By Barbie Humble

 

If you aren’t going out into the field to do a formal critical incident stress debriefing (CISD) you can still use this approach with patients in your office. It can be used with anyone who has just had a recent exposure to a traumatic event.

Why We Use CISDs

CISDs are used after a traumatic event to prevent post traumatic stress and PTSD symptoms and increasing the mechanisms of psychological and emotion resilience. In the work place Critical Incident Stress Debriefings are used to off-set risk, mitigate fall out and enhance recovery and sustainability in the event of an acute or short term natural work place stoppage. Human Resource directors use debriefings with staff members to support their employees but also for liability reasons. CISDs are frequently used within professions where employees are exposed to acute trauma such as law enforcement, firefighters and military personnel.

Continue reading Using Brainspotting in Critical Incident Stress Debriefing

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In this article for Psychotherapy Networker Dr. David Grand explores how traumatic experiences can influence athletic performance, creating blocks and other problems.

David also describes how Brainspotting therapy can be used to assist athletes, drawing from a specific example of a baseball catcher he once worked with. David elegantly describes Brainspotting as “a therapeutic approach I’ve developed over the past 12 years to access the emotional and somatic areas deep in the brain, bypassing the areas of thought and language. Through an integration of EMDR and Somatic Experiencing, it focuses on using eye gaze and body awareness to access and process traumatic memories that may be difficult to bring to consciousness otherwise.”

Read David’s article to learn more about how to apply Brainspotting to sports performance.

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By Jennifer Delaney, MA, NCC

 

It was a pleasure speaking at the last brown bag lunch. RMBI members form a friendly and supportive group. In the following article, I summarize the benefits of a practice of presence, and I offer exercises to use as resource tools throughout the week.

Echoing Dr. Bob Scaer’s words in The Body Bears the Burden, Dr. Grand encourages us to remind clients that trauma reactions are physiological and not psychological. When they react rather than respond, there is no point in blaming themselves. Compassion is imperative to heal as clients recognize their programmed triggers, and then, we can teach them body-centered exercises for support as they come into deeper awareness of the emotions being held in their bodily, as well as the resulting “feelings.”

Continue reading Body-Centered Tools to Support Brainspotting and Other Modalities

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Have you ever wondered what the heck David Grand was talking about when he referred to the “Uncertainty Principle” in the level one training?! Here’s an excellent read by trainer, Christine Ranck, on the concept, including how it applies to us psychotherapists. Enjoy!  ~ Melanie Young

 

By Christine Ranck, PhD, LCSW

 

We are used to looking at the world in a simple way…believing that something is there, or it is not there, whether we are looking at it or not.  All our experience tells us that the physical world is solid, real, and completely independent of us.  To observe the world “objectively” means to see it as it would appear to an observer who has no prejudices about what s/he observes.

But the new science, Quantum Physics, says that this is simply not accurate; that it is not possible to observe reality without changing it; that we can never eliminate ourselves from the picture.

Continue reading What the Heck is the Heisenberg Uncertainty Principle? (The No-Assumptions Model)

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By Monika Baumann, with Marie-Jose Boon, Monika Gos, Mark Grixti, Patricia Jacob, and Martha Jacobi

 

Recently I was deeply touched by an 11- year- old young girl, asking me if I could help her to get rid of her stuttering.

I applied Brainspotting and she shared special moments of her life with me.

While she was processing–very profoundly–her tears dropped slowly, heavily, and silently on my office floor – the tissue she used got soaked! I witnessed her face changing… relaxing. Her body sensation, of having a tight band around her neck, slowly disappeared. She was relieved!

Still the girl could not take her eyes off the little “King” finger-puppet, whom she chose to be her assistant. It became like a magnet for her gaze. I somehow felt, just to be silent….. Tears again– but they were different tears. This time running quickly down her chest, and then a Whisper, “I´m so happy – so deeply happy!”

My therapeutic feeling for her tears at this moment was: “What a gift.“

 

Last fall I asked therapists from various groups to share their experiences with Brainspotting for young people. Martha from New York, Marie José from Amsterdam, Monika originally from Poland, Patricia from Brasil, and Mark from Great Britain povided their time and experience while Skyping with me. A big thank you to them.

I asked five questions, which I will first answer describing the above case from a therapeutic point of view, followed by discussions about Brainspotting with young people.

Case Discussion:

1) Do we need to prepare our young patients?

Some days ago an 11 year old girl came into my office to Brainspot her stuttering. This girl is definitely a very bright young lady and so far, she had never stuttered in front of me. But, she said, she often stuttered in school or at home – especially when she was arguing with one of her siblings.

Having a very smart, wonderful young lady in front of me motivated me to explain how her brain could help the Brainspotting process. She basically understood the neurological background of Brainspotting, before we started. I also told her the following fairy tail, to make clear that “kissing the ugly frog“ can mean transforming stuttering into normal fluent language.

…. There once was a princess who was playing with her golden ball …… all of a sudden the ball fell into a deep well, and she wept bitterly. Unexpectedly, an ugly frog emerged from the depths and offered to bring the ball back, on one condition. His condition was, that from then on she had to take him everywhere as a playmate and treat him lovingly. The princess promised everything and the frog brought her the golden ball. Overjoyed, she ran home alone, disobeying her promise. During the family dinner the frog appeared. The princess was frightened and told her father what had happened. He advised and supported her to be loving and respectful with the frog. Although the frog disgusted the princess, she held on to her father’s advice. As soon as she was in her playroom with the frog, he was accepted for the first time. In some versions of the story the frog is kissed by the princess, in other versions he is thrown against the wall. Either way, however, the frog could turn into a prince again, and the two still live together, happily!

