Brainspotting & Somatic Therapy
When What You Know and What You Feel Don’t Match
Sometimes you can understand something intellectually and still have a very different response emotionally and physically.
You may know that something painful happened a long time ago. You may understand why you responded the way you did, recognize the beliefs you developed because of it, and know that the situation is no longer happening. CBT, mindfulness, and other kinds of therapy may have helped you understand your experience and respond to it differently.
And yet something still doesn’t quite match.
Your mind knows one thing, while another part of you continues to respond as though something else is true.
This is one of the places where I may suggest Brainspotting.
Brainspotting is a brain-body therapy developed by psychologist David Grand in 2003. It grew out of his observation that where we look can affect what we feel and access internally. Brainspotting uses specific points in the visual field, along with awareness of emotional and physical responses, to support processing that may not be readily accessible through language and conscious analysis alone.
I often integrate Brainspotting into therapy when insight has been useful, but there still seems to be something underneath that insight that hasn’t shifted.
How Brainspotting Works
Brainspotting is designed to engage subcortical processing – the emotional, physiological, and associative responses involved in experiences such as trauma that aren’t always readily accessible through language and conscious thought.
We begin with something you want to work on and notice what happens when you bring your attention to it. That includes not only thoughts and emotions, but also what you feel in your body.
From there, we find a point in your visual field, called a brainspot, that is associated with that internal activation. You maintain your gaze around that point while paying mindful attention to what emerges.
What happens next is often much less linear than a typical conversation.
You might notice a physical sensation, followed by an emotion, an image, a memory, a thought, or something that initially seems completely unrelated. You might talk quite a bit. You might say very little.
You don’t have to organize the experience into a coherent explanation for me or figure out where it is supposed to go. In fact, people who are accustomed to more structured forms of therapy sometimes catch themselves trying to do exactly that—apologizing for being scattered or wondering whether what just came up is relevant.
With Brainspotting, we stay curious and follow what emerges.
This internally guided process is part of what drew me to Brainspotting. Rather than directing you through a predetermined sequence, I am following your process with you while your own associations, sensations, emotions, and memories lead the way.
Trauma, Memory, and Activation
Sometimes we can do a great deal of work around a traumatic experience and still find that parts of it remain unresolved.
You can know that you’re safe now and still feel your body react to a reminder as though the danger is present. You can rationally understand that something wasn’t your fault and still experience shame. You can know that one relationship is different from another and still find yourself bracing for what happened before.
Brainspotting gives us another way to work with that gap between what you understand and what you continue to experience.
Even though the memories themselves typically remain, many people find that the emotional and physiological activation connected to them becomes less intense through Brainspotting.
This can be particularly meaningful when you have already spent a great deal of time thinking, talking, and gaining insight about an experience, but something about it continues to feel persistently present.
Dual Attunement: Doing the Work Without Doing It Alone
One of the central concepts in Brainspotting is called dual attunement.
The term can sound complicated, but an important part of it is very human: while you are paying close attention to what is happening inside you, I am paying close attention to you.
Trauma often involves experiences of profound aloneness. It may also involve secrecy, fear, shame, or experiences that felt too overwhelming to fully take in at the time.
Brainspotting can look quieter from the outside than many of the other ways I work. I may not be asking many questions or doing much of the talking. But I am very actively present with you throughout the process.
I am paying attention to what is happening, tracking your verbal and nonverbal responses, and offering guidance when it is useful. You don’t need to explain everything you’re experiencing for me to remain with you in it.
Brainspotting describes this therapeutic relationship alongside attunement to your brain-body responses as the Dual Attunement Frame. The client leads the internal processing while the therapist provides an attentive, responsive framework around it.
You are doing deeply internal work, but you are not doing it alone.
Focused Mindfulness and the Body
Brainspotting also uses what David Grand calls focused mindfulness.
Rather than trying to change, challenge, or analyze each thought or feeling that arises, you observe your internal experience while maintaining the relevant eye position.
We pay attention to what changes.
Maybe a sensation moves or softens. An emotion changes. A memory appears. Something suddenly connects to something else. Sometimes what emerges is surprising. Sometimes very little seems to be happening for a while.
There isn’t a correct sequence.
My role is not to decide what your brain and body should be doing or to interpret every association for you. We stay with the process, notice what is happening, and give it room to unfold at your pace.
What Happens at the End of a Brainspotting Session?
Toward the end of a Brainspotting session, we return to what you originally wanted to work on and notice what is different.
Brainspotting even has a wonderfully unscientific sounding name for part of this process: “squeezing the lemon.”
Once the activation has decreased, we deliberately check to see whether there is any more of it there. If bringing your attention back to the original issue reveals another layer of activation, we can return to the Brainspot and continue processing.
Then we give you time to come back out of the focused work and reorient before the session ends.
Processing can also continue after the session. I sometimes describe the next day or two as a “wet paint” period – a time to give yourself some room to notice what continues to emerge or settle rather than feeling as though you need to immediately analyze or make conclusions about the work.
