Updated November 2026 · By Joel Blackstock, LICSW-S

In brainspotting, you hold your gaze on one eye position, found with a slowly moving pointer, and notice what a painful memory or symptom does in your body while a therapist watches closely. Its developer, David Grand, proposes that the fixed gaze engages midbrain orienting circuits such as the superior colliculus. That is a published hypothesis, not an observed mechanism, and the outcome trials so far are small.The argument of this page is that the defensible account of brainspotting is psychological, not anatomical. The method trains a person to orient toward distress, to keep attention on it while the body is activated, and to stay in contact with another person while that happens. Those ingredients are real, and they matter in trauma work. The brain-region story attached to them has not been tested. The one recording of brain activity during brainspotting that we could find, a small 2026 thesis, had no control condition and did not examine the structures the theory names. An earlier version of this article described the amygdala calming, the hippocampus rewriting memories and particular EEG waves rising during brainspotting. No study has shown any of that, and the papers cited for it were general reviews of fear circuitry and EEG, or studies of EMDR and neurofeedback, not studies of brainspotting. This rewrite separates what is known from what is proposed.

What happens in a brainspotting session

Grand is a New York clinician who trained in psychoanalysis, was trained in EMDR by Francine Shapiro, and worked for years as a sports psychotherapist. He dates brainspotting to 2003. In his account, told in his 2013 book and retold in a 2024 Psychotherapy Networker profile, he was using EMDR with a 16-year-old figure skater who could no longer land a triple loop. As his fingers crossed her visual field, her eyes wobbled and then locked at one point. He held his hand still there, and she reported a rush of memories and body sensations she had not reached before.^{1, 2} We tell the longer story in our profile of David Grand and the skater's frozen gaze. It is one clinician's anecdote, and it is the source of the method's central claim, Grand's motto that "where you look affects how you feel."²A typical session follows a short sequence:

• You bring an issue to mind: a memory, a symptom, a performance block, a feeling you cannot shake.
• You notice where it registers in your body and rate the activation from 0 to 10.
• The therapist moves a pointer slowly across your visual field, usually side to side and then up and down, to find the eye position where the activation feels strongest. That point is called the brainspot.
• You keep your gaze there, or in some sessions close your eyes once the spot is found, and let your attention go wherever it goes: images, memories, sensations, emotion, sometimes nothing for a while. The therapist mostly stays quiet.
• Every so often you re-rate the activation, and the cycle repeats until it settles or the session ends.²

Brainspotting trainings distinguish an "inside window," in which you report where the feeling is strongest, from an "outside window," in which the therapist watches for reflexive responses at a given eye position, such as a blink, a facial twitch, a yawn or a shift in posture. Grand treats responses like these as signs of midbrain activity.² Many therapists also use a "resource spot," an eye position where you feel calmer, as a place to return to when the work gets too intense. Corrigan and Grand describe the whole process as facilitated by a therapist "focused on the client and monitoring with attunement."³ In practice a session can look as if very little is happening. Much of it is silent.

