Deep Brain Reorienting (DBR)
is a trauma psychotherapy

It has been developed mainly for the treatment of attachment shock; but it can also be applied to the processing of other unresolved traumatic experiences.

The indication that past events continue to have an impact is that there are clinically significant symptoms which would not be present if the experiences had not occurred.

Deep Brain Reorienting (DBR)
is a trauma psychotherapy

It has been developed mainly for the treatment of attachment shock; but it can also be applied to the processing of other unresolved traumatic experiences.

The indication that past events continue to have an impact is that there are clinically significant symptoms which would not be present if the experiences had not occurred.

Deep Brain Reorienting (DBR)
is a trauma psychotherapy

It has been developed mainly for the treatment of attachment shock; but it can also be applied to the processing of other unresolved traumatic experiences.

The indication that past events continue to have an impact is that there are clinically significant symptoms which would not be present if the experiences had not occurred.

Deep Brain Reorienting (DBR)
is a trauma psychotherapy

It has been developed mainly for the treatment of attachment shock; but it can also be applied to the processing of other unresolved traumatic experiences.

The indication that past events continue to have an impact is that there are clinically significant symptoms which would not be present if the experiences had not occurred.

cross section of brain from top

DBR Background

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.

DBR Development

Deep Brain Reorienting (DBR) aims to access the core of the traumatic experience in a way which tracks the original physiological sequence in the brainstem, the part of the brain which is rapidly online in situations of danger or attachment disruption. There may be threat and attachment wounding together when, for example, an experience of abandonment in infancy activates age-appropriate fears for survival.

The first structure capable of initiating a movement response is the superior colliculus (SC), which can direct eye movements. The SC also prepares the head for turning by bringing in tension in the muscles of the neck. This orienting tension, although often fleeting and unnoticed, is a major component of DBR. The focus in a DBR session on face and neck tension arising from turning attention to the memory of the traumatic event, or to whatever has been the present-day trigger, gives an anchor in the part of the memory sequence that occurred before the shock or emotional overwhelm that is leading to the continuing symptoms. Deepening awareness into this orienting tension provides an anchor for grounding in the present so that the mind is neither swept away by the high intensity emotions, nor diverted into a compartment holding a self-state frozen in time in which contact with the present is lost. Although the theory is simple the practice of DBR can be difficult. It does not work for everyone. Therapists who will find it most useful are those who use transformational trauma therapy approaches that are body-based, or “bottom-up”. These approaches do not rely on restructuring of thoughts or meanings at a complex verbal level for “top-down” control of symptoms, nor do they rely on exposure for establishing cortical control of fear responses.

side view brain illustration
side view brain illustration

DBR Development

Deep Brain Reorienting (DBR) aims to access the core of the traumatic experience in a way which tracks the original physiological sequence in the brainstem, the part of the brain which is rapidly online in situations of danger or attachment disruption. There may be threat and attachment wounding together when, for example, an experience of abandonment in infancy activates age-appropriate fears for survival.

The first structure capable of initiating a movement response is the superior colliculus (SC), which can direct eye movements. The SC also prepares the head for turning by bringing in tension in the muscles of the neck. This orienting tension, although often fleeting and unnoticed, is a major component of DBR. The focus in a DBR session on face and neck tension arising from turning attention to the memory of the traumatic event, or to whatever has been the present-day trigger, gives an anchor in the part of the memory sequence that occurred before the shock or emotional overwhelm that is leading to the continuing symptoms. Deepening awareness into this orienting tension provides an anchor for grounding in the present so that the mind is neither swept away by the high intensity emotions, nor diverted into a compartment holding a self-state frozen in time in which contact with the present is lost. Although the theory is simple the practice of DBR can be difficult. It does not work for everyone. Therapists who will find it most useful are those who use transformational trauma therapy approaches that are body-based, or “bottom-up”. These approaches do not rely on restructuring of thoughts or meanings at a complex verbal level for “top-down” control of symptoms, nor do they rely on exposure for establishing cortical control of fear responses.

head-illustration-side-v1

DBR Clinical Applications

It is well-recognised that traumatic experiences can lead to the development of the full syndrome of post-traumatic stress disorder (PTSD) with its characteristic intrusive features, such as flashbacks and nightmares, and attempts to avoid triggers to further distress.

In more complex forms of PTSD there may be more derealisation and depersonalisation, consistent with the brain’s attempts to avoid being overwhelmed by shock and horror, and by intense affects of fear, rage, grief, or shame. The more dissociative forms of PTSD occur when there has been early life attachment disruption preceding other traumatic experience. Dissociative disorders may arise from early life separation experiences experienced as painful and unresolved even when there has been no later abuse. The pain of aloneness may be an internal driver of defensive and affective responses and may thus contribute to difficulties in regulating emotions. Any such difficulty may lead to efforts to control distress through substance abuse, eating disorders, or self-harm – or it may be expressed through troublesome anxiety or mood disturbance. It is not so much the clinical presentation which is important for DBR – but whether there is an underlying event or experience at the origin of the distress.

side view brain illustration on yellow background

Hypothetical basis of DBR

The hypotheses have been described in a paper published in the journal Medical Hypotheses by Frank Corrigan and Jessica Christie-Sands:

Corrigan, F.M., Christie-Sands, J. (2020). An innate brainstem self-other system involving orienting, affective responding, and polyvalent relational seeking: Some clinical implications for a “Deep Brain Reorienting” trauma psychotherapy approach. Medical Hypotheses, 136, 109502.

View paper

Upcoming training schedule

NOW FULLY BOOKED
An Introduction to Deep Brain Reorienting (DBR)
March 27th 2021, 9.30 am – 5.30 pm

This workshop offers participants an opportunity to understand the key role of deep midbrain systems in traumatic experiences which have clinical consequences. There is an emphasis on attachment shock, which may be historic or recent, and early life adversity. A distinction between circuits for shock and circuits for affective and defensive responding underlies the clinical approach of Deep Brain Reorienting (DBR).

The workshop is being administered by Trauma Training in Scotland (TTiS). If you have contacted us your details will be shared with TTiS for the sole purpose of providing information on this workshop or any future DBR training.

Upcoming training schedule

NOW FULLY BOOKED
An Introduction to Deep Brain Reorienting (DBR)
March 27th 2021, 9.30 am – 5.30 pm

This workshop offers participants an opportunity to understand the key role of deep midbrain systems in traumatic experiences which have clinical consequences. There is an emphasis on attachment shock, which may be historic or recent, and early life adversity. A distinction between circuits for shock and circuits for affective and defensive responding underlies the clinical approach of Deep Brain Reorienting (DBR).

The workshop is being administered by Trauma Training in Scotland (TTiS). If you have contacted us your details will be shared with TTiS for the sole purpose of providing information on this workshop or any future DBR training.

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