Brainspotting and EMDR
Brainspotting and EMDR are both trauma therapies that incorporate visual attention and brain-body processing, but the experience of them can be quite different.
EMDR uses a structured treatment protocol and typically includes bilateral stimulation as the client processes traumatic material. Brainspotting is generally less structured and more internally guided. Once we have established the Brainspot and the frame for the work, we follow your internal process rather than trying to move it through a predetermined sequence.
Brainspotting also does not require you to give me a detailed verbal account of everything that emerges during processing. You can talk when talking is useful and be quiet when it isn’t.
The flexibility and self-referencing nature of Brainspotting are among the reasons it fits naturally into the way I work.
An Organic Way of Processing What Has Been Stuck
I use Brainspotting both as a therapy in its own right and alongside approaches such as Cognitive Behavioral Therapy, mindfulness, and somatic work.
Different kinds of therapy give us different ways of approaching the same human experience. Sometimes we need to understand something. Sometimes we need practical tools for responding differently. Sometimes we need to notice what is happening in the present moment.
And sometimes we understand quite a lot already, but the emotional and physical response hasn’t caught up.
Brainspotting gives us another way in.
It allows us to work with what emerges without requiring it to be tidy, linear, or easily put into words—and to do that work within a therapeutic relationship where you have room to follow your own process while I stay closely present with you.
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Licensed Professional Counselor
Cheryl Zandt
Telehealth Counseling in Washington DC and Virginia
Cheryl Zandt is a Licensed Professional Counselor providing online therapy for women in Virginia and Washington DC. For more than 20 years, she has worked with women experiencing anxiety, burnout, panic, relationship challenges, life transitions, and other sources of stress and overwhelm.
Her approach is thoughtful, collaborative, and grounded in curiosity about why we think, feel, and respond the way we do. She brings clinical experience and research-informed approaches to the work while recognizing that each client is the expert on her own experience.
Cheryl helps clients better understand what has been shaping their experiences, develop practical ways to respond differently, and have more choice in what happens next.
Your questions, answered
What is Brainspotting?
Brainspotting is a brain-body therapy developed by psychologist David Grand in 2003. It is based on his observation that “where you look affects how you feel,” and uses specific points in the visual field, called brainspots, to help access and process experiences that may be difficult to reach through conversation and conscious thought alone.
Brainspotting combines focused attention, awareness of what is happening in the body, eye position, and close attunement between therapist and client. It is often used for trauma, but it can also be incorporated into therapy for anxiety, grief, chronic stress, emotional reactions that feel difficult to shift, and other experiences that remain unresolved even when you understand them intellectually.
How does Brainspotting work?
In Brainspotting, we begin with something you want to work on and notice how you experience it in the present moment. We then find an eye position, or brainspot, that seems connected with that experience. You keep your gaze around that position while paying attention to what happens internally.
Grand conceptualizes Brainspotting as a way of accessing subcortical brain processes involved in emotion, memory, body responses, and experiences that may sit outside ordinary conscious awareness. Brainspotting allows us to stay with that internal experience without requiring you to explain, analyze, or direct everything that happens.
The specific neurological mechanisms behind Brainspotting are still being studied. There are theories about why eye position and focused attention may affect processing, but we don’t yet have a complete explanation of what is happening in the brain.
What is a brainspot, and how do we find one?
A brainspot is a point in your visual field that appears to be connected with the experience we’re working on.
There are several ways we might find one. Sometimes you notice that a particular eye position feels more activated, significant, or connected to what you’re experiencing. Other times, I may notice a subtle change in your blinking, breathing, facial expression, or body response as your gaze moves across your visual field. Sometimes a brainspot emerges naturally from where you find yourself looking while talking about something meaningful.
We use that information together. Finding a brainspot isn’t a test, and there isn’t a correct spot you’re supposed to locate.
What actually happens during a Brainspotting session?
We’ll start by talking about what you want to work on and noticing how you experience it in the present moment. That might include an emotion, memory, physical sensation, or simply a sense that something still feels unresolved.
Once we identify a brainspot, you’ll usually keep your gaze around that position and pay attention to whatever you notice internally.
There isn’t a particular thing you’re supposed to think, feel, remember, or discover. Your experience might move through sensations, emotions, memories, thoughts, images, or unexpected associations. Sometimes very little seems to be happening for a while.
My role is to stay closely attuned to you and help us follow the process without deciding in advance where it should go.
What does Brainspotting feel like?
Brainspotting is often quieter and more internally focused than traditional talk therapy.
You may notice physical sensations, emotions, memories, thoughts, images, impulses, or associations. Sometimes what comes up makes immediate sense. Sometimes it seems unrelated or surprising. Sometimes the process is subtle.
You don’t need to analyze everything while it is happening. Part of Brainspotting is noticing your experience and allowing it to unfold without needing to immediately explain or organize it.
Will you be talking to me during Brainspotting?
