Three questions come up before a first Deep Brain Reorienting (DBR) session: what you will be asked to do, how much you will have to say, and how you will feel when you leave. Redefine Wellness & Treatment offers DBR among its clinical therapies, and the clearest public account of a session comes from the one published trial, whose protocol was written with DBR's developer.
Before the first session
DBR is rarely the first thing that happens. In the trial, a clinician assessed every participant before treatment began. At Redefine, whether DBR belongs in a plan at all is decided at assessment.
A few things are worth bringing to that first conversation:
- What you want to be different, in your own words.
- A rough sense of what sets you off. The moment to work with is chosen together, so you do not need to pick one in advance.
- Anything that could affect pacing, such as going numb or spacing out under stress, recent alcohol or drug use, or a change in medication.
- Your questions. How will we choose what to work on? How do I signal a pause? What happens if I feel overwhelmed? How long are sessions, and are they in person or by video?
How a session ran in the published trial
DBR's developer, Frank Corrigan, proposes that a threatening moment sets off a sequence: a quick orienting tension in the head and neck, sometimes a jolt of shock, then emotion. That model behind Deep Brain Reorienting is still unproven. The steps below are how the 2023 trial, run with Corrigan as one of its authors, turned it into a session. A therapist outside the trial may adapt them.
- Choosing a target. Participants named a recent trigger or a past traumatic experience. With the therapist's help they narrowed it to the moment that most caught their attention, such as a look or a posture.
- Orienting to the present. They let that memory go and noticed their body in the room: their posture, the chair holding them, sounds near and far. Then they softened any tension they could in the forehead, jaw and neck.
- Bringing the target back. The therapist asked them to bring the moment to mind again, just enough for a reaction to begin.
- Noticing the orienting tension. The first thing to look for was tension, almost always in the muscles around the eyes, the forehead or the back of the neck. If strong feeling came first, the therapist guided attention back to that tension, which became the anchor for the rest of the session.
- Letting the rest unfold. When a jolt or a wave of feeling came, participants were encouraged to let it happen rather than push it away. Memories linked to it were allowed to play out in the mind. The therapist said little and kept the pace slow.
- Closing. Tension and feeling typically eased by the end, and participants were asked whether a new perspective on themselves had emerged. If one had, they were encouraged to keep it in mind after the session.
What it can feel like
Sessions vary, even for the same person. Some follow the sequence clearly. Others stay quiet, with a tension so faint it is easy to miss. The trial measured symptoms rather than how sessions felt, and it does not link any particular reaction to a better result.
Do you have to talk about the trauma?
Not in detail. In the trial, the starting point was named briefly, and it could be a recent trigger rather than the original event. After that the work was attention to sensation, with the therapist commenting as little as possible. EMDR, by contrast, invites some discussion between sets, one of several practical differences in how DBR compares with EMDR.
In the trial, the assessment before treatment was different. It asked about what happened and how it affected the person, and it included the Clinician-Administered PTSD Scale, a structured interview about trauma symptoms. So some talking does happen, mostly before DBR starts.
Staying in control of the pace
You can ask to slow down, pause or stop at any point in a session.
Pacing is built into the protocol. The trial aimed for enough activation to notice what was happening without being flooded or shutting down. If a feeling became unmanageable, or a participant started to dissociate (feel numb, foggy or far away), the therapist guided attention back to the orienting tension. In very rare cases where that was not enough, long, slow out-breaths were added.
Signs worth saying out loud:
- A feeling is building faster than you can stay with it.
- You feel numb, foggy or disconnected from the room.
- You have lost the tension and cannot find it again.
The trial did not report adverse events, so how often a session goes badly is not known. That is the main gap in DBR's safety evidence, and a good reason to agree a pause signal with your therapist before you begin.
After a session
There is no standard after-session experience. In the trial, tension and feeling usually eased by the end, and some people leave lighter. Others leave stirred up, and some notice little change. None of these, on its own, shows whether DBR is working.
Feeling worse for a while is a known pattern in trauma therapy. In a 2016 study of cognitive processing therapy and prolonged exposure, a minority of people had a temporary rise in symptoms during treatment, and as a group they still improved by the end. Nobody has measured how often it happens with DBR.
Tell your therapist how you left each session. Contact them before the next one if the distress is strong, if it has not settled, or if it is getting in the way of sleep, work or looking after yourself. Thoughts of harming yourself are a reason to reach out straight away, not at the next appointment. If you are in distress or experiencing a mental health crisis, please call or text 988, or go to the nearest emergency department.
How many sessions, and how long until it helps?
There is no set number. The trial fixed its schedule in advance so that results could be measured, and that is a research design, not a prescription.
The 2023 trial gave adults with PTSD eight weekly sessions of 90 minutes each, by video. A second registered study, in complex dissociative disorders, plans 16 weekly 45-minute sessions after one to three preparatory ones, alongside short group meetings. In your own care, the number, length and format of sessions are agreed with your clinician and reviewed as you go.
How long DBR takes to help has no promised answer either. The trial measured symptoms before treatment, after the eighth session and three months later, so it cannot say when any one person will notice a change. At Redefine Wellness & Treatment, DBR is front and center among more than 20 modalities offered to adults, and progress is reviewed with your clinician rather than measured against a fixed date.
It can be either. Every session in the published trial took place by video because of COVID-19 restrictions, so the research describes online DBR, and no study has compared online and in-person sessions. Ask your clinician which format they use, and say so if one feels more comfortable to you.
No. In the trial, participants were encouraged to close their eyes to cut down on what was going on around them, and anyone who found that uncomfortable lowered their gaze to their lap instead. If closing your eyes feels unsafe, mention it before you start so the therapist can plan around it.
It can be, though the research covers only a narrow version of it. Trial participants could stay on a stable dose of psychiatric medication, but people already in more intensive therapy, such as exposure therapy or cognitive behavioral therapy, were excluded. Redefine offers DBR along with other trauma therapies, and which ones go into a plan is decided after assessment.
It helps to leave a little room. In the trial, anyone with leftover tension at the end was encouraged to use slow breathing, neck stretches and self-massage of the tense areas. If you know a demanding meeting or a long drive follows your appointment, tell your therapist so the session can be paced with that in mind.
You can. Agreeing to a course of sessions does not commit you to finishing it, and in the trial one of the 29 people assigned to DBR did not complete it. If DBR is not working for you, saying so lets your clinician consider a different approach instead of leaving you to push through.
