Deep Brain Reorienting Therapy
Scroll down to find out more about Deep Brain Reorienting [DBR] and how it can support your journey to healing, addressing trauma and working through the shock of distressing memories
What exactly is DBR therapy?
Deep Brain Reorienting (DBR) is a neuroscientifically-guided therapy into PTSD treatment that targets the sequence of events that occurred in the brainstem at the time of a traumatic event. The sequence of events at the time of the initial shock during a traumatic event occurs through 3 areas of the brain that DBR targets. When something shocking occurs, the brain moves your eyes towards or away from the shocking experience before the higher levels of your brain (like your cortex) can think through what is happening and before you have an emotional response to what is happening. Therefore, since DBR therapy targets this sequence of the initial shock through this part of the brain, DBR could be an important way to process the initial moments of shock of a traumatic experience [Dr. Ruth Lanius]
What happens in a DBR session?
The DBR process involves bringing up a recent traumatic trigger (e.g., the harsh tone of a stranger’s voice) while mentally focusing on what happens in the muscles of the shoulders, neck, head and face. When we are faced with a threatening person or situation, we use these muscles to pay attention to it – we turn our head and eyes toward the threat, even before any emotion sets in. Throughout the session, the therapist guides the client to notice the tension, and slowly notice any sensations that change in the tension and any instincts to move their head. The therapist also helps the client mindfully observe if any emotions arise in response to the changes in tension.
At the end of the session, the therapist helps the client feel present and asks if their sense of themselves or their sense of the world has changed. By the end of the session, the client often feels a sense of relief physically and emotionally and has new perspectives, which they are encouraged to remain aware of after the session.
We anticipate that the DBR process of slowing down a traumatic memory,and paying attention to the related muscle tension might help people process the traumatic experience(s). Processing the memory in this way, from the bottom up, might change how it is stored in the brain, perhaps reducing PTSD symptoms. The person does not need to talk about the traumatic experience, which is one reason we are very excited about DBR, since talking about traumatic experiences can be too triggering for many people.
There are well-researched trauma psychotherapies which offer hope of full recovery as they are not dependent on top-down management of symptoms. These transformational approaches rely on the human brain having an inherent ability to find healing from emotional trauma when the memory of the initiating event is approached in a specific way.
However, it can often be difficult to get to the core of an adverse experience to liberate this healing flow. Sometimes it is difficult because returning to the event is emotionally overwhelming and there is a protective tendency to turn attention away from the memory as soon as possible. Sometimes there is a more evident dissociation from the present-day experience through numbing, blanking out, shutting down, or switching into a self-state like that which occurred at the time of the original trauma. Sometimes there has been a shock – before the emotions became intense – which replays so fast that it is easily missed during treatment. More commonly it is because the original experience that was so disturbing has been covered in layers of thoughts and feelings and distressing re-experiencing. It may also have been compounded by relational problems which themselves were precipitated by the continuing distress.