Brainspotting and How I Think About It
I keep coming back to a line from Gabor Maté:
Trauma isn't what happens to you, it's what happens inside you as a result of what happened to you.
We’ve all had things, even “little" things (maybe, to someone else) that have left us with what I call “blueprints”, “re-looping tapes/scripts”, or “emotional echoes” - that keep reverberating, keep finding ways to affect today - through body sensations, hidden core beliefs, how we are with ourselves/the world/others, how we deal and cope. That’s what we go to therapy for. Because at some point, what protected us or made sense then is tripping us up now, and causing some kind of …unpleasantness.
I completed my basic Brainpotting Level II training a while back - and I’ve gotten so much mileage out of just the introductory techniques alone. This is because of my focus on what tends to be helpful at its core in an overarching, big picture way.
I also recently joined an ongoing weekly consultation group, Brainspotting: Beyond the Pointer, run by Melanie Twite, a Brainspotting trainer and consultant. I’m writing here to reflect on a combination of what I’ve come to know and love about brainspotting, as well as what I’ve been learning from Melanie and the group.
Brainspotting is not protocol: on purpose.
Brainspotting was developed by Dr. David Grand PhD, and one thing comes up constantly in the training world around it:
there's. no. protocol.
it’s not about the “frames” (how your therapist “sets up the session”)
Sure, some setups might help guide you regarding - does the client have access to the sense of where the helpful place is, or do they need more help finding it?
Apart from that, you don’t have to follow frame set ups in a “rote” way. No one way is going to slip into “you did it wrong”, and now your client is ruined forever (thank goodness). There is no “use this frame for depression”, no “use that frame for anxiety”. In fact, trainers will often use the word “frame” now, so that is sounds LESS like a formula.
I’m sure insurance companies would love more protocolized treatments: ones where we can guarantee that if we just follow these steps, this workbook, this manual - then you should be clear of your ailments in 7 sessions or less (and they we don’t have to pay for you anymore!). And who wouldn’t want to get better faster. Us therapists are always interested in how we can help our clients more, better, faster (it’s also why most of us have to muzzle ourselves from pouring all of our time and funds into extra training after extra training!). But we also know that - while improvement in our work is always possible - sometimes, it’s just not that clear-cut. The human mind, heart, and soul happens to be … brace yourselves … complex … and wildly unique :)
These frames setups are really just ways of helping you to access the body-felt sense (which is deeper than just the thinking brain) of the issue you are trying to process, deeper.
The thing I notice and always say: this is already happening in good psychotherapy - sometimes intentionally but mostly by happenstance! Have you noticed yourself telling a story to your therapist, and your eyes wander off as you really sink into it? That’s helping you connect to what you’re talking about.
What I love about brainspotting is that it sort of distills this process - making it explicit, intentional, consenual, targeted, and sustained.
You don't need a dramatic story for brainspotting to work
You do not need a diagnosable trauma history for brainspotting to be useful.
A lot of what brings people to me is seemingly quieter or “smaller” than that. Chronic overwhelm. A pattern of anxiety you can't quite locate the start of. Feeling flat, or stuck, or like you're managing your life instead of living it. None of that needs to trace back to a single dramatic event to be worth working with. Current-day stress, a belief you're not quite aware you're carrying, a pattern you keep repeating, those are just as valid a starting point, and I'd argue often a more useful one (more on why below). For a lot of my clients that's exactly where we start, and it's often the ones who show up saying "I don't even know if this counts" who find the most in this work.
Some of my clients come to this sideways, too. They started with me for medication management and eventually got curious about adding something that works differently than a prescription does.
The honest flip side: if you're in acute crisis, actively unsafe, or your days are organized around getting through them, that's usually not the moment to start opening things up. Stabilizing comes first, and that's worth saying plainly rather than implying this is the right entry point for everyone. Brainspotting can absolutely help with heavier and more developmental trauma, and it's used that way widely. That work tends to want a longer runway and more support around it than what I'm describing here.
What I think the eye position is actually doing
Here's my own theory, and I hold it loosely:
I don't think Brainspotting is doing anything that different.
I think it's making explicit and consensual something that already happens in good therapy anyway. You look away sometimes while you're telling me something hard. A good therapist is already tracking that and attuning to it without naming it. What brainspotting adds is naming it: we're going there, on purpose, together.
As for the mechanism: You’ll often hear “Where you look affects how you feel” - Grand's own stated motto for the whole approach.
But I don't split hairs about the exact mechanism, and I think the neuroscience sometimes gets stated with more certainty than it's earned. No study has confirmed the underlying hypothesis yet, though Grand and his colleagues believe the midbrain is involved, and I'm comfortable holding that gap openly rather than talking past it. Grand's own emphasis has always been less formulaic than ”stare here, feel that" and more about taking advantage of the orienting reflex, an old, primal response where your eyes are constantly scanning and locating both outside and inside at once. He's explicit that it's a no-assumptions model, not a fixed map.
