Does brainspotting work for clients?

There has been some controversy recently about brainspotting. Although the approach has gained popularity, there are major questions about whether it works and whether it does what it proposes to do. So, is brainspotting effective and will it help clients feel less traumatized?

Brainspotting asserts that different parts of the visual field are associated with different areas of the brain where trauma is stored. The idea is that if you can access those areas of the brain in therapy by finding those points in the visual field and having the client focus on those points, you can help relieve trauma stored in those areas. In many ways, it is related to the bilateral stimulation approach within EMDR.

What the research says about whether brainspotting works

But does brain spotting help clients feel less traumatized? A few small studies have shown that brain spotting may reduce symptoms within the same individual. However, these studies lacked key crucial elements needed to understand whether treatment really works. For example, control comparison groups that allow you to compare the effects of treatment on a group of individuals with another group of individuals who did not receive the treatment.

Research that compares brainspotting to other established treatment to see how it stacks up is also lacking.  That is, does brainspotting perform as good or better than established approaches, like cognitive processing therapy or prolonged exposure therapy. These comparisons allow us to know whether it is truly effective or not.

Extensive clinical and neurological research also finds that memory does not function in the way that brainspotting proposes. Memory in trauma is more about a process that plays in multiple brain regions rather than memories sitting in location where they are “stored”. This process involves a complex interaction between the hippocampus, the amygdala, and the prefrontal cortex to determine how trauma memories initially develop and are later recalled. Our article on the important role of memory in trauma provides an easy overview of that process.

Anecdotally, therapists sometimes report their clients experience relief after brainspotting sessions. But it is difficult to connect exactly what made clients feel better each session. For instance, it could have been therapist empathy or other strategies employed by the client. Additionally, whether that relief maintains over months or years is also unknown from those reports.

Brainspotting’s origins in bilateral simulation also makes how we understand it problematic. That is, extensive research in the early 2000s found that bilateral stimulation on its own is not helpful to relieve trauma or PTSD.

This research showed that the true helpful ingredients for trauma relief involves attending to trauma memories through verbal and mental exploration of those memories. This exploration is consistent in the extensive neurological research showing how memory processes are extremely important in trauma / PTSD.

What it all means for effective therapy

Verbally exploring memories in therapy is also consistent with established approaches like Cognitive Processing Therapy (CPT) and Prolonged Exposure for PTSD (PE). These approaches are not harmful and shown to be very effective. They help clients reduce how threatening memories and triggers that bring about those memories really are.

An analysis in 2024 found that brainspotting met criteria for being defined as a pseudoscientific approach. We won’t comment on whether it meets that definition and we kind of don’t care. What we care about is what the science behind something might say. In this case, research does not support the efficacy of brainspotting. There are simply no high-quality or randomized controlled trials to show that it works.

Other key ingredients appear to make effective treatment. In particular, discussion and exploration of the trauma memory (via approaches like CPT or PE). Additionally, an empathetic therapist is crucial. Lastly, the self-efficacy a client then begins to feel as they gain mastery over their trauma triggers and trauma memories. It’s hard but it’s worth it.