The proposed brain mechanism, and what kind of claim it is

The fullest statement of how brainspotting is supposed to work is in two papers by Frank Corrigan, then at Argyll and Bute Hospital in Scotland, and Grand, published in Medical Hypotheses, a journal founded to publish theoretical proposals, including ones with little experimental support yet. The 2013 paper proposes that the body activation felt while describing a trauma has "a resonating spot in the visual field." It suggests that holding attention there engages a pathway from the retina to the superior colliculus and on to the medial pulvinar of the thalamus, the anterior and posterior cingulate cortex and a parietal region connected to the insula. It places the healing of "the altered feeling about the self" in the midbrain, at the superior colliculi and the periaqueductal gray.³ The 2015 follow-up argues that when arousal threatens to become overwhelming, full orientation to the traumatic memory fails to occur, and that brainspotting lets the orienting response complete so that the memory is "reconsolidated without distress."⁴The authors call these "testable hypotheses," and that is the right label. They are informed guesses about anatomy. A PubMed search in November 2026 returned just four records for the term, one of them an unrelated neurology editorial column. None of the other three imaged the brain, recorded EEG or measured these pathways during a session. Outside PubMed, the only attempt we found to record brain activity during brainspotting is a 2026 master's thesis at Carleton University in Ottawa. Nineteen adults without PTSD, each holding a distressing memory, had one laboratory session while EEG and heart rhythm were recorded. Broad EEG patterns associated with attention and salience shifted over the session and distress ratings fell, but heart rate variability did not change. There was no control condition, and the author cautions that attention, viewing conditions, expectancy or nonspecific therapy factors could account for the changes.⁵ It did not measure the colliculus or any other structure the hypothesis names. The earlier version of this page went further than its own sources. It described amygdala downregulation, hippocampal memory updating, anterior cingulate and prefrontal changes, N200, P300 and late positive potentials, alpha coherence and theta power as if they were likely features of the method. They are findings from other research, in other settings, with other questions.Some of the background science is solid. The superior colliculus is one of the most studied structures in the brain. Forty years of research show it is critical for turning an animal toward things of interest, and newer work ties it to attention and decision making.⁶ It also responds to threat. In a small functional MRI study of 16 adults with PTSD from prolonged childhood abuse and 16 healthy controls, the PTSD group showed increased activity in the superior colliculus, periaqueductal gray and locus coeruleus when a virtual face made direct eye contact. Healthy controls instead engaged prefrontal and temporal areas involved in social evaluation.⁷ And gaze position does affect recall: when people were made to look at the location where objects had been shown, they remembered how the objects were arranged better than when they looked elsewhere.⁸None of those findings shows that a particular eye position holds a particular traumatic memory, or that holding the eyes still changes anything in the colliculus. Where the eyes go and where attention goes are tightly linked, a subject we explore in what the eyes and pupils reveal about attention. The jump from there to a "brainspot" is the part nobody has tested. For the wider field of methods built on this kind of neuroscience reasoning, see new frontiers in brain-based therapies for trauma.

What the method is doing that we can defend

Set the anatomy aside and brainspotting has three active ingredients you can see in the room.Orienting toward distress. The setup asks you to turn toward the activation and find where it is strongest, not to manage it or look away. Avoidance is one of the core symptom clusters of PTSD, and the trauma therapies with the best evidence all find some way to approach what has been avoided. Brainspotting does this through the body and the visual field rather than through a detailed retelling, which some people find easier to tolerate.Sustained attention while activated. The fixed gaze gives attention an anchor. Instead of narrating the memory, you stay with what it does: tightness in the chest, heat in the face, an urge to move or to hide. That is close to what mindfulness-based and somatic therapies ask for. It also offers a way in for people who have few words for feelings. For clients with alexithymia, the difficulty identifying and naming emotions, a body-first method can be an easier place to start than conversation.An attuned relationship. The therapist sits close, watches and says little. That is not decoration. In a meta-analysis of 295 studies covering more than 30,000 patients, the strength of the working alliance correlated with outcome at about r = .28, across treatment types, countries and measures.⁹ A method that concentrates the therapist's attention this much may draw a good part of its effect from that.Two comparisons sharpen the picture. In EMDR, moving the eyes while holding a memory adds a moderate effect over the same procedure without eye movements, and in laboratory studies it makes the memory less vivid.¹⁰ The best-known explanation, first tested by Andrade and colleagues in 1997, is working memory: tracking the eye movements and holding the image compete for limited capacity, so the image becomes less vivid and less upsetting.¹¹ Brainspotting holds the eyes still. Whatever it does, that explanation does not carry over, which is one reason the two methods should not be treated as interchangeable. Our comparison of brainspotting and EMDR goes through the practical differences.The second comparison is memory reconsolidation, the idea that recalling a memory briefly makes it changeable before it is stored again. Brainspotting writers lean on it heavily. The idea grew out of animal research. A major critical review of the human studies found many observations consistent with reconsolidation, along with inconsistent results and alternative explanations, and called it "a viable but hotly contested explanation" for changes in memory.¹² It is a reasonable frame for any trauma therapy, not an established mechanism for this one.The most useful test of the orienting idea so far comes from a relative of brainspotting. Corrigan, co-author of the hypothesis papers, went on to develop Deep Brain Reorienting, which in its authors' words targets "the brainstem-level neurophysiological sequence that transpired during a traumatic event." In a randomized trial, 54 adults with PTSD were assigned to eight videoconference sessions of Deep Brain Reorienting or to a waitlist. Clinician-rated PTSD symptoms fell more in the treatment group, with large effects after treatment and at three months.¹³ It was an interim analysis against no treatment, and it is a different method, so the result cannot be borrowed for brainspotting. It does show that orienting-based ideas can be put to a proper test.