Where I'd add my own read: I think what's happening is more complicated than just location or position alone. Sometimes it's symbolic, what you happen to be looking at carries some idiosyncratic meaning for you specifically, not a universal one. You’ll feel differently for example, looking up at the sky vs down at a cross trash can. Someone connecting to expansion might “feel it” more looking upwards. Someone working on relationship issues might explicitly want to gaze towards their therapist or away from them - because even your therapist can become a symbol (it’s okay, we know that, and we’re happy to work with you on that - some of the best work happens here).
Sometimes it's simpler: your gaze goes still, not unlike trataka, the candle-gazing concentration practice from the Hatha Yoga tradition, and that stillness alone occupies your thinking mind enough that something underneath it gets room to surface. Either way, you don't need the mechanism resolved for the useful part to be true. As they say: ”you don’t need to know what it is, to know that it is.”
At the end of the day, a fixed point of focus (it’s okay if it ends up shifting by the way!) can connect you to what's happening inside you while you stay present with it, with an attuned presence. That’s the formula.
Why I sometimes call this "psychedelics sober"
Psychedelic work is my other passion and I have years of experience in above-ground (legal!) ketamine-assisted psychotherapy.
The overlap between that work and Brainspotting is one of my favorite things about both.
Both work in deep subcortical, less verbal territory. Both ask me to hold a kind of presence that's mindful, curious, and compassionate while something unfolds inside someone's awareness that I'm not directing, just accompanying. The formula is the same.
Both depend far more on attuned relational presence far far more than on any specific technique. It’s why I think both have enhanced any kind of therapy that I do - because I think those are some of the most important components ultimately.
Somewhere along the way I started half-jokingly calling Brainspotting "psychedelics sober," and the joke stuck because it's a pretty accurate description of what the work actually feels like from where I sit. It's one of my favorite ways to work, for exactly that reason.
What actually starts a session
Whatever you come in with, the actual starting frame is almost always the same three questions.
As Melanie Twite puts it simply:
What hurts?
Where do you feel it in your body?
How much does it hurt?
Not "tell me the whole story," not "what happened." (Again, when you do this and do feel better, I think you’re going through this process anyhow, by happenstance!)
Just the distress, location, intensity. Whether you're dealing with a specific memory, a relationship pattern, anxiety with no clear cause, or something you can't quite name, that's still where we start. What's different is what we find once we're in.
The five doors into your system
I loved learning about this! It really helped me organize what I see in therapy in a more clear light.
This is Melanie Twite's framing, from Beyond the Pointer, and it's reorganized how I think about where to start with someone. There are roughly five entry points into a person's nervous system:
the actual event and its memory
the sensation you feel in your body right now
the belief you formed about what it meant, unhelpful core beliefs
whatever is bothering you today, in current time (yup!)
patterns (how we are with ourselves, others, and the world) and the coping strategies that grew out of all of it
The actual event is usually the least useful door. By the time you're sitting across from me, so much has happened since then, the sleep problems, the way your body reacts to certain situations, the conviction that you are bad somehow, that the event itself is rarely what's driving your distress anymore, now (not directly at least). What's driving it is what your brain made of it (took it to mean) and what you built around it since. That's usually where we get more traction (and what hurts more).
Here's what that can look like in practice. You want to feel your feelings more, but you can't seem to get there, you'd rather talk about things than sit with them. Underneath that is sometimes an old belief, maybe “I’m too much (the other person can’t handle it)”, “feelings will overwhelm me and I can’t handle it,” “that’s not okay” (the world can’t handle it). These often formed long before you had language for it - automatically, without you knowing. If that's true for you, digging for the specific memory, the index event when this happened - well, sometimes that’s helpful. But usually it isn't the useful move or even possible.
Noticing what happens in your body right now, when you bring up the belief itself, usually is.
I've met more than a few clients over the years who'd done EMDR before coming to me, and for whom it landed as too activating, too distressing, too “dysregulating”, with more churned up than settled. It’s not everyone and EMDR is still a really helpful modality! EMDR is a well-studied, well-established treatment, and it helps a lot of people. However, it does focus on an event/memory and continues re-directing you to it. Brainspotting was actually derived from EMDR, when someone (Dr. Grand) was attuned, responsive, relational, and not formulaic - and said to himself “there’s something here, what if we just stay here?” (Instead of pushing more towards protocol or rapidly moving the client between eye positions which accessed different states). I don't have a confident theory for why EMDR instead becomes this dysregulating for some people. Like any powerful “opener” (even psychedelics) sometimes it’s too much too fast, sometimes it’s the lack of attunement. But if it happens to you, just know that you’re not alone, it’s not unusual, you didn’t do anything “wrong”, and it can get better.
