Research And Case Studies

Posttraumatic stress disorder (PTSD) is widely recognized as involving disruption of core neurocircuitry that underlies processing, regulation, and response to threat. In particular, the prefrontal cortex–hippocampal–amygdala circuit is a major contributor to posttraumatic dysfunction. However, the functioning of core threat neurocircuitry is partially dependent on sensorial inputs, and previous research has demonstrated that dense, reciprocal connections exist between threat circuits and the ventral visual stream. Furthermore, emergent evidence suggests that trauma exposure and resultant PTSD symptoms are associated with altered structure and function of the ventral visual stream. In the current review, we discuss evidence that both threat and visual circuitry together are an integral part of PTSD pathogenesis. An overview of the relevance of visual processing to PTSD is discussed in the context of both basic and translational research, highlighting the impact of stress on affective visual circuitry. This review further synthesizes emergent literature to suggest potential timing-dependent effects of traumatic stress on threat and visual circuits that may contribute to PTSD development. We conclude with recommendations for future research to move the field toward a more complete understanding of PTSD neurobiology.

The recent review by Harnett et al. (1) highlighted a critical yet underexplored dimension of posttraumatic stress disorder (PTSD): the intricate interplay between visual and threat- processing neurocircuitry. The recognition that PTSD impli- cates not only core threat circuits, including the prefrontal  cortex, hippocampus, and amygdala, but also the ventral visual stream represents a paradigm shift in understanding the disorder. The reciprocal connections between these systems emphasize their joint role in encoding, processing, and retrieving threat-related memories, with sensorial inputs likely playing a pivotal role in shaping trauma-related responses. This raises essential questions, such as how the ventral visual stream uniquely contributes to the emotional salience of trauma-related stimuli and whether specic visual properties such as contrast, motion, or spatial frequency amplify threat memory formation. Addressing these questions could enhance our understanding of PTSD susceptibility and resilience. Furthermore, the bidirectional relationship between visual and threat circuits suggests novel therapeutic opportunities, including the use of neuromodulation techniques like trans-cranial magnetic stimulation targeting visual cortical regions to disrupt maladaptive threat memory consolidation. Clinical trials are warranted to assess the efficacy and safety of such interventions (2,3).

Visual components of trauma memories are often vividly re-experienced by survivors with deleterious consequences for normal function. Neuroimaging research on trauma has primarily focused on threat-processing circuitry as core to trauma-related dysfunction. Conversely, limited attention has been given to visual circuitry which may be particularly relevant to posttraumatic stress disorder (PTSD). Prior work suggests that the ventral visual stream is directly related to the cognitive and affective disturbances observed in PTSD and may be predictive of later symptom expression. The present study used multimodal magnetic resonance imaging data (n = 278) collected two weeks after trauma exposure from the AURORA study, a longitudinal, multisite investigation of adverse posttraumatic neuropsychiatric sequelae. Indices of gray and white were combined using data fusion to identify a structural covariance network (SCN) of the ventral visual stream 2 weeks after trauma. Participant’s loadings on the SCN were positively associated with both intrusion symptoms and intensity of nightmares. Further, SCN loadings moderated connectivity between a previously observed amygdala-hippocampal functional covariance network and the inferior temporal gyrus. Follow-up MRI data at 6 months showed an inverse relationship between SCN loadings and negative alterations in cognition in mood. Further, individuals who showed decreased strength of the SCN between 2 weeks and 6 months had generally higher PTSD symptom severity over time. The present ndings highlight a role for structural integrity of the ventral visual stream in the development of PTSD. The ventral visual stream may be particularly important for the consolidation or retrieval of trauma memories and may contribute to ef cient reactivation of visual components of the trauma memory, thereby exacerbating PTSD symptoms. Potentially chronic engagement of the network may lead to reduced structural integrity which becomes a risk factor for lasting PTSD symptoms.

Brainspotting, discovered in 2003 by Dr.  David Grand, is an innovative method for emotional regulation and trauma processing. Evidence for the therapeutic efficacy of Brainspotting is available (i.e. D’Antoni et al. 2022; Hildebrand et al. 2017).

The article explains the fundamentals and practice of Brainspotting, supported by case studies and neuro-biological hypotheses. Its effectiveness is described not only for trauma and its long-term effects but also for unlocking potential.

Finally, the method is presented as a valuable addition to any therapeutic setting.

