Dr. Karma Guindon & Associates

Deep Brain Reorienting (DBR®) is a sophisticated approach to trauma therapy, particularly focusing on the brain structures involved in orienting - a fundamental process of how the brain directs attention to significant stimuli and prepares the body for action - and shock - ??. Central to DBR® is the understanding that trauma can deeply affect these brain structures, particularly the superior colliculus and other key parts of the brainstem such as the locus coeruleus and the periaqueductal gray (PAG). These structures play vital roles in emotional responses, defensive reactions, and orienting behavior.

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The Core Brain Structures in DBR:

1. Superior Colliculus (Midbrain):
   The superior colliculus is responsible for orienting the body in response to external stimuli. When something captures our attention, the deep layers of the superior colliculus activate muscles, particularly those of the neck, to prepare for head movement. This activation also affects the eyes and forehead, creating subtle sensations that can be felt in these areas. During overwhelmingly distressing experiences,?? the tension associated with orienting to a threat becomes heightened and may persist, especially if the threat was overwhelming. This Orienting Tension acts as a physiological anchor in DBR, helping individuals stay grounded in the present moment, without becoming lost in the overwhelming emotions or dissociation often triggered by trauma memories.

2. Locus Coeruleus:
   The locus coeruleus, located in the brainstem, plays a key role in arousal and stress responses. It is especially activated in response to shock or overwhelming stimuli, triggering a rapid fight-or-flight response. In DBR, this is identified as preaffective shock, a response that precedes emotional and defensive reactions. The preaffective shock, if processed effectively, can clear the shock response and create space for subsequent emotional processing, without leading to overwhelming affective states.

3. Periaqueductal Gray (PAG):
   The PAG is integral to the body’s defensive responses—whether fight, flight, or freeze—as well as the affective emotional responses like fear, rage, grief, and shame. In DBR, the PAG’s activation is seen as a later phase in the trauma response, occurring after the initial orienting and shock responses. By allowing this process to unfold logically, DBR helps guide trauma memories through their natural course of activation, allowing them to be processed without becoming stuck in a defensive cycle.

The DBR Process and Benefits:

The DBR® process is designed to help individuals ground themselves in the present moment while processing the physiological markers of trauma. This grounding helps the person to stay connected to their body’s responses, especially the subtle Orienting Tension that often accompanies traumatic memories. Key steps in DBR processing include:

1. Grounding in the Present:
   Before delving into trauma processing, individuals are asked to focus on where they are in the present moment. This grounding establishes a safe and stable context, preventing the person from becoming overwhelmed by the intensity of the emotions that may arise.

2. Accessing the Initial Awareness of Trauma:
   The individual is encouraged to connect with their initial awareness of the traumatic event. Instead of focusing immediately on emotional responses or defensive reactions (which might lead to dissociation or overwhelm), DBR encourages focus on the Orienting Tension that arises when the person first becomes aware of the trauma. This tension is often subtle, located in the neck, eyes, or forehead, and it serves as a bridge to the body's initial response to the event.

3. Isolating the Body’s Initial Response:
   The Orienting Tension is separated from the emotional and defensive responses that may have developed afterward (such as fear, rage, or dissociation). This allows for a more focused processing of the trauma, moving from the body’s initial reaction through the brainstem structures involved in trauma, such as the superior colliculus and PAG, in a natural and fluid way.

4. Preaffective Shock and Subsequent Emotional Processing:
   If preaffective shock (locus coeruleus activation) is present, it is addressed early in the process, often helping clear some of the initial shock responses. This facilitates smoother emotional processing in later stages, reducing the emotional intensity and making it easier to process complex trauma memories.

5. Emotional Processing and Resolution:
   After shock responses are cleared, the emotional affective responses (such as fear, grief, rage) are processed through the periaqueductal gray (PAG), which regulates these responses. This step involves emotional regulation and release, enabling the person to complete the trauma processing cycle without getting stuck in defensive or dissociative patterns.

Advantages of DBR in Trauma Healing:

1. Prevents Overwhelm and Dissociation:
   By focusing on Orienting Tension and grounding the person in the present, DBR helps prevent the individual from being overwhelmed by intense emotions or from dissociating during the trauma-processing process. This makes it particularly effective for people with dissociative disorders or those with early attachment traumas.

2. Facilitates Efficient Trauma Processing:
   DBR does not necessarily require working through each traumatic event individually. By focusing on the Orienting Tension, which may underlie many different traumatic experiences, it allows for a more economical processing of multiple traumas that share a common sequence or pattern.

3. Promotes Shifts in Self-Perception and Relational Patterns:
   Many individuals report profound changes in how they perceive themselves, others, and the world after DBR processing. Common outcomes include increased self-compassion, reduced trauma-related cognitive distortions, and improvements in emotional regulation.

4. Support for Early Attachment and Dissociative Disorders:
   DBR has been found especially beneficial for those who have experienced early attachment trauma or dissociative disorders. By working through the brainstem's role in attachment and defensive responses, DBR helps individuals heal from early relational wounds, promoting healthier attachment patterns and improved self-regulation.

Conclusion:

Deep Brain Reorienting (DBR®) offers a nuanced, evidence-based framework for trauma healing, particularly in addressing the physiological and neurological underpinnings of trauma. By focusing on the superior colliculus, locus coeruleus, and periaqueductal gray, DBR works with the brainstem's fundamental processes of orienting, shock, and defense, helping individuals process trauma in a grounded and integrated manner. The approach has shown promise in reducing trauma-related symptoms while facilitating deeper healing, particularly for individuals with attachment injuries or dissociative disorders.