Deep Brain Reorienting (DBR)
Los Angeles
What is DBR?
Developed by Scottish psychiatrist Dr. Frank Corrigan, Deep Brain Reorienting is a newer trauma treatment that targets the physiological sequence that unfolds in your body when something unexpected or frightening occurs.
By the time you are consciously aware of a threat, such as that car almost cutting you off, your brain has already sounded its own alarm. Sometimes, though, these internal alarm systems can get stuck.
DBR treats trauma by tracking and targeting this alarm system at its earliest, preconscious stage. By allowing any stuck processes to complete, DBR may change how trauma is stored as well as the oversensitivity of the alarm itself.
The benefits of DBR for treating trauma:
DBR does not require you to talk about traumatic material. Instead, initial focus can simply be a recent time something grabbed your attention, like seeing that Slack message from work, or hearing that tone in your partner’s voice.
In spite of the present-day focus, DBR may reach early experiences that preceded language or memory, making it effective for treating complex trauma, adverse childhood experiences, and relational trauma.
You may notice an outsized defensive pattern, such as the urge to fight, flight, freeze, please and appease, go numb, or get incredibly sleepy. DBR targets the brain structure (PAG, see below) associated with these survival responses and with emotional reactions such as fear, grief, rage, and shame.
DBR is unique in targeting the shock residue from childhood attachment injuries and other traumas. This shock may be maintaining and amplifying painful feelings in the here and now.
DBR follows the natural physiology of the brain in a way that minimizes overwhelm, flooding, dissociation, and unhelpful cognitive analysis.
The rapid sequence DBR tracks in the brain
THE THEORY UNDERLYING DEEP BRAIN REORIENTING
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The brainstem, which connects your brain to your spinal cord, is responsible for many essential and automatic functions, like your heartrate, breathing, and blood pressure.
Whenever you encounter something unexpected, even horrifying, several regions in the brainstem react. These reactions are outside of your control and even your initial awareness. DBR tracks and targets three of these regions particularly critical to trauma processing: the superior colliculi, the locus coeruleus, and the periaqueductal gray.
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The superior colliculi first detect a potential threat through your senses. They may pick up potential danger through what you see, hear, or touch, for instance, as well as through the recall of a traumatic memory.
Depending on the nature of the trigger, the superior colliculi then coordinate your head and eye movements and orient you toward or away from the stimulus, creating tension in your forehead, around the eyes, and/or at the base of the skull in the process of preparing you for movement.
It is this “Orienting Tension” that DBR utilizes as a gateway into and anchor for safe trauma processing.
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In response to the detected threat, especially if it is horrific or shocking, the locus coeruleus — a brain region in close contact with the superior colliculi — may blast noradrenaline to many areas of the brain to quickly increase arousal, vigilance, and readiness for action.
During the DBR process, which slows down this sequence, you will process some of this residual shock activation.
For instance, you may experience fleeting electrical sensations, sudden heat or cold, pressure in the head, muscle bracing, or shivering during this part of the process.
DBR hypothesizes that shock, left unprocessed, amplifies the intensity of emotions associated with trauma. Therefore, there is a strong emphasis on first digesting this pre-affective shock during DBR.
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As shock dissipates, both active and passive defense strategies (like fight, flight, freeze, or shutdown) and emotional responses (like rage, grief, fear, or shame) may become more apparent.
These reactions are largely governed by another structure in the brainstem, the periaqueductal gray (PAG).
At times, you may also become aware of an underlying aloneness pain, or pain related to past experiences of abandonment, rejection, humiliation, betrayal, or injustice.
This pain, often diffuse and initially hard to notice or name, may actually be driving the PAG’s emotional responses and defensive reactions.
Tracking and following the naturally unfolding physiological sequence is thought to help complete stuck processes and allow healing from a deeper part of the brain.
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Because DBR slows down the rapid sequence occurring in the superior colliculi, locus coeruleus, and periaqueductal gray, it can help separate out and process through aspects of traumatic experience that may otherwise be inaccessible or feel overwhelming.
Much of the session is spent mindfully noticing and allowing the ebb and flow of shock sensations, underlying pain, survival impulses, and emotions to surface at a tolerable pace and in a manageable way.
In slowly and gently beginning to turn towards these difficult experiences, DBR can help loosen entrenched patterns of defense and improve emotion regulation. Dissolved blocks may give way now to increased motivation and vitality. New understandings and experiences of the self may also emerge.
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The first randomized controlled trial of DBR was published in 2023.
Results showed that, after eight 90-minute DBR sessions conducted online, over 48% of participants who received DBR no longer met the criteria for PTSD.
The waitlisted (control) group, in contrast, did not show any significant improvements.
Only 1 person dropped out of the study, suggesting that DBR may be better tolerated than many other trauma modalities.
This is considered a large effect size and additional research is expected.
What does a typical DBR session look like?
Together we’ll select a recent incident that grabbed your attention. We’ll get specific about the moment you first became aware something was off. Perhaps it was something you saw or heard, whether related to a person or something else in your environment.
We’ll set that aside while I take you through a brief grounding exercise that really heightens your natural attunement to your body’s positioning, to the boundaries of the space around you, and to your present location in time and place. This will help set the stage for the orienting response in the following step.
When you bring up the agreed-upon trigger, you’ll become aware of tension in the forehead, around the eyes, or at the base of the skull. This is the Orienting Tension that will serve as a safe anchor for processing. We may return to this anchor at various points during the DBR experience.
From here, you may notice different body sensations associated with shock activation. You may notice tingling, heat or cold, a shiver down the spine, pressure in the head, or a hollowing feeling in the chest, for instance. You’ll spend time gently and mindfully observing the shock sensations while they unfold on their own.
You may become aware of underlying pain, active and passive defense mechanisms, and emotions such as rage, fear, shame, or grief. If especially intense, you may be guided to do release breathing or return to the Orienting Tension. Most clients find that the slow, mindful pacing of DBR makes it easier to turn toward visceral experiences that have long been avoided or even inaccessible, making it possible to complete stuck processes and create a path toward healing at the deep brain level.
You may become aware of a new way of seeing yourself. This is often more of an experiential shift rather than a cognitive one. Sometimes, clients will report the world looks brighter, for instance, or that they are experiencing a new self-compassion.
Next steps
How it Works
01
Reach Out
Reach out to schedule a free 20-minute phone consultation. I’ll answer any questions you have and make sure we’re a good fit.
02
first Session
At the intake session, we’ll talk about what brings you to therapy and what changes you’d like to see through our work together.
03
resolve stuckness & thrive
Join me weekly to achieve your goals OR break through blocks in the intensive format.