DBR Therapy | Deep Brain Reorienting with Dr Millia Begum
Written and medically reviewed by: Dr Millia Begum, Consultant Psychiatrist (MRCPsych, DHA Licensed)
Trauma triggers in the present day are echoes of the past. If you have experienced trauma, you may notice that your body reacts to certain reminders before you have fully realized what is happening. A facial expression, tone of voice, sound, movement or a memory can quickly trigger defensive and emotional responses.
Deep Brain Reorienting (DBR) works at the earliest of the threat response sequence. This is often not the defensive and emotional responses, but an orienting, tension, and shock responses. Dr Millia is trained in all levels of DBR therapy and applies it to complex trauma related presentations especially those not responded to traditional therapies.
Key Insights About DBR Therapy
- Focuses on brains early threat responses: DBR tracks subtle responses associated with trauma, including orienting, orienting tension, shock, and subsequent emotional and defensive responses.
- Slow and carefully paced: DBR does not require repeated, detailed retelling of traumatic experiences. Processing is deliberately slowed to help reduce emotional overwhelm.
- Used for trauma-related conditions: DBR may be considered for PTSD, complex trauma, attachment-related trauma, developmental trauma and dissociative symptoms.
- Neuroscience-informed: DBR draws on research into midbrain and brainstem systems involved in orienting, arousal and defensive responding.
- An emerging therapy: Early research into DBR is encouraging, but the evidence base remains considerably smaller than for established PTSD treatments such as EMDR and trauma-focused CBT.
What is Deep Brain Reorienting (DBR)?
DBR is a neuroscience-informed trauma therapy developed by psychiatrist Frank Corrigan. Deep Brain Reorienting (DBR) is a neuroscience-informed trauma therapy developed by psychiatrist Dr. Frank Corrigan. It focuses on the brain’s immediate, subconscious threat-response sequence that occurs before full emotional or defensive reactions take over.
DBR carefully slows down and tracks these early responses while maintaining the ‘Where-Self’—the brainstem’s fundamental awareness of where you are in space right now.
While research into DBR is still emerging, initial clinical studies show promising results for PTSD, as well as complex trauma (CPTSD), attachment-related trauma, and dissociative symptoms.
Book an Appointment
Book a consultation with Dr Millia Begum at First Psychiatry Clinic, Dubai.
Book at First Psychiatry ClinicHow Does DBR Therapy Work?
When a threatening or emotionally intense event occurs, your nervous system responds faster than your conscious thought. DBR breaks this process down into four distinct phases.
Within the DBR model, this response is understood as a sequence:
Orienting: Your nervous system instantly detects a stimulus (“Where is it?” comes before “What is it?”).
Orienting Tension: Subtle muscular tension develops as the body prepares to respond (commonly felt around the eyes, forehead, head, neck, or shoulders).
Shock: A brief physiological shock reaction that can occur if the stimulus is overwhelming.
Affect & Defence: Emotional reactions (such as fear or anger) and defensive survival urges (such as fight, flight, or freeze) surface.
What Happens in a DBR Session?
A DBR session is slow and carefully paced.
- Initially, case conceptualization helps inform where the work begins. Often, this may involve a series of present-day activations or recent triggering moments. Identifying the underlying themes that repeatedly generate these triggers can also be valuable.
- Together, we identify an activating stimulus to work with. For example, this might be a recent conflict, focusing particularly on the moment when the body first registered that something was off or that something was about to happen.
- From here, we establish the Where-Self—an embodied awareness of being located in the present moment and present-day environment.
- The next step involves finding the orienting tension that emerges as attention turns towards the felt sense of the activating stimulus.
- While maintaining this orienting tension, the therapist carefully guides the client in tracking what follows. This may include shock, if present, followed by affective and defensive responses. Dissociative responses may also emerge and can be carefully followed as part of the processing.
- As the process develops, it may sometimes lead towards a deeper core pain underlying the original response.
- As these responses are processed, the original experience may begin to feel different, and new perspectives, meanings or bodily shifts can sometimes emerge naturally.
DBR Therapy for Complex Trauma
Learn more about this here: DBR Client Information For Complex Trauma Disorders
What Conditions Can DBR Therapy Help With?
DBR may be considered for people experiencing PTSD, complex trauma, attachment-related trauma, dissociation and the effects of early developmental trauma.
It may also be relevant when earlier traumatic or relational experiences continue to contribute to present-day difficulties, such as emotional dysregulation, heightened sensitivity to rejection or abandonment, persistent threat responses, or intense emotional and bodily reactions within relationships.