Usually less than we would during a more conversational part of therapy, but I’m not simply sitting silently while you do the work by yourself.
Brainspotting emphasizes what David Grand calls dual attunement: attention to what is happening internally for you along with close relational attention from the therapist.
While you are paying close attention to what is happening inside you, I am paying close attention to you.
I may check in, reflect something I notice, or respond when that seems useful. The quieter role is intentional, but it is still an active and connected therapeutic process.
Do I have to talk about my trauma in detail?
No. Brainspotting allows us to work with an experience without requiring you to give me a detailed verbal account of everything that happened.
You can tell me what feels useful for me to know, and we can work with emotions, physical sensations, images, memories, or other aspects of your experience without requiring you to put all of it into words.
That doesn’t mean we never talk about what happened. It means detailed retelling isn’t a requirement for doing meaningful work.
Is Brainspotting only for trauma?
No. Although Brainspotting was developed in the context of trauma work and is often used with traumatic experiences, it can be applied more broadly.
I may incorporate Brainspotting when we’re working with anxiety, grief, chronic stress, emotional reactions that feel difficult to shift, or experiences where you understand something intellectually but still feel affected by it.
I don’t use Brainspotting simply because a particular problem appears on a list. We’ll decide together whether it seems like a useful approach for what you want to work on.
How is Brainspotting different from regular talk therapy?
In talk therapy, language and conscious reflection often do much of the work. We might examine a pattern, make connections, question an assumption, or think together about a different way of responding.
Brainspotting asks you to spend more time noticing what happens when we aren’t trying to understand or change an experience primarily through words. That can include thoughts and emotions, but also physical sensations, images, memories, impulses, or associations that emerge while you remain focused around the brainspot.
I use both approaches. Brainspotting doesn’t replace thoughtful conversation. It gives us another way to work when insight and conversation haven’t fully shifted what you’re experiencing.
How is Brainspotting different from EMDR?
Brainspotting grew partly out of David Grand’s work with EMDR, but they are distinct therapeutic approaches.
One visible difference is how the eyes are used. EMDR commonly uses repeated bilateral stimulation, which may include eye movements. In Brainspotting, we generally find a relevant eye position and maintain the gaze around that point while following the internal process.
Brainspotting also tends to be less structured in the moment. Rather than directing the process toward a particular response, I stay closely attuned to what is happening for you and follow where the process goes.
I value both approaches. I use Brainspotting in my own practice and am happy to refer clients for EMDR when that seems like a better fit.
Does Brainspotting actually work?
Some people experience meaningful changes through Brainspotting, including feeling less emotionally or physically activated by experiences that previously triggered a strong response. Memories themselves typically remain, but the emotional and physiological response connected with them may become less intense.
Not everyone responds to any therapy in the same way, and Brainspotting isn’t something I expect to work simply because we try it. We’ll pay attention to what you’re actually experiencing and whether the work is helping with what brought you to therapy.
My use of Brainspotting is informed by my training in the approach, the available research, and my clinical experience with how clients respond to it.
Is there research on Brainspotting?
Yes. Brainspotting has been studied in published clinical research, including studies involving trauma, PTSD symptoms, and distressing memories. Some studies have found meaningful reductions in symptoms following Brainspotting.
The research base is still relatively small, particularly compared with treatments that have been studied for decades. There is also an important distinction between research on whether people improve with Brainspotting and theories about exactly why it works neurologically.
David Grand and other researchers have proposed neurological models for Brainspotting, including possible roles for subcortical and midbrain processes. Those models help inform the approach, but the specific mechanisms have not yet been established conclusively.
How many Brainspotting sessions will I need?
There isn’t a standard number.
I incorporate Brainspotting into therapy rather than treating it as a fixed package of sessions. How often we use it and for how long depends on what you want to work on, the complexity of what you’re experiencing, how you respond to the process, and whether it continues to feel useful.
Some experiences may shift through relatively focused work, while longstanding or more complex concerns may take longer. We’ll keep paying attention to what is changing rather than working toward a predetermined number of sessions.
Can Brainspotting be done online?
Yes. I provide Brainspotting through telehealth as part of my online therapy practice in Washington DC and Virginia.
The basic process remains the same: we identify what you want to work with, find a relevant point in your visual field, and use that eye position while you pay attention to your internal experience. I remain closely attuned to you throughout the process, just as I would if we were sitting in the same room.
You’ll need a private space where you can see your screen comfortably and give yourself enough room to focus without being interrupted.
Can Brainspotting be combined with other kinds of therapy?
Yes. I use Brainspotting as one part of therapy rather than assuming every session or every concern needs to be approached in the same way.
We might spend part of our work talking through something, use Cognitive Behavioral Therapy (CBT) to understand a pattern, draw from mindfulness or somatic approaches, or use Brainspotting when a more internally focused way of working seems useful.
The approach can change depending on what we’re working on and what seems to be helping. You don’t have to choose between “Brainspotting therapy” and everything else we might do together.