With this fairy tale, I gave her the reassurance of knowing that I will be with her whatever may come. (Attunement – Relational and neurobiological frame)

2) How do we use the pointer with young clients? How do we use Inside Window, Outside Window, and Gazespotting with them?

Finding the spot with a finger-puppet on top of the pointer was done in a traditional way. By using the Inside Window, the girl chose a spot in front of her and to her left side.

Motivated by the above story – a finger-puppet frog (that we later changed into a finger- puppet king) was selected and put on the pointer. The girl could clearly define the activation point (Inside Window) which later became a Resource Brainspot, when she changed the frog into a king!

3) How do we find out from young clients about their body activation or body resource, and how do we use the SUDS?

The girl described the feeling of a tight band around her neck (SUDS 9). She kept telling me that the band became steadily looser, and in the end it felt like it had fallen off of her (SUDS 0).

4) Do we use Biolateral Sound with young people?

The girl liked to put on the headphones, with the “Best of Biolateral“ playing, before she found the activation point.

5) What is processing like for young people?

Fixing the Brainspot was also easy for the girl, and her processing was as I described above: deeply emotional. She shared life moments with me, when she felt very impotent. (e.g death in her family, unsolved conflicts…) I could observe her being helpless with her tears dropping silently on the floor and in her very deep way of looking at the pointer.

During these times no one supported her. Being so lost, she started stuttering…..what a feeling of shame – what a feeling of being helpless!

While processing, the girl’s face turned from very sad, with many silent tears, to a relaxed young lady’s face! Sitting near to her, I could see and feel that she was getting released from her tension. She told me, that it seemed like the band around her neck slowly fell off of it. Processing continued. She asked me to change the frog into a king and then kept staring at the same Brainspoint. Finally her words, ” I´m so happy – so deeply happy,” changed it into a Resource Brainspot!

General Discussion of Brainspotting with Kids and Adolescents:

1) Do we need to prepare our young patients?

The emotional part for us as therapists is the trust that young people bring with them. They want to get rid of their symptoms and we are allowed to be creative and find any posible access to start Brainspotting.

In contrast to the case described above, let me share the experience that once our clients trust us, they do not necessarily need an explanation of what will be done!

It depends on the age and development of the clients, and on us as therapists– whether we feel that the frame is well-enough set.

A general observation is, the younger the children are, the less explanation they need. Many kids trust easily and are mostly very brave in processing.

A four year old boy was sitting on his mum’s lap. There was no need at all to explain what will be done, because he was ready to process. His mum described sexual abuse and explained his difficulties since then. He felt so confident, that Brainspotting (Gazespotting) with him happened without any explanation during the talk“.

By the way, sometimes children are overwhelmed by their feelings. A way of keeping them processing, is to explain that these emotions are like waves – coming huge and then drifting away. They can also be told that their brain is very clever and stupid at the same time. Clever because it starts facing horrible thoughts and stupid because it says, “Oh what a a horrible thought – I have to run away….“ So let us help the brain not to be stupid, and to change the horrible thoughts!

Mark from Great Britain wrote a picturebook:“Brainspotting with young people – An adventure into the mind – by Mark Grixti and Illustrated by Rosanna Dean” explaining Brainspotting for kids. He mentioned that he uses it more for the parents than for the young ones.

A form of explanation used successfully is that the pointer shows the direction of the “window” through which they can have access to the forgotten and often painful worlds! By opening this window (looking at it) they can clear those forgotten worlds and make them more cozy and fresh.

Often it is not even planned to use Brainspotting in a session and it just happens. So let me answer the question “Do we need to prepare our young patients?“ with one guiedeline: Kids are so open minded. Whatever we explain or do not explain in advance of using Brainspotting in a session, let us hold the frame around the young people in such a way that they can keep their confidence!

2) How do we use the pointer with young clients? How do we use Inside Window, Outside Window, and Gazespotting with them?

Bainspotting with this age group can be so full of happiness and joy and at the same time full of seriousness.

You may have them lying on the floor, dancing hip hop while focusing on an activation point, seriously sitting in the chair and processing for a long time, drawing pictures (e.g one for the resource point and one for the activation point), using Gazespots or day dreaming while focusing, playing theater, role playing, using the one-eye glasses (giving them the feeling, that they are smart enough to change their symptoms into normal feelings with only one eye), darken the room and let them work with flashlights……and so on, and so on, and so on! Just catch them from where they are and use the Inside or Outside Window, or a Gazespot, as it is appropiate.

Whatever you choose to do, enjoy finding an access to the subcortex!

3) How do we find out from young clients about their body activation or body resource, and how do we use the SUDS?

Young people easily get access to their body feelings (even if they suffered from abuse – which personally surprised me).

