Deep Brain Reorienting
Deep Brain Reorienting® (DBR) is a trauma-focused psychotherapy developed by psychiatrist Dr Frank Corrigan.
When something threatening or overwhelming occurs, the nervous system begins responding before we have had time to consciously understand what is happening.
DBR is based on the understanding that rapid orienting and shock responses may form part of the foundation of a traumatic experience. These initial responses can be followed by intense emotion and defensive reactions such as fighting, fleeing, freezing, collapsing or submitting.
When the distressing experience has not been fully integrated, elements of this response may continue to be activated by present-day situations. This can contribute to fear, shame, emotional shutdown, dissociation, bodily distress or reactions that feel disproportionate to what is happening now.
DBR aims to support the processing of these underlying responses while helping the person remain connected to the present.
The work is generally slow and internally focused. Rather than analysing your experience in detail, you are supported to notice and be present with what emerges and to remain within a manageable range of activation. You remain aware and in control throughout the process, and you do not need to disclose every detail of an experience for meaningful therapeutic work to occur.
What DBR May Help With
Research into DBR remains at an early stage. Preliminary findings suggest that it may be a promising treatment for post-traumatic stress disorder, although further research is needed.
In clinical practice, DBR may be considered where trauma, attachment disruption or learned threat responses contribute to current difficulties. Depending on the individual formulation, this may include:
• Post-traumatic stress symptoms
• Complex or repeated trauma
• Early childhood or pre-verbal trauma
• Attachment-related difficulties
• Dissociation or emotional shutdown
• Persistent shame, fear or helplessness
• Strong bodily reactions to reminders of earlier experiences
• Emotional or relational patterns that have not shifted through insight alone
• Difficulties accessing a clear or coherent memory of what occurred
DBR is not suitable for every person or every concern. An assessment is required to determine whether it is an appropriate treatment approach and whether preparation is needed before trauma processing begins.
DBR for Complex Trauma and Dissociation
Complex trauma may involve multiple interconnected experiences rather than a single event. It can affect emotional regulation, identity, relationships and a person’s capacity to feel safe and remain present.
For some people, approaching traumatic material through detailed discussion or sustained emotional exposure can lead to overwhelm, shutdown or disconnection. DBR’s emphasis on pacing, present-moment awareness and early physiological responses may offer another way of working with experiences that are difficult to access through words alone.
DBR and EMDR Therapy
DBR and Eye Movement Desensitisation and Reprocessing are both trauma-processing approaches, but they attend to different aspects of traumatic experience.
EMDR commonly works with distressing memories, associated beliefs, emotions and physical sensations. DBR places particular emphasis on early orienting and shock responses that may occur before intense emotion and defensive reactions become established.
The decision to use DBR, EMDR or an integration of approaches depends on your history, current difficulties, treatment goals and responses during therapy.
What to Expect from Treatment
DBR may be provided within standard 55-minute psychological therapy appointments. The number of sessions required cannot be predicted in advance.
Treatment length depends on the complexity of the concerns being addressed, the amount of preparation required, your current circumstances and how you respond to the work.
As with any psychological treatment, DBR cannot guarantee a particular outcome. Progress is reviewed collaboratively, and the treatment plan may be adjusted if another approach appears more appropriate.
Further Information
DBR Summaries by Professor Ruth Lanius
Targeting Traumatic Shock with Deep Brain Reorienting
A Randomised Controlled Trial of DBR for PTSD
Videos
Deep Brain Reorienting (DBR): What Is It?
Dr Ruth Lanius on Her Clinical Experience Using DBR
Shock Before Trauma: The Science of Deep Brain Reorienting — Dr Frank Corrigan
Taking the Next Step
If you are considering trauma-focused therapy, you can book a complimentary 15-minute matching call to briefly discuss what you are looking for and whether my practice may be a suitable fit.