You might notice your eyes land on me
That’s okay!
We talked about this in Beyond the Pointer and other trainings as well.
Sometimes, especially around anything connected to being cared for or let down - anything relational, we might find that using your therapist as your gaze spot (or intentionally away) becomes relevant.
A lot of our early wiring is built around who we looked to for our basic emotional needs - comfort, soothing, safety, protection, attunement, responsiveness. Those unmet needs can still leave deep inside of us. It’s also why it’s hard to think your problems away.
Either way, when you land on me during processing, some of that old learning tends to surface. It isn't a flaw in you, and I don't take it personally.
I might ask something like "is it the same if I step back, or if I stay right here - and which do you prefer“ that's not me being tentative. I'm finding out whether being seen right now is helping you or activating something old, and either answer is useful.
What actually prevents harm
Something I want people to know before we ever process anything hard, and this is Melanie's teaching more than mine: the thing that tends to cause harm in this work isn't intensity. It's being left alone with it. This is something that rings wildly true from my work in psychedelics.
If something big comes up and I'm attuned to you through it, tracking you, present, not flinching, not disturbed, that activation usually moves through and settles. Activation without someone steady beside you is a lot more likely to leave a mark.
I want to be careful not to overpromise here. That's a clinical principle I find reliable, not a guarantee, and no therapist can promise you'll never have a hard session or a rough few days after one. What I can tell you is that if that happens, it's information we work with, not evidence you're too much or that you did it wrong. As a therapist, your steady attunement, presence, and strong sense of “I’ve got you” tends to matter more than any technique I know.
If "how do you feel in your body" doesn't land
Going to be honest - I can kind of sound like a broken record with this one. And I’ve also come to ask about physical sensations to be more specific.
This one I picked up from Frank Corrigan's theorizing, one of the researchers whose work underlies a lot of Brainspotting's thinking about the body. His foundational paper with David Grand was published in a journal built specifically to host speculative, not-yet-proven ideas rather than standard peer-reviewed findings, and I'd rather you know the actual weight of the evidence than borrow more certainty than the field has earned.
That said, the practical tip holds up regardless of the underlying theory.
"What do you feel in your body" can be a hard question to answer, especially if you tend to think your way through things (I get it, me too). So instead I'll often ask something more specific: what's the physical sensation? Tight, loose, heavy, fluttery, restricted. That tends to get an answer instead of a thought about a feeling (but those are okay too - there’s really no wrong way, and we mean that). And sometimes nothing physical comes up at all, a memory instead, or a blank, or something as mundane as what you're making for dinner. All of that counts. The goal is tracking whatever's actually there, not finding the "correct" body sensation - sometimes not finding one at all.
If nothing happens, that's something
If you sit with something and feel nothing, that's not a dead end, and it's not you doing it wrong.
It echoes again in my psychedelic training program: when we spent an entire hour on “Nothing is Happening” (something always is, including the “experience” of “nothing” and your thoughts and feelings about it!) Take that for a headspin!
The one useful follow-up question, which I picked up from Brainspotting initial trainings and now use constantly, is what kind of nothing: does it feel more numb and checked out, or more like actual calm? Numb and checked out is itself something to notice, not something to push past.
This connects to something else: dissociation, checking out, going blank, feeling far away from yourself, zoning out, is not automatically a problem in and of itself. It’s often a sign something is too much for you - maybe you need more resourcing (we can help you with that). Or it’s a pattern to compassionately observe - this is how you emotionally survived so many times before. It’s also another part of yourself to compassionately and lovingly be with, understand, love and help, not just beat it up as a problem for existing.
Feeling “dissociated” is on a spectrum, and most of what shows up in trauma work sits at the milder end of it. Losing real chunks of time, or feeling detached from your own identity, is much much rarer than people assume. Mild dissociation is just your nervous system doing something it learned to do a long time ago, and it only becomes something to worry about if it gets treated like an emergency.
Your eyes will probably wander, and that's fine
You'll likely start focused on one spot and end up somewhere else entirely partway through, without meaning to. That's not you failing to hold still or doing the technique wrong. There is no wrong: I promise.
Sometimes your eyes moving is your nervous system giving itself a small break mid-process. Sometimes it reflects more than one thing that's relevant to what's coming up. What I'm actually tracking isn't whether your eyes are in a particular place. It's whether you're still with what you're feeling while you talk, or whether you've drifted into narrating the story from a distance. If it's the second one, I'll gently invite you back into your body, if you can (if you can’t again, that’s fine - we’re just following your thread in an attuned way, wherever that leads us). If you're still connected while your eyes drift, that's the process working, not a mistake.
