Deep Brain Reorienting (DBR)
A trauma-focused psychotherapy for working with the body and brain’s earliest responses to distressing experiences.
What is DBR?
Deep Brain Reorienting (DBR) is a trauma-focused psychotherapy developed by Scottish psychiatrist Dr. Frank Corrigan. It works from the understanding that our nervous system may begin responding to something significant before we’ve consciously made sense of what’s happening.
A change in someone’s tone, a look on their face, a sudden sound, a moment of rejection, or a frightening event can activate an immediate orienting response before thoughts such as I’m not safe or they’re leaving have fully formed. The theory is that the reaction begins before we’ve consciously made sense of what’s happening.
DBR pays close attention to the sequence that may follow that initial activation: orienting tension, shock, and then emotional or defensive response. Rather than starting primarily with the story or interpretation of an experience, the work helps you notice subtle shifts in tension, sensation, movement, emotion, or impulse connected to the nervous system’s initial response.
The goal isn’t simply to understand why a reaction exists. DBR slows the process down enough that we can notice the sequence underneath it and work with what happens before the story has fully formed.
Slowly bringing the unconscious to conscious presence.
Slow enough that we can begin noticing what usually happens before you have words for it.
A reaction can start in the body before you consciously understand what you’re reacting to. DBR slows that sequence down so we can notice the orienting tension, shock, sensation, emotion, or impulse that may normally pass too quickly to recognize. In that sense, we’re making more of an automatic process available to conscious awareness.
Once we can see the sequence, we can stay with it intentionally rather than only meeting the reaction after it has already become fear, shame, anger, collapse, or a familiar story about what something means.
What can DBR help with?
DBR is a newer trauma-focused approach currently being studied for PTSD and related symptoms, including dissociation. It may also be especially useful when attachment-related or automatic body-based reactions feel difficult to shift through insight alone.
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Helping you stay more present with your own experience rather than disappearing, shutting down, or becoming disconnected when something difficult is activated.
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Working slowly enough with shock, emotion, and body-based responses that experiences which once felt unbearable become more possible to stay with.
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Reducing the intensity of responses that seem to happen before you have much choice in the matter.
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Working with attachment-related pain, rejection, distance, shame, or fear that may continue to shape how you respond to closeness and conflict.
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Helping deeply learned responses such as something is wrong with me, I’m alone, or I’m not safe feel less absolute and less tied to the present.
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Increasing your ability to experience sadness, fear, anger, grief, or vulnerability while remaining connected to yourself in the present.
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As the original shock response settles, people may find there is more room for information, meaning, or perspective that was difficult to access when the system was still organized around the original experience.
What does a DBR session look like?
DBR sessions are often quieter and slower than people expect. We may begin by noticing where you experience yourself, then paying close attention to subtle changes in tension around the eyes, forehead, face, or neck.
From there, we track the sequence as it unfolds: orienting tension, shock, and whatever follows next. I may ask you to stay with a sensation, notice a small shift, or describe what changes without needing to explain or analyze it.
The work can move back and forth between shock, emotion, aloneness pain, and new perspective. If something starts to feel like too much, we can return to the orienting tension, slow the process down further, or stop.
My personal experience with DBR
What does the research say?
Deep Brain Reorienting is a newer psychotherapy, and the research so far is encouraging. The first randomized controlled trial, published in 2023, studied eight virtual DBR sessions for adults with PTSD. Participants showed significant reductions in PTSD symptoms compared with those on a waitlist, and those gains remained at three-month follow-up. About half of participants no longer met diagnostic criteria for PTSD after treatment or at follow-up.
Researchers are now building on that work with larger studies and fMRI research before and after DBR treatment to better understand how the therapy may change the brain’s response to traumatic material.
DBR is still earlier in its research timeline than more established approaches like EMDR, but the combination of emerging clinical evidence, neuroscience, and what I see in practice makes it an approach I take very seriously.
Read the 2023 randomized controlled trial →
Explore Ruth Lanius’s current DBR research →
Frequently asked questions
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They are quite different processes, even though both are designed to help experiences from the past have less power in the present. EMDR uses bilateral stimulation and works with memory networks through a structured eight-phase protocol. DBR slows the earliest moments of the stress response down and focuses first on orienting tension and shock before moving further into emotion or meaning. Early DBR research has also shown very low treatment dropout, suggesting that people may experience the process as quite tolerable, though DBR has not yet been directly compared with EMDR in a randomized trial.
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DBR translates very well to telehealth. In fact, the first randomized controlled trial of DBR was conducted entirely through videoconference during the COVID-19 pandemic, with participants completing eight weekly online sessions. Most of the work involves closely tracking subtle internal sensations and shifts, so we do not need to be physically in the same room for the process to happen.
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Generally, no. DBR is not about immersing you in a detailed traumatic memory or asking you to repeatedly relive an experience. We usually begin with something relatively manageable so you can get a feel for the process, and much of the work can begin with recent or present-day situations that activate a familiar response. We are paying attention to what happens in your body and nervous system as the response unfolds, rather than trying to push you deeper into the story.
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In DBR, shock can show up as almost any new sensation that enters conscious awareness as we slow the sequence down. People often describe twitching, tingling, a slight energetic buzz, tightening, or another subtle shift in the body.
Sometimes shock has a more specific quality. Implosive shock can feel sudden and sharp, almost like an ice pick to the head. Vestibular shock may feel more like dizziness, dropping, falling, or a brief disruption in your sense of balance or orientation.
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That is information, not a failure of the process. DBR was developed with dissociation very much in mind. We can slow down, return to the orienting tension, reconnect with where you experience yourself, or pause altogether. The point is to stay close enough to the experience that we can work with it without overwhelming the system.
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No, although mindful attention is part of the process. In DBR, attention is used very specifically to track a predictable sequence of orienting tension, shock, and what follows. We are not simply observing thoughts or sensations in a general way; we are slowing the response down enough to work with parts of the sequence that usually happen automatically.
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There is no single timeline. The first clinical trial used eight sessions, but real-world treatment will depend on what we are working on, how interconnected the material is, and what changes along the way. I prefer short-term goals and regular check-ins about what is actually shifting rather than assuming we need an open-ended course of treatment.
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No. I generally prefer to begin with something gentler and more contained, often a recent trigger or a situation that is not heavily relational, so you can learn what DBR feels like before we work with more emotionally loaded material. From there, we can decide together what makes sense to address next.
Wondering whether DBR might be a fit?
If your reactions tend to feel fast, automatic, or difficult to reach through words alone, DBR may be worth exploring. We can talk about what you’re noticing and whether this approach fits the kind of change you’re looking for.