In person in Wellington, New Zealand
and online worldwide
Deep Brain Reorienting (DBR) therapy
in Wellington and online across New Zealand
Understand what DBR is, how it can help and if it can be the right fit for you.
What is DBR therapy?
Deep Brain Reorienting (DBR) is a trauma therapy that helps with PTSD and complex PTSD. It works with the very first response your brain and body have when something feels threatening or overwhelming — before you have had time to think about what is happening or make sense of it. DBR helps you slow down and pay attention to these early body sensations, giving your brain time to process the shock response that can remain after a traumatic experience. Over time, this can help reduce how strongly your brain and body react when something in the present reminds you of what happened.
One of the things that makes DBR different from many other trauma therapies is that you don't need to talk in detail about the traumatic event. Instead, we use something happening in your life now that causes a mild to moderate reaction to gently access the underlying trauma response. We stay with these sensations slowly and carefully, allowing your brain and body to process what is there without needing to analyse or retell the story of what happened.DBR can feel very different from traditional talking therapy — sessions are often quiet and experiential, with the focus on gently supporting your brain and body to process what has remained unresolved.
What does DBR therapy feel like?
DBR therapy can feel significantly different from traditional forms of talking therapy - being both quiet and rich at the same time. While it is still the two of us sitting together in my cozy counselling room in central Wellington or spending an hour of therapy time together online, what we ‘do’ in that hour different. Some parts of the session are very structured, especially at the beginning of sessions so you will quickly know what to expect. After the initial DBR steps, you will be invited to turn your attention inward to sensations you're noticing in your body. When I first started by own DBR therapy, it felt important for me to be reassured that we are not just 'paying attention to what anxiety feels like', as this can feel deeply uncomfrotable. Instead, because we are bringing our attention to shock sensations, anxiety can still be there in the background but it is not the focus of our work or the main sensation we pay attention to. DBR sessions can feel like nothing is happening and yet a lot is happening internally at the same time. Sometimes the sensations may be uncomfortable, interesting, fleeting, surprising, frustrating, comfortable, calm or emotional. Throughout the process, I'm deeply present with you the entire time, attuned to your processing and guiding you to stay with sensations. While you're paying attention to sensations happening internally, we stay connected and check in about how things are feeling for you. There are plenty of ways we will slow the process down should it ever become overwhelming. It's normal to feel spacey, tired or a bit vulnerable after DBR sessions and these feelings often resolve quickly, although as our brains continue processing between sessions, some people experience their symptoms more strongly before they start to resolve. This is something we will always manage together.
Is DBR therapy evidence-based?
DBR is an emerging, neuroscience-informed therapy with a small but growing evidence base and strong clinical relevance. This randomised controlled study found large improvements in PTSD symptoms after the 8 sessions of DBR therapy and even more improvements at the 3 month follow up compared to no significant improvements for the control group over the same period of time. This shows that the large improvement in symptoms in the group who did DBR therapy is because DBR was effective. After the 8 sessions, 48.3% of the people in the DBR group no longer met the criteria for PTSD, and at their 3 month follow up, 52% of the people in the DBR group no longer met the criteria for PTSD.
As DBR is a new therapy, introduced in 2020. This means that it is evolving and each year we learn more and more that helps refine the approach. To stay up to date and ensure my DBR practice is up to a high standard, I attend regular group consultation with an experienced DBR practitioner who meets with Frank Corrigan - the founder of DBR.
How is DBR different to other therapies?
DBR is unique and different to many approaches my clients have tried before, including IFS, EMDR, Somatic Experiencing, Hakomi and Sensorimotor Therapy and Havening. Here are some of the major ways in which DBR is different to common trauma treatment approaches.
- Many talk therapies focus on what happens after the nervous system activation and emotional activation and after thoughts and narratives are created about a situation or painful event. We may be talking about how an event or a trigger (for example a critical look or comment) made you feel and what narrative, story or meaning your brain made of it. We might look at how these affected your behaviour.
