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Book Review-Brainspotting: The Revolutionary New Therapy for Rapid and Effective Change

It started with a wobble and pause.  Practicing a variant of EMDR, David Grand crossed the visual field of a patient, when her eyes wobbled, then locked – and Grand felt as if his hand was locked in the place where the patient was looking.  Thus were the beginnings of what he calls Brainspotting: The Revolutionary New Therapy for Rapid and Effective Change.  Conceptually Grand explains that, “Where you look affects how you feel.”

Roots

Before we can get to the heart of the Brainspotting approach, it is necessary to explain its roots.  One of these roots is EMDR – eye-movement desensitization and reprocessing.  EMDR is a validated therapy approach.  The other component is Somatic Experiencing, Peter Levine’s approach, as explained in In an Unspoken Voice.  While Somatic Experiencing has less empirical support, it’s generally regarded as promising.

EMDR is primarily focused on lateral eye movements, but other approaches, including hand tapping and audio stimulation, are used to trigger rapid coordination between the right and left hemispheres of the brain.

Somatic Experiencing is based on the concept that, during traumatic events, there’s energy released that our human brains thwart the release of.  This happens when we suppress fighting or fleeing.  When we freeze, Levine posits that we store that energy and fail to release it.  He cites the reactions of animals as they recover from being frozen by a threat.  Many, if not most, animals “shake it off” when they unfreeze, but humans don’t have this response.  This is placed in the broader experience of recognizing and relating to our bodies (thus somatic).  This is inclusive of acknowledging unpleasant sensations in the past or current.

From these two therapies, Grand created what he called “Natural Flow EMDR.”  His previous book on this technique published 11 days before the tragic 9/11 attacks.  As a result of the attacks, there was an influx of patients with trauma experience.  (Grand is based in New York.)

Outside and Inside

The initial discovery required that the therapist observe a disturbance in the eyes of the patient.  This is what Grand calls “outside window spotting.”  That is, someone outside of the person is triggering and identifying the “brainspot.”  The converse is when the person guides themselves and detects something as they sweep their eyes.

In both cases, there’s a catch.  The catch is that the person must be “activated.”  If they’re in a place of complete calm, they won’t be able to discover their brainspots.  It’s a common thing for therapists and researchers to “prime” individuals so that they’re more receptive, so the idea that someone is activated isn’t particularly different or concerning.  However, there is a careful balance to be struck.  If someone is too activated, they’ll be unable to work through an issue – and if they’re not activated enough, the brainspots will likely not surface.

The Problems

There are a few problems with Brainspotting as a technique.  First, the research on the technique is still very weak.  The studies have low power, and the designs are subject to substantial therapist influence.  It’s not been shown to be harmful – but the research is weak at best.  This is normal for emerging approaches but with a 10 year history of Brainspotting, one would expect for more robust research support.

More than that, some of the assumptions that Grand makes are not well accepted either.  For instance, while talking about blinking, he claims, “aspects of the brain are timeless, and so they experience this shutdown of visual input as a significant pause.”  The research on flow indicates that time calculation in the brain is very complex, and it happens across multiple centers.  (See Flow, Finding Flow, and The Rise of Superman.)  We know that the ability to process time is quite frequently taken offline temporarily.  Flow, in fact, is remarkable in the fact that changing blood flows in the brain takes the ability to maintain a sense of time offline.

Additionally, we know that the brain is constantly filling in details that are missing.  Incognito powerfully shows what happens when your brain needs to fill in information, because one eye is covered and there is a hole in the remaining visual field where the retina attaches to the optic nerve.  We also know that the rods and cones of the eyes have a slight retention of the previously recorded image – particularly when there is no new input.  In short, the brain is in a constant mode of filling in information, so the milliseconds of time during the obscuring part of a blink aren’t significant in any particular way.

Holding Space

Like many therapies, Brainspotting proposes that we hold space for people.  That is, we create feelings of safety – as much as is possible – and we accept them for who they are and for what has happened.  This is an important aspect of healing that is often absent in our daily lives.  It’s rare to hear people acknowledge their traumas, too – without trying to one-up the person sharing.

It can be that some of the moderate effects that are seen with Brainspotting are the effects of creating safety and validating the person for who they are.

Three Dimensional

A key divergence from the basis of EMDR is Grand’s discovery that the places where people could look and discover an issue are three dimensional.  It’s more than the lateral movement prescribed in EMDR (x-axis).  He introduced vertical (y-axis) movement as well with reportedly good results.  Finally, Brainspotting has evolved to include a depth or z-axis dimension.  There may be a trauma connection to this space, but it’s hard to say.  It could be that exposing trauma can be done by concentrating on a point and can be resolved with cognition.  If it is, then we should all start Brainspotting.