Assuming that specific eye positions correspond to therapy-relevant stressful
experiences, Brainspotting was developed out of EMDR as a treatment to trigger processing via the body. Acquired patterns of stress or trauma reactions can be restructured using affect bridges. Brainspotting can be integrated into the method used by the therapist.

The study investigates the effectiveness of  Brainspotting combined with behavioural therapy in a randomised two-arm study (“Brainspotting immediately” vs. “Brainspotting later”).

Early response was significantly higher in the “Brainspotting immediately” group than in those receiving Brainspotting after the early response measurement. At the end of therapy and catamnestically, there were large effects on the IES-R for both groups. Anxiety and depression symptoms improved significantly and sustainably; the moderator effect of the therapeutic relationship was not confirmed.

The combined use of Brainspotting and cognitive behavioural therapy showed clinically significant effects at an early stage. The generalization of these results is considerably restricted through limitations. Randomized controlled trials are necessary for more evidence-based results.

International Body Psychotherapy Journal, Published by the European & United States Associations for Body Psychotherapy & Somatic Psychology, Volume 22, Winter 2023-2024, Page 57. LeeAnn M. Horton, Cynthia Schwartzberg, Cheryl D. Goldberg, Frederick G. Grieve, Lauren E. Brdecka

Palsimon, Jr., T. (2022). The preliminary efficacy and clinical applicability of Brainspotting among Filipino women with severe posttraumatic stress disorder. Archives of Psychiatry and Psychotherapy.

Jeanne Talbot, MD, PhD1,2, Sara de la Salle, PhD1 , and Natalia Jaworska, PhD1,3

1. University of Ottawa Institute of Mental Health Research, Ottawa, ON,Canada
2. Department of Psychiatry, University of Ottawa, Ottawa, ON, Canada
3. Department of Cellular & Molecular Medicine, University of Ottawa, Ottawa, ON, Canada

Fabio D’Antoni 1,2,3,* , Alessio Matiz 2,3 , Franco Fabbro 2,4 and Cristiano Crescentini 2,4

1. Maternal Infant Services Unit of Udine, Azienda Sanitaria Universitaria Integrata Friuli Centrale (ASUFC), 33100 Udine, Italy
2. Department of Languages and Literatures, Communication, Education and Society, University of Udine, 33100 Udine, Italy; alessio.matiz@uniud.it (A.M.); franco.fabbro@uniud.it (F.F.); cristiano.crescentini@uniud.it (C.C.)
3. Department of Psychology, Sapienza University of Rome, 00118 Rome, Italy
4. Institute of Mechanical Intelligence, Scuola Superiore Sant’Anna di Pisa, 56010 Pisa, Italy

* Correspondence: fabio.dantoni@asufc.sanita.fvg.it

Abstract

Objectives: We explored the effects of a single 40-min session of Eye Movement Desensitization and Reprocessing (EMDR), Brainspotting (Brainspotting), and Body Scan Meditation (BSM) in the processing of distressing memories reported by a non-clinical sample of adult participants.

Design: A within-subject design was used. Methods: Participants (n = 40 Psychologists/MDs) reported four distressing memories, each of which treated with a single intervention. EMDR, Brainspotting, and BSM were compared with each other, and with a Book Reading (BR) active control condition, using as dependent measures, SUD (Subjective Units of Disturbance) and Memory Telling Duration (MTD) on a 4-point timeline: Baseline, Pre-Intervention, Post-Intervention, Follow-up. Results: SUD scores associated with EMDR, Brainspotting, and BSM significantly decreased from Pre- to Post-Intervention (p < 0.001).

At Post-Intervention and Follow-up, EMDR and Brainspotting SUD scores were significantly lower than BSM and BR scores (p < 0.02). At both Post-Intervention and Follow-up, BSM SUD scores were lower than BR scores (p < 0.01). A reduction in MTD was observed from Pre- to Post-Intervention for EMDR and Brainspotting conditions (p < 0.001).

Conclusions: Overall, results showed beneficial effects of single sessions of EMDR, Brainspotting, or BSM in the processing of healthy adults’ distressing memories. Study limitations and suggestions for future research are discussed.

Received: 22 December 2021
Accepted: 18 January 2022
Published: 20 January 2022

Joanic Masson1, Amal Bernoussi1 & Charlemagne Simplice Moukouta1

1 Center of psychology (EA 7273), University of Picardy Jules Verne, 80025 Amiens, France

Correspondence: Dr Joanic Masson, Center of Psychology, UFR Sciences Humaines et Sociales, Chemin du Thil, 80025 Amiens Cedex, France.