DBR is an emerging trauma therapy, and the current research evidence is strongest for its use in relation to PTSD symptoms. Research specifically examining DBR for Complex PTSD, attachment-related trauma, developmental trauma and dissociation remains limited.
Whether DBR is appropriate depends on the individual’s symptoms, history, current circumstances, treatment goals and overall clinical needs.
Can DBR Therapy help with Dissociation?
DBR may be helpful when dissociation is part of a person’s trauma response.
During processing, dissociative responses themselves can become part of what is carefully tracked, rather than simply being regarded as something that must be eliminated before trauma processing can occur.
Responses such as sleepiness, fogginess, drifting away, feeling distant or becoming less present can be noticed and followed carefully within the therapeutic process.
This is supported by the attuned presence of the therapist and by maintaining the Orienting Tension (OT), which can provide an additional anchor to present-moment embodied awareness while dissociative responses are being processed.
The work is paced carefully, with attention to the person’s capacity to remain sufficiently present throughout the session.
Can DBR Therapy Help Attachment Trauma?
Trauma does not always result from a single overwhelming event. Early experiences of rejection, abandonment, misattunement, threat or disruption within important relationships can also have lasting effects.
Within the DBR model, specific relational experiences—such as a facial expression, tone of voice, withdrawal or feeling rejected—can act as activating stimuli for early orienting, shock, emotional and defensive responses. DBR can work with these responses without requiring detailed retelling of the person’s entire childhood or relationship history.
How Is DBR Different From EMDR?
Both EMDR (Eye Movement Desensitisation and Reprocessing) and Deep Brain Reorienting (DBR) are approaches used to work with traumatic experiences, but they differ in their therapeutic focus and method.
A simple way to understand the difference is that EMDR works directly with traumatic memories and their associated emotions, beliefs and bodily sensations, while DBR focuses on the early orienting, tension and potential shock responses that may occur before the full emotional and defensive response develops.
Neither therapy is necessarily “better” than the other for an individual person. EMDR currently has a substantially stronger evidence base for PTSD. DBR offers a different therapeutic approach that may be considered according to a person’s presentation, previous treatment experiences, preferences and clinical needs.
| Feature | EMDR | Deep Brain Reorienting (DBR) |
|---|---|---|
| How it works | Uses a structured trauma-processing protocol that includes bilateral stimulation, commonly eye movements, tapping or auditory stimulation. | Uses careful attention to orienting and orienting tension while tracking the responses that subsequently emerge. |
| Main focus | Traumatic memories together with associated emotions, beliefs and bodily sensations. | Early orienting, orienting tension, potential shock, and subsequent affective and defensive responses. |
| During processing | Attention may move between different aspects of a traumatic memory, including images, thoughts, emotions and bodily sensations. | Processing is deliberately slowed, with close attention paid to subtle bodily and perceptual changes as they unfold. |
| Detailed retelling required? | No. EMDR does not require prolonged detailed retelling of the traumatic event. | No. DBR can work with a specific activating element without prolonged detailed retelling. |
| Evidence base | Extensive. EMDR has been studied in numerous clinical trials and has an established evidence base for PTSD. | Emerging. Early research is encouraging, but DBR currently has a much smaller evidence base. |
Does DBR Therapy Require Retelling Trauma in Detail?
No. DBR does not require prolonged, detailed retelling of a traumatic experience. Instead, therapy can work with a specific activating element associated with the experience while carefully tracking subtle bodily responses, including orienting tension and subsequent emotional or defensive responses.
For some people, this slower and more focused approach may make traumatic material feel more manageable to explore, particularly when talking about what happened is difficult or overwhelming.
What Makes DBR Therapy Different From Traditional Talk Therapy?
DBR differs from many traditional talk therapies in where it places therapeutic attention. Rather than focusing primarily on discussing, interpreting or making sense of an experience, DBR pays close attention to moment-to-moment bodily and perceptual responses associated with traumatic activation.
These may include orienting tension, physiological activation, shock, emotional responses and defensive reactions. The therapist carefully tracks these responses as they unfold while helping the person remain oriented to the present.
DBR can therefore involve less detailed retelling of traumatic experiences, although conversation remains an important part of understanding what is being worked on and guiding the therapeutic process.
Is There Research Supporting DBR?
Yes. DBR is an emerging trauma therapy with promising early research. A randomised controlled trial found significant reductions in PTSD symptoms following eight sessions of DBR compared with a waitlist, with improvements maintained at three-month follow-up. However, this was a relatively small study, and further independent research with larger samples and comparisons with established trauma therapies is needed.
