BRAINSPOTTING AND OTHER SUBCORTICAL THERAPIES – REFERENCES v 2023.06.19

BRAINSPOTTING

1. D’Antoni F, Mariz A, Fabbro F, Crescentini C. Psychotherapeutic Techniques for Distressing Memories: A Comparative Study between EMDR, Brainspotting, and Body Scan Meditation. Int J Environ Res Public Health 2022; 19(3),1142; https://doi.org/10.3390/ijerphi19031142

Abstract - Objectives: We explored the effects of a single 40-min session of Eye Movement Desensitization and Reprocessing (EMDR), Brainspotting (BSP), and Body Scan Meditation (BSM) in the processing of distressing memories reported by a non-clinical sample of adult participants. Design: A within-subject design was used. Methods: Participants (n = 40 Psychologists/MDs) reported four distressing memories, each of which treated with a single intervention. EMDR, BSP, and BSM were compared with each other, and with a Book Reading (BR) active control condition, using as dependent measures, SUD (Subjective Units of Disturbance) and Memory Telling Duration (MTD) on a 4-point timeline: Baseline, Pre-Intervention, Post-Intervention, Follow-up. Results: SUD scores associated with EMDR, BSP, and BSM significantly decreased from Pre- to Post-Intervention (p < 0.001). At Post-Intervention and Follow-up, EMDR and BSP SUD scores were significantly lower than BSM and BR scores (p < 0.02). At both Post-Intervention and Follow-up, BSM SUD scores were lower than BR scores (p < 0.01). A reduction in MTD was observed from Pre- to Post-Intervention for EMDR and BSP conditions (p < 0.001). Conclusions: Overall, results showed beneficial effects of single sessions of EMDR, BSP, or BSM in the processing of healthy adults’ distressing memories. Study limitations and suggestions for future research are discussed.

2. D'Antoni F. Brainspotting reduced disturbance and increases Heart Rate Variability linked to distressing memories: A pilot study. Mediterr J Clin Psychol. 2023;9(3). https://doi.org/10.13129/2282-1619/mjcp-3055

Abstract Brainspotting (BSP) is a relatively new type of brain-body psychotherapeutic approach discovered and developed by David Grand (2003) that accesses the client’s innate self-observing and self-healing capacities in the frame of a neurobiologically attuned clinical relationship. Despite it being increasingly growing in popularity among therapists, there is still a paucity of literature on its effectiveness. The aim of the study was to explore the efficacy of BSP in treating distressing (not necessarily traumatic) memories in a non-clinical sample of adults. A within-subjects design was employed for the Brainspotting effectiveness analysis, with two within-subjects factors (treatment, time). The treatment factor had two levels: Brainspotting, and a control condition (Body Scan Meditation). Both objective (Heart Rate Variability - HRV parameters) and subjective (self-report) measures were used in the study. Results showed that, after about 40 minutes of treatment, Brainspotting significantly reduced memoryrelated distress in comparison with Body Scan Meditation control condition (p = .028).

Additionally, the participants had better HRV than before the treatment (all Time Domain parameters p < .05). Participants’ Interoceptive Awareness dimensions and dispositional traits such as attachment style, temperament and character were also examined and discussed within the Brainspotting theoretical frame. These findings, more broadly, highlighted the key role of interoceptive awareness in the processing of distressing memories.

3. Fletcher SH. Spot the Anger: Reducing Anger and Irritability with Brainspotting (Doctoral dissertation, Brandman University)

4. Foo M, Yudistiro-Konselor R. A study of brainspotting therapy in PTSD using 18FDG brain PET scan to evaluate glucose metabolism changes. Ejournal.unp.ac.id

5. Grand, D. Brainspotting: The revolutionary new therapy for rapid and effective change. Sounds True, 2013.

6. Hildebrand A, Grand D, Stemmler M. Brainspotting – the efficacy of a new therapy approach for the treatment of posttraumatic stress disorder in comparison to eye movement desensitization and reprocessing. Mediterr J Clin Psychol. 2017;5:1-17.