Received: February 7, 2017 Accepted: March 16, 2017 Online Published: May 29, 2017

doi:10.5539/gjhs.v9n7p103 URL: https://doi.org/10.5539/gjhs.v9n7p103

Abstract

Brainspotting psychotherapy (Brainspotting), elaborated by Grand in 2003, aims at managing patients suffering from psycho-traumatic syndromes: Post-Traumatic Stress Disorder, emotional dysregulation, anxiety and/or depressive syndromes.

This original approach combines features of hypnotherapy and EMDR (Eye Movement Desensitization and Reprocessing) and is based on the concept of eye positions capable of soliciting the psychological assimilation processes of traumatic memories. We briefly present this therapeutic tool (framework, protocol, expected effects) and propose certain hypotheses which may explain its efficacy. For this, we draw on research into the practice of Mindfulness and the theory of mnesic malleability. Finally, the follow-up of a victim of the 2015 attack on the Bataclan in Paris supports the discussions developed here.

Anja Hildebrand1, David Grand2, Mark Stemmler1

1. Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany
2. Trainer and developer of Brainspotting, psychotherapeutic practice in New York City, USA.

Abstract

Objective: This study aims at determining the efficacy of the new therapy approach Brainspotting (Brainspotting) in comparison to the established Eye Movement Desensitization and Reprocessing (EMDR) approach for the treatment of Posttraumatic Stress Disorder (PTSD). Method: The sample consisted of 76 adults seeking professional help after they have been affected by a traumatic event. Clients were either treated with three 60-minute sessions of EMDR (n=23) or Brainspotting (n=53) according to a standard protocol. Primary outcomes assessed were self-reports of the severity of PTSD symptoms. Secondary outcomes included selfreported symptoms of depression and anxiety. Assessments were conducted at pretreatment, posttreatment and 6 month after the treatment.

Results: Participants in both conditions showed significant reductions in PTSD symptoms. Effect sizes (Cohen’s d) from baseline to posttreatment concerning PTSD related symptoms were between 1.19 – 1.76 for clients treated with EMDR and 0.74 – 1.04 for clients treated with Brainspotting. Conclusion: Our results indicate that Brainspotting seems to be an effective alternative therapeutic approach for clients who experienced a traumatic event and/or with PTSD.

This report has been prepared and released by the Distribution Committee of the Sandy Hook School Support Fund based on solicitation of public input into the current individual and community needs as it relates to the tragedy on 12/14/12.

The Distribution Committee is comprised of nine Sandy Hook/Newtown residents who represent perspectives from many different impacted groups including victims, surviving children, surviving teachers, emergency responders, Sandy Hook parents, community members, and the faith community. It is the responsibility of the Distribution Committee to solicit public input in order to better understand the needs and gaps that exist in the community as well as the strengths so that they can be built upon for long-term sustainable recovery.

For background on the history and formation of the Newtown-Sandy Hook Community Foundation, Inc. and the Sandy Hook School Support Fund or information about funds spent to date please visit www.nshcf.org.

Research Director: Dr. Javier Anderegg1

Abstract

Both in applied research and in clinical practice it is common to have to evaluate the change experienced by patients as a result of their treatment.

This is a clinical experimental comparison study in which three therapeutic intervention techniques are discussed for the treatment of generalized anxiety disorder (GAD), with respect to a control group (CG). The first technique is based on cognitive behavioral therapy programs (CBT), the second one in the techniques of eye movement desensitization and reprocessing (EMDR), and the third one consisting in location techniques involving relevant eye position and the neural network activated to access to the particular spot where the problem is fixed in the brain (Brainspotting). These therapeutic procedures were administered to a total of 59 patients with generalized anxiety disorder, assigned by a random procedure to the three treatment groups. 19 plus GAD patients remained in the waiting control group. The assessment of efficacy was performed using the follow up psychometric tests: State-Trait Anxiety Inventory. (STAI) of C.D. Spielberger, the Beck Anxiety Inventory (BAI) and the Subjective Units of Disturbance (SUDS). The results show that the three programs achieved a clinically significant change in this disorder in most people, resulting in a more effective new treatment approach of Brainspotting and the techniques of eye movement desensitization and reprocessing .

