A therapy with “deep brain” in its name can sound far more invasive than an hour in a therapist's office. Redefine Wellness & Treatment offers Deep Brain Reorienting (DBR) among its clinical therapies, and the fair way to judge its safety is to separate what the research measured from what it left unmeasured.
What the trial measured, and what it did not
The only randomized trial of DBR with published results is Kearney and colleagues' 2023 study in the European Journal of Psychotraumatology. It assigned 54 adults with PTSD to eight weekly 90-minute DBR sessions by video (29 people) or to a waitlist (25 people). The paper is an interim analysis of a trial that is still running.
It contains no adverse-event protocol, no safety monitoring section and no list of harms. Therapists filled in a weekly form on recent symptoms, but the paper does not report it as safety data. The safety steps it describes are a screen before treatment and a procedure inside the session. Before enrolment, the researchers screened out some groups for safety (see who the trial left out, below). Inside a session, if a reaction felt unmanageable or a participant began to dissociate, the therapist guided them back to the orienting tension.
What the trial did report on the safety side is who stayed. One of the 29 people who started DBR did not finish, which the authors compare with average dropout of up to 18% or more in other trauma-focused treatments. From that, they write that a low attrition rate “suggests that DBR is generally well-tolerated.”
That sentence is the whole published basis for calling DBR safe.
Well tolerated is not the same as safe
Well tolerated and safe are different claims, and the difference is the most useful thing to know here.
Well tolerated is a statement about attrition. It means people kept coming. That is real information: a therapy that hurt most of the people who tried it would lose them, and this one did not.
Safe is a statement about harm. It means someone looked for damage and reported what they found. For DBR, that study has not been published.
The gap matters because a person who finished eight sessions and a person who was harmed and quietly stopped look the same in a dropout count. With 29 people, one departure moves the figure by more than three percentage points. The Discussion says “suggests.” By the abstract's conclusion it has become “a well-tolerated treatment,” which is how the finding usually gets repeated.
Can DBR make things worse?
Nobody can say it never does.
What can be said is narrower. DBR asks you to go toward a reaction you might normally avoid, the first physical response that the Deep Brain Reorienting model centers on, so feeling stirred up during or after a session is plausible. Research on other trauma-focused therapies gives a sense of scale. In a 2016 study of 192 women treated with cognitive processing therapy or prolonged exposure, Larsen and colleagues found that between 14.7% and 28.6% had a temporary rise in symptoms, depending on the therapy. As a group they still improved by the end, and the rise did not predict dropping out. Nothing comparable has been measured for DBR.
So a hard session is not proof of harm, and it is not something to sit through alone either. Distress that is strong, that does not settle, or that starts to affect sleep, work or looking after yourself is worth raising with your therapist before the next session. How a therapist slows things down inside a session is part of what happens in a DBR session. If you are in distress or experiencing a mental health crisis, please call or text 988, or go to the nearest emergency department.
A side-effect list written for another therapy cannot simply be carried over to DBR, which works differently and has far less research behind it than EMDR, whose side effects and risks are well documented.
Who the trial left out
The study excluded people with pronounced identity instability, people with suicidal intent or a plan, and people with bipolar disorder, a psychotic disorder or an active substance use disorder. Its registration also excluded significant head injury, neurological disorders and anyone already in more intensive therapy. The people it did include were mostly women (91%) and mostly White (84%).
That list is close to a description of the people whose safety question is sharpest. Being left out of a trial is not a finding of harm. For most of these groups it means the question was not asked. For two of them, pronounced identity instability and current suicidal intent or a plan, the researchers excluded people because they judged a fixed eight-session course unsafe for them.
Who may be a good candidate
There is no checklist you can apply to yourself, and no study has defined who DBR suits best. At Redefine, DBR is used with PTSD and complex trauma, especially where early attachment disruption has led to dissociative symptoms, and whether it belongs in a plan is decided at assessment.
Some of those presentations sit close to the groups the trial left out, so for them the evidence is thinnest exactly where interest is highest. That is a reason for a careful assessment, not a reason to rule DBR out. Most of the trial's exclusions mark groups with no data yet, not a finding that DBR harms them. The two the researchers excluded for safety reasons are a reason to stabilize first and plan carefully, which is a decision for a clinician who knows your history.
Can DBR help with PTSD?
In the one trial, PTSD symptoms fell for many participants. After eight sessions, total PTSD scores in the DBR group fell by 36.6% on average, and 14 of 29 people (48.3%) no longer met criteria for PTSD. At three months, 12 of the 23 who completed follow-up no longer met criteria. In the waitlist group, one person no longer met criteria at either point. The difference between the groups was large.
Those are promising early results, and they are early. The comparison was with waiting, not with an established therapy. The sample was small, mostly White and female, treated entirely by video, and screened to leave out several common complications. No trial has yet put DBR next to a recommended PTSD therapy, a gap that shapes the comparison with EMDR. The benefits the trial supports are fewer PTSD symptoms in people like its participants; it did not test the brainstem model or any wider claim.
Questions to ask before you start
Since the research cannot tell you whether DBR is safe for you specifically, the conversation with a clinician has to do that work. These questions are worth asking of anyone offering DBR, Redefine included:
- What training do you have in DBR specifically? Not trauma therapy in general. The method is young, and a clear answer here tells you more than a long list of nearby credentials.
- How does my history change your recommendation? Name anything in your history the trial excluded. A clinician who treats it as routine rather than as something to plan around 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 DBR the wrong place to start for me? An answer of “nothing” is worth noticing.
- How will we know if this is making things harder, and what would we do then?
Asking them is not being difficult. It collects the information the published research has not produced yet.
It depends on what kind. About a third of the people who received DBR in the trial met criteria for the dissociative subtype of PTSD, so some dissociation was included. People with pronounced identity instability were excluded. A small registered study of DBR in complex dissociative disorders is under way, by invitation and with no comparison group.
There is no trial data. The trial excluded people with an active substance use disorder, and its registration excluded alcohol or substance problems in the previous three months. Redefine's own description of DBR notes that unresolved trauma can show up as substance use, so for many people this is a question to work through at assessment, with their full history on the table.
Nothing in the DBR research asks you to. Trial participants who took psychiatric medication, including about 45% of the DBR group on antidepressants, were on a stable dose before starting and were asked to stay on it through follow-up. Changing a medication is a separate decision to make with whoever prescribes it, not a step to take for therapy.
The trial enrolled only adults who met criteria for PTSD, so that is the only group the research covers. Redefine describes DBR as focusing less on the clinical diagnosis than on identifying the root traumatic experience, and uses it with complex trauma as well as PTSD. Whether it suits you is decided at assessment, not by a label.
DBR is young: its developers' peer-reviewed description of the approach appeared in 2019 and 2020, and the first trial began in 2020. What matters next is whether new studies track harms. The dissociative-disorders study lists how well participants tolerate treatment among its main outcomes. The newest registered DBR study lists symptom change and therapist interviews as its outcomes, not adverse events.