All of these processes happen in the higher brain, often after the initial orienting response and shock response (which happen in the mid-brain) have gone. In DBR, we specifically access the mid-brain as the area of healing, intentionally keeping higher brain activation minimal.
- Some trauma therapies, including EMDR involve a focus on the traumatic even itself. While being effective for many, for some people this can feel very triggering, overwhelming, off-putting and in some cases distabilising if not approached carefully. DBR is different as it uses present day triggers to access the healing sequence in the brain. Rather than thinking about, recalling and discussing the worst of the event that happened, we just want to identify the very first moment the brain registered something's not right (an uh-oh moment or a moment we moved towards or away from the threat). We don't analyse or discuss the event beyonf that point and once the brain sequence related to this event is open and processing we generally don't re-visit the trigger for the duration of the trigger. This is very helpful, in partiular fr when therapy touches on things we can't remember or when the trauma occured before we had words to think or talk about it (for example as an infant).
What happens in a DBR therapy session?
Initially, we chose the starting point that we will use to start our processing. In the first few sessions, we will identify something recent, non-relational (not involving other people) and mildly to moderately activating. I will guide you to find the right 'activating stimulus'.
Once we agree on that, we will do an exercise that taps into our proprioception witn the intention to become more present with our 'mid brain' (we typically spend time in our higher/cortical brain when we talk about issues). Some people find it easier to do this process with their eyes closed and you can decide what's comfortable for you.
I then present the 'activating stimulus' to you and guide you to pay attention to sensations in your forehead, face and neck to find our 'anchoring spot' - this is a place you can return your attention throughout the process to slow processing down.
Then, I gently guide you to start paying attention to shock sensations that may be present - such as shivers, shudders, flickers, sense of emptying or hollowing or heat and cold. We stay in communication while you attend to these sensations and allow the shock held in the body to be processed with my support.
For some people, this will take majority of the session while for others, emotions or affect may start to appear from under the shock. We then stay with the emotions which will likely feel more manageable now that we have allowed shock to process.
Before returning your focus to the present, I'll invite you to check in with yourself - if there is anything that feels different t0 before we started. It is normal to feel better, notice no change at all or even feel worse or just a bit fragile. Because I take a very slow approach to processing, this is normal and often resolves quickly. Some processing may continue to occur in the hours and days after the session so the recommendation is to go gentle and give yourself plenty of time and support following sessions.
How does DBR help with trauma?
DBR is a neuroscience-based treatment developed to help with PTSD including complex PTSD. It helps resolve symptoms of trauma by targeting the sequence of events that occurrs in the brainstem at the time of the traumatic event. DBR therapy uses present day triggers to access this sequence and by slowing down the sequence, helps change brain's sensitivity to triggers.
According to DBR theory, when we first experience a traumatic event or events, our body experiences a series of brain activations. Firstly, our superior colliculus area of the brain activates when we first orient to the source of threat, then, our locus coeruleus activates with shock. This happens before the higher/cognitive levels of your brain can think through what is happening and before you have an emotional response to what is happening. DBR therapy targets this sequence of the initial shock experience and by allowing this shock a lot of time to be processed, can reduce the sensitivity of the superior colliculus and reduce the intensity of feeling triggered.
Who is DBR therapy for?
DBR can be helpful for people who are living with the effects of trauma. It may be particularly helpful if you find that certain situations, interactions, sensations or reminders trigger strong reactions in your body, even when you logically know you are safe. It's also very suitable to people experiencing stress, anxiety, exhaustion, hypervigilance, dissociation or “not good enoughness, especially when everythin in their present life is going 'fine'. DBR can also be useful when your experiences are difficult to put into words, when you don't have clear memories of what happened, or when talking in detail about the past feels overwhelming.
In DBR, we work gently with what happens in your body when you are triggered in the present. It may be a good fit if you have tried talking therapy or other trauma approaches and feel that something deeper is still unresolved, or if you would prefer a quiet, body-focused approach rather than spending most of your therapy time talking about what happened.