Are You Looking for DBR Therapy in Dubai?
Dr. Millia Begum is a Consultant Psychiatrist and advanced trauma therapist with over 25 years of experience. She is trained in Deep Brain Reorienting (DBR Level 2) and integrates DBR with EMDR and Internal Family Systems (IFS) therapy.
DBR is used in her practice as a core trauma approach, particularly for individuals who experience overwhelm, dissociation, or difficulty with more direct trauma therapies.
How does DBR Therapy Work in the Brain?
Deep Brain Reorienting (DBR) is based on the understanding that the brain responds to threat through a sequence of rapid, automatic orienting responses and shock tension reactions that occur before conscious awareness.
In traumatic situations, this orienting response may be interrupted or impaired, particularly when the nervous system is overwhelmed. The body may remain locked into this shock energy, leading to amplified affective and defensive responses and unhelpful conclusions.
Deep Brain Reorienting therapy works with these early brain responses by gently bringing awareness to the orienting tension and subsequent shock responses that arise in the body. By tracking this sequence carefully and slowly, the nervous system can begin to complete responses that were previously interrupted.
Over time, this process allows the brain to reorganize itself (from its natural healing capabilities), reducing physiological distress and helping the person experience greater emotional regulation and stability.
DBR focuses on this ordering—often summarized as Orienting (O), OT (Orienting Tension), Sh (Pre-affective Shock), and A (Affect/Pain)—to help process the nervous system’s response patterns.
What Happens During a Deep Brain Reorienting (DBR) Session?
Key Steps in a DBR Therapy Session
Understanding the Trigger
The therapist begins by exploring a recent situation or memory that activates distress. The focus is usually on a current trigger or a past experience that still carries emotional charge.
Establishing Grounding and Safety
Before approaching the activating moment, the therapist helps the client develop grounding through practices such as Where-Self orientation or Proto-Self grounding, supporting stability and awareness in the body.
Tracking the Orienting Response
Attention is gently brought to the body’s orienting tension, the subtle response that occurs when the brain detects potential threat. This helps the nervous system stay regulated while the experience is processed.
Processing Shock Responses
Clients may notice early physiological responses such as shock tension or shock energy in the body. DBR prioritises these deep brain responses before moving toward emotions, defences, or dissociation.
Integration and Completion
As the sequence unfolds, the nervous system gradually resolves the trauma response. Sessions are slow and carefully paced, allowing the brain’s natural processing mechanisms to complete safely.
Who can benefit from DBR Therapy?
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.
Research and Evidence of DBR Therapy
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.
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.
How Deep Brain Reorienting Differs from Other Trauma Therapies
Deep Brain Reorienting (DBR) differs from many other trauma therapies in the stage of the trauma response that it targets. While some approaches focus on the emotional meaning of events or the narrative of the traumatic experience, DBR works with the earliest orienting responses in the brain that occur when threat is first detected.
In DBR therapy, attention is carefully directed toward the sequence of physiological responses that unfold in the deep brain during a traumatic moment. By working with these early responses, the therapy aims to allow the nervous system to complete responses that may have remained unresolved at the time of the original experience.
Other trauma therapies may focus more on different aspects of healing. For example:
EMDR therapy often works with traumatic memories through bilateral stimulation while maintaining dual attention between the past and present.
Internal Family Systems (IFS) therapy focuses on understanding and healing the different “parts” of the inner system that developed to protect the individual.
Somatic approaches often emphasise body awareness and regulation of nervous system states.
DBR therapy complements these approaches by working specifically with the deep brain orienting response that occurs before many emotional or cognitive reactions emerge.
DBR is often contrasted with established trauma therapies such as EMDR (Eye Movement Desensitization and Reprocessing) or trauma-focused cognitive behavioral approaches. While EMDR and CBT focus on cognitive and memory processing mechanisms, DBR emphasizes the body’s early defensive responses and deep brain activity.
These differences reflect distinct therapeutic philosophies—not necessarily superior efficacy.
