A gaze- and body-focused psychotherapy technique considered selectively within a carefully paced, trauma-informed treatment plan.
Traumatic or distressing experiences can continue to affect attention, emotion, bodily sensation, behavior, sleep, relationships, and the way a person responds to reminders. Some clients can describe what happened clearly but still feel physically activated, emotionally overwhelmed, or disconnected when the material is approached.
Brainspotting is a psychotherapy technique in which a client focuses on a distressing or meaningful issue while attending to a fixed point in their visual field and noticing internal experience. The therapist remains present, monitors response, and supports the client as thoughts, emotions, memories, or bodily sensations change.
At THE BALANCE, Brainspotting is not presented as a proven way to locate trauma in the brain or as an established first-line treatment for PTSD. It may be considered selectively when a suitably qualified clinician believes that the method fits the individual formulation, explains the limited evidence base, and integrates the work into a broader trauma treatment plan.
Each fully private residential program is dedicated to one client. Preparation, pacing, session length, recovery time, and coordination with psychiatric care, mental health treatment, sleep, and continuing therapy can therefore be organized around the person rather than around a fixed intensive protocol.
What Is Brainspotting?
Brainspotting is described by its developers as a brain-body and relational psychotherapy approach. The therapist and client identify a topic or internal experience, then explore whether a particular direction of gaze appears connected with a change in emotional or bodily activation.
The selected gaze position is called a “brainspot.” The client may hold that position while noticing thoughts, images, emotion, memory, movement impulses, or physical sensation. The therapist usually uses less verbal direction than in some structured therapies and follows the client’s experience as it develops.
The name can create an impression of anatomical precision that the evidence does not support. A point in the visual field is not a diagnostic image of the brain, and a therapist cannot determine from eye position where a memory is stored.
How Brainspotting Was Developed
Brainspotting emerged from David Grand’s clinical work with eye-movement and trauma-focused methods. The approach is commonly dated to 2003, when he observed that a client’s response appeared to change when her gaze paused at a particular position.
That clinical observation became the basis of a wider method involving gaze, bodily awareness, and therapist attunement. Historical origin, professional popularity, and practitioner experience do not by themselves establish effectiveness. The method requires the same evidence, governance, and outcome review expected of other psychotherapies.
What Happens in a Brainspotting Session?
A responsible session begins before the pointer or gaze exercise is introduced. The clinician should understand the client’s current symptoms, diagnosis, trauma history, stability, dissociation, substance use, medication, sleep, risk, and previous response to trauma treatment.
A session may include:
- Clarifying the focus. The client and therapist identify the memory, situation, feeling, belief, bodily sensation, or current difficulty to be explored.
- Assessing activation. The client may rate distress or activation and identify where it is experienced physically.
- Locating a gaze position. The therapist may move a pointer slowly through the client’s visual field, or the client may identify a position that feels connected with the selected issue.
- Maintaining dual awareness. The client attends to the internal experience while remaining aware of the room, the therapist, and present safety.
- Allowing experience to develop. Thoughts, images, sensations, emotions, or periods of quiet may arise. The therapist monitors and intervenes according to need.
- Closing and reviewing. The session ends with orientation to the present, reassessment of activation, and planning for the period after the session.
Not every session produces a dramatic experience. Lack of imagery, tears, movement, or immediate relief should not be interpreted as resistance or failure.
How Is a Brainspot Identified?
Practitioners describe several ways of selecting a gaze position.
In an “inside window” approach, the client identifies where activation feels strongest or most relevant while looking across the visual field. In an “outside window” approach, the therapist observes small changes such as blinking, swallowing, breathing, facial tension, or movement while guiding the gaze. A naturally recurring gaze position may also be used.
These observations are part of the method’s clinical procedure. They should not be described as validated neurological markers. Blinking, swallowing, muscle tension, and gaze shifts can have many explanations.
What Is “Dual Attunement”?
Brainspotting training emphasizes both relational attunement and attention to the client’s neurophysiological experience. In ordinary clinical terms, this means that the therapist remains responsive to the person while monitoring signs of activation, disengagement, overwhelm, or change.
A strong therapeutic relationship may contribute to safety and outcome across many forms of psychotherapy. It does not prove the distinctive neurological claims of Brainspotting, but it remains clinically important.
What Does the Evidence Say?
The Brainspotting evidence base is limited. A frequently cited 2017 study compared three sessions of Brainspotting with three sessions of EMDR among 76 adults affected by traumatic events. Participants in both groups reported symptom reductions, but allocation was not randomized, group sizes differed, outcomes relied heavily on self-report, and one of the study authors developed Brainspotting.
Other publications include theoretical papers, observational studies, case reports, surveys, and small clinical projects. These can generate hypotheses but do not establish effectiveness across diagnoses or show that the proposed mechanism is correct.
Major PTSD guidelines recommend treatments such as trauma-focused cognitive behavioral therapies, prolonged exposure, cognitive processing therapy, and EMDR. Brainspotting is not currently supported by a comparable body of randomized trials or guideline endorsement.
THE BALANCE should therefore describe it as a selectively used emerging technique, not as a proven replacement for established trauma-focused psychotherapy.
Brainspotting Compared With EMDR
Brainspotting and EMDR both involve attention to distressing material and use the visual field, but their procedures and evidence bases differ.