Also with adolescents it is observed that they can feel where the body has its resource or activation point. They sometimes need special help because they feel this question to be inapropiate for them or their age. It helps to let them know that “one of my other clients felt a crummy feeling in her stomach when she was thinking about the difficult situation….“

Finding a Body Resource is described as a great help during the therapy, especially when the patients are overwhelmed. Making a “Body Resource gift“ at the end of the Brainspotting process provides a feeling of strength that can always be recalled. “It was so funny, whenever I passed the place where they attacked me, I thought of Mr. Poppy and felt his strength in my arms…..no more worry, that I would be unable to pass.“

There are many ways of offering SUD Scales:

Smilies, playing cards, using our hands as a measure, colours or just the difference between three feelings: really bad – bad – not any more.

“A very scared 8 year old girl was left alone and locked in her room by a babysitter 5 years before the therapy. At the beginning of the therapy she was not able to be by herself or stay at home, even with trusted persons, if they were not in the same room with her.

She drew a picture of her body and pointed to the heart as a body sensation. To express the

intensity of her feelings she chose UNO cards and created a SUD scale across the floor. She processed the trauma several times over various sessions, and always turned the cards face- down when she did not feel the described feeling. After five sessions all of the cards were turned over and her parents could leave her with a responsible caregiver, without her showing any fear if the caregiver was in another room.“

4) Do we use Biolateral Sound with young people?

The Biolateral Sound seems to be very pleasureable to young people They enjoy listening and it gives them a feeling of importance.

“Wow you’ve got blue headphones!“

The music and the reason to use it can be described as a help for our brain, to allow the bad feelings to dissolve: “Did you know,that our brain consists of two parts, and that in reality each part needs the help of the other one? This music, while being louder and then softer on each side, activates the little helper in the brain…..“

When the Brainspotting happens spontaneously, you might not use the Biolateral Sound.

5) What is processing like for young people?

Working with young people is “gift time” for us as therapists. As I described in the case above, this age group so often surprises us.

The innocence, honesty, and/or directness of these clients increases their ways of expressing feelings, sharing their lives with us, and showing emotions for which they have no words. Young people are mostly quicker in processing than adults. With confidence, it can be said that witnessing children’s different ways of processing and healing can motivate us to use Brainspotting creatively with the age group between newborns and approximately sixteen/seventeen-year-olds.

The following two examples are from different therapists, who were surprised by the processing of their clients.

1–A fourteen-year-old girl, very fashionable and cool, who has just had her first bad experience with drugs:

When she found the Brainspot she jumps up in her chair – shouting at me loudly:

“What is that – something happens here – this is spooky!“

I start to explain a little bit while she focuses the pointer. She gets calm and starts telling about her  childhood…..she goes back to the time when she was eight and nobody limited her bad behaviour…..

“Why did they never stop me? At that time my father was still there and nobody ever told me that I was so disrespectful and nasty, and the more they let me do what I wanted, the worse I behaved—-can you imagine, they just didn´t stop me… I think they were afraid of me, is it possible that they were afraid of me?“

2–A seven year old boy suffering from fears:

“We found the Resource Spot, connecting with the sensation of fear and imagining that the little bee (at my pointer) felt the same. I asked him to try to become aware if the fear he felt, was more like if something bad would happen, or a feeling of abandonment, or of being alone and unprotected (he could never answer this before). He promptly answered that it was a sensation of abandonment.

“Just watch what is happening with the little bee and inside of you.” “The bee died.”

“What happened to her?”

“She was born and then died.” “What happened when she was born?”

“I was abandoned. I was born from other parents who had abandoned me. Then my parents who are now my parents got me. But I was abandoned when I was born.”

“So just stay with that idea and notice what else comes up while you look at the bee.” “That’s it.”

“Well, I wonder if this is a feeling that something really bad happened when you were born, that felt as if your parents abandoned you. Remember when we talked with your mother and she told you that she got really sick shortly after you were born and could not take care of you, carry you on her lap and show you love, as you needed? “

“Yes.” (With a sad face)

“Could it be that the baby there inside you still feels abandoned because of it?” “Yes.”

“Can you imagine yourself, explaining to him what happened to your mother, that she is a loving mum now, and is with you when you are afraid, so that he does not need to feel abandoned anymore? “

(He repeated to the baby inside him my words his own way, looking at the pointer)

“So, what happened to him when he heard these words?”

(He became more agitated, distracted for a while, mostly not looking at the pointer, and did not answer)

“Can you now look at the bee again and try to see how baby J is?”

(Spent little time looking at the pointer, talking playfully about the sofa, twisted my pointer he had in his hand (!!!),was distracted, and then stopped)

“He understood. He feels loved now.” (tiny tears in his eyes). “Where do you feel that good feeling of being loved in your body?”

“In my heart” (now quiet, looking at the pointer without distraction)

“So take some time enjoying this good feeling, looking at little bee…” (After a while)

“It’s good. Let’s play now?”

“Yes. But just to finish for today, try to bring back your fear, as we started and see what happens now?”

“Much better. But I still feel that my father doesn’t love me. He must come here too! Shall we play now?

Just to let you know!

We all: Martha, Marie José, Patricia, Monica, Mark and I, feel that it is a special honor to be responsible for this age-group. We work with children who have a huge variety of symptoms: From learning disabilities, to autism, abuse, abandonment, fears, hyperactivity, suffering from disasters, school shootings, etc. etc. None of us  mentioned any difficulties using Brainspotting for a special symptom or therapeutic question.

Reading the cases and thoughts above, you might have realized that working with kids and adolescents is full of creativity and of surprises.

