Brainspotting (BSP) Part 1: What’s in Your Brain?

In last month’s post, we discussed the clinical presentation of Posttraumatic Stress Disorder (PTSD) and Complex-PTSD (C-PTSD). These carry a constellation of symptoms that can be a significant challenge to treat.

One reason for this difficulty is that talk-therapy, and even “gold-standard” treatments (e.g. Cognitive Processing Therapy) rely on neocortical activity. This means that the bulk of the treatment consists of processing the traumatic events/story in the “thinking center” of the brain, which is responsible for executive functions such as problem-solving, rational thought, day-to-day tasks, etc. It can feel extremely relieving to tell one’s story for the first time to a compassionate and validating therapist; this type of talk therapy can assist the client in making sense of their timeline, and notice patterns that have emerged post-trauma. However, neocortical processing can only go so far.

So, where’s the trauma?

The simple reason for the limitations of cognitive-based therapy is that unprocessed trauma does not “live” in the neocortex, but rather within the subcortex and brainstem. These brain regions develop earliest in life, and contain the structures responsible for emotions, memory and autonomic functions (breathing and heart rate, for example) amongst many other critical functions.

Ideally, when a traumatic event occurs, the brain will consolidate the experience to long-term memory such that the events are experienced as contained within the past. When this ideal process does not occur, the brain will often attempt to protect the individual by encapsulating and burying those memories to avoid thinking about the traumas again. When these “capsules” are triggered, the individual will repeatedly experience emotional flooding, flashbacks, and, in the case of more complex traumas, even physical issues such as chronic pain and stomach aches.

What fires together, wires together.

Within the developing brain there exists over 4 quadrillion synapses that create the neural pathways connecting emotions, memories, and automatic functions associated with each impactful event. How do these pathways develop? By firing and wiring together: for example, you are 3 months old in your crib. You wake up hungry and need a diaper change, so you cry (because that is what babies do). No one comes to you. You hear screaming and fighting and loud noises in the room. Maybe see through the bars a violent fight with your parents. At that moment you cannot explain what you feel as a baby at 3 months old, but your brain may be wiring together fear, worry, anxiety, while then connecting it to the stomach pain from being hungry and the uncomfortable feeling from the dirty diaper. So, the next time you feel these feelings your brain has already started the wiring for this, and your brain goes back to the 3-month old in the crib. If you feel afraid or worried when you are 16, or 25, or yesterday, it will connect the same pathway in the brain to when you were 3 months old.

Brainspotting for trauma

BSP helps to unwire the pathways so that the trauma network is disconnected from everything that has ever happened in your life. So that when something makes you afraid today it’s no longer attached to everything in your life that has caused fear. It causes the brain to take the traumatic memories and consolidate them to long term memories, moving them out of the reactive areas of the subcortex and storing them properly.

In Part 2, I will explain how this revolutionary therapy resolves trauma, including what to expect in a session, more in-depth.