Deep Brain Reorienting

This method was developed by Dr. Frank Corrigan, a highly respected trauma specialist whose work is significantly informed by a deep understanding of neuroscience. His aim was to create a therapeutic approach that could access and address the effects of trauma at a more fundamental level within the brain than what is typically achieved through more traditional therapies.³ Many individuals who have engaged in DBR therapy have found it to be a surprisingly gentle yet profoundly effective way to work through the complexities of trauma, often without the need to constantly revisit and detail the most painful memories.⁴

At its core, DBR operates on the principle of directly targeting the deepest and most automatic parts of the brain, specifically the brainstem and the midbrain.² These regions of the brain are foundational to our survival, governing our most basic instincts and our immediate reactions to perceived danger or stress. These responses often occur instantaneously, even before we have the opportunity to consciously think about or emotionally react to what is happening.²When traumatic experiences occur, particularly during the early developmental years, they can leave lasting neurological imprints within these deep brain structures. These imprints can manifest as automatic stress responses that are easily triggered by everyday situations or reminders of the past, even when there is no actual threat present.¹

The fundamental aim of DBR is to access and facilitate the reprocessing of these deeply ingrained responses at their neurological origins within the brainstem and midbrain. This process allows the brain and body to learn, at a fundamental level, that past dangers are no longer a current reality, which in turn can lead to a significantly enhanced sense of safety and an overall increase in feelings of calm and well-being in daily life.⁵

During a typical Deep Brain Reorienting (DBR) therapy session, while there will be some level of discussion and interaction with your therapist, the primary focus often shifts away from extensive verbal storytelling and towards cultivating a heightened awareness of the subtle physical sensations that you experience within your body.² Your therapist will guide you in paying close attention to these bodily sensations, as they are understood to hold crucial information about how your body and nervous system responded to difficult or traumatic events in the past, even in instances where conscious memories of those events might be vague or incomplete.² This emphasis on your physical experience is a key aspect of DBR, as it helps to create a stronger connection between your mind and body, which can facilitate a more holistic and integrated healing process.¹

What does a DBR session entail?

Many DBR sessions often commence with a “Where-self” or “Proto-self” exercise. The purpose of this exercise is to help you establish a feeling of presence, safety, and connection to your physical self in the current moment.² This exercise involves your therapist guiding you through a specific script designed to help you anchor your awareness within your body which enables access to areas of your brainstem. This region is considered the starting point for the deeper processing that occurs in DBR therapy.²This preparatory step of orienting to the present moment and your physical being is considered essential for building a stable foundation of safety before engaging with any potentially activating or emotionally charged material.¹³

Following the Where-self or Proto-self phase, your therapist will gently guide you to bring to mind a specific event, a challenging emotion, or a trigger that you have identified as something you would like to work on.² It is important to note that this process does not necessarily require you to recount the entire narrative of the event in extensive detail. Instead, the primary focus will be on observing any sensations, emotions, or even fleeting memories that spontaneously arise within your body as you bring this target to your awareness.² Your therapist will then help you to pay attention to a natural sequence of responses that often occurs when we encounter something overwhelming or traumatic. This sequence is frequently referred to as OTAS, which stands for Orienting, Tension, Shock, and Affect (emotion).²

The Orienting response is the initial, often automatic, turning of your attention towards something that is perceived as salient or important, which can be accompanied by subtle shifts in your eye gaze, head position, and neck posture.¹¹ Following this initial orienting, you might then become aware of fleeting Tension, particularly around your eyes, forehead, or the back of your neck, as your body subconsciously prepares for a potential motor response or action.¹¹ This subtle “orienting tension” is a particularly significant point of focus within DBR therapy.¹² Before strong emotions fully emerge, there is often a flow of Shock which emerges as or physical sensations such as shakes, shutters, and micromovements.⁴ Finally, the Affect stage involves the emergence of the emotions that are associated with the event.² This OTAS sequence provides a neurobiological framework for understanding how the brain and body naturally respond to traumatic experiences, and DBR therapy is specifically structured around carefully tracking and processing each of these stages.²