Sometimes they have no words but find great ways of expressing their emotions.

To finish this article let me share with you the WhatsApp message, I recently received from the 11 year old girl who gave up stuttering:

“Hi

It´s me.

You know what!

I´m not stuttering any more!

I´m having great times after your treatment.

 

Monika Baumann is an Austrian psychotherapist currently living in Paraguay. Since 2000 she has had a private practice specializing in working with children. She provides diagnostics and support for children with learning disorders, as well as systemic family therapy with special focus on brainspotting and hypnotherapy. This article was written with input from several other psychotherapists who use brainspotting with children: Marie-Jose Boon, Monika Gos, Mark Grixti, Patricia Jacob, and Martha Jacobi.

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RMBI has always had a long term goal of creating a Brainspotting Treatment Fund to help clients of limited financial means access brainspotting therapy. In 2014 we held a fundraiser to generate seed funding to further this goal. We are also working with a grant writer to help us secure additional funds for the Brainspotting Treatment Fund.

After exploring various avenues and ideas, we are now ready to pursue a pilot of our Brainspotting Treatment Fund. The final program that we ultimately develop will be broader in scope than the pilot, but we recognize that we are venturing into uncharted waters for RMBI. We need to proceed in stages to ensure that we get this right. Thus, the goal of the pilot is to help us define exactly how the process will operate (while helping a few deserving clients in need of brainspotting). We expect the pilot to raise issues we have not anticipated, and allow us to iron out all the kinks before we launch the full program. At this point we would like to call on RMBI members to assist us with the pilot.

For the pilot, potential clients will complete an application that is submitted to the RMBI board. RMBI will pay participating therapists $100 for a 60 minute session and can request 3-10 sessions. For the pilot therapists need to be RMBI members and have completed Levels 1 and 2 brainspotting training. (RMBI board members are not eligible to participate.) Therapists will be required to complete a pre and post questionnaire with the client. Clients must have experienced one or more traumas and will be asked to describe their financial need. The clients need to be new and not current clients. We are currently finalizing the application process and will share the details when that is ready.

Our Request to You: If you get a referral from a client who may be eligible for this program OR if you are a qualified RMBI member therapist who is interested in participating, please email RMBI to let us know.

We are excited about getting the pilot program off the ground and invite your participation in helping us make it a success.

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If you’re like most therapists, you rely on talk therapy or a technical modality such as EMDR or Somatic Experiencing. What you are missing is the brain-body relation.

Screen Shot 2015-07-19 at 10.00.30 AMBrainspotting is a new brain-based relational treatment approach developed by David Grand, PhD. that will give you more effectiveness as a therapist and avoid poor client responses. Join Dr. Grand via live webcast on October 2 as he explains this exciting new modality.

Brainspotting is a powerful, focused treatment method that works by identifying, processing and releasing core neurophysiological sources of emotional/body pain, trauma, dissociation and a variety of challenging symptoms.

Trauma overwhelms the brain’s processing, leaving pieces of unprocessed experiences frozen in time. Brainspotting will provide you with powerful tools enabling your clients to quickly and effectively focus and process through the deep brain sources of many emotional, somatic and performance problems.

Where we look reveals critical information about what is going on in our brain. By carefully observing how and where clients look and focusing on the particular spot, this helps the client process disturbing material more gently and deeply.

Why is it better than many approaches?

  • Flexible
  • Bridges the gap between talk and technical modalities
  • No protocols to master (like EMDR)
  • Open and relational
  • Responsive to the needs of the client
  • Includes brain-body tools
  • Can be adapted into any clinical approach and therapeutic style

Reserve your seat today at this rare event with Dr. David Grand!

Follow this link for registration details and enter the code SPOTDG to receive a $25 discount.

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 By Deborah Antinori, MA, RDT, FT, LPC

 

Orienting is a constant process of our relationship to our own internal bodily sensations, emotions and perceptions, and to the environment. Our experience and interpretation of these internal and external assessments involves multi-faceted processing. It begins with automatic reflexes in the mid- and hindbrain interfacing with learned assessments and perceptions, all of which are based on survival.

We orient to our environment as a basic part of our survival driven by millions of years of evolution. The earliest reptiles date back 315 million years ago, and earliest mammals to 200 million years ago (web references). The evolution of the primate brain has encompassed 53 million years of evolution including the reptilian and mammalian parts of the current human brain (Craig, 2015). In order to survive, we need to know where to look to locate food, shelter and to sense with whom it is safe to engage. We have the same neurobiology as our early ancestors living in caves, on the plains or in the jungle. Our systems are programmed to react, even to overreact to internal and external stimuli (Cozolino, 2011). It is better to assess a shape similar to a bush or a bear as a bear – better to have the tribe laugh at you running away from a juniper bush than to end up as the bear’s lunch! Those who reacted/overreacted lived to have their genes carry on. We are descended from those ancestors who had more highly reactive nervous systems – who tended to orient to their sensing in a “worst case scenario” manner.

Our reptilian and mammalian brains are instinctual. It is good to keep this in mind as we go through the material on orienting and trauma. I find that normalizing for clients what they are experiencing can be very helpful for them. To know that our nervous systems are aptly named – they are, in fact, nervous systems – can be helpful to those struggling with, or even ashamed of how they have been affected by trauma. To know that your brain/body has been constructed in a certain way, dictated by millions of years of conservation in evolution, can be a great relief to those suffering with the effects of trauma and who also may have a particularly high strung instrument.

