Brainspotting: What It Is and What the Evidence Shows
Brainspotting is a trauma therapy developed by David Grand in 2003, built on the idea that where you look affects how you feel. The therapist helps you find an eye position that holds the activation, then you stay with it, mostly in silence, while they stay with you. This guide covers what a session involves, how it compares with EMDR, and why the evidence is still thin.
Reviewed byMichael Callans, MSWWhat happens in a brainspotting session
- You name the issue: a memory, a feeling, a pattern, a performance block, sometimes just a vague unease you cannot place.
- You find it in your body and rate the activation out of ten, which gives both of you a reference point to come back to.
- The therapist locates the brainspot: moving a pointer slowly across your field of vision and watching for a reflexive response, asking where the feeling intensifies, or using the place your eyes went by themselves.
- You hold that gaze and stay with whatever arises, usually with bilateral music playing softly through headphones. Sets last minutes, not seconds.
- You report occasionally, in a few words: an image, a sensation, a shift. The therapist mostly stays quiet and tracks you rather than steering the content.
- The session closes by re-rating the activation, orienting back to the room, and agreeing what you will do with the rest of your day.
Terms you will hear
Brainspotting and EMDR compared
The procedure
EMDR: repeated left and right eye movements, taps or tones in sets of roughly twenty to forty seconds. Brainspotting: one sustained eye position held for several minutes, often with bilateral music in the background.
The structure
EMDR: eight defined phases, a named target, disturbance and belief ratings, an installation phase and a formal closure. Brainspotting: an open frame in which the therapist follows your body rather than working through a protocol, with far less talking.
The evidence
EMDR: recommended for PTSD by WHO, NICE and conditionally by the APA, on the back of many randomized trials. Brainspotting: one non-randomized comparison study, one single-session experiment in healthy adults, case reports, and no guideline recommendation.
Before you start: your own preparation page
- What I want to work on, in one sentence, and how I would know it had shifted.
- Where I feel it in my body, and the number out of ten it sits at on an ordinary day.
- Two or three things that reliably settle me, and which of them I can use in a room with someone else present.
- My signal for stop: the word or gesture I will use, agreed out loud before the first long set.
- My own signs of going too far: what my body does, what happens to my sense of the room, what I start wanting to do.
- What I have scheduled for the rest of that day, and what I can move if the session leaves me raw.
- What else I am doing or have tried for this, including medication, so the therapist is not working blind.
Questions worth asking a brainspotting therapist
- What license do you hold, and which board regulates you?
- Which brainspotting training levels have you completed, and when?
- What else are you trained in for trauma, and why are you suggesting this one for me?
- You know the evidence base here is small. How do you talk to clients about that?
- How will you notice if I am overwhelmed or starting to dissociate, and what will you do?
- What do the first few sessions look like, and how long before we would reconsider the approach?
- What do you want me to do, and not do, in the twenty-four hours after a session?
A note on the evidence, in plain terms
Two studies carry most of the weight. The 2017 comparison with EMDR found real improvement in both groups, with somewhat larger numbers for EMDR, but it did not randomize anyone, the two groups were very different in size, every outcome was self-reported, and the method's developer and trainer was an author. The 2022 single-session experiment was run by an independent group with a tidier design, and brainspotting beat a meditation control, but the participants were healthy professionals recalling upsetting memories rather than patients being treated.
What follows from that is a fair-minded position rather than a dismissal. It is reasonable to try brainspotting with a licensed clinician, particularly alongside or after a treatment with evidence behind it, and particularly if talking in detail about what happened has not worked for you. It is not reasonable for anyone to present it as established, equivalent to EMDR, or a reason to skip the treatments the guidelines actually recommend.
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Karin ClementsLCSW, MSW
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About this tool
Brainspotting is a trauma therapy in which a therapist helps you find a particular eye position, called a brainspot, that seems to hold a feeling or a memory in place, and then keeps you there while you notice what happens in your body. Sessions are quiet. There is little talking, no script to work through, and often long stretches where you simply hold the gaze and the therapist says almost nothing. David Grand, a New York psychotherapist and EMDR trainer, developed it in 2003 after noticing that where a client's eyes settled seemed to change what they could reach. His one-line summary of the premise is that where you look affects how you feel.
The claim is that an eye position can act as an access point to activation held below the level of talking. In a 2013 paper in Medical Hypotheses, Frank Corrigan and Grand proposed a route from the retina through midbrain structures including the superior colliculi and periaqueductal gray, up through the pulvinar and cingulate cortices, and argued that the processing happens at that subcortical level rather than in deliberate thought. It is important to read that paper for what it is: Medical Hypotheses publishes theory for discussion, and the article proposes a mechanism rather than demonstrating one. No imaging study has confirmed the pathway.
The second idea in brainspotting is what Grand calls the dual attunement frame. One half is relational: the therapist's job is to stay present with you, attentive and non-intrusive, in the way an attachment figure might. The other half he calls neurobiological attunement: following the body's signals, the brainspot, the flicker in the eye, the shift in breathing, rather than steering the content. The therapist is described as a witness rather than a guide. It is why sessions can feel unstructured compared with a protocol-driven therapy, and why the quality of the particular clinician matters so much here.
