What Is Brainspotting? A Clinical Guide for People Who've Tried Everything
- Stephanie Sanz, LMHC
- Jun 1
- 7 min read
I want to talk about the clients who've done "everything right" - years of therapy, the journaling, the CBT worksheets and still feel like there's still more to process and heal. Like the healing is just out of reach. That's usually when Brainspotting enters the chat.
I'm Stephanie, and I am the founder of Cognitive Reset Counseling in New York. My background is in neuroscience, trauma, and behavior, and my main clinical modalities are Brainspotting and neurofeedback. I also use HRV coherence breathwork, somatic approaches, and IFS because healing is rarely one-size-fits-all, and the nervous system responds to a lot of different things.
Brainspotting (BSP) is the modality I lead with. Not because it's new or buzzworthy. Actually, it's been around since 2003 but because of what I see it do. I've watched clients unlock things in a single session that they couldn't reach in years of traditional talk therapy. That gets my attention.
So let me break it down: what it actually is, what the research says (honestly so that includes the limitations), and why it works especially well for anxiety, trauma, and complex PTSD.
So What Even Is Brainspotting?
Brainspotting was developed by a therapist named David Grand in 2003. While working with clients, he noticed that their eyes would drift across the room while speaking. When he slowed down the eye movement part and let clients just hold a fixed gaze, something different happened. Something deeper. He started mapping what he called "brainspots": specific eye positions that seemed to be connected to stored emotion, trauma, and physical activation in the body.
The motto of Brainspotting is "where you look affects how you feel." That sounds simple, almost too simple. But there's real neuroscience behind it which I will get to in a minute.
In a BSP session, the therapist helps you find a point in your visual field that activates something (a feeling, a sensation, a memory, etc.). Then you hold your gaze there while they stay present and attuned. That's it, on the surface. But underneath, your nervous system is doing a lot. It's accessing and processing what's been stored in your body and your brain below the level of conscious thought. Below language. Below the story you've been telling yourself about what happened.
The Neuroscience (Bear With Me — It's Actually Cool)
Here's the part where I geek out a little, because I think understanding why this works makes it less mysterious and more trustworthy.
When something traumatic happens, the memory doesn't always get processed and stored the way a normal memory does. Instead of a more gradual and steady process that incorporates the the cortex (the higher-order thinking parts of the brain) and getting filed away in, it gets trapped in the subcortex, the deeper, older part of your brain. The part that doesn't speak in words or logic, that leans heavily into emotion and sensations. The part that scans for danger and responds to it, whether the danger is still real or not. The part that helps us survive in the face of danger.
This is why someone can know logically that they're safe and still feel terror in their chest. The thinking brain knows. The survival brain hasn't gotten the memo yet.
Talk therapy is fantastic, and I mean that. But it mostly works through the neocortex, the thinking, language-processing part of your brain. It can help you understand your history, reframe your story, build insight. What it often can't do alone, however, is reach down into the subcortex and update what's held there. That requires a different process and a different means to opening a door that talk therapy may not have the keys to.
Brainspotting uses eye position to access two key subcortical structures:
The superior colliculi — processes visual and auditory information and is involved in orienting and threat responses.
The periaqueductal gray (PAG) — regulates pain, fear, and the freeze response. It works collaboratively with the amygdala (the threat surveillance system of the brain and where fear derives). This one is huge for trauma.
A 2020 study in the Annals of the New York Academy of Sciences found real, meaningful overlap between the oculomotor system (eye movement) and the hippocampal memory system so the eye-brain connection isn't just theoretical. And research from 2013 specifically pointed to the superior colliculi and PAG as structures involved in how Brainspotting may facilitate trauma processing at the midbrain level.
Here's how I sometimes describe it to clients who have a more spiritual lens: the body holds memory the way the earth holds what's been buried in it. Certain conditions like the right light, the right season, the right pressure, allow what was buried to rise. Brainspotting is one of those conditions.
What Does the Research Actually Say?
I'm going to be straight with you here: Brainspotting doesn't have the volume of large-scale randomized controlled trials that CBT or EMDR have. Anyone who tells you otherwise is overselling it. The evidence base is emerging, not established. Some of the early studies were done by researchers affiliated with the Brainspotting Institute, which is worth knowing.