In Frank Corrigan and David Grand’s first article, “Brainspotting: Recruiting the midbrain for accessing and healing sensorimotor memories of traumatic activation”, adaptive orientation is described as a sequence: “arousal, activity arrest, sensory alertness, muscular adjustments, scanning, locating in space, identifying, evaluating, taking action and reorganizing” (Ogden, et al., 2006). Because our complex brains have one quadrillion possible synaptic connections as well as intricate looping sequences through various areas of the brain for optimal functioning, this full sequence of adaptive orienting can become truncated at any point due to trauma (Corrigan, Grand, 2013) (Corrigan, et al., 2015). Orienting to danger is survival, it is making survival successful – we lived. Events occur so quickly in many cases of trauma, that the brain cannot possibly integrate all parts of the effects of that trauma on the individual (Corrigan, et al., 2015). This leaves the residue of trauma. However, activation around these residues is really a resource – the individual survived as the original orientation to that trauma produced continued survival, not death. Currently, rather than activation, David Grand is using the term “access” as the more precise description of what that phenomenon really is. Residues of trauma give us access to the original orientation to the threat which produced a successful result – survival. This makes the access/activation a resource and is the essence of BSP being a resource model (Grand, 2015).

With Brainspotting Therapy, we are looking to create the environment for adaptive orientation to the trauma by finding the relevant eye position to the trauma. We look for the Brainspot as a function of the natural tendency of humans to orient to what is salient in the environment, as stated in the paragraph above, orienting to what gives the best possible shot at survival. “A brainspot is a stored oculomotor orientation to a traumatic incident which has failed to integrate” (Corrigan, Grand, 2013). It reminds me of the famous line in the movie Cool Hand Luke, “What we have here is a failure to communicate.” I suppose we could say that areas of the brain are failing to communicate with each other when there is a trauma. To repeat, the outcome of the original threat has been survival – the individual has been successful. However, the experience of that fact has not been fully connected in the brain.

The following is my basic understanding of Corrigan and Grand’s 2013 article as it explains orienting. This article is the reference for the statements in quotes that follow here (except where indicated by other authors and their dates of publication). The elements I highlight here can never cover all the exquisite detail of what is occurring in the brain as Corrigan and Grand have described, but rather attempt to capture the meaning of a portion of this extensive article that would hopefully make sense to a client, therapist or other interested party regarding Brainspotting Therapy and orienting.

A certain sequence of brain activity occurs as a result of trauma and is described as “frozen maladaptive homeostasis” (Grand, 2013). In a BSP session, access to this maladaptive homeostasis through identification of bodily felt sense (and/or reflexive facial and body movements) in relation to the trauma connects to that network which is floundering, looking to complete the sequence of orienting begun by the trauma, yet left unfinished. Somatosensory disintegration in the brain/body can result in PTSD, dissociation and other distressing or painful body sensations and emotions.

As we begin the process of physically locating the Brainspot, we encounter the first assistant in the brain to help with orienting – “the Superior Colliculi (SC) in the midbrain are “first responders” for orienting, they control shifts of gaze and also shifts of attention. The SC directs movements towards or away from a stimulus…Saccadic activation (eye movement) and gaze fixation are connected with memory…to the SC….(releasing) gaze fixation neurons in the SC….the sustained gaze holds the brainstem bookmark.” Additionally, Antonio Damasio (2010) finds that the SC “engenders ‘core consciousness’ in all mammals” and he suggests this as the beginnings of the self. Panksepp (2008) adds, “Fundamental healing of deep wounds to the self will only occur when the treatment acts at the midbrain level.”

While other therapies may engage the midbrain, it is usually coincidental to the theory and clinical practice of that therapy. In BSP, this midbrain engagement is fundamental to how we work with the client. It is understood that we are looking to drop down the client subcortically, since that is where we understand that the brain functions which bring about optimal homeostasis and adaptive orienting lie (Grand, 2015). “The gaze fixation used in BSP immediately involves the SC in the midbrain and this neurobiological aspect of the Dual Attunement model is specific to BSP.” This is an important fact regarding BSP – we intentionally employ clinical methodology to access the client’s midbrain. We are deliberately looking for the midbrain access via the visual field and informed by the sensing in the body (Inside Window) and/or reflexive body and facial movements (Outside Window) (Grand, 2015).

One of the reflexive body signals we look for in Outside Window technique in BSP is blinking. Looking at blink research (Nakano, et al, 2012), spontaneous blinking leads to activation of the anterior and posterior cingulate cortex and to the insula with their memory and integrative functions – “insular cortex…cingulate cortex…are paired homeostatic components of the homeostatic sensorimotor hierarchy” (Craig, 2015). These parts of the brain were previously not “online” according to the blink research fMRI studies, but now they are actively functioning – “…disruption of focused attention during blinking is allowing assimilation of the emotional and somatic experience by facilitating the emotional and memory functions of the cingulate and insular cortices… When blinking is observed in the Outside Window technique, it is picking up the momentary heightening of the internal experience that follows the spontaneous tendency to focus the gaze on what is salient.” Brainspotting accesses the very networks in the brain that can begin to naturally restore somatosensory integration and provide for adaptive orientation.