A session usually starts the way most trauma work does: you name what you want to work on, notice where you feel it in your body, and rate the distress out of ten. The therapist then looks for the eye position. Sometimes they move a pointer slowly across your visual field and watch for a reflexive signal, a blink, a twitch, a swallow, a change in breath, or ask where the feeling gets stronger. Sometimes they use where your eyes naturally went when you started talking, which Grand calls gazespotting. You hold that gaze and report sensations now and then, often with bilateral music playing quietly through headphones. Sets are long: many minutes rather than the half-minute bursts used in EMDR.
Read the diagram as text
An eye on the left looks out across a quiet arc of five candidate positions. Four of them are dashed outlines, passed over; the fifth is solid and carries a brand ring, and the gaze line reaching it is the one brand line in the fan. From that ringed position a brand tie line runs across to a torso on the right, with no arrowhead on it, and arrives at a brand ring around an accent mark: the sensation the held gaze is paired with, rather than a route it is claimed to travel. The brand marks the one position that is kept and what it reaches. On the phone canvas the arc fans downward and the torso sits below it.
What the visual field offers, and what the session keeps
Conceptual selection, not counts
A position high in the visual field: Passed over: no reflexive signal, so the pointer moves on
A position just above level: Passed over: no reflexive signal, so the pointer moves on
A position straight ahead: Passed over: no reflexive signal, so the pointer moves on
A position just below level: Kept as the brainspot: a blink, a twitch, a change in breath, or the place the feeling gets stronger, and the gaze stays here for long sets
A position low in the visual field: Passed over: no reflexive signal, so the pointer moves on
Added to the representation: The body sensation the held position is paired with, reported now and then rather than talked through
On the evidence, the honest position is that brainspotting is promising to its practitioners and unproven by the standards guidelines use. The main clinical study is Hildebrand, Grand and Stemmler's 2017 paper in the Mediterranean Journal of Clinical Psychology: seventy-six adults seeking help after a traumatic event, treated across several countries with three sixty-minute sessions of either EMDR or brainspotting. Both groups improved on self-reported PTSD symptoms. The brainspotting effect sizes ran from 0.74 to 1.04, the EMDR ones from 1.19 to 1.76. Participants were not randomly assigned, the groups were unequal (fifty-three and twenty-three), outcomes were self-report, and Grand, who developed the method and trains clinicians in it, is a co-author.
The second study worth knowing is D'Antoni and colleagues' 2022 comparison in the International Journal of Environmental Research and Public Health. Forty psychologists and physicians each recalled four distressing memories and received a single forty-minute session of EMDR, brainspotting, body scan meditation or book reading as a control. Distress ratings fell for all three active conditions, and brainspotting and EMDR did better than the meditation and the reading. That is an independent research group and a cleaner design, which is why it matters, but the participants were healthy adults recalling upsetting memories, not patients with a diagnosis, and a single session is not a course of treatment.
Nothing in that evidence base is enough for a guideline, and none of them list brainspotting. The World Health Organization's 2013 stress guidelines, the UK NICE guideline on PTSD and the American Psychological Association's 2025 guideline all name trauma-focused cognitive behavioral therapy and EMDR among the treatments to consider for post-traumatic stress disorder, and brainspotting does not appear in any of them. That is not a verdict that it fails; it reflects an absence of the randomized trials that would let anyone judge. The practical consequence is that where there is only one course of trauma treatment available, the options with evidence behind them have the stronger claim on it.
People often ask how brainspotting differs from EMDR, since it came out of it. The procedure is the clearest difference: EMDR moves your eyes repeatedly left and right in short sets inside an eight-phase protocol with rating scales, an agreed target and a defined closure; brainspotting holds one eye position for long stretches inside a much looser frame, with the therapist following rather than directing. EMDR asks you to report after each set and installs a new belief about yourself. Brainspotting mostly asks you to stay with the body and talks less. The research gap is the other difference, and it is large: hundreds of trials against a handful.
Cautions are the same ones that apply to any body-focused trauma work, and the looser structure makes them matter more. Long silences while holding activation can tip some people out of their window of tolerance, and dissociation, blanking out or feeling unreal during a session is a reason to stop and change the plan rather than push on. Brainspotting is not a substitute for stabilization if you are in current danger, drinking or using heavily, or newly out of a crisis. Ask any clinician how they will notice you are overwhelmed and what they will do, because the method itself supplies less scaffolding for that than a protocol does.
Training in brainspotting is organized by Grand's own training body rather than by a professional licensing board. Clinicians take phase one, phase two and phase three courses and can go on to a certification route, but no state or national regulator recognizes brainspotting as a credential in its own right. What protects you is the underlying license: a therapist who is a licensed psychologist, social worker or counselor is accountable to a board whatever method they use, and someone offering brainspotting without that license is not. Ask what their license is and what else they are trained in, because most brainspotting clinicians also offer something with a stronger evidence base. The printable below is for exactly that conversation, plus the preparation a quiet, body-led session calls for. Our EMDR Therapy guide covers the better-tested relative, and Window of Tolerance explains the limits to watch for.