Patrícia FM*, José FP, de F and Marcelo M
Universidade Federal de São Paulo Rua Borges Lagoa, 570 – Vila Clementino, São Paulo – SP, Brazil
*Corresponding author: Patrícia Ferreira Mattos Rua Dr. Nicolau de Souza Queiroz, 406 apto 16 Vila Mariana, São Paulo – SP, 04005 001, Brazil, Tel: +55 11 98381
5281; E-mail: mattos.patricia@gmail.com
Rec date: Apr 21, 2015, Acc date: Jun 08, 2015, Pub date: Jun 15, 2015

F.M. Corrigan a,b,*, D. Grand c, R. Raju a
a Argyll & Bute Hospital, Lochgilphead, Argyll PA31 8LD, UK
b Manor Hall Centre for Trauma, Doune, Stirling, UK
c 350 West 42nd Street, 17B, New York, NY 10036, United States

Abstract

We set out hypotheses which are based in the technique of Brainspotting (Grand, 2013) [1] but have wider applicability within the range of psychotherapies for post-traumatic and other disorders. We have previously (Corrigan and Grand, 2013) [2] suggested mechanisms by which a Brainspot may be established during traumatic experience and later identified in therapy. Here we seek to formulate mechanisms for the healing processing which occurs during mindful attention to the Brainspot; and we generate hypotheses about what is happening during the time taken for the organic healing process to flow to completion during the therapy session and beyond it.

Full orientation to the aversive memory of a traumatic experience fails to occur when a high level of physiological arousal that is threatening to become overwhelming promotes a neurochemical de-escalation of the activation: there is then no resolution. In Brainspotting, and other trauma psychotherapies, healing can occur when full orientation to the memory is made possible by the superior colliculi-pulvinar, superior colliculi-mediodorsal nucleus, and superior colliculi-intralaminar nuclei pathways being bound together electrophysiologically for coherent thalamocortical processing. The brain’s response to the memory is ‘‘reset’’ so that the emotional response experienced in the body, and conveyed through the paleospinothalamic tract to the midbrain and thalamus and on to the basal ganglia and cortex, is no longer disturbing. Completion of the orientation ‘‘reset’’ ensures that the memory is econsolidated without distress and recollection of the event subsequently is no longer dysphorically activating at a physiological level.

Anja Hildebrand1, David Grand2, Mark Stemmler1

1. Institute of Psychology, Friedrich-Alexander-University Erlangen-Nuernberg, 91052
   Erlangen,
2. Psychotherapist and Developer of Brainspotting, psychotherapeutic practice in New
   York, United States

Version: 14.1129.05.2012 Words: 3,193 Characters including spaces: 24,488
(accepted for publication in 2014)

Abstract

Posttraumatic stress disorders (PTSD) frequently emerge in people who have suffered from extreme psychological stress. Therefore, it is of most importance to develop new therapeutic treatments and to test their efficacy. This pilot study investigates the efficacy of a newly by David Grand developed treatment for PTSD called Brainspotting. The data of 22 clients from Germany and the U.S., who were treated with Brainspotting were analyzed. Clients’ self-reports as well as evaluations by therapists were assessed. Within three Brainspotting sessions the PTSD symptoms and related psychological disturbances were significantly reduced. According to the therapists’ evaluations, the majority of clients benefited significantly. According to the clients’ reports, in addition, negative cognitions related to the trauma were heavily reduced. The results of this pilot study suggest that with Brainspotting the treatment of PTSD could be extended with another potent intervention method.

Frank Corrigan a,b,*, David Grand c
a Argyll & Bute Hospital, Lochgilphead, Argyll PA31 8LD, UK
b Manor Hall Centre for Trauma, Doune, Stirling, UK
c 350 West 42nd Street, 17B New York, NY 10036, USA

Abstract

Brainspotting is a psychotherapy based in the observation that the body activation experienced when describing a traumatic event has a resonating spot in the visual field. Holding the attention on that Brainspot allows processing of the traumatic event to flow until the body activation has cleared. This is facilitated by a therapist focused on the client and monitoring with attunement. We set out testable hypotheses for this clinical innovation in the treatment of the residues of traumatic experiences. The primary hypothesis is that focusing on the Brainspot engages a retinocollicular pathway to the medial pulvinar, the anterior and posterior cingulate cortices, and the intraparietal sulcus, which has connectivity with the insula. While the linkage of memory, emotion, and body sensation may require the parietal and frontal interconnections – and resolution in the prefrontal cortex – we suggest that the capacity for healing of the altered feeling about the self is occurring in the midbrain at the level of the superior colliculi and the periaqueductal gray.