How brainspotting works over telehealth
My whole practice is telehealth, so I get asked this a fair amount: does Brainspotting actually work over video?
In my experience, yes, absolutely.
I can't hold a physical pointer for you, so I lean on what's sometimes called gaze spotting: your eyes scan the quadrants of your own screen or visual field to localize roughly where something lives, then hone in from there, without me directing it. Some clients use their own finger as a pointer if that's helpful. Others just let their eyes move around on their own. Both work.
We can also have you make your laptop screen video as large as possible - and I use my pointer. Your field of view is smaller - but it still works! This is partly because your eye positions still change, the “gaze” concept (the idea that just gazing on something helps bring you deeper), and also just using this an an explicit entry point into mindful awareness of whatever it is that is coming up for you:
Thoughts. Memories. Or nonverbal: body sensation, urges to move (you can move!), symbolism, relational meaning, etc.
Just like I tell people with psychedelic work: pay attention beyond the visual (or the verbal). As Ram Dass is famous for saying, referencing the old psychoanalytic saying “it’s all grist for the mill.”
Frequently asked questions
What is Brainspotting? Brainspotting is a body-based therapy that uses a fixed point of visual focus to help access and process places where your nervous system has gotten stuck. It was developed by David Grand and doesn't follow a fixed protocol; it's built around attunement between clinician and client, not a formula tied to a specific diagnosis.
Do I need to have experienced serious trauma for Brainspotting to help? No. Chronic stress, anxiety with no clear starting point, or just feeling stuck can all be valid places to start. The specific incident is usually the least important entry point; the belief you formed and the patterns that grew out of it tend to matter more.
Is Brainspotting the same as EMDR? No, though they're both eye-position-based trauma therapies. EMDR follows a structured protocol built around specific targets. Brainspotting doesn't use a fixed protocol, and in my experience it tends to feel less intense for people who found EMDR activating.
Can Brainspotting be done over telehealth? Yes. My whole practice is telehealth. I use gaze spotting instead of a physical pointer, and I track activation through what's visible on video, like breathing, swallowing, and facial tension.
What if I don't feel anything during a session? That's common, and it isn't a sign you're doing it wrong. Sometimes the useful question is what the "nothing" actually feels like: numb and checked out is different from calm, and both are real information.
How many sessions does Brainspotting typically take? There's no fixed number, and I'd rather say that plainly than give you a figure that isn't really true for anyone. Some people find real relief in a handful of sessions when what they're working on is specific and current. Longer-standing patterns take longer.
Do I have to describe what happened in detail? No. Sessions start with what hurts, where you feel it in your body, and how intense it is, not a detailed narrative. You're welcome to share as much or as little of the story as you want.
Is Brainspotting similar to psychedelic-assisted therapy? Not literally, there's no substance involved, but the felt experience has real parallels: working in a slower, more subcortical, less verbal space, with a therapist holding calm, attuned presence while something unfolds. I sometimes call Brainspotting "psychedelics sober" for that reason.
Can I add Brainspotting if I'm already seeing you for medication management? Yes, and that's a fairly common path. Some people start with medication, get curious about working in a different register, and add it from there.
Is Brainspotting safe? Could it make things worse? Hard sessions and rough patches afterward do happen, and I'd rather say that than promise otherwise. What matters most is not being alone with what comes up. If something lands badly, that's information we work with, not a sign you did it wrong. If you're in acute crisis or not currently safe, stabilizing comes before this kind of processing work.
If you're curious
If any of this sounds like something you'd want to try, or you're just wondering whether it might help, even if what you're carrying doesn't feel dramatic enough to justify it, you can find a time to talk through booking.
Sources
Corrigan, F., & Grand, D. (2013). Brainspotting: Recruiting the midbrain for accessing and healing sensorimotor memories of traumatic activation. Medical Hypotheses, 80(6), 759-766. https://pubmed.ncbi.nlm.nih.gov/23570648/ (Published in a journal that uses editorial rather than peer review, intended for speculative, hypothesis-stage ideas.)
Craig, A.D. (2009). How do you feel - now? The anterior insula and human awareness. Nature Reviews Neuroscience, 10(1), 59-70. https://www.nature.com/articles/nrn2555
Feldman, R. (2017). The neurobiology of human attachments. Trends in Cognitive Sciences, 21(2), 80-99. https://doi.org/10.1016/j.tics.2016.11.007
About the author
Patricia Pop, MD is a board-certified psychiatrist practicing in California, available be telehealth practice throughout the state. She works with high-functioning adults and specializes in integrative psychotherapy, medication management, Brainspotting, psychedelic-informed care, and ketamine education (ketamineprep.com).