The central aspect of DBR involves gently directing your attention to the very initial stages of this OTAS sequence, with a particular emphasis on the orienting tension that you might notice in your head, face, and neck.¹¹ These subtle physical responses are often the very first way that your brainstem registers a potential threat or a disruption in your sense of safety and connection with others.¹¹ By focusing on these pre-emotional responses, DBR aims to help your brainstem to process the initial shock of the traumatic experience without immediately triggering overwhelming emotions or strong defensive reactions.¹² Throughout this process, your therapist will support you in noticing any subtle shifts or changes in this tension, as well as any natural urges that might arise to move your head. This careful attention allows the brain’s inherent natural healing process to unfold organically.¹¹ The ultimate goal of this focused attention is to help “reorient” your brain’s automatic responses, so that reminders of past difficult events no longer trigger the same intense and distressing reactions in your present life.¹

Compared to more traditional talk therapies, DBR often involves less emphasis on detailed verbal recounting of traumatic experiences, which can be particularly beneficial for individuals who find it difficult to articulate their trauma in words or who feel overwhelmed by having to repeatedly describe painful events.²The focus on subtle body sensations allows for processing to occur at a deeper, pre-cognitive level of the brain, which can be especially helpful for addressing early or complex trauma where explicit memories might be fragmented, incomplete, or even entirely inaccessible.² Many clients who have experienced DBR report that it feels like a gentle and well-tolerated process that effectively helps to alleviate the distressing symptoms associated with trauma.⁴

Following a DBR session, it is common to experience a range of responses as your body and brain continue to integrate the processing that has occurred.² Some individuals report feeling an immediate sense of relief, a greater sense of calm, or an enhanced connection to their bodies and emotions.² Others might experience temporary feelings of fatigue, mild physical discomfort, or a lingering of emotions as their nervous system continues to adjust to the processing.² Your therapist might suggest practicing simple grounding techniques or body awareness exercises between sessions to further support this ongoing integration process.² It is also not uncommon for new insights or shifts in perspective related to the processed material to emerge even in the days or weeks following a DBR session, as the deeper neurological processing continues to unfold.²

To understand how Deep Brain Reorienting (DBR) works at a deeper level, it is helpful to consider the role of the brainstem and midbrain. These are the most fundamental and evolutionarily ancient parts of your brain.² They function as the primary control center for essential life functions, such as breathing and heart rate, and are also the first to respond to any perceived threat or significant event, particularly those related to your safety and your sense of connection with others.² These areas of the brain operate largely outside of our conscious awareness and are responsible for the rapid, automatic responses that are designed to keep us safe in dangerous situations.² When traumatic experiences occur, especially during early development, they can leave lasting neurological imprints within these deep brain structures. These imprints can then lead to the development of automatic stress responses that can be easily triggered by seemingly minor things in everyday life, even when there is no actual danger present.¹ DBR’s effectiveness lies in its ability to directly engage with these foundational brain regions.

When you experience something traumatic, whether it is a sudden and acute danger or a more prolonged disruption in your sense of safety and connection with others, such as early neglect or loss, your brainstem and midbrain initiate a very rapid sequence of physiological responses. This sequence is designed to ensure your immediate survival.³ This initial “alarm” system activates even before the higher, thinking parts of your brain (the cortex) can fully process what is happening or before you have the chance to consciously feel intense emotions.¹¹ A key aspect of DBR is its aim to access and help process the very first moments of this response, specifically the point at which your deep brain registered that something was wrong or threatening – often referred to as the initial “uh-oh” moment.¹⁴

Several key brain regions within the brainstem and midbrain play specific roles in the process of Deep Brain Reorienting:

The Superior Colliculus (SC), located in the midbrain, is critically involved in orienting your attention towards important stimuli, particularly those that might represent a potential threat. It plays a direct role in controlling your eye movements and in preparing the muscles of your head and neck to turn towards or away from whatever has captured your attention.¹¹ This preparation of the neck muscles results in a subtle tension, known as the “orienting tension,” which is a primary focus of attention in DBR therapy.¹¹ DBR strategically utilizes this natural orienting response as a kind of anchor to access and process traumatic material in a way that minimizes the risk of becoming overwhelmed.¹²

