Brainspotting is a trauma-focused psychotherapeutic modality developed by the American psychologist David Grand in 2003. It works with the visual field, body-based attention, and the therapeutic relationship. The proposed mechanisms remain at the level of hypothesis, and the empirical evidence base is small and emerging.
The conceptual framework
The framework that anchors brainspotting is what its developers call "dual attunement." The idea is that effective trauma processing involves two simultaneous channels of attention on the part of the clinician. The first is relational attunement, which is the moment-to-moment tracking of the person's emotional state and the maintenance of a felt sense of safety in the room. The second is neurobiological attunement, which is the clinician's tracking of the body's signals, including breath, gaze, micro-movements, and indicators of activation or shutdown (Corrigan & Grand, 2013).
The proposed mechanism
The proposal, presented in two hypothesis papers by Corrigan and Grand in 2013 and 2015, is that specific eye positions, called "brainspots," correspond to subcortical activation patterns associated with traumatic memory and the body's response to it. By holding attention on a brainspot while the dual attunement is maintained, the modality proposes that material difficult to reach through verbal channels can be processed.
Two things are worth noting about the mechanism papers. They are hypothesis papers, which means they present a theoretical model with reasoning from neuroanatomy and clinical observation. They are not data papers. The proposal that specific visual field positions correspond to specific subcortical activation patterns has not been demonstrated empirically.
What a session involves
A brainspotting session typically begins with the client identifying an issue, memory, or sensation to work with. The clinician helps the client locate a relevant brainspot in the visual field, often using a pointer or by tracking the client's reflexive eye movements. The client then holds attention on that point while the clinician maintains the dual attunement. The processing that follows is largely internal. The client may notice shifts in body sensation, emotional state, imagery, or thought. The session is paced according to what the client's nervous system shows.
The structure is quite different from purely verbal therapy. There is less talking, more attention to internal experience, and more reliance on the body's own pacing. The modality differs from Eye Movement Desensitization and Reprocessing, which uses bilateral stimulation (typically rhythmic eye movements, taps, or sounds), in that brainspotting uses sustained attention on a single visual field point.
The state of the evidence
The brainspotting evidence base is small. As of 2026, there is no published systematic review or combined study of research findings specific to brainspotting. The empirical literature consists of a non-randomised comparative study with seventy-six participants (Hildebrand et al., 2017), a within-subjects pilot study with forty non-clinical participants (D'Antoni et al., 2022), and a small number of additional pilot studies and case series. Several published studies include the modality's developer as a co-author, which is a known source of allegiance bias in psychotherapy research.
By contrast, the third edition of the Australian Guidelines for the Prevention and Treatment of Posttraumatic Stress Disorder (Phelps et al., 2021) names trauma-focused cognitive behavioural therapy and Eye Movement Desensitization and Reprocessing as first-line approaches, both with substantial randomised controlled trial evidence and meta-analytic support.
Brainspotting is a comparatively new modality with a coherent theoretical framework, an actively practised clinical community, and a small, emerging evidence base. A reader weighing up trauma-focused therapy can hold all of those pieces at once. With those pieces in view, a conversation with a clinician about what makes sense for a particular person is the next step.
For how we work with trauma, what sessions cost, and how to begin, see Working with trauma in adults.