Within the Corrigan and Grand article, very complex looping sequences are described that enable optional functioning of the brain as a self-orienting, self-scanning organ. These functional looping sequences in the brain are disrupted by trauma. When we don’t have full adaptive orienting, we have somatosensory disintegration – not all parts of the brain are functioning in their intended manner for homeostasis. If we were to see the fMRI of a person with PTSD we would see certain parts of the brain light up that are not the best areas for effective integration of traumatic material. We would see areas of the brain which signal sympathetic activation of the autonomic nervous system with hyperarousal emotionally, hypervigilance, elevated cortisol levels and flight/fight/freeze responses. Contrast this to an fMRI of someone meditating, and we will see other parts of the brain light up that are working in synchrony to produce oscillations in the brain that indicate parasympathetic activation – the part of the autonomic nervous system that allows for restoration, recuperation, rebuilding, and social affiliation (Porges, 2011).

This brings to mind the dissociation or trauma capsule about which Robert Scaer (2013) has written. As Scaer describes it, the trauma has become a procedural memory, not an episodic memory with a sense of time (past, present, future), and a story with a beginning, middle and end. The trauma remains fragmented and in the present tense within our brain/body. The trauma capsule makes for looping in a dysfunction manner in our brain – not the functional brain looping to facilitate adaptive orientation to the trauma. Procedural memory develops when we learn to ride a bike or drive a car. After one has put in hours of conscious learning and motor sequences to effectively drive, they no longer have to consciously think to put the key in the ignition, put their right foot on the gas, etc. A sequence of procedures to get the car going and drive occur without a person having to think of the disparate elements to do so. This is what Scaer tells us happens with the response to the traumatic event – it quickly gets a “life of its own” and has the same automatic qualities as procedural memory.

To sum up the aspects I am highlighting in Corrigan and Grand’s article so far, the SC in our midbrain are our “first responders” for what is salient in the environment and guide our eye movements (saccades) while we are scanning, looking for the Brainspot. With the reflexive activity of spontaneous blinks, the anterior and posterior cingulate and insula come into play with memory and integrative functions. Our brainstem bookmark is held in place by the original engagement of the SC and the sustained gaze. This gives us an excellent platform for deep and lasting healing as posited by Damasio and Panksepp, healing that occurs at the midbrain level.

A word about the brainstem bookmark here – in addition to being the brainstem bookmark, the Brainspot also inhibits excitation of saccades (eye movements) that would naturally occur by fixing the gaze on the spot. These excitation saccades might have found their endpoint in some type of discharge through natural eye movements, however, the gaze fixation forces the excitation to go elsewhere, possibly accessing a deeper internal processing or discharge in the brain itself. By inhibiting the powerful tendency to move the eyes, a deeper brain discharge is effected rather than the natural brain practice. Is this possibly what BSP does? Why it works as it does? (Grand, 2015)

Here is some further information about these key parts of the brain described in the Corrigan and Grand article and which I have highlighted here:

The Posterior Cingulate Cortex (PCC) is involved with episodic memory, internally directed thought, emotions and pain (Badenoch, 2008). Where we previously had procedural memory with its trauma/dissociation capsule, we now have the possibility of episodic memory – a story with a beginning, middle and end – the trauma now has the possibility to be located in the past and integrated into the fabric of our current day life.

The Anterior Cingulate Cortex (ACC) “…assembles cognitive and affective information to make decisions and mediates the shifting of attention.  Because streams of information containing rational and emotional cognitions converge here, it is one of the primary areas supporting neural integration” (Badenoch, 2008).

The Insular Cortex or Insula “…gathers together sensory data into an emotionally meaningful context…It mediates what the amygdala pumps out” (Badenoch, 2008). The amygdala is the organ of appraisal prior to the development of our cortex . From birth to 18 months, everything is being appraised by the amygdala – safe and warm, threatening or inviting, moving towards or away from – all is based on visceral feel by the infant.  All the preverbal memory is formed at this time in our development – most of us is subcortical (Grand, 2015). The foundation upon which the rest of the brain is built through individual temperament, brain development over time and in concert with the environment (caretakers, parents) begins with these early amygdaloid assessments of the environment. With the left dorsolateral prefrontal cortex being the adult brain executor of goals, plans, decisions and other higher order assessment, it is resting upon that early foundation with original assessment being amygdaloid, visceral. The insula is mediating what the amygdala is assessing from that early vantage point in our lives and continues throughout our lives to give that certain quality or feel – “Racy, sweaty”, says Uri Bergmann (2007) is insular.

For more on the insula, I suggest a book I am reading that Frank Corrigan has suggested by A.D. (Bud) Craig, How Do You Feel?: An Interoceptive Moment with Your Neurobiological Self (2015). Bud Craig is a functional neuroanatomist with over 30 years experience in research. He describes interoception as “sensory representation of the condition of the body” and the insula as the part of the brain that makes our subjective feelings possible based on interoceptive integration. The insula is an important part of the brain to be engaged in healing trauma since it mediates the quality of a feeling and also places it in a time context, he says, for our subjective sense of time. He goes on to say that there is evidence that “interoceptive or insular activation in the brain can be modified by biofeedback training using realtime fMRI, which could be especially useful in clinical patients”. Implicating that, he would most likely find that BSP likewise modifies insular activation since it is organic neurobiology we work with in BSP rather than technologically produced brain states the client achieves by synchronizing/controlling their brain state with a biofeedback machine. We must work on getting him a personal BSP experience!