Abstract: Objective: This study aims at determining the efficacy of the new therapy approach Brainspotting (BSP) in comparison to the established Eye Movement Desensitization and Reprocessing (EMDR) approach for the treatment of Posttraumatic Stress Disorder (PTSD). Method: The sample consisted of 76 adults seeking professional help after they have been affected by a traumatic event. Clients were either treated with three 60-minute sessions of EMDR (n=23) or BSP (n=53) according to a standard protocol. Primary outcomes assessed were self-reports of the severity of PTSD symptoms. Secondary outcomes included selfreported symptoms of depression and anxiety. Assessments were conducted at pretreatment, posttreatment and 6 month after the treatment. Results: Participants in both conditions showed significant reductions in PTSD symptoms. Effect sizes (Cohen’s d) from baseline to posttreatment concerning PTSD related symptoms were between 1.19 – 1.76 for clients treated with EMDR and 0.74 – 1.04 for clients treated with BSP. Conclusion: Our results indicate that Brainspotting seems to be an effective alternative therapeutic approach for clients who experienced a traumatic event and/or with PTSD.

7. Kishpaugh JM. The Use of the Psychotherapy Technique Brainspotting in the Treatment of Test Anxiety. 2023. Dissertation, Lincoln Memorial University.

Abstract: The researcher investigated the self-reported test anxiety levels of students at a college of osteopathic medicine and a college of veterinary medicine at a university in the southeastern United States at the beginning of the 2022-23 school year. Student’s test anxiety levels were measured using the Spielberger Test Anxiety inventory at the beginning of the semester, before their first exam. Sixty six students participated in the

study and were randomly divided into two treatment populations; (a): a Brainspotting treatment group (BSP) and (b), a Rational Emotive Behavior Therapy/relaxation technique treatment (REBT) group. Students not meeting criteria for the study were given the opportunity to receive free mental health counseling at the college’s office of mental health counseling. The investigator, a licensed clinical mental health counselor and director of mental health at the university, provided the Brainspotting treatment, while the REBT treatment group received treatment from two other licensed clinical mental health counselors employed at university’s office of mental health counseling. Study participants from each treatment group received three, 60-90 minute counseling sessions occurring over a six -week period. The investigator reassessed participants’ self-reported test anxiety at the end of their third counseling session and again at 4 weeks post-treatment. Treatment results suggested that Brainspotting was the more effective treatment immediately following three treatment sessions and at 4 weeks post-treatment. The treatment results also showed that participants receiving brainspotting experienced continued improvement 4 weeks after treatment, while participants in the REBT with relaxation group experienced a reduced treatment effect.

8. Laino J. Brainspotting: A Prospective Look at Utilzing Novel PTSD Treatment in College Students. University of Lynchburg Doctor of Medical Science Doctoral Project Assignment Repository 2022;4(2)

9. Langford P. Somatic experiencing, EMDR, and Brainspotting, An African-centered critique. In Trauma and Mental Health Social Work with Urban Populations. Routledge. 2021.

10. Masson J, Bernoussi A, Moukouta CS. Brainspotting Therapy: About a Bataclan Victim. Global J Health Science, 2017;9(7)103-107. DOI: 10.5539/gjhs.v9n7p103

Abstract: brainspotting psychotherapy (BSP), elaborated by Grand in 2003, aims at managing patients suffering from psycho-traumatic syndromes: Post-Traumatic Stress Disorder, emotional dysregulation, anxiety and/or depressive syndromes.

This original approach combines features of hypnotherapy and EMDR (Eye Movement Desensitization and Reprocessing) and is based on the concept of eye positions capable of soliciting the psychological assimilation processes of traumatic memories. We briefly present this therapeutic tool (framework, protocol, expected effects) and propose certain hypotheses which may explain its efficacy. For this, we draw on research into the practice of Mindfulness and the theory of mnesic malleability. Finally, the follow-up of a victim of the 2015 attack on the Bataclan in Paris supports the discussions developed here.