What the outcome research shows

The clinical evidence is thin, and critics point out that most of it comes from brainspotting practitioners.² These are the main studies.

• Hildebrand, Grand and Stemmler (2017). 76 adults seeking help after a traumatic event received three 60-minute sessions of either EMDR (23 people) or brainspotting (53 people). Self-reported PTSD symptoms fell in both groups. Effect sizes from baseline to the end of treatment were larger for EMDR (d = 1.19 to 1.76) than for brainspotting (d = 0.74 to 1.04). The abstract does not report random assignment, there was no untreated comparison group, and Grand was a co-author.¹⁴
• D'Antoni and colleagues (2022). Forty psychologists and physicians, not patients, each brought four distressing memories and received one 40-minute session per memory: EMDR, brainspotting, body scan meditation or book reading. Distress ratings were lower after EMDR and brainspotting than after the body scan or reading, both right after the session and at follow-up.¹⁵ This is a useful laboratory comparison. It says little directly about PTSD.
• Horton and colleagues (2023). Described by the National Center for PTSD as the first randomized trial of brainspotting: 63 people with PTSD seen in a private practice were assigned to five sessions of brainspotting or treatment as usual. Only 27 finished, 14 and 13 per group. Both groups improved. Among completers there was a statistically significant group-by-time interaction for PTSD and depression, but the authors did not report the follow-up tests needed to show where the groups differed; on visual inspection, the groups improved at a similar rate and the brainspotting group had better scores at a follow-up four to six weeks later.^{16, 17} The National Center for PTSD's review of the trial points to the small sample, high dropout, completer-only analysis, unconfirmed diagnoses and loosely defined comparison condition, and concludes that "methodologically stronger studies will be needed."¹⁷
• Glantschnig (2025). In one therapist's private practice in Austria, 100 adults distressed by a single stressful or traumatic event were randomly assigned to cognitive behavioral therapy with brainspotting from the start, or to the same therapy with brainspotting added only after the fourth or fifth session. Most did not have PTSD; seven met full criteria on a structured interview. By that early checkpoint, scores on the Impact of Event Scale had fallen much more in the brainspotting-first group. By the end of therapy and three months later, both groups had improved by similar, large amounts. The author delivered all the treatment and notes that allegiance effects cannot be ruled out.¹⁸
• Palsimon (2022). Thirteen women in residential care in the Philippines, with severe interpersonal trauma, received three sessions, and their symptoms were lower two weeks later. There was no comparison group.¹⁹

A 2015 critical review grouped brainspotting with energy psychology and yoga as novel trauma therapies that warranted closer study, in a field where many new methods enter practice without a solid evidence base.²⁰ That is still a fair summary. Compare the established options. A systematic review of 64 trials rated the evidence strongest for exposure therapy, including prolonged exposure, moderate for cognitive processing therapy and cognitive therapy, and low to moderate for EMDR and narrative exposure therapy. For exposure therapy, cognitive processing therapy, cognitive therapy and EMDR, fewer than four people had to be treated for one to lose the PTSD diagnosis.²¹ Brainspotting is not in that class yet.The claims that travel furthest online concern addiction and chronic pain. Grand has said brainspotting can help with substance use, fibromyalgia and chronic fatigue.² We found no controlled trial of brainspotting for any of those conditions. If pain is your main problem, the stronger psychological evidence currently belongs to approaches that have been through controlled trials, such as pain reprocessing therapy. In a single randomized trial of 151 adults with chronic back pain that had no identifiable tissue cause, it outperformed both an open-label placebo injection and usual care, and the difference was still present a year later.²² Our piece on fibromyalgia covers that condition in more depth. For addiction, brainspotting belongs at most alongside established care, never in place of it.