Another finding of Craig is that the cingulate projects to the periaqueductal grey (PAG), which is the homeostatic motor structure. He goes on to state, “Accordingly, their activation corresponds with the sensory aspect (cingulate) and the affective/motivational aspect (PAG), respectively, of feelings from the body” (2015.) Corrigan and Grand have offered that the SC and PAG are of great importance to midbrain access promoting deep healing. We have a loop back from the cingulate to the PAG. It is these looping functions in the brain that functionally connect brain structures for optimal processing of feelings and information from interception (information coming in from the body) and stimuli coming in from the environment. Corrigan and Grand have much information in their article about the PAG which I have not included here, but wanted to touch upon briefly.

And so I will finish this blog article as the Corrigan and Grand article begins: “We hypothesize that the orientation to highly emotional complex information involves the basic orienting response in the midbrain tectum…we hypothesize that adaptive orientation to information of a distressing nature involves a nested hierarchy based in the superior colliculus…”.

 

Deborah Antinori, MA, LPC, FT, RDT has had a private practice of therapy for twenty-four years. Certified in Brainspotting, she is in the BSP Trainer Trainee group taught by David Grand and has been a member of his NY supervision group since 2009. Deborah has been a part of the Brainspotting community since its inception. She holds her Masters Degree from NYU’s Drama Therapy department and is a Registered Drama Therapist. She has a Fellowship in Thanatology from the Association for Death Education and Counseling, and holds certifications in EMDR and Pesso Boyden System Psychotherapy. Her critically acclaimed audiobook, Journey Through Pet Loss, won an Audie Award from the Audio Publishers Association and a ForeWord Book of the Year Silver Award. Originally an actress, Deborah graduated with her BFA from the Boston Conservatory of Music with a drama major/musical theater minor. You can contact Deborah by email.

 

References

Badenoch, B., 2008. Being a Brain-Wise Therapist, W.W. Norton & Co., Inc., New York, NY.

Bergmann, U., 2007. The Neurobiology of EMDR. EMDR National Conference, Dallas, PowerPoint presentation & CD series.

Corrigan, F,. & Grand, D., 2013. Brainspotting: Recruiting the midbrain for accessing and healing sensorimotor memories of traumatic activation, Medical Hypotheses, Vol. 80, Issue 6, p759-766.

Corrigan, F., Grand, D., Raju, R., Brainspotting: Sustained attention, spinothalamic tracts, thalamocortical processing, and the healing of adaptive orientation truncated by traumatic experience, Medical Hypotheses, Vol. 84, Issue 4, p384-394.

Cozolino, L., 2011. The Neuroscience of Trauma & Effective Trauma Treatment, Premier Education Solutions, Web Seminar.

Damasio, A., 2010. Self Comes to Mind: Constructing the Conscious Brain, William Heinemann, London.

Grand, D., 2013. Brainspotting: The Revolutionary New Therapy for Rapid and Effective Change, Sounds True, Boulder, CO.

Grand, D., 2015, personal communication.

Ogden, P., Minton, K., Pain, C., 2006. Trauma and the Body: A Sensorimotor Approach to Psychotherapy, Norton, New York, NY.

Porges, S.W., 2011. The PolyVagal Theory: Neurophysiological Foundations of Emotions, Attachment, Communication and Self-Regulation, W.W. Norton & Co., Inc., New York, NY.

Scaer, R.C., 2013, The Dissociation Capsule, www.traumasoma.com.

Web references, http://nature.ca/notebooks/english/coalrep.htm; http://www.earthlife.net/mammals/evolution.html

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Mark your calendar. RMBI member Jen Delaney, MA, NCC, will be the presenter at out next brown bag lunch. A somatic specialist, Jen will be teaching us a number of “Body-Centered Exercises to Support Brainspotting.” Jenheadshot5-2015-300x300

When: October 9, 2015. 12 noon – 1:30pm (approx one hour presentation followed by networking)

Where: InCahoots Meeting Place, 4800 Baseline Rd, Suite A-112. This is in the Meadows Shopping Center at Baseline Rd and Foothills Pkwy, Boulder. The meeting space is located in the breezeway west of Michael’s and the Chinese restaurant. Look for the white flag.

Cost: Free for RMBI members. $15 for non-members.

RSVP: Space is limited to 30, so email Ruth to reserve your spot.

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Exemple

By Wendy Conquest, MA, LPC, CSAT-S

Wendy ConquestThis blog is based on a recent talk I did for RMBI on sex addiction and resulting spousal trauma. For ease of writing I will be referring to the sex addict (SA) as “him” and the Partner as “her,” however, I see clients along the sexuality spectrum. Most SAs come in after their secret life has been found out. This time is commonly referred to as “Discovery.” There is a lot happening for both the SA and the Partner during this period. The SA experiences shock and stress as his two worlds collide. There is usually some relief that the secret is out. The Partner also experiences shock and disbelief as she finds out her partner has a hidden life. We now know she goes into a freeze response and becomes traumatized on many different levels. We also know he goes into similar shock which can cause denial and minimization with the breadth and length of his behaviors.