11. Mattos P, Fiks JP, Mello MF. Persistent Genital Arousal Disorder as a Dissociative Trauma Related Condition Treated with Brainspotting – A Successful Case Report. Journal of Sexual Medicine, 2015. 12:345. If using this check publication as two different journals show up.

12. Ningrum D. The Efficacy of Brainspotting Therapy for the Treatment of Tantrum in Young Children. Child Education Journal 2022; 4(2)111-122. https://doi.org/10.33086/cej.v4i2.3146

Abstract: Tantrum appears mainly at the age of 2-4 years old. This behavior is also found in children past 4 years of age. Even though tantrum is the most common behavior problem in young children, they can also cause behavior issues in the future, such as; becoming withdrawn, violent, or having a verbal outbursts and antisocial behavior. In that case, psychological intervention is needed. This study uses a new approach of Brainspotting therapy to treat tantrums in young children. Bainspotting is a psychotherapeutic model that has been conceptualized as a brain and body-aware relational attunement process. Thus, the study's main objective is to determine whether Brainspotting is an effective alternative approach to address the issue of tantrums in young children. A study case of the qualitative method was applied, and data was collected by observing the progress of a 6 years old's child each session, interviewing and comparing assessment of present challenges of a child before and after 10 sessions. The result indicates that Brainspotting is effective as an alternative to reducing tantrums and developing emotional regulation in young children

13. Palsimon T. The preliminary efficacy and clinical applicability of Brainspotting among Phillippine women with severe post traumatic stress disorder. Arch Psychiatry and Psychotherapy, 2022;1:54-64

Abstract Introduction: Brainspotting (BSP) is a relatively new neurophysiological-based approach to PTSD treatment that recognizes the relevance and correlation of eye position to neurological and emotional experience. This paper aims to examine the efficacy of BSP in ameliorating severe PTSD symptoms among female residential patients across three-time points. Methods: This study employed a one-group pretest-posttest with delayed posttest quasi-experimental design to establish and determine causal change among different conditions. Different versions of gold-standard measures were administered to individuals with trauma exposure; the Clinician-Administered PTSD Scale 5 (CAPS-5) and the Posttraumatic Stress Disorder Checklist 5 (PCL-5). The sample comprised 13 participants at the Marillac Hills Alabang who incurred severe interpersonal trauma and suffered markedly elevated PTSD symptoms for at least two years. They received three sessions of BSP guided by a therapist’s manual and were assessed at three-time points – pretreatment, posttreatment, and two weeks after the treatment completion. Primary data include self-report posttraumatic stress symptoms, which were analyzed using repeated-measures ANOVA with a Greenhouse-Geisser correction and post-hoc test with a Bonferroni correction. Results: Results showed significant improvements in both measures with large effect sizes from 0.859 to 0.979. Conclusion: At α0.01 (99%) confidence interval, the results suggest that BSP has significant efficacy in decreasing posttraumatic stress symptoms. After the three BSP

sessions, all participants were assessed with absent to mild PTSD symptoms. The effects of the treatment persisted during the short-term follow-up evaluation.

14. Palsimon T. Efficacy of brainspottinginameliorating posttraumatic stress disorder symptoms among Filipino residential patients. PhD Diss, De la Salle University-Dasmannas, 2020.

15. Talbot, Jeanne; de la Salle, Sara; Jaworska, Natalia. A Paradigm Shift in Trauma Treatment: Converging Evidence for a Novel Adaptation of Eye Movement Desensitization and Reprocessing (EMDR). Canadian Journal of Psychiatry, 2023. Vol.68(4) 283-285. DOI: 10.1177/07067437221142283