DBR does not yet have the extensive evidence base of established PTSD treatments such as EMDR and trauma-focused CBT, which are recommended in major international treatment guidelines.
DBR should therefore be understood as a promising but still developing trauma therapy rather than an established first-line treatment for PTSD.
Read the research article with the results of the first randomised controlled study of DBR led by Prof. Ruth Lanius: PTSD Study
Frequently Asked Questions About Deep Brain Reorienting (DBR)
Practical questions about DBR therapy, assessment, suitability, treatment and booking in Dubai.
How do I book DBR therapy in Dubai?
Appointments with Dr Millia Begum can be arranged through First Psychiatry Clinic in Dubai. You can contact the clinic to enquire about an initial consultation, current availability and whether DBR may be appropriate for the difficulties you are experiencing.
Do I need an assessment before starting DBR?
Yes. An initial clinical assessment helps clarify your current symptoms, trauma history, dissociation, previous treatment and treatment goals. It also allows consideration of whether DBR, EMDR, another therapeutic approach or an integrated treatment plan may be more suitable.
How do I know whether DBR is right for me?
DBR may be considered when traumatic experiences continue to produce strong emotional or bodily responses, when directly talking or thinking about trauma feels overwhelming, or when difficulties are associated with complex, developmental or attachment-related trauma.
DBR is not appropriate for everyone. Assessment helps determine whether DBR or another treatment is likely to be more suitable for your individual needs.
How many DBR sessions might I need?
There is no fixed number of DBR sessions. Treatment length depends on the nature and complexity of the difficulties, trauma history, dissociation, treatment goals and how the person responds over time. This can be reviewed as therapy progresses.
Is DBR therapy available in Dubai?
Yes. Dr Millia Begum provides Deep Brain Reorienting (DBR) therapy at First Psychiatry Clinic in Dubai. DBR may be offered as part of an individualised trauma treatment plan following clinical assessment.
Is DBR therapy effective for Complex PTSD?
DBR is clinically used with people experiencing complex and developmental trauma, and early research into DBR for PTSD is encouraging. However, research specifically establishing its effectiveness for Complex PTSD (CPTSD) remains limited.
DBR may be considered when difficulties are associated with early developmental or attachment-related experiences, but suitability depends on the individual’s symptoms, history and treatment needs.
What is the most effective trauma therapy?
There is no single trauma therapy that is best for everyone. Treatment depends on the type of trauma, symptoms, diagnosis, dissociation, previous treatment, individual preferences and clinical needs.
EMDR and trauma-focused CBT have substantial evidence for PTSD and are recommended in major international treatment guidelines. DBR is a newer trauma therapy with encouraging early research, but its evidence base remains considerably smaller.
Other approaches, including Internal Family Systems (IFS), may also be incorporated into an individualised treatment plan where clinically appropriate.
Who offers DBR therapy in Dubai?
Dr Millia Begum is a Consultant Psychiatrist and Level 3 trained DBR therapist providing Deep Brain Reorienting at First Psychiatry Clinic in Dubai.
She also has training and experience in other trauma-focused approaches, including EMDR and Internal Family Systems (IFS), allowing treatment options to be considered according to each person’s clinical needs.
Is DBR therapy safe?
DBR is designed to approach traumatic material slowly and carefully while maintaining orientation to the present. As with other trauma-focused therapies, however, working with difficult experiences can sometimes bring up distressing emotions or physical sensations.
DBR should therefore be provided by an appropriately trained clinician who can assess suitability, monitor the person’s response and adapt treatment where necessary.
About Dr. Millia
Dr. Millia Begum is a British-trained Consultant Psychiatrist and an expert trauma specialist with over 25 years of clinical experience in psychiatry and therapy.
She is an EMDRIA Certified Therapist™ and EMDRIA Approved Consultant™, a former EMDR researcher, and a former board member of the EMDR Association UK. She uses EMDR, Deep Brain Reorienting (DBR) Therapy and is a Certified Internal Family Systems (IFS) Therapist . She brings a compassionate, parts-informed approach to her work with clients in Dubai.
PROFESSIONAL ACCREDITATIONS
IFS Certified Therapist | EMDRIA Certified Therapist™ and EMDRIA Approved Consultant™|DBR Trained
Book a Mental Health Appointment
Arrange a confidential consultation with Dr Millia Begum at First Psychiatry Clinic in Dubai.
Villa 975, Municipality 363856
Al Manara, Umm Suqeim 2
Dubai, UAE
Office: +971 4 221 6000
Email: info@firstpsychiatryclinics.com