The Locus Coeruleus (LC), situated in the brainstem, is a major center for the body’s stress response system. It releases norepinephrine, a powerful neurotransmitter that increases your level of arousal, heightens vigilance, and contributes to the experience of shock and alarm in response to perceived danger.¹² One of the goals of DBR is to gently slow down and facilitate the processing of this initial shock response that occurs even before strong emotions fully emerge. By addressing this early stage, DBR aims to prevent the escalation of emotional overwhelm that can sometimes occur during trauma processing.¹²

The Periaqueductal Grey (PAG), also located in the midbrain, has a complex role in regulating pain perception, fear responses, and a wide range of other emotional and behavioral responses.¹⁰ While DBR’s primary focus is on the earlier responses that occur in the Superior Colliculus and the Locus Coeruleus, by effectively processing the initial orienting response and the feeling of shock, DBR indirectly helps to regulate the downstream emotional responses that are mediated by the Periaqueductal Grey. This can lead to improved emotional stability and an increased capacity for emotional regulation over time.¹²

Through the therapist’s guidance in focusing on the subtle physical sensations in the body, particularly the orienting tension, and by allowing the natural OTAS sequence to unfold in a safe and supported environment, DBR helps to gently “reorient” these deep brain responses that may have become fixed or maladaptive as a result of traumatic experiences.¹ This process facilitates the completion of the brain’s natural process of responding to and integrating the traumatic event, a process that may have been interrupted or overwhelmed at the time the trauma occurred.¹² This reorientation at the level of the brainstem can lead to a fundamental shift in how your nervous system responds to reminders of the past, resulting in a decrease in the intensity of your reactions, a greater sense of overall safety and calm in your daily life, and an enhanced capacity for regulating your emotions.⁵ In essence, DBR aims to facilitate a kind of “brain reset” by helping the deep brain structures to more fully process and integrate traumatic experiences, which can lead to more adaptive and regulated responses in the future.⁹

To further illustrate this, consider an analogy: Imagine your brain has a very sensitive alarm system that has become overly reactive and now gets triggered by things that are not actually dangerous, like a smoke detector that goes off every time you cook even a little bit of toast. Deep Brain Reorienting is like gently recalibrating that alarm system so that it only goes off when there is a genuine threat, not just everyday occurrences.² This recalibration happens at the deepest level of the alarm system, within the brainstem. Another helpful analogy is to think of your brain like a computer program that froze or crashed during a critical update due to a sudden shock. DBR helps to safely restart the program and complete the update, allowing it to run smoothly and efficiently again without getting stuck in the past.⁹

Deep Brain Reorienting (DBR) shares the goal of healing trauma with other therapeutic approaches, but it differs in its specific focus and methodology. When comparing DBR to EMDR (Eye Movement Desensitization and Reprocessing), both are recognized as effective therapies for processing traumatic experiences and both acknowledge the brain’s inherent capacity for healing.⁶ However, EMDR typically involves the client recalling specific traumatic memories while simultaneously engaging in bilateral stimulation, such as guided eye movements, tapping, or auditory cues, to facilitate the reprocessing of these memories and reduce their emotional intensity.⁶ In contrast, DBR focuses more directly on the physiological responses to trauma as they are experienced in the body, particularly within the brainstem. This often occurs without the need for a detailed recounting of the entire traumatic event or the use of external bilateral stimulation.⁶ Instead, the primary focus in DBR is on the initial orienting response and the associated tension that may be noticed in the head and neck.¹¹ DBR is often described as a gentler approach that operates at a deeper neurological level, specifically targeting the pre-emotional shock response. It may be particularly beneficial for individuals who have experienced complex trauma, early developmental trauma, and attachment wounds – experiences that may have occurred before the development of language or clear memory formation.⁶ While EMDR can also be effective for these types of trauma, it is frequently considered a first-line treatment for single-event PTSD and other more recent traumas where memory recall is more accessible.⁶ Feature EMDR DBR Primary Focus Reprocessing traumatic memories using bilateral stimulationAddressing the brainstem’s initial physiological response to trauma Memory Recall Often requires detailed recall of traumatic memoriesDoes not require detailed recall; focuses on triggers and body sensations Processing Level Engages the brain’s information-processing systemTargets deeper subcortical structures, including the brainstem vs External Stimulation Typically involves eye movements, tapping, or audio cuesRelies on internal focus on body sensations Best Suited For Single-event trauma, PTSD, anxietyComplex trauma, early developmental trauma, attachment wounds Emotional Intensity Can be emotionally intense due to memory recallGenerally considered gentler and less overwhelming Speed of Results Often shows results relatively quicklyMay be a slower process focused on deep, lasting healing

