Deep Brain Reorienting
The Latest Advancement in Trauma Treatment
What is Deep Brain Reorienting (DBR)?
Deep Brain Reorienting (DBR) is a cutting-edge psychotherapy developed by Dr. Frank Corrigan, a psychiatrist with over 30 years of experience in the Scottish National Health Services. Dr. Corrigan has combined his extensive experience in treating trauma with his research on the neurobiology of trauma to create a transformational therapy that addresses the root of traumatic experiences deep within the brain.
DBR is grounded in neuroscience, focusing on brainstem activity—often referred to as the "lizard brain." This part of the brain houses the alarm system responsible for orienting to threats and triggering emotional and defensive responses.
How Does Trauma Affect the Brain?
During a traumatic event, a rapid sequence of deep brain activity occurs, often without our conscious awareness:
Orienting to the Threat: This can involve the eyes scanning, or noticing other sensations like sound or vibration.
Shock: This moment of realization can manifest as a gasp, recoil, or the sensation of your stomach dropping.
Emotional and Defensive Responses: Depending on the situation, you might feel anger and an urge to fight, panic and an urge to flee, or resignation leading to dissociation.
This sequence can become "stuck," leading to symptoms such as flashbacks, anxiety, and hypervigilance.
How Does DBR Work?
DBR works by guiding you through this sequence in ultra slow motion, allowing you to process the shock and defensive responses under the guidance of an experienced therapist. The result is that the original stimuli no longer trigger intense emotional responses, often leading to a new, integrated sense of self.
The process typically involves the following steps:
Identifying the Activating Stimulus: Your therapist helps you pinpoint a recent or past event that triggers unwanted reactions or symptoms.
Tapping into the Midbrain: Your therapist then helps you focus in the deep part of your brain that orients you to your surroundings.
Processing the Sequence: The therapist slowly guides you through the orienting tension, shock, and emotional responses, with a focus on how your body and nervous system experienced the event. This process emphasizes feeling over talking, relying on the therapist's expertise in trauma neurobiology to keep you on track.
How Effective is DBR?
Though DBR is relatively new, early research is promising. One study found that after eight weeks of treatment, PTSD symptoms were reduced by 36%-48%, with nearly half of the participants no longer meeting the criteria for PTSD.
In my clinical experience, DBR produces rapid results, similar to EMDR, but in a more subtle way. Unlike EMDR, which requires clients to process traumatic memories one at a time and in chronological order, DBR allows for a more flexible approach, addressing the entire neural network of related experiences at once.
Both DBR and EMDR are "bottom-up" therapies, but they target different areas of the brain. While EMDR focuses on the limbic system (the "mammal brain"), DBR works at the brainstem level (the "lizard brain"), at the root of the shock. I find that processing at this deeper level facilitates more integration.
DBR vs. EMDR and Talk Therapies
So, is DBR better than EMDR or talk therapies? It depends. Both DBR and EMDR excel at processing trauma more rapidly and deeply than traditional talk therapies. Both therapies seem to help clients viscerally understand how their trauma has shaped them—whether as people-pleasers or distrusting loners—and propell them towards self-actualization. I personally prefer DBR for trauma processing, although there are situations where EMDR may be more appropriate, such as cases of acute trauma or desensitization to specific environmental stimuli. Also, not everyone can do DBR. People should find what works best for them.
Talk therapies (top-down), like Internal Family Systems and Trauma-Focused Cognitive Behavioral Therapy, complement DBR and EMDR by helping clients logically integrate what they've processed and providing a break from the intensity of bottom-up processing. Some clients experience fatigue or ongoing processing after a DBR or EMDR session, so it's important to balance the intensity of these therapies with other approaches.
Ultimately, I collaborate with each client to structure their treatment plan based on what works best for them. Some prefer the intensity of DBR or EMDR in nearly every session, eager to put the past behind them. Others appreciate the pacing and integration offered by talk therapies.