16. Anderegg J. Effective Treatments for Generalized Anxiety Disorder, 2016. Unpublished.

Abstract - Both in applied research and in clinical practice it is common to have to evaluate the change experienced by patients as a result of their treatment. This is a clinical experimental comparison study in which three therapeutic intervention techniques are discussed for the treatment of generalized anxiety disorder (GAD), with respect to a control group (CG). The first technique is based on cognitive behavioral therapy programs (CBT), the second one in the techniques of eye movement desensitization and reprocessing (EMDR), and the third one consisting in location techniques involving relevant eye position and the neural network activated to access to the particular spot where the problem is fixed in the brain (BSP). These therapeutic procedures were administered to a total of 59 patients with generalized anxiety disorder, assigned by a random procedure to the three treatment groups. 19 plus GAD patients remained in the waiting control group. The assessment of efficacy was performed using the follow up psychometric tests: State-Trait Anxiety Inventory. (STAI) of C.D. Spielberger, the Beck Anxiety Inventory (BAI) and the Subjective Units of Disturbance (SUDS). The results show that the three programs achieved a clinically significant change in this disorder in most people, resulting in a more effective new treatment approach of Brainspotting and the techniques of eye movement desensitization and reprocessing.

17. Newtown-Sandy Hook Community Foundation, Inc. Report of Findings from the Community Survey, September 2016.

BRAINSPOTTING THEORETICAL PAPERS

1. Corrigan FM, Grand D, Raju R. Brainspotting: Sustained Attention, Spinothalamic Tracts, Thalamocortical Processing, and the Healing of Adaptive Orientation Truncated by Traumatic Experience. Medical Hypotheses, 2015.

Abstract - We set out hypotheses which are based in the technique of Brainspotting (Grand, 2013) [1] but have wider applicability within the range of psychotherapies

for post-traumatic and other disorders. We have previously (Corrigan and Grand, 2013) [2] suggested mechanisms by which a Brainspot may be established during traumatic experience and later identified in therapy. Here we seek to formulate mechanisms for the healing processing which occurs during mindful attention to the Brainspot; and we generate hypotheses about what is happening during the time taken for the organic healing process to flow to completion during the therapy session and beyond it. Full orientation to the aversive memory of a traumatic experience fails to occur when a high level of physiological arousal that is threatening to become overwhelming promotes a neurochemical de-escalation of the activation: there is then no resolution. In Brainspotting, and other trauma psychotherapies, healing can occur when full orientation to the memory is made possible by the superior colliculi-pulvinar, superior colliculi-mediodorsal nucleus, and superior colliculi-intralaminar nuclei pathways being bound together electrophysiologically for coherent thalamocortical processing. The brain’s response to the memory is ‘‘reset’’ so that the emotional response experienced in the body, and conveyed through the paleospinothalamic tract to the midbrain and thalamus and on to the basal ganglia and cortex, is no longer disturbing. Completion of the orientation ‘‘reset’’ ensures that the memory is econsolidated without distress and recollection of the event subsequently is no longer dysphorically activating at a physiological level.

2. Corrigan F, Grand D. Brainspotting: Recruiting the Midbrain for Accessing and Healing Sensorimotor Memories of Traumatic Activation. Medical Hypotheses, 2013.

Abstract - Brainspotting is a psychotherapy based in the observation that the body activation experienced when describing a traumatic event has a resonating spot in the visual field. Holding the attention on that Brainspot allows processing of the traumatic event to flow until the body activation has cleared. This is facilitated by a therapist focused on the client and monitoring with attunement. We set out testable hypotheses for this clinical innovation in the treatment of the residues of traumatic experiences. The primary hypothesis is that focusing on the Brainspot engages a retinocollicular pathway to the medial pulvinar, the anterior and posterior cingulate cortices, and the intraparietal sulcus, which has connectivity with the insula. While the linkage of memory, emotion, and body sensation may require the parietal and frontal interconnections – and resolution in the prefrontal cortex – we suggest that the capacity for healing of the altered feeling about the self is occurring in the midbrain at the level of the superior colliculi and the periaqueductal gray

OTHER

1. Baek J, Lee S, Cho T, et. Neural circuits underlying a psychotherapeutic regimen for fear disorders. Nature, 2019;566(7744):339-343.

