Deep Brain Reorienting (DBR) is an emerging trauma-focused psychotherapy developed to help individuals process and heal from the deep physiological impacts of traumatic experiences. It differs from many traditional therapies by emphasizing early, deep-brain responses to threat rather than narrative detail or cognitive restructuring.
This approach is offered by Dr. Millia Begum, a UK-trained Consultant Psychiatrist (MRCPsych) with over 25 years’ experience in psychiatry and psychotherapy. Dr Millia is Level 2 trained in Deep Brain Reorienting (DBR).
DBR may be particularly helpful for individuals whose trauma responses feel automatic, bodily, and pre-verbal; for those with complex trauma and dissociative disorders; and for those resistant to talk-based approaches. Sessions are delivered in a slow, carefully paced, and contained way, with strong emphasis on safety, consent, and nervous-system regulation.
What Is DBR?
Deep Brain Reorienting (DBR) is designed to engage the rapid physiological reactions that occur in the brain’s deeper structures — before conscious emotional appraisal or narrative memory formation.
Unlike therapies that primarily focus on trauma narratives or cognitive reframing, DBR works with the body’s instinctive responses—particularly in the brainstem and midbrain—where survival instincts and shock responses originate.
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What Is DBR Designed For?
DBR has been most widely discussed as a treatment for Post-Traumatic Stress Disorder (PTSD), especially in cases where physiological responses to trauma remain persistent. Research suggests it may also have relevance for complex trauma and early attachment wounds, though clinical evidence outside of PTSD remains limited.
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How DBR Works: Conceptual and Neurobiological Framework
The theoretical foundation of DBR holds that trauma symptoms are linked to unresolved defensive responses within subcortical brain circuits. These responses are activated before the higher brain mechanisms of conscious thought and detailed memory come into play.
The therapy tracks a sequence of physiological events that begin with an orienting response to danger (e.g., tension in neck and shoulders), progress through an initial shock reaction, and are followed by affective responses such as fear, anger, or grief. DBR focuses on this ordering — often summarised as OT (Orienting Tension), Sh Pre- affective Shock), A (Affect), Pain —to help retrain the nervous system’s response patterns.
Research and Evidence
Controlled Clinical Trials
A randomized controlled trial published in 2023 found that eight sessions of DBR delivered via videoconference significantly reduced PTSD symptom severity compared with a waitlist control group. Participants showed meaningful improvements that endured at follow-up.
Though promising, the overall research base is relatively small; most publications are theoretical or consist of early clinical observations rather than large-scale trials.
DBR Compared with Other Trauma Therapies
DBR is often contrasted with established trauma therapies such as EMDR (Eye Movement Desensitization and Reprocessing) or trauma-focused cognitive behavioural approaches. While EMDR and CBT focus on cognitive and memory processing mechanisms, DBR emphasises the body’s early defensive responses and deep brain activity.
These differences reflect distinct therapeutic philosophies—not necessarily superior efficacy.
References:
Kearney eta al: “A randomized controlled trial of Deep Brain Reorienting: a neuroscientifically guided treatment for post-traumatic stress disorder”. European Journal of Psychotraumatology. 14 (2): 5244–5258.
Corrigan, Frank M.; Young, Hannah; Christie-Sands, Jessica (2024-11-28). Deep Brain Reorienting. Routledge.
