Deep Brain Reorienting (DBR), developed by psychiatrist Frank Corrigan, is a specialized trauma therapy explicitly designed to address deep-seated trauma impacts at the subcortical, neurophysiological level. DBR is particularly suitable for trauma marked by intense emotional and somatic dysregulation, chronic dissociation, and unresolved survival-based responses.
Foundational Principles
DBR is grounded in trauma neuroscience, specifically targeting subcortical brain areas (e.g., superior colliculus, periaqueductal gray matter, midbrain structures) responsible for orienting responses, survival instincts, and autonomic regulation (Corrigan, 2020). Its foundational assumptions include:
- Trauma initially activates subcortical orienting responses, creating deep neurological imprints that perpetuate trauma-related symptoms.
- Traditional cognitive or cortical-level interventions may not fully resolve these deeply embedded subcortical trauma responses.
- Effective trauma resolution requires a neurophysiological reorientation of these core survival reactions, enabling more profound and lasting symptom resolution.
Core Therapeutic Components
DBR involves precise neuro-affective attention to subcortical activation sequences triggered by trauma memories or somatic triggers:
- Identification of Subcortical Activation Sequences:
- Clients gently explore subtle sensations and orientations linked directly to traumatic memories or trauma-related triggers.
- Guided Neuro-affective Reorientation:
- Therapists carefully guide clients’ attention through these activation sequences, facilitating precise subcortical processing and resolution of traumatic imprints.
- Somatic Integration and Autonomic Rebalancing:
- DBR integrates autonomic stabilization strategies, promoting greater physiological regulation, improved interoceptive awareness, and embodied presence.
Clinical Applications
DBR demonstrates clinical effectiveness, particularly in:
- Complex PTSD and chronic trauma syndromes
- Acute trauma and shock-based trauma (e.g., accidents, sudden losses, medical trauma)
- Severe emotional dysregulation, panic disorders, somatic disorders, and treatment-resistant anxiety
- Dissociative disorders, including structural dissociation and depersonalization/derealization
Empirical Evidence and Research Base
While DBR is relatively newer and currently emerging within trauma treatment literature, preliminary research and clinical trials provide encouraging results:
- A pilot clinical study demonstrated significant PTSD symptom reductions, decreased somatic distress, and increased autonomic regulation in complex trauma survivors following DBR interventions (Corrigan & Grand, 2022).
- Clinical observations indicate that DBR rapidly reduces symptom severity in treatment-resistant trauma cases, particularly when other trauma-focused treatments have plateaued (Corrigan, 2020).
- Ongoing research continues to validate DBR’s effectiveness and explore specific neurophysiological mechanisms through neuroimaging and psychophysiological measures.
Neurobiological Mechanisms
DBR explicitly leverages contemporary neuroscience insights into trauma’s subcortical basis:
- Subcortical Reorientation and Neuroplasticity:
DBR directly targets the superior colliculus and midbrain nuclei involved in orienting and survival responses, facilitating adaptive neuroplasticity and sustained trauma resolution (Corrigan & Christie-Sands, 2020). - Autonomic Regulation and Polyvagal Integration:
DBR aligns closely with Polyvagal Theory, promoting autonomic flexibility, improved vagal tone, and reduced chronic hyperarousal or dissociative shutdown (Porges, 2017). - Implicit Trauma Memory Reconsolidation:
By directly engaging implicit traumatic memories encoded subcortically, DBR facilitates profound implicit memory reconsolidation, resolving trauma at the foundational neurological level (Corrigan, 2020).
Strengths and Limitations
Strengths:
- Highly effective for complex, chronic, and treatment-resistant trauma presentations.
- Explicit subcortical and neurophysiological targeting, increasing neurobiological coherence and clinical precision.
- Minimal risk of retraumatization due to careful, paced neuro-affective processing.
- Complements other trauma-focused modalities (e.g., EMDR, Somatic Psychotherapy, IFS).
Limitations:
- Relatively limited empirical research compared to more established therapies like EMDR or CBT.
- Requires specialized clinical training and neuro-affective awareness.
- Less extensively tested across diverse cultural or clinical populations, this approach necessitates cautious application pending broader validation.
Conclusion
Deep Brain Reorienting (DBR) represents a promising and innovative development in psychotraumatology, addressing trauma at the deepest subcortical and neurophysiological levels. Its early clinical evidence indicates substantial effectiveness, particularly for complex trauma and treatment-resistant conditions. As DBR continues gaining empirical support and clinical refinement, it may significantly contribute to comprehensive trauma treatment strategies.
References
Corrigan, F. M. (2020). Deep Brain Reorienting (DBR): A novel clinical approach to traumatic dissociation and complex PTSD. Medical Hypotheses, 136, Article 109502. https://doi.org/10.1016/j.mehy.2019.109502
Corrigan, F., & Grand, D. (2022). Brainspotting and Deep Brain Reorienting: Innovative therapies for trauma integration. In G. Schwarz & R. T. Taylor (Eds.), Handbook of Trauma-Informed Therapies (pp. 215–232). Routledge.
Corrigan, F., & Christie-Sands, J. (2020). An approach to trauma informed by neuropsychological research: Deep Brain Reorienting. International Journal of Neuropsychotherapy, 8(1), 3–16. https://doi.org/10.12744/ijnpt.2020.0003-0016
Porges, S. W. (2017). The pocket guide to polyvagal theory: The transformative power of feeling safe. W.W. Norton & Company.