I am asked if sex addiction is the same as other addictions such as alcoholism, drug addiction, and gambling. The answer is yes…and no. To qualify as an addiction there are certain criteria that must be met. These include a loss of control, previous attempts to stop, loss of time in the addiction, preoccupation, an inability to fulfill obligations, continuing with the behavior despite negative consequences, an escalation, social, occupational and recreational losses, and withdrawal. The reason sex addiction is different is that you can be angry with your partner if they are drunk every night. And feelings are intense if your home is in jeopardy from a gambling addiction. However, when your loved one chooses someone else to be sexual with (and this includes images as well as real people) there is a sense of rejection, humiliation and shame that is incomparable.

There is a common expectation that when the secret life of the addict is found out the Partner will be surprised or in some sort of shock for a while, but then she will be able to quickly and competently look at her part of the problem. What we are now finding is that the effects on the partner are quite severe, categorized as Complex PTSD. Dr. Omar Minwalla’s article entitled the “Thirteen Dimensions of Sex Addiction-Induced Trauma (SAIT) among Partners and Spouses Impacted by Sex Addiction” explores the many ways Partners are affected, including:

  • Discovery Trauma
  • Disclosure Trauma
  • Reality-Ego Fragmentation
  • Impact to Body and Medical Intersection
  • External Crisis and Destabilization
  • SAIT Hyper vigilance and Re-Experiencing
  • Dynamics of Perpetration, Violation and Abuse (SAIP)
  • Sexual Trauma
  • Gender Wounds and Gender-Based Trauma (GBT)
  • Relational Trauma and Attachment Injuries
  • Family, Communal and Social Injuries
  • Treatment-Induced Trauma
  • Existential and Spiritual Trauma

In my presentation I explained Disclosure Trauma, Sexual Trauma, Treatment-Induced Trauma and Existential Trauma. My intent was to highlight entry points for Brainspotting. I talked about Treatment-Induced trauma since I have many couples coming to me after they have been to other therapists. A common mistake among some couples’ therapists is to treat “an affair” as a one-off without seeking further to see if there is a compulsive pattern around sex and sexuality. As a certified sex addiction therapist, I have clients complete a questionnaire with over 400 questions that compiles the data needed to determine if there is sex addiction (and its extent) as well as to identify attachment style, specific problem areas around the addiction and quantifying motivation for change. This assessment is only available to CSATs, however, I was asked if I would be willing to collaborate with other therapists and the answer is “YES”! What a wonderful idea!

We talked about one event with sex addiction and spousal trauma being multi-pronged. I am finding that I can clear one event, let’s say when the Partner discovers the addiction is one BSP point. But then later another aspect of the discovery will pop up. For example, the spouse may not be confident in knowing her inner voice. The main point is to be aware of the different dimensions that are attached to one trauma, with varying visual points for both the SA and the Partner.

My book, Letters To A Sex Addict: The Journey Through Grief and Betrayal, is available through me directly or Amazon (paperback or Kindle format). The book provides a visceral experience of what the Partner goes through. She may experience isolation, rejection, invalidation from friends and family, church and the culture. Confusion, shame and despair result. I encourage therapists to have the Partner read the book and highlight sections that are applicable to them, and then Brainspot those. Clinicians also have the SA read the book to increase empathy and work on his shame targets. Couples therapists use the book in session as a path to talk about the betrayal. There is a short but thorough explanation of sex addiction in the introduction. If you have any questions after reading the book please e-mail me! This book is the only one I know which accurately reflects all the aspects of the Partner’s experience.

There are a few special considerations in using BSP with the Partner. I start by having them listen to the bilateral sounds and see if they calm down or if their anxiety increases. If anxiety increases, I emphasize somatic pieces to ground them and get them more stable before proceeding with Brainspotting. If they calm down I start with the resource eye on a resource spot. I continually check in with the body, not with their interpretation of whether they are “ok” or feeling “good”. From there I move to different pieces of whatever the current struggle is, whether that be “I hate him touching me” to “I don’t feel safe”. Because the addict usually is learning to distinguish between reality and dishonesty, many times in early recovery he is not yet safe to the Partner. My goal is to help her clear the trauma to get her instincts back on-line.

For the addicts, we go back into their history to find out where the link between safety and sex, acceptance and sex began. This might have involved masturbating to calm down when mom and dad were fighting, or using pornography to calm social anxiety. Perhaps a fetish started with neglect from mom and dad. I want him to know that the addiction is a very old and ineffective coping mechanism and that it is not who he authentically is. Sometimes I will start with more current trauma points such as the addiction being discovered, feelings of worthlessness with causing pain to their partners, or feeling inept in general.

I recently opened The Sex Addiction Counseling Center (SACC) in Boulder. I have two other therapists on my staff and my ambition is to start a program for teens struggling with pornography in 2016. Please visit the web site to learn more!

 

Wendy Conquest. MA, LPC, CSAT-S
Certified in Brainspotting, Integrative Body Psychotherapy and Sex Addiction
2975 Valmont Rd.
Boulder, CO 80301
720.338.7418
wendyconquestlpc @ gmail.com

 

 

 

 

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The Rocky Mountain Brainspotting Institute (RMBI) is a nonprofit 501(c)(3) organization that was created to promote and advance the use of Brainspotting, an emerging new treatment in psychotherapy.

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