Deep Brain Reorienting (DBR)

Deep Brain Reorienting (DBR) is a trauma therapy developed by psychiatrist Dr Frank Corrigan. It is designed to work with the very fast, automatic responses that can happen in the brain and body when we experience something frightening, overwhelming or emotionally painful, before we have time to think about or make sense of what is happening.

When something frightening, shocking or emotionally painful happens, the nervous system may respond almost instantly. Our eyes may orient towards or away from what is happening, muscles in the forehead, face, head, neck or shoulders may tense, and the body may prepare to protect itself. These reactions are part of the brain’s natural survival system. Only afterwards do emotions, thoughts and meaning about the experience fully develop.

For some people, particularly after trauma or repeated stressful experiences, these responses can continue to be triggered long after the original experience has passed. You may logically know that you are safe, but your body can still react as though the danger is happening now.

What happens during a DBR session?

You do not need to tell the whole story or relive the traumatic event in detail.

Together, you and your therapist choose a small activating stimulus. This might be:

• a brief image or moment from a memory

• a recent trigger

• a particular facial expression or tone of voice

• a body sensation

• a feeling of rejection, danger, helplessness or being alone

• a theme connecting several similar experiences.

Before focusing on the trigger, your therapist helps you identify an Orienting Tension—often a subtle sensation around the forehead, eyes, face, scalp, neck or shoulders.

You are then supported to notice what happens very slowly, without trying to make anything happen. You might notice changes in pressure, tightness, temperature, heaviness, numbness, trembling, breathing, eye position, or an impulse for your head or body to move. Feelings or memories may emerge, but they do not need to be forced.

The therapist helps you stay connected to the orienting tension and the present moment so that the experience remains manageable.

Shock and emotion

An important part of DBR is distinguishing the body's initial shock response from the emotions that may follow it.

Shock can sometimes feel like:

stillness • blankness • numbness • pressure • tightening • freezing • dizziness • disorientation • heaviness • a sudden jolt • an urge to turn or pull away

Emotions such as fear, sadness, anger, shame or grief may arise afterwards. DBR allows these parts of the experience to unfold gradually rather than becoming overwhelmed by everything at once.

Does DBR work?

DBR is a relatively new therapy, so the research base is still developing. A 2023 randomised controlled trial involving 54 adults with PTSD compared eight 90-minute DBR sessions with a waitlist condition. Participants receiving DBR showed substantial reductions in PTSD symptoms, which were maintained or further improved at three-month follow-up. Approximately 48% no longer met diagnostic criteria for PTSD immediately after treatment and 52% at three months. Importantly, DBR was also well tolerated, with very few participants discontinuing treatment.

Research: Kearney BE, Corrigan FM, Frewen PA, et al. (2023). A randomized controlled trial of Deep Brain Reorienting: A neuroscientifically guided treatment for post-traumatic stress disorder. European Journal of Psychotraumatology, 14(2), 2240691.

The aim of DBR

DBR is not about forcing yourself to revisit painful memories. It is about slowing things down enough for your brain and body to process what could not be fully processed at the time.

As this happens, people may notice that the memory or trigger feels less immediate, their body reacts differently, emotions become easier to tolerate, or their understanding of themselves and what happened begins to shift.

Who might DBR be helpful for?

DBR may be considered when distress seems to be driven by experiences that feel automatic, physical or difficult to put into words. This may include experiences associated with:

• PTSD and complex trauma

• developmental or attachment trauma

• repeated experiences of threat, rejection or helplessness

• strong reactions to particular facial expressions, tones of voice or interpersonal situations

• trauma that is experienced primarily through body sensations rather than clear memories

• experiences where talking about what happened feels overwhelming

• dissociation, shutdown or feeling “stuck” when approaching traumatic material.

DBR can also be useful when you understand intellectually that you are safe now, but your body continues to react as though something dangerous is happening.

Do I have to talk about my trauma?

Not necessarily.

One of the features many people appreciate about DBR is that detailed retelling of traumatic experiences is usually not required. We may work with only a small fragment of an experience—for example, a facial expression, a tone of voice, a moment of realisation, an image or a body sensation.

You remain in control of what you choose to share.

What might I notice during DBR?

DBR involves carefully noticing very subtle changes in the body. There is no particular response that you are supposed to have.

People may notice sensations such as:

pressure • tension • tingling • heaviness • numbness • warmth or cold • trembling • changes around the eyes or forehead • tightness in the neck or shoulders • an impulse to turn the head • changes in breathing • emotions or memories appearing

Sometimes very little appears to be happening externally while significant internal processing is occurring.

The aim is not to force a reaction but to notice what the nervous system naturally does when given enough time and attention.

How is DBR different from EMDR?

Both DBR and EMDR are trauma-focused therapies, but they approach traumatic memories somewhat differently.

EMDR commonly begins with a disturbing memory and works with the associated image, negative belief, emotion and body sensations while using bilateral stimulation.

DBR slows the process down even further and attempts to identify what may have happened before the full emotional response developed—the orienting and shock response that occurred in the first moments of the experience.

For some people, these therapies may be used separately. For others, DBR can form part of a broader trauma treatment plan alongside EMDR, attachment-focused therapy, parts work or other approaches.

Why slow everything down?

When something frightening happens, the brain can respond in fractions of a second.

You may orient towards something, experience shock, prepare to protect yourself and experience an emotional response before you have consciously understood what has happened.

DBR deliberately slows this sequence down.

Rather than jumping immediately to the fear, sadness, anger or shame associated with a memory, we become curious about:

“What happened just before that?”

That very small window of time can sometimes contain important information about the body's original response to the experience.

What if I dissociate or become overwhelmed?

DBR is designed to work slowly.

Your therapist will continually monitor how you are responding and can help you return attention to your Orienting Tension, your body and the present moment if the material begins to feel too intense.

You can pause or stop at any time.

Trauma therapy should not involve simply pushing through overwhelming experiences. The pace of the work is adjusted according to your capacity to remain present and engaged.

How many DBR sessions will I need?

There is no single number that applies to everyone.

Some people work with a specific event or trigger, while others have experienced developmental or complex trauma involving many interconnected experiences. In these situations, DBR may form one part of a longer period of therapy.

We will regularly review what is changing and decide together what approach is most useful.

DBR and early or complex trauma

Sometimes there is no single traumatic event.

For people who experienced chronic stress, neglect, frightening caregiving, repeated rejection or other difficulties early in life, the nervous system may have learned patterns of responding long before there was language to describe what was happening.

In these situations we may work with themes or clusters of experiences rather than trying to identify one particular memory.

This can make DBR particularly interesting as an approach to developmental and relational trauma.