Image by Zoltan Tasi on Unsplash @zoltantasi
This writing expands on an earlier post I wrote about the differences between EMDR and Brainspotting. It’s long enough to be an article so if you want the short version, which includes a comparison chart, see my October blog post.
EMDR and Brainspotting are both powerful healing modalities, Eye Movement Desensitization and Reprocessing therapy (EMDR) was discovered in 1987 by Francine Shapiro, PhD, a clinical psychologist. Dr. Shapiro was taking a walk in the park when she noticed that her upsetting thoughts dissipated as she quickly moved her eyes from side to side. She formed the hypothesis that the bilateral movement of her eyes created a relaxed state in her brain which helped her to release the upsetting thoughts.
Dr. Shapiro incorporated eye movements into her clinical work and eventually created her own therapy protocol which included additional sources of bilateral stimulation like tappers and auditory tones. A cognitive component was added to address “negative cognitions”, a term Dr. Shapiro used to describe unproductive thought and feelings toward oneself. She designed a “future template” to allow clients to imagine and integrate a positive outcome to their issue.
During a typical session, clients are asked to bring up a target memory and hold the most disturbing aspects of that memory in their minds while the therapist’s hand moves across their field of vision. The back-and-forth movement of the hand stimulates both sides of the brain (bilateral stimulation). There is a large body of research available on the effectiveness of this modality, and the quality of the experience of bilateral stimulation is described as similar to the mechanisms of REM (Rapid Eye Movement) sleep.
Some clients prefer handheld tappers or bilateral sounds to eye movements. The tappers connect to a control box using six-foot wires and small paddles that people hold in their hands as they vibrate in an alternating fashion, providing gentle tactile stimulation. About every 30 seconds to a minute (the interval varies by client) the therapist asks, “What are you getting?” The client responds briefly by saying something like “An image of myself as a child sitting alone on the front steps” and the therapist says, “Go with that.” Clients may also report emotions, sensations, or thoughts. This continues throughout the session and the combination of the bilateral stimulation and relationship with the therapist create the containment necessary for clients to re-process and integrate disturbing memories from the past in present time.
The result is that the meaning of those memories is transformed, and eventually clients feel empowered and relieved. Clients often notice a changed attitude toward themselves and the disturbing memory. The final phase includes developing an imaginary future template which involves visualizing and tapping in a more positive resolution to the issue. This is a brief description of EMDR.
Brainspotting was discovered by Dr. David Grand in 2003. Dr. Grand is a psychoanalyst who was trained in EMDR by Dr. Shapiro. He had been practicing and teaching EMDR for years and he noticed that many of his clients reported feeling overwhelmed after their sessions. In response to his clients feedback, he developed his own version of EMDR which he called Natural Flow EMDR. His training in Somatic Experiencing with Dr. Peter Levine had a significant impact on his EMDR work.
He used slower eye movements which appeared to be more soothing and when clients got too activated, he asked them to shift their attention to a place in their bodies where they felt more settled and relaxed; he even produced his own bilateral music for people to listen to during their sessions.
Dr Grand’s discovery of Brainspotting occurred during a Natural Flow EMDR session with a young woman who was a professional ice skater. Her childhood trauma was affecting her athletic performance, specifically, her ability to complete a “triple loop”. He noticed that during EMDR when his fingers crossed the midline of his client’s nose, her eyes began to wobble. When he stopped and held his fingers still in front of her eyes, they locked into place, and she was able to process memories that had not surfaced during the prior year of twice weekly EMDR sessions. The next day she called him from the skating rink and reported that she was able to perform the triple loop several times without any problem.
Dr. Grand’s clientele included many therapists who were interested in trying this new technique; these were his first Brainspotting clients, though he hadn’t yet named the modality. He began his sessions in his usual EMDR way, asking clients to bring up a disturbing issue. Then he looked for reflexive responses like eye wobbles, deep inhales/exhales, swallows, and changes in their facial expressions. When he noticed a response, he kept his hand still and waited. Once they found the eye position, his clients reported deep, profound processing which continued during between sessions.
Brainspotting is based on a fixed eye position, while EMDR utilizes eye movements. At the beginning of a session, clients are invited to explore anything in their lives that feels unpleasant or disturbing. The client does not have to have a memory of what happened for the process to be effective. The focus is on the client’s felt sense in the moment as they describe the issue, and the presenting problem sometimes changes during the processing.
Brainspotting utilizes a simple set of steps called a “setup.” At the start of each session, people are asked to describe the issue they want to work on and identify their level of activation using a Subjective Unit of Disturbance (SUDS) scale of 0-10; EMDR uses this same scale. The word activation is used to describe the emotional and somatic distress associated with this situation.
The distress emerges as the client begins to describe their issue, tracking uncomfortable sensations in the body, painful emotions, disturbing thoughts, or images. The client is invited to listen to bilateral music using headphones playing at a low volume. Some clients prefer to put the music on at the start of the session and some wait until they have described their presenting problem.
Once the client rates their level of activation, if it is high enough (5 or greater) then the next step is finding a Brainspot, an eye position that corresponds to their current experience of the distressing issue. The therapist asks the client what they are noticing in their body and uses a pointer to assist the client in locating a Brainspot where that sensation feels the strongest. Locating the spot occurs by first tracking the client’s eyes horizontally and then vertically with the pointer. Finding the spot is an intuitive process and clients are often surprised by how quickly they locate it.
The spot functions like a portal, allowing access into the deep, subcortical part of the brain where trauma is stored. Once the brainspot is located, a period of focused mindfulness (processing) begins. During this time, the therapist and client are not talking much, this is an important distinction from EMDR where the therapist is checking in more frequently. In Brainspotting training, therapists learn the acronym WAIT, which means “Why Am I Talking”, because talking takes the client out of the subcortical brain and into their neocortex, the thinking, planning brain.
The client focuses on the pointer and periodically checks in, reporting sensations, emotions, and images to the therapist. The therapist may offer brief words of encouragement or invite the client to quietly notice their internal experience, alternating with long periods of silence to allow the client to drop into the experience without getting distracted by having to respond to the therapist’s questions.
Clients track and name sensations in their bodies along with any emotions that arise. People sometimes notice a “slideshow” of images as their brain integrates disturbing material from the past that was activating the issue in the present. The client’s nervous system goes through cycles of regulation and dysregulation throughout the session.
The last ten minutes of the session are reserved for clients to discuss anything significant that arose during the processing (or not) and return to a more grounded state before returning to their day. The processing “work” continues between sessions and many clients notice increased access to sensations, emotions, and images along with vivid dreams (processing) for the next several days or longer.
The first time someone practiced Brainspotting on me was during a training and afterward I walked into Whole Foods feeling like everyone in the store loved me; it felt as if a layer of protection had been removed from my heart.
In addition to processing distress, Brainspotting can be used for expansion work, where clients focus on increasing their strengths as opposed to reducing activation. Expansion work can be used to address performance issues, remove creative blocks, help athletes prepare for events, and a wide variety of other situations where people want to expand on an existing strength. I especially like using this setup with parents, we focus on their parenting strengths which reduces their pressure to be perfect parents.
This is a very brief description of Brainspotting, to learn more I recommend reading David Grand’s book “Brainspotting: The Revolutionary New Therapy for Rapid and Effective Change.” Dr Shapiro has written many books on EMDR and there is more information available on the EMDR Institute website www.emdr.com. I am also trained in Attachment Focused EMDR, and highly recommend Dr. Laurel Parnell’s training and books; you can learn more about her work at https:drlaurelparnell.com
I welcome your comments on this article, I realize I have only scratched the surface on this interesting subject!