EMDR uses a structured eight-phase protocol and typically includes sets of bilateral stimulation, such as side-to-side eye movements, taps, or tones. It is recommended for PTSD by major clinical guidelines.
Brainspotting usually uses a fixed gaze position and a more open-ended processing period. Its advocates may describe it as more flexible or less directive, but there is not adequate evidence to state that it is gentler, deeper, faster, or more effective than EMDR.
The choice should be based on diagnosis, treatment goals, prior response, preference, clinician competence, and evidence—not on marketing comparisons.
What Brainspotting May Be Used to Explore
Practitioners use Brainspotting with a wide range of concerns, including:
- trauma-related memories and symptoms;
- anxiety or emotional activation;
- grief and loss;
- body-based distress;
- performance anxiety or blocks;
- relationship or attachment-related themes;
- pain or difficult physical sensations.
The existence of clinical use does not establish effectiveness for each of these concerns. Brainspotting should not be selected from a diagnosis alone, and it should not displace a better-supported treatment without a clear rationale.
Brainspotting for PTSD and Complex Trauma
PTSD treatment may involve trauma memories, avoidance, threat-related beliefs, hyperarousal, sleep, dissociation, shame, guilt, relationships, and current safety. A single technique cannot be assumed to address all of these domains.
For complex or developmental trauma, pacing and the therapeutic relationship may require particular attention. However, the word “complex” should not be used to justify indefinite unstructured treatment or to assume that an emerging method is automatically preferable to established care.
Brainspotting may be used as one element within Trauma-Focused Therapies when the clinician can explain why it is being selected and how progress will be reviewed.
Brainspotting in Mental Health Treatment
Some practitioners use Brainspotting to explore cravings, emotional triggers, shame, trauma-related activation, or memories associated with substance use.
It does not manage intoxication or , reduce overdose risk, or replace evidence-based mental health treatment. Medical stabilization, medication, counseling, prevention, psychiatric care, and environmental change may all remain necessary.
Trauma processing during mental health treatment requires coordination so that increased distress does not destabilize sleep, substance use, self-harm risk, or participation in the wider program.
Readiness and Suitability
Readiness is not determined by whether the client is willing to endure intense distress. The clinician considers whether Brainspotting is likely to be safe and useful at this stage.
Assessment may include:
- current diagnosis and target symptoms;
- self-harm, suicide, aggression, exploitation, or environmental danger;
- dissociation, psychosis, mania, severe depression, or cognitive impairment;
- substance use, intoxication, and risk;
- sleep, nutrition, medication, and physical health;
- ability to orient to the present and communicate a need to stop;
- previous trauma treatment and adverse reactions;
- support available after the session and after residential care.
Stabilization or another treatment may take priority. A client can decline Brainspotting without making the wider plan incomplete.
Safety and Possible Adverse Responses
Brainspotting can bring distressing material into awareness. Possible responses include increased anxiety, sadness, anger, shame, intrusive memories, nightmares, fatigue, headache, eye strain, emotional flooding, numbness, or dissociation.
Temporary discomfort can occur in trauma-focused treatment, but significant worsening should not be dismissed as evidence that deep processing is occurring.
The therapist should monitor orientation, speech, movement, breathing, engagement, and the client’s stated experience. The session can be slowed, paused, changed, or stopped. Acute risk or marked deterioration follows the appropriate psychiatric, medical, or emergency pathway.
Provider Qualifications and Clinical Responsibility
Brainspotting training alone does not establish competence to diagnose or treat complex psychiatric conditions.
The provider should hold an appropriate professional psychotherapy or mental-health qualification in the relevant jurisdiction, have specific Brainspotting training, work within scope, and have experience with the client’s presentation.
The proposal should identify who holds clinical responsibility, how the method is supervised, what happens if symptoms worsen, and whether the provider is part of THE BALANCE or an independent professional.
How Progress Is Evaluated
Progress is not measured by locating more brainspots or experiencing more intense sessions.
Relevant outcomes may include:
- change in PTSD or trauma-related symptoms;
- reduced avoidance;
- improved sleep and daily functioning;
- greater ability to remain present with reminders;
- less disruption from a selected memory or trigger;
- reduced dissociation or emotional flooding;
- improved participation in psychotherapy and relationships;
- appropriate validated symptom measures.
If benefit is absent, symptoms worsen, or another therapy is more appropriate, the plan should change.
Brainspotting Within the Balance Model
Brainspotting is considered within Assessment and Treatment Planning, Trauma-Informed Care, and the Multidisciplinary Clinical Model.
Where appropriate, it may be coordinated alongside:
- psychiatric assessment and medication management;
- individual psychotherapy;
- EMDR or another trauma-focused method;
- mental health treatment;
- sleep and physical-health support;
- somatic or grounding work;
- family and relationship therapy;
- transition and continuing care.
The team should avoid combining multiple activating trauma methods merely to make treatment appear intensive.
Fully Private Trauma-Focused Care
THE BALANCE provides fully private residential treatment in Mallorca and Zurich, with each program and residence dedicated to one client.
For executives, public figures, internationally mobile families, and HNWI or UHNWI clients, this structure allows trauma-focused work to be scheduled discreetly around stability, rest, professional responsibilities, and authorized communication.
The premium distinction is not a claim that Brainspotting is more advanced or exclusive. It is the ability to select and sequence care around one person while maintaining clinical governance and privacy.