What this looks like in therapy

At Taproot Therapy Collective in Hoover, brainspotting is one tool inside a broader trauma practice, not a stand-alone promise. In general terms, this is how it tends to go.Assessment comes first. Before any eye-position work, the therapist needs your history, a sense of how stable daily life is, and a picture of how you handle being activated. People who dissociate heavily, lose time or go numb under stress need a slower pace and more time with resource spots and grounding. We explain that approach in brainspotting with severe dissociation.The work is quieter than talk therapy. You may spend long stretches looking at the tip of a pointer and noticing sensations. Some people cry, shake, yawn or feel suddenly tired. In Somatic Experiencing, Peter Levine's method, reactions like these are read as "discharge," a sign the nervous system is settling after arousal. That is an interpretation, not a measured process, and the research on Somatic Experiencing itself is preliminary and of mixed quality.²³ A careful therapist treats these reactions as information and keeps them within what you can tolerate. Some people feel tired or raw for the rest of the day, so it helps not to schedule anything demanding right after a session.Progress gets measured. The 0-to-10 activation rating is a within-session gauge, not an outcome measure. A standard questionnaire such as the PTSD Checklist for DSM-5, repeated every few weeks, shows whether symptoms are changing in daily life.It can be combined, or set aside. Brainspotting sits easily alongside parts-based work, EMDR and ordinary conversation. If several sessions produce intense experiences but your daily symptoms are not moving, the honest next step is to try something with stronger evidence, such as EMDR, cognitive processing therapy or prolonged exposure, rather than more of the same.It can be done by video. Grand demonstrates brainspotting over video calls, and the Deep Brain Reorienting trial was delivered entirely by videoconference.^{2, 13} For people elsewhere in Alabama, remote sessions are a practical option.

Choosing a brainspotting therapist in Alabama

Brainspotting is a technique taught through private trainings in phases. It is not a license. In Alabama it should be delivered by someone already licensed to practice psychotherapy, such as a licensed independent clinical social worker, a licensed professional counselor or a psychologist. Questions worth asking any therapist who offers it:

• What brainspotting training do you have, and what other trauma therapies do you offer?
• How do you assess dissociation, and what do you do if a session becomes too much?
• How will we know whether this is working, and what will we try if it is not?
• What do you think the evidence for brainspotting does and does not show?

A therapist who answers the last question with "it rewires the brain," or who promises results in a set number of sessions, is overselling. One who calls it a promising, under-tested method that they use within a wider trauma practice is giving you an accurate answer.If you are in the Birmingham area and want to talk through whether brainspotting fits what you are dealing with, our page on brainspotting therapy for trauma explains how we use it, and you can contact us to set up a first conversation. We will tell you plainly what it can offer and when another approach might suit you better.

