Most people typing this question have never met anyone who has had DBR, and the name suggests something far more invasive than what actually happens. The pages that rank answer with reassurance. The evidence answers differently.
The harder answer is that nobody has measured it. One randomized trial of DBR has been published, and it did not track adverse events. That is not a criticism hiding in a compliment. It is the actual state of the evidence, and it is worth understanding properly before you decide anything.
What the one trial actually measured
The trial is Kearney and colleagues, published in the European Journal of Psychotraumatology in 2023. Fifty-four adults with PTSD were randomly assigned, 29 to DBR and 25 to a waitlist, and the DBR group received eight weekly sessions of 90 minutes each by videoconference.
Read in full, the paper contains no adverse-event protocol, no safety monitoring section and no list of harms experienced by participants. Nobody was asked, in any systematic way, whether the treatment made anything worse. The one place the study touches this is a note that therapists could redirect a participant back to grounding techniques if affective responses or sensations felt unmanageable, and no resulting difficulties are recorded.
What the trial did measure, on the safety side, is who stayed. One participant of the 29 who started DBR did not complete treatment. The authors report that as minimal attrition and compare their dropout rate favourably with what they describe as an average of up to 18 percent or more in other trauma-focused treatments. From that, they write one sentence: a low attrition rate "also suggests that DBR is generally well-tolerated."
That one sentence is the whole of the published evidence behind the claim that DBR is safe.
Well tolerated and safe are not the same claim
Well tolerated and safe get used interchangeably, and the difference between them is the most useful thing on this page.
Well tolerated is a statement about attrition. It means people kept turning up. That is genuinely informative: a therapy that hurt everyone who tried it would empty out, and this one did not. But it is measured by counting chairs, and it can only tell you about the people who were in them.
Safe is a statement about harm. It means somebody looked for damage and reported what they found. That study has not been done for DBR. Not done badly, not done with a disappointing result: not done.
The gap between those two matters because one person completing eight sessions and one person being harmed and quietly leaving look identical in an attrition figure. With a denominator of 29, a single misread departure moves the number by three points. The trial's own authors were careful to write "suggests", and almost everything downstream of them has dropped the word.
Who the trial left out
The study excluded people with pronounced identity instability, people with active suicidal intent or a plan, and people with co-occurring bipolar disorder, psychotic disorders or active substance use disorders. The sample was also small and predominantly White and female.
That list is worth reading twice, because it is close to a description of the people whose safety question is the sharpest. If you are asking whether a trauma therapy might destabilise you, there is a reasonable chance you are asking because something about your history makes you think it could, and the study cannot speak to you.
The important part is what that does and does not mean. Being excluded from a trial is not a finding. It does not mean DBR was tested on people like you and went badly. It means the question was not asked. Those are different things, and the second one leaves the decision with you and a clinician rather than with a paper.
This matters here more than it might elsewhere. Trauma and substance use travel together often enough that a great many people reading this will fall into one of the excluded groups without thinking of themselves as an edge case.
Can DBR make things worse?
Nobody can tell you it cannot, and anybody who does is going beyond what has been published.
What can be said is narrower and still useful. Trauma processing of any kind asks you to go near something you have spent energy staying away from, and feeling stirred up during or after a session is a normal part of that rather than a sign something has gone wrong. The DBR trial built in a way for therapists to slow things down when a participant found a response unmanageable, which tells you the researchers expected that to happen and planned for it. No harm is recorded for any of the 29 people in the treatment arm, and that is a statement about what was written down rather than about what happened. Nobody was systematically asked.
What that is not is a side-effect profile. You will find lists of DBR side effects online that are, on inspection, EMDR's side effects with the name changed. Those two therapies work differently, and one of them has been studied far more than the other, so borrowing the findings is not conservative. If you want to see what a well-documented side-effect picture looks like for a trauma therapy, our guide to EMDR side effects is a fair comparison, and the contrast with DBR is the point rather than a reason to equate them.
How this compares with a better-studied therapy
EMDR has been through enough randomized trials that researchers can now stand back and ask how well side effects were tracked across the whole body of them. DBR has one trial, and the answer to the same question is that adverse events were not systematically tracked in it.
What to ask before you start
Since the research cannot tell you whether DBR is safe for you specifically, the useful move is to make the conversation with a clinician do that work instead. These questions are worth asking of anyone offering DBR, including us.
- What training do you have in DBR specifically? Not trauma therapy generally. The modality is young, and a clear answer here is more informative than a long list of adjacent credentials.
- How does my history change your recommendation? Name the thing the trial excluded, whether that is dissociation, bipolar disorder, an active substance use issue or thoughts of harming yourself. A clinician who treats it as routine rather than as a complication has told you something.
- What happens in a session if I get overwhelmed? The trial's therapists had a way to slow down. Ask what yours is.
- What would make you say DBR is not the right place to start for me? The answer "nothing" is worth noticing.
- How will we know if this is making things harder rather than easier, and what would we do then?
You are not being difficult by asking these. You are collecting the information the published research has not produced.
Where this leaves you
DBR is a psychotherapy with an early evidence base, one completed trial, no systematic safety data and a second study now under way in a population the first one excluded. That is enough to make it a reasonable thing to ask about and not enough to make anyone's reassurance about it mean very much. A reader who holds that distinction can make a decision; a reader who has been told it is gentle and safe cannot.
Redefine Wellness & Treatment offers Deep Brain Reorienting as one of the trauma therapies available here, and the questions above are as fair to put to our clinicians as to anyone else's. If you are weighing it against approaches with longer track records, the range of PTSD treatment options is the wider context that decision sits in.
Unknown, and that is a more interesting answer than it sounds. The published trial excluded people with pronounced identity instability, so it offers nothing either way. The second registered DBR study is specifically in complex dissociative disorder and is enrolling by invitation, so the population left out of the first trial is the subject of the next one. That research does not exist yet, but it is being done.
DBR entered the published literature in 2020. One completed randomized controlled trial at that age is ordinary rather than alarming, and it puts DBR roughly where most psychotherapies sit early on. The thing worth watching is not the number itself but whether the next studies track harms, since the first one did not.
No, and neither is any other talking therapy. The FDA approves drugs and devices, so a psychotherapy never appears on that list no matter how strong its evidence is. EMDR is not FDA approved either. The question that actually separates therapies is how much research has tested them and what that research looked for, which is where DBR and EMDR differ sharply.
The one published trial delivered all eight sessions by videoconference, so the small amount of safety information that exists comes from remote delivery. That cuts in a direction people do not expect. It does not show that online DBR is safer. It means in-person DBR has even less published evidence behind it than the little the remote format has.