When comparing DBR to traditional talk therapy approaches, such as Cognitive Behavioral Therapy (CBT) or psychodynamic therapy, the primary distinction lies in the level of focus. Traditional talk therapies primarily emphasize understanding and modifying thoughts and emotions through verbal communication and by exploring past experiences in detail.² DBR, while certainly involving a therapeutic relationship and some level of discussion, places a much greater emphasis on bringing conscious awareness to and processing the body’s physiological responses to trauma at a subcortical level – specifically within the brainstem and midbrain.²DBR operates on a “bottom-up” principle, starting with the body’s reactions, rather than primarily focusing on the “top-down” cognitive or emotional processing that is characteristic of many talk therapies.²² This makes DBR potentially more effective in accessing and beginning to heal trauma that occurred before the development of language or explicit memory, which can often be challenging to reach and process effectively through talk therapy alone.¹⁴By directly targeting the initial shock and orienting responses within the brainstem, DBR aims to address the foundational neurological impacts of trauma that may underlie a wide range of emotional and behavioral difficulties.¹²

Deep Brain Reorienting (DBR) offers a range of potential benefits for individuals who have experienced trauma and other related challenges. By directly targeting the brainstem and midbrain, DBR can facilitate the resolution of deep-seated trauma at its neurological roots, potentially leading to lasting relief from deeply ingrained patterns of distress.⁵ Working with the brain’s fundamental threat response system can result in improved emotional regulation and resilience, providing a greater capacity to manage intense emotions, reduce reactivity to triggers, and enhance the ability to cope with stress.⁵ The emphasis on noticing physical sensations in DBR can also lead to enhanced body awareness and connection, helping individuals become more attuned to their body’s signals and fostering a greater sense of embodiment and presence in their lives.¹

Research has indicated that DBR can be highly effective in achieving a significant reduction in PTSD symptoms, such as flashbacks, nightmares, hypervigilance, and avoidance behaviors.⁵ A notable randomized controlled trial demonstrated a substantial 48.6% reduction in PTSD symptoms following eight sessions of DBR therapy.¹¹ Given its specific focus on attachment shock, DBR can be particularly beneficial for the healing of early attachment wounds and relational trauma, addressing the lasting impact of early life experiences, neglect, and difficulties in forming healthy relationships.³ It can aid in processing the profound pain of aloneness and disconnection that often accompanies these experiences.¹⁴

Because DBR does not necessitate detailed verbal recounting of traumatic events, it can be a particularly valuable option for individuals who struggle with verbalizing their trauma, including those with pre-verbal trauma or a tendency towards dissociation.² Many individuals who have participated in DBR therapy report experiencing a potential for increased self-compassion and understanding towards themselves, as well as noticeable increases in their energy levels and an overall improvement in their sleep patterns.⁴ While primarily recognized for its effectiveness in treating trauma, DBR may also offer benefits for a broad range of other mental health challenges that are frequently rooted in or exacerbated by unresolved trauma, such as various anxiety disorders, depression, dissociative symptoms, panic disorders, eating disorders, and even substance use challenges.⁴

In conclusion, Deep Brain Reorienting presents itself as a groundbreaking and highly promising therapeutic modality for healing from the complex and often long-lasting effects of trauma by directly addressing the deep, automatic responses that originate in the brainstem and midbrain.² Through its unique emphasis on body awareness, particularly the subtle orienting tension, and by facilitating the natural processing of the OTAS sequence, DBR gently guides the reorientation of these fundamental responses towards states of safety, secure connection, and overall well-being.² This gentle yet powerful therapy operates at a foundational neurological level, offering the potential for profound and lasting healing from past difficult experiences, including those from early in life and attachment-related traumas, often without the need to extensively revisit or detail traumatic memories.² For individuals who have been struggling with the persistent impact of trauma, anxiety, depression, or other related challenges, and who may have found other therapeutic approaches less effective, Deep Brain Reorienting could offer a new and hopeful pathway towards significant healing, meaningful recovery, and a greater sense of feeling fully alive and connected within their own bodies.²

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