References

1. Grand, D. (2013). Brainspotting: The revolutionary new therapy for rapid and effective change. Sounds True.
2. Lyford, C. (2024, January/February). Turning the spotlight on Brainspotting: Did an unexpected discovery reveal a quicker path to healing? Psychotherapy Networker. https://psychotherapynetworker.org/article/turning-the-spotlight-on-brainspotting
3. Corrigan, F., & Grand, D. (2013). Brainspotting: Recruiting the midbrain for accessing and healing sensorimotor memories of traumatic activation. Medical Hypotheses, 80(6), 759–766. https://doi.org/10.1016/j.mehy.2013.03.005
4. Corrigan, F. M., Grand, D., & Raju, R. (2015). Brainspotting: Sustained attention, spinothalamic tracts, thalamocortical processing, and the healing of adaptive orientation truncated by traumatic experience. Medical Hypotheses, 84(4), 384–394. https://doi.org/10.1016/j.mehy.2015.01.028
5. Comisso, L. (2026). Processing a triggering memory during a 'Brainspotting' session: Effects on brain microstate features and heart rate variability (Master's thesis, Carleton University). https://doi.org/10.22215/etd/2026-17049
6. Basso, M. A., & May, P. J. (2017). Circuits for action and cognition: A view from the superior colliculus. Annual Review of Vision Science, 3, 197–226. https://doi.org/10.1146/annurev-vision-102016-061234
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8. Johansson, R., & Johansson, M. (2014). Look here, eye movements play a functional role in memory retrieval. Psychological Science, 25(1), 236–242. https://doi.org/10.1177/0956797613498260
9. Flückiger, C., Del Re, A. C., Wampold, B. E., & Horvath, A. O. (2018). The alliance in adult psychotherapy: A meta-analytic synthesis. Psychotherapy, 55(4), 316–340. https://doi.org/10.1037/pst0000172
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11. Andrade, J., Kavanagh, D., & Baddeley, A. (1997). Eye-movements and visual imagery: A working memory approach to the treatment of post-traumatic stress disorder. British Journal of Clinical Psychology, 36(2), 209–223. https://doi.org/10.1111/j.2044-8260.1997.tb01408.x
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13. Kearney, B. E., Corrigan, F. M., Frewen, P. A., Nevill, S., Harricharan, S., Andrews, K., Jetly, R., McKinnon, M. C., & Lanius, R. A. (2023). A randomized controlled trial of Deep Brain Reorienting: A neuroscientifically guided treatment for post-traumatic stress disorder. European Journal of Psychotraumatology, 14(2), Article 2240691. https://doi.org/10.1080/20008066.2023.2240691
14. Hildebrand, A., Grand, D., & Stemmler, M. (2017). Brainspotting – the efficacy of a new therapy approach for the treatment of posttraumatic stress disorder in comparison to eye movement desensitization and reprocessing. Mediterranean Journal of Clinical Psychology, 5(1). https://doi.org/10.6092/2282-1619/2017.5.1376
15. 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), Article 1142. https://doi.org/10.3390/ijerph19031142
16. Horton, L. M., Schwartzberg, C., Goldberg, C. D., Grieve, F. G., & Brdecka, L. E. (2023). Brainspotting: A treatment for posttraumatic stress disorder. International Body Psychotherapy Journal, 22(2), 57–72.
17. National Center for PTSD. (2024). First RCT of Brainspotting. CTU-Online, 18(4). U.S. Department of Veterans Affairs. https://www.ptsd.va.gov/publications/ctu_docs/ctu_v18n4.pdf
18. Glantschnig, S. (2025). Einbettung von Brainspotting in Kognitive Verhaltenstherapie nach singulären belastenden/traumatisierenden Erlebnissen. Psychotherapie Forum, 29(1–2), 59–66. https://doi.org/10.1007/s00729-025-00275-5
19. Palsimon, T., Jr. (2022). The preliminary efficacy and clinical applicability of Brainspotting among Filipino women with severe posttraumatic stress disorder. Archives of Psychiatry and Psychotherapy, 24(1), 54–64. https://doi.org/10.12740/APP/143015
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21. Cusack, K., Jonas, D. E., Forneris, C. A., Wines, C., Sonis, J., Middleton, J. C., Feltner, C., Brownley, K. A., Olmsted, K. R., Greenblatt, A., Weil, A., & Gaynes, B. N. (2016). Psychological treatments for adults with posttraumatic stress disorder: A systematic review and meta-analysis. Clinical Psychology Review, 43, 128–141. https://doi.org/10.1016/j.cpr.2015.10.003
22. Ashar, Y. K., Gordon, A., Schubiner, H., Uipi, C., Knight, K., Anderson, Z., Carlisle, J., Polisky, L., Geuter, S., Flood, T. F., Kragel, P. A., Dimidjian, S., Lumley, M. A., & Wager, T. D. (2022). Effect of pain reprocessing therapy vs placebo and usual care for patients with chronic back pain: A randomized clinical trial. JAMA Psychiatry, 79(1), 13–23. https://doi.org/10.1001/jamapsychiatry.2021.2669
23. Kuhfuß, M., Maldei, T., Hetmanek, A., & Baumann, N. (2021). Somatic experiencing – effectiveness and key factors of a body-oriented trauma therapy: A scoping literature review. European Journal of Psychotraumatology, 12(1), Article 1929023. https://doi.org/10.1080/20008198.2021.1929023