:

  • Eye movement: EMDR uses bilateral eye movements; brainspotting uses fixed positions
  • Processing style: EMDR follows specific protocols; brainspotting is more flexible
  • Verbal processing: EMDR includes cognitive components; brainspotting emphasizes somatic awareness
  • Session structure: EMDR has eight phases; brainspotting is less structured

Is brainspotting evidence-based?

Brainspotting has emerging research support but is not yet considered a fully evidence-based treatment by major psychological organizations. Currently, brainspotting is still considered a newer therapeutic approach, and yes, there's limited research available compared to long-established methods like cognitive behavioral therapy. But that doesn't mean it's not effective. In fact, the early studies we do have are quite promising.

How many sessions are typically needed?

The number varies based on individual needs and issue complexity. Some studies report improvements in 3-6 sessions, while complex trauma may require longer-term treatment. A small (N = 53) trial demonstrated that just three BSP sessions were as effective as EMDR in treating PTSD symptoms (EMDR typically averages 8–12 sessions).

Can brainspotting be done online?

Some practitioners offer online brainspotting, though in-person sessions are generally preferred. The effectiveness of online delivery is still being studied.

What are the risks or side effects?

Brainspotting is generally considered low-risk, but potential effects include:

  • Temporary increase in emotional distress
  • Fatigue after sessions
  • Vivid dreams or memories surfacing
  • Physical sensations or discomfort

Always work with a properly trained therapist who can provide appropriate support.

Is brainspotting suitable for everyone?

Brainspotting may not be appropriate for:

  • Individuals with certain eye conditions
  • People experiencing active psychosis
  • Those with severe dissociative disorders (without proper preparation)
  • Individuals unable to tolerate emotional activation

How Therapy Can Help

If you're considering brainspotting therapy or other trauma-focused treatments, working with a qualified mental health professional is essential. Many therapists integrate brainspotting with other evidence-based approaches to provide comprehensive care tailored to individual needs.

When seeking treatment for trauma or PTSD, consider:

  • Therapists trained in multiple trauma-focused modalities
  • Professionals who stay current with research
  • Practitioners who can explain their approach clearly
  • Those who prioritize the therapeutic relationship
  • Clinicians who offer informed consent about treatment options

Remember that healing from trauma is possible, and various therapeutic approaches can support recovery. Whether through brainspotting, EMDR, cognitive-behavioral therapy, or other evidence-based treatments, the key is finding the right fit for your unique needs and circumstances.

Find a Therapist

Ready to explore your therapy options? GoodTherapy can help you find qualified mental health professionals in your area who specialize in trauma treatment and various therapeutic approaches. Our directory includes therapists trained in brainspotting, EMDR, and other evidence-based treatments for trauma and PTSD.

Search for a therapist near you who can help you on your healing journey.

References:

  1. American Psychological Association. (2025). Clinical practice guideline for the treatment of posttraumatic stress disorder (PTSD) in adults. Retrieved from https://www.apa.org/ptsd-guideline
  2. American Psychological Association. (2024). Guidelines for working with adults with complex trauma histories. Retrieved from https://www.apa.org/practice/guidelines/adults-complex-trauma-histories.pdf
  3. Corrigan, F. M., & Grand, D. (2015). Recognition of the neurobiological insults imposed by complex trauma and the implications for psychotherapeutic interventions. BJPsych Bulletin, 39(2), 79-86. https://doi.org/10.1192/pb.bp.114.047134
  4. 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, 19(3), 1142. https://doi.org/10.3390/ijerph19031142
  5. Dyben, J. (2024). A preliminary examination of the efficacy of brainspotting. Hanley Center White Paper. Retrieved from https://www.hanleycenter.org/brainspotting/
  6. Edwards-Stewart, A., Smolenski, D. J., Bush, N. E., et al. (2021). Posttraumatic stress disorder treatment dropout among military and veteran populations: A systematic review and meta-analysis. Journal of Trauma Stress, 34(4), 808–818. https://doi.org/10.1002/jts.22653
  7. McKay, D., & Coreil, A. (2024). Hypothesis testing of the adoption of pseudoscientific methods. Medical Hypotheses, 182, 111229. https://doi.org/10.1016/j.mehy.2023.111229
  8. National Institute of Mental Health. (2024). Transforming the understanding and treatment of mental illnesses. Retrieved from https://www.nimh.nih.gov/
  9. Substance Abuse and Mental Health Services Administration. (2022). Understanding childhood trauma. Retrieved from https://www.samhsa.gov/child-trauma
  10. Talbot, J., de la Salle, S., & Jaworska, N. (2023). A paradigm shift in trauma treatment: Converging evidence for a novel adaptation of eye movement desensitization and reprocessing (EMDR). The Canadian Journal of Psychiatry, 68(4), 283-285. https://doi.org/10.1177/07067437221142283