Brainspotting: Understanding This Eye-Position-Based Therapy

Brainspotting is a psychotherapy developed in 2003 by David Grand, an American psychotherapist specializing in the treatment of trauma. According to his account, the method came out of a clinical observation: while working with a patient using the EMDR protocol, Grand noticed that one precise position of the gaze seemed to trigger a particularly intense emotional activation. This observation led him to formulate the central idea of the method: the position of the eyes in the visual field would influence the patient's emotional state.

Unlike conventional talk therapies, brainspotting does not rely on conscious analysis or on verbalizing the traumatic experience. According to its proponents, holding the gaze on a specific point, called a brainspot, would give access to subcortical areas of the brain linked to traumatic memories, which are hard to reach through speech.

David Grand sums up the idea this way: where you look affects how you feel. The therapist looks for an eye position linked to an unresolved experience, and the patient stays on that point in a safe setting. This explanation remains a hypothesis[3].

Brainspotting rests on identifying points of eye fixation that, according to its proponents, would activate the neural networks linked to trauma. Two aspects structure this understanding: the role of the visual field and how a session actually unfolds.

The role of the visual field in treatment

Each brainspot corresponds to a precise position of the eyes in the visual field. When the gaze fixes on this point, the networks associated with a traumatic memory would be activated. This mechanism remains a hypothesis, published mostly in theoretical form[3].

Where cognitive therapy asks the patient to put thoughts into words, analyze them and restructure them, brainspotting leaves less room for speech. In a study of 40 psychologists and physicians without a diagnosed disorder, a single session of brainspotting or EMDR reduced the distress linked to a painful memory[4]. This is not enough to draw a conclusion about treating a disorder.

A brainspot is located by progressively scanning the visual field, often with a pointer held by the therapist. The patient indicates, verbally or through bodily reactions, the areas where activation is strongest. This is where the treatment work begins. The fixation is then maintained on that point for as long as it takes for emotions and sensations to change.

How a typical session unfolds

A session often lasts about an hour. It begins with an initial discussion: the therapist invites the patient to identify the issue to work on and to rate their level of emotional activation.

Next comes the localization phase. The therapist slowly guides a pointer across the patient's visual field, watching for telltale physical indicators: wavering of the gaze, unusual blinking, pupil dilation, facial micro-tics, noticeable bodily tension. For the practitioner, these reactions signal that a brainspot has been found.

Once the point is identified, the patient keeps their gaze fixed on it. The therapist stays present and attentive, without directing the content of what emerges. The patient lets the process unfold, often accompanied by bilateral music played in the background to support activation.

Good to know: you remain conscious throughout the session, and you can stop it at any time. It is not a hypnosis session: the therapist does not seek to induce a hypnotic state.

These two methods share a common origin: both use eye movements as a therapeutic vehicle and target traumatic memories. But their approaches diverge on several essential points.

EMDR, developed by Francine Shapiro in the late 1980s, relies on alternating bilateral stimulation: the patient follows eye movements from right to left while recalling the traumatic event. The protocol is structured in eight precise phases, with defined steps and a codified progression. According to the 2015 INSERM report on EMDR[1], this method enjoys solid scientific and institutional recognition, notably for the treatment of simple post-traumatic stress.

Brainspotting, by contrast, relies on fixation on a single point rather than bilateral movements. The protocol is deliberately more flexible: the therapist adapts to the patient's reactions in real time, without following a rigid sequence. This flexibility can be an advantage for patients whose trauma is hard to circumscribe or put into words.

Here are the main points of comparison:

• Eye movement: bilateral and alternating in EMDR, static fixation in brainspotting
• Protocol structure: highly codified in EMDR, flexible and adaptive in brainspotting
• Verbalization: more present in EMDR, minimal in brainspotting
• Scientific evidence: established for EMDR (INSERM report[1], WHO guidelines[2]), very limited for brainspotting

The choice between the two depends on the patient's profile, their ability to put things into words, and the nature of the trauma. A practitioner trained in both methods can guide you toward the more suitable one.

The proposed uses are broad, much broader than what studies allow us to claim. The method is aimed first and foremost at people who have lived through traumatic experiences.

Trauma and post-traumatic stress:

• Simple trauma: a single event (accident, assault, disaster)
• Complex trauma: repeated exposure over time (abuse, chronic violence)
• Post-traumatic stress disorder (PTSD) with intrusive symptoms, avoidance, hypervigilance

Anxiety disorders and phobias:

• Specific phobias (animals, heights, enclosed spaces, transport)
• Generalized anxiety
• Social anxiety

Other proposed uses:

• Depression, particularly when linked to difficult life events
• Addictions and dependence behaviors
• Chronic pain with an emotional component
• Performance difficulties (athletes, artists, professionals under heavy pressure)

Appearing on this list does not mean that effectiveness has been demonstrated. For post-traumatic stress, EMDR and trauma-focused CBT are much better documented[1][2].

For specific phobias, exposure remains the reference. The virtual reality exposure therapy offered by C2Care allows the practitioner to conduct graded, controlled exposures, adapting them to each patient.

Absolute contraindications remain rare, but some situations call for caution: acute psychotic states, severe unstabilized dissociation, or an active suicidal crisis. In these cases, a prior assessment by a qualified mental health professional is essential.

There is no universal answer. The length of a brainspotting treatment depends on several interrelated factors.

No study makes it possible to give a reliable average duration. A complex or long-standing trauma generally takes more time.

The factors that influence duration:

• How long ago the trauma occurred
• Nature of the trauma: simple (a single event) or complex (repeated exposures)
• Individual reactivity: some patients make rapid progress from the first sessions, while others need time to adjust
• Engagement in the process: regular sessions and emotional availability between sessions play a real role

Take stock regularly with your therapist: if nothing is changing, talk about it, and do not hesitate to consider a better-documented approach, such as EMDR or trauma-focused CBT[2].

What is known about its effectiveness?

Very little to date. The main publication on its mechanism is a theoretical article[3]. In the study cited above, conducted with 40 psychologists and physicians who were not ill, a single session reduced the distress linked to a painful memory[4]: this tells us nothing about the treatment of a disorder. Brainspotting does not appear in the WHO guidelines on post-traumatic stress, unlike EMDR[2].

Brainspotting is a recent method, created in 2003 by David Grand, that uses the position of the gaze within the visual field to work on trauma, with little reliance on speech. Its mechanism remains a hypothesis[3].

Its strengths: a flexible protocol and a reduced role for verbalization, which is useful for some people.

Its current limitations: very limited evidence, whereas EMDR has a 2015 INSERM report[1] and appears in the WHO guidelines[2]. This calls for an informed approach, particularly in cases of post-traumatic stress.

Choosing a practitioner specifically trained in brainspotting remains the first condition for quality care. Check their training and their experience with the type of disorder concerned, and do not hesitate to ask questions about their approach before committing to a course of treatment.