References
- Grand D. Brainspotting: The Revolutionary New Therapy for Rapid and Effective Change. Sounds True; 2013.
- Corrigan F, Grand D. Brainspotting: recruiting the midbrain for accessing and healing sensorimotor memories of traumatic activation. Medical Hypotheses. 2013;80(6):759-766. doi:10.1016/j.mehy.2013.03.005
- 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. Mediterranean Journal of Clinical Psychology. 2017;5(1).
- D'Antoni F, Matiz A, Fabbro F, Crescentini C. Psychotherapeutic techniques for distressing memories: a comparative study between EMDR, brainspotting, and body scan meditation. International Journal of Environmental Research and Public Health. 2022;19(3):1142. doi:10.3390/ijerph19031142
- World Health Organization. Guidelines for the Management of Conditions Specifically Related to Stress. Geneva: WHO; 2013. https://www.who.int/publications/i/item/9789241505406
- American Psychological Association. Clinical Practice Guideline for the Treatment of Posttraumatic Stress Disorder (PTSD) in Adults. 2025. https://www.apa.org/ptsd-guideline
Cite this source
Psychology.com. (2026, November 6). Brainspotting. Psychology.com. https://psychology.com/tools/brainspotting
Brainspotting FAQ
What is brainspotting?
Brainspotting is a trauma therapy developed in 2003 by David Grand, a psychotherapist who had been an EMDR trainer. The therapist helps you find an eye position, a brainspot, that seems to hold the charge of a memory or feeling, and you then hold that gaze for several minutes at a time while noticing what happens in your body. Sessions are quiet and largely unstructured compared with protocol-based therapies, and the clinician is described as a witness who tracks you rather than a guide who directs you. It is used for trauma, anxiety, grief and performance blocks.
Is brainspotting evidence-based?
Not in the sense guidelines use. Brainspotting rests on one non-randomized comparison with EMDR in seventy-six adults, published in 2017 and co-authored by its developer, one independent 2022 experiment in which forty healthy professionals had single forty-minute sessions, and a collection of case reports. The 2013 paper often cited as its scientific basis is a theory article in Medical Hypotheses that proposes a brain pathway rather than testing one. No major guideline, including the WHO, NICE and American Psychological Association guidelines on PTSD, lists it. That is a lack of evidence rather than evidence that it fails.
Brainspotting vs EMDR: which should I choose?
If you want the treatment with the strongest case behind it, that is EMDR, which many national guidelines recommend for post-traumatic stress disorder on the basis of a large trial literature, whereas brainspotting is not in any of them. The practical differences are real, though. EMDR works through eight phases with ratings, a defined target and a formal close; brainspotting holds one gaze for long stretches, follows the body and asks you to say very little. People who found the talking and structure of other therapies hard sometimes prefer it. A reasonable order is to try the better-evidenced option first, or ask a clinician trained in both.
What does a brainspotting session feel like?
Quieter and slower than most people expect. After you name the issue, locate it in your body and rate it out of ten, the therapist finds an eye position and you hold it, often with soft music panning between your ears through headphones. Then little happens out loud. Images, memories, sensations and emotions tend to come in waves, and you report them in a few words every so often. Some people find the silence and the lack of instruction freeing; others find it uncomfortable or unmoored, which is worth saying in the room rather than enduring. Sessions commonly run longer than fifty minutes.
Is brainspotting safe, and what are the side effects?
The reported effects are the ones common to trauma work: feeling tired or raw afterward, emotion continuing to move for a day or two, vivid dreams, and new memories surfacing between sessions. The specific risk with brainspotting is its openness. Holding activation in long silences can take some people outside what they can manage, and feeling detached, unreal or blank during a session is a reason to stop and change the approach rather than keep going. It should be delayed in favor of stabilizing work if you are in current danger, using heavily, or recently out of a crisis.
How many brainspotting sessions does it take?
There is no established course length, which is itself a limitation. Practitioners often describe a few sessions for a single contained event and open-ended work for anything longer-standing, and sessions are frequently booked at sixty to ninety minutes rather than fifty. The 2017 study used three sixty-minute sessions and found improvement, which tells you something about short courses in that sample but little about treating complex trauma. It is fair to ask at the start what the clinician expects, what would count as progress, and at what point you would both reconsider the method.
Can I do brainspotting on myself?
Self-brainspotting is promoted online and we would not recommend it. The whole premise of the method is the dual attunement frame: another person stays present with you, tracks your breathing and your eyes, and notices when you are past your limit, which is precisely what you cannot do while holding activation yourself. Alone, you lose the part of the method its own developer treats as essential, and you keep all the risk of opening a memory with nobody there. The preparation page here, naming your goal, your settling skills and your warning signs, is the part that is yours to do.