2. Bochynska A, Laeng B. Tracking down the path of memory: eye scan paths facilitate retrieval of visuospatial information. Cogn Process. 2015;16(Suppl 1):159-163

3. Bromet, E., Karam, E., Koenen, K., & Stein, D. (Eds.). (2018). Trauma and Posttraumatic Stress Disorder: Global Perspectives from the WHO World Mental Health Surveys. Cambridge: Cambridge University Press. https://doi.org/10.1017/9781107445130

4. Christodoulou, G., Salami, N., & Black, D. S. (2020). The utility of Heart Rate Variability in Mindfulness research. Mindfulness, 11(3), 554–570. https://doi.org/10.1007/s12671-019-01296-3

5. Chubb, C., Dosher, B. A., Lu, Z.-L., & Shiffrin, R. M. (Eds.). (2013). Human information processing: Vision, memory, and attention. American Psychological Association. https://doi.org/10.1037/14135-000

6. Corrigan FM, Hull AM. Recognition of the neurobiological insults imposed by complex trauma and the implications for psychotherapeutic interventions. BJPsych Bulletin. 2015. http://dx.doi.org/10.1192/pb.bp.114.047134. 39(2), 79-86.

7. Ditto, B., Eclache, M., & Goldman, N. (2006). Short-term autonomic and cardiovascular effects of mindfulness body scan meditation. Annals of Behavioral Medicine, 32(3), 227–234. https://doi.org/10.1207/s15324796abm3203_9

8. Edwards-Stewart A, Smolenski DJ, Bush NE, et al. Posttraumatic stress disorder treatment dropout among military and veteran populations: a systematic review and meta-analysis. J Trauma Stress. 2021;34(4):808-818.

9. Füstös, J., Gramann, K., Herbert, B. M., & Pollatos, O. (2013). On the embodiment of emotion regulation: interoceptive awareness facilitates reappraisal. Social cognitive and affective neuroscience, 8(8), 911–917. https://doi.org/10.1093/scan/nss089

10. Geller S, Porges S. Therapeutic presence: Neurophysiological mechanisms mediating feeling safe in therapeutic relationships. Journal of Psychotherapy Integration 24. 2014. 178-192

11. Gupta MA. Review of somatic symptoms in posttraumatic stress disorder. Int Rev Psychiatry. 2013 Feb;25(1):86-99. doi: 10.3109/09540261.2012.736367. PMID: 23383670.

12. Kleiger, R. E., Stein, P. K., & Bigger, J. T. J. (2005). Heart rate variability: Measurement and clinical utility. Annals of Noninvasive Electrocardiology: The Official Journal of the International Society for Holter and Noninvasive Electrocardiology, Inc, 10(1), 88–101. https://doi.org/10.1111/j.1542-474X.2005.10101.x

13. McLaughlin KA, Koenen KC, Hill ED, Petukhova M, Sampson NA, Zaslavsky AM, Kessler RC. Trauma exposure and posttraumatic stress disorder in a national sample of

adolescents. J Am Acad Child Adolesc Psychiatry. 2013 Aug;52(8):815- 830.e14. doi: 10.1016/j.jaac.2013.05.011. Epub 2013 Jun 25. PMID: 23880492; PMCID: PMC3724231.

14. Ogden, P., Minton, K., & Pain, C. (2006). Trauma and the body: A sensorimotor approach to psychotherapy. WW Norton & Company.

15. Ryan JD, Shen K, Liu ZX. The intersection between the oculomotor and hippocampal memory systems: empirical developments and clinical implications. Ann N Y Acad Sci. 2020:

16. Salvador, M. The Frame as Listening and Accessing the Deep Emotional Life. The Lens to reach the subcortical brain. Revista de Psicoterapia, 2021 Mar;32(118)

17. Schore, A. N. (1994). Affect regulation and the origin of the self: The neurobiology of emotional development. Erlbaum.

18. Squire, L. R. (2009). Memory and brain systems: 1969–2009. The Journal of Neuroscience, 29(41), 12711– 12716. https://doi.org/10.1523/JNEUROSCI.3575-09.2009