What is Deep Brain Reorienting? (DBR)
The phrase “trauma processing” gets thrown around a lot in our vernacular, however it can be unclear as to what exactly “to process” means. “To process” in the literal sense refers “to performing a series of mechanical or chemical operations on something in order to change or preserve it”. However, “processing” feels more allusive when brought into the emotional context.
When I talk to clients about trauma processing, I emphasize the part of the definition that sees processing as changing. Re-hashing our trauma in the same way that it is currently stored in the brain or understood in the body, will not lead to anything new and in fact, may do more harm than good. While there are many different models of trauma processing, all emphasize that an internal change must occur for the trauma symptoms to subside. Deep Brain Reorienting (DBR) is a newer form of trauma processing that relies on neuroanatomy to help initiate said change.
Developed in the 2010s by Frank Corrigan, Deep Brain Reorienting is unique among trauma processing models as it was created out of the research on how the brain initially registers a traumatic event instead of relying on a primary theory of change. During trauma, the initial shock or attachment injury is first synapsed in the “deep brain” regions including the superior colliculus. In traditional trauma processing models, we discuss affect (emotion registered in the midbrain, amygdala) or cognitions (registered in the frontal cortex), but we may miss these first symptoms that are upholding the entire sequence on a physiological level.
Think of it like a weed in the grass. If we pick the leaves (cognitions) or even cut it off at the stem (emotions), it still might grow back because we haven’t pulled out the roots (shock). In DBR, it is theorized that trauma processing becomes easier once the initial shock is metabolized.
DBR has shown statistically significant effects on PTSD symptom alleviation in a recently published randomized control trial, however more research needs to be done for it to be considered a gold standard treatment. That being said, the same study also found that it might be better tolerated than other trauma processing models evidenced by a higher retention rate than typical.
So, what does this look like in practice? Clients are first asked to bring in a contemporary “activating stimulus” (AS). This might be a recent moment where they registered a shock trauma. Think, seeing a text that made your heart sink or registering that a car is coming in your peripheral vision prior to an accident. Clients then set aside the memory. They will not be discussing it in detail. After completing a grounding exercise, clients are then asked to return to the AS, and notice the base of their skull, forehead or muscles around their eyes. This is referred to as the “Orienting Tension” (OT). Imagine you hear a loud noise coming from the right side of the room. Your body will naturally tense and orient to this stimulus. Recalling this moment of tension is believed to be a way of “opening the file” for the trauma that we would like to process (i.e. change). The therapist then guides the client through noticing symptoms of shock (like shivers, cold/hot feelings, hallowing etc.) and affect (sadness, guilt, shame etc.). In the end a “new perspective” may emerge as a result of being with the body in this way.
If you are interested in learning more about DBR and other forms of trauma processing, please contact me jennifer@homebodycounselling.ca
References
Kearney BE, Corrigan FM, Frewen PA, Nevill S, Harricharan S, Andrews K, Jetly R, McKinnon MC, Lanius RA. A randomized controlled trial of Deep Brain Reorienting: a neuroscientifically guided treatment for post-traumatic stress disorder. Eur J Psychotraumatol. 2023;14(2):2240691. doi: 10.1080/20008066.2023.2240691. PMID: 37581275; PMCID: PMC10431732.