That said, the research we do have is genuinely promising. Here's what's out there:
COMPARED TO EMDR
Because Brainspotting grew out of EMDR, a lot of the early research naturally puts them side by side. What those studies consistently show is that both modalities work and they work in comparable ways. That's not a slight to either one. It actually speaks to the shared underlying mechanism; the eye-brain connection and the nervous system's capacity to process and release stored experience when given the right conditions.
Note - I want to be clear: I'm trained in EMDR and I have a lot of respect for it. It has a robust evidence base and it genuinely changes lives. Both modalities draw from the same well — the eye-brain connection, bilateral stimulation, somatic awareness — and both work. The difference is really in structure and delivery. EMDR follows a specific protocol with defined phases and directed eye movement. Brainspotting is more open. The eyes rest on a fixed point and the client's own nervous system leads the processing. As a clinician, I'm drawn to that less structured framework because it creates space for the client's body intelligence to show up and guide the work in a way that feels organic to them, not prescribed by a protocol. For some people, the structure of EMDR is exactly what they need. For others, the more fluid nature of Brainspotting feels like a better fit. Neither is universally superior. It's about the person in front of you.
A 2022 study compared EMDR, Brainspotting, and Body Scan Meditation in how well they helped people process distressing memories. Both EMDR and BSP significantly reduced distress, with comparable effects between them and those gains held at a two-month follow-up. For me, findings like this confirm that we're working within the same neurological territory. The question isn't which one is better; it's which one is the better fit for a particular person at a particular moment in their healing.
Brainspotting for PTSD and Complex Trauma
After six sessions of Brainspotting, one pilot study found significant drops in PCL-5 scores (the standard PTSD measure for DSM-5), along with improvements in social functioning and depression. A 2022 study on Filipino women with severe PTSD found similar results. The neuroimaging case studies are small but interesting with some showing actual changes in brain glucose metabolism after BSP treatment, not just symptom self-report.
What Actually Happens in a Brainspotting Session
In a BSP session, I help you locate a "brainspot", a specific point in your visual field that activates a feeling, sensation, memory, or physical response in your body. We find it together by paying close attention to what shifts as your gaze moves. Once we find it, you hold your gaze there. And I stay present with you.
On the surface, that's it.
But underneath, your nervous system is doing extraordinary work. It's accessing and processing what has been stored in the body and brain below the level of conscious thought; below language, below narrative, below the story you've been telling yourself about what happened. The client leads. The body leads. I follow. This is one of the things I love most about Brainspotting as a modality.
Who is Brainspotting for?
Brainspotting tends to be a good fit for people who have been in therapy before and feel like something still isn't shifting; who experience anxiety that lives in the body. It is helpful for those who are working with trauma, PTSD, or complex trauma; who find it hard to talk about difficult things directly (BSP doesn't require verbal re-processing of the event); who are navigating performance anxiety. Athletes, performers, and creatives often respond powerfully to this work or who are curious about deeper, body-based approaches to healing.
Brainspotting is not the right fit for every person or every moment. If someone is in acute crisis or needs stabilization first, we address that before going into deeper processing work. And Brainspotting is one tool in a much larger clinical picture. At CRC, it can be used alongside neurofeedback, somatic therapy, HRV coherence training, and IFS, because different layers of a person's experience need different things.
A Note on the Spiritual Dimension
I work from a deeply science-grounded framework. And I also believe that the space Brainspotting opens is, for many people, something that touches what I'd call the sacred.
There's a reason so many clients describe their BSP sessions in ways that sound almost like ceremony: the stillness, the going inward, the sense of something releasing that had been held for a very long time. When the body begins to process what it's been carrying, it can feel like a kind of unburdening. Like grief moving through. Like a weight lifting.
I think of the nervous system as both a biological system and a vessel, one that has recorded everything, held everything, and has the capacity to release what no longer belongs to the person it was meant to protect. Whether you call that healing, integration, or liberation is yours to decide.
Brainspotting Therapy in NYC
Brainspotting sessions at Cognitive Reset Counseling are available in person in Greenpoint, Brooklyn (252 Java Street, Suite 209) and via telehealth across New York State.
If you've been in therapy for a while and feel like something is still just out of reach, I'd genuinely love to talk. A free consultation is the first step:
