What to Expect in a Brainspotting Session | ScienceWorks

Last reviewed: 07/01/2026

Reviewed by: Dr. Kiesa Kelly

If you are wondering what to expect in a Brainspotting session, you are probably weighing something more specific too: is this going to be strange, overwhelming, or hard to do over a screen? Those are fair questions. Brainspotting can look unusual from the outside, and not knowing what happens is one of the biggest reasons people put off starting trauma work at all.

This article walks through a session step by step, honestly and without hype. You will see what happens before, during, and after, how it feels, how it works over telehealth, and where the safety limits are. Brainspotting is an emerging approach, so we will also be clear about what it can and cannot promise.

In this article, you'll learn:

• What happens before your first session

• Each step of a Brainspotting session, from finding the brainspot to grounding

• How you might feel during and after, and what is normal

• How Brainspotting works over telehealth

• The safety limits and what the evidence realistically shows

Before your first session

A first session usually starts with a conversation, not processing. Your therapist asks about your history, what you want to work on, and how you cope now. This is also where you decide together whether Brainspotting is a good fit or whether another trauma-focused therapy would be a more responsible starting point. If your distress is very high or you are in crisis, the first priority is stability, not opening deep material.

It helps to come with a rough sense of what you would like to feel differently, a private and comfortable space, and no pressure to perform. There is no wrong way to show up, and you can ask as many questions as you need about how the work fits into your overall trauma care before you begin.

A Brainspotting session, step by step

Naming what you want to work on

Your therapist helps you identify a focus and notice where you feel it in your body. Rather than asking for the whole story, they might ask, "what is the worst part of this for you right now?" and then, "where do you notice that in your body?" The felt sense, not the narrative, is the starting point.

Finding the brainspot

Next, your therapist helps you locate the eye position that connects most strongly to that sensation. They may slowly move a pointer across your field of vision and watch for reflexive cues, such as a blink, a swallow, a shift in breathing, or a change in your expression. You may also notice for yourself where the feeling intensifies as you look. That position becomes the brainspot.

Holding the gaze and letting material surface

You hold your gaze on that spot and let whatever comes, come. This is the quiet center of the work. You might notice memories, images, waves of emotion, or shifts in body sensation. There is nothing you need to make happen. Your therapist stays present and attuned, often saying very little, so your own processing can lead.

Body and emotion during processing

As you stay with the brainspot, your body may respond, with tears, warmth, tension releasing, a sigh, or a settling. Emotions can rise and then ease. Your therapist tracks these changes with you and helps you stay inside a tolerable range rather than tipping into overwhelm.

Grounding and closing

Sessions end with grounding so you leave settled rather than stirred up. Your therapist may guide you back to the present with breath, orienting to the room, or a brief check-in about how you feel and what support you have for the rest of the day. Closing well is part of the method, not an afterthought.

How you might feel during and after

During a session, feelings can be vivid but usually come in waves that rise and settle. Afterward, some people feel lighter or calmer; others feel tired, tender, or a bit activated as processing continues over the next day or two. All of this is within the normal range. It helps to plan something gentle after a session rather than a packed schedule. If you understand how trauma affects the brain and body, these after-effects make more sense: your nervous system is doing real work.

Here is what that can look like in practice. Consider someone in an early Brainspotting session for a car accident that still tightens their chest whenever they merge onto a highway. They find the brainspot near the left edge of their vision, and for a minute or two, not much happens. Then their breathing shifts, their eyes water, and the moment of impact rises into awareness, holds, and slowly loosens. Their therapist says almost nothing, just stays present. By the end, the chest tightness that had been a low constant hum has eased into something quieter. Nothing dramatic happened on the outside, but something moved on the inside, and that is often how the work goes: subtle, internal, and paced by your own nervous system rather than forced.

How Brainspotting works over telehealth

Brainspotting translates to secure video more smoothly than people expect. Your therapist can guide eye position on screen, watch your responses, and stay attuned the same way they would in person. What changes is small: you set up your own comfortable, private space and a device positioned so you can see and be seen. What does not change is the core of the work, the attunement, the pacing, and the grounding. Many people are surprised that being in their own home can actually help, since a familiar, safe space can make it easier to let their guard down enough to process.

We provide Brainspotting on a telehealth basis across Tennessee, which removes travel and makes it easier to find a clinician trained in the approach. Online delivery of Brainspotting is newer than in-person work, so your clinician will confirm it is a good fit for you before going further.

How many sessions, and how progress is tracked

There is no fixed number of sessions, and we will not pretend otherwise. Small studies have used as few as three to five sessions, but real courses vary widely. Rather than promising a timeline, we set goals with you and check in on how symptoms and daily functioning are changing. A validated measure like the PCL-5 can help track post-traumatic symptoms over time so progress is based on more than a general impression.

Is it safe? Who should go slowly

Brainspotting is generally well tolerated, but because it can open deep material, it is not the right first move for everyone. If you dissociate heavily, are in acute crisis, or lack current stability and support, a stabilization-first approach is safer before any processing work. A skilled clinician screens for this and will not rush you into processing. This is exactly why Brainspotting belongs in the hands of a trained trauma therapist rather than a self-help exercise. If you are unsure where you stand, our overview of trauma treatment options can help you think it through.

Does it work? What to realistically expect

Here is the honest picture. A few small studies suggest Brainspotting may reduce trauma, anxiety, and depression symptoms, and that its short-term effects can look similar to EMDR [1][2]. A small randomized study found benefits that held at follow-up [3]. But the evidence base is limited, the studies are small, and Brainspotting is not yet on the major guidelines' lists of recommended PTSD treatments the way EMDR and cognitive processing therapy are [4][5]. So the realistic expectation is cautious optimism: it may help, it is worth trying for the right person within a thoughtful plan, and it is not a guaranteed or quick fix.

Carrying something that still feels close?

Trauma-focused care - including approaches like EMDR - can help you process what happened at a pace that feels safe, with a clinician who understands trauma responses. If you would like to talk through whether Brainspotting is a good fit before you begin, we are glad to help.

Schedule a trauma consultation →

Frequently Asked Questions

Does Brainspotting hurt or feel intense?

Brainspotting is not physically painful, but it can bring up strong emotions or body sensations as material surfaces. That intensity usually comes in waves and settles, and your therapist paces the work and grounds you so it stays manageable. You remain in control throughout and can slow down or pause at any point. Feeling something is common; feeling overwhelmed for long is a signal to adjust.

What if nothing comes up during my session?

That is normal and not a sign of failure. Some sessions are quiet, and processing can continue in the days afterward. Your therapist may adjust the eye position, return to the body sensation, or simply give it more time. Brainspotting follows your nervous system's pace, so a slow start does not mean the approach is not working for you.

How is a Brainspotting session different from EMDR?

In EMDR, your eyes usually move back and forth in a structured, phased protocol. In Brainspotting, your eyes hold one fixed position while you notice what surfaces, and the process follows your body more flexibly. Sessions tend to feel quieter and less scripted than EMDR. EMDR also has a stronger research base, which is worth weighing when you choose.

Can I do Brainspotting online?

Yes. Brainspotting can be delivered over secure video, with your therapist guiding eye position on screen and staying attuned to your responses. We offer it on a telehealth basis across Tennessee. Online delivery is newer than in-person Brainspotting, so your clinician confirms it is a good fit and keeps grounding and safety central in every session.

How soon might I notice a difference?

It varies, and the research is too limited to promise a timeline. Some people notice shifts within a few sessions, while others need longer, and progress is not always linear. Rather than promising fast results, we track how you are doing over time and adjust the plan. Brainspotting is an emerging approach, so we stay honest about what to expect.

About the Author

Dr. Kiesa Kelly is a licensed clinical psychologist and the founder of ScienceWorks Behavioral Healthcare, with more than 20 years of experience in psychological assessment and evidence-based treatment. Her clinical background includes advanced training in trauma care, and she leads the practice's telehealth-forward model serving clients across Tennessee.

Dr. Kelly reviews the practice's clinical content for accuracy, including its descriptions of what trauma sessions involve, so readers get a clear and realistic picture of the process before they begin.

References

1. Hildebrand A, Grand D, Stemmler M. Brainspotting - the efficacy of a new therapy approach for the treatment of Posttraumatic Stress Disorder in comparison to Eye Movement Desensitization and Reprocessing. Mediterr J Clin Psychol. 2017;5(1). https://www.semanticscholar.org/paper/Brainspotting-%E2%80%93-the-efficacy-of-a-new-therapy-for-Hildebrand-Grand/34593072b2769274a0e1117403004f72c5cc6887

2. D'Antoni F, Matiz A, Fabbro F, Crescentini C. Psychotherapeutic Techniques for Distressing Memories: A Comparative Study between EMDR, Brainspotting, and Body Scan Meditation. Int J Environ Res Public Health. 2022;19(3):1142. https://pmc.ncbi.nlm.nih.gov/articles/PMC8835026/

3. Horton LM, Schwartzberg A, Goldberg P, Grieve K, Brdecka L. Brainspotting: Introducing Brainspotting as a treatment for PTSD. Int Body Psychother J. 2023-2024;22(2):57-72. https://ibpj.org/issues/articles/Horton,%20Schwartzberg,%20Goldberg,%20Grieve,%20Brdecka%20-%20Brainspotting.pdf

4. U.S. Department of Veterans Affairs, U.S. Department of Defense. VA/DoD Clinical Practice Guideline for the Management of Posttraumatic Stress Disorder and Acute Stress Disorder. 2023. https://www.ptsd.va.gov/professional/treat/txessentials/cpg_ptsd_management.asp

5. American Psychological Association. Clinical Practice Guideline for the Treatment of Posttraumatic Stress Disorder (PTSD) in Adults. 2017. https://www.apa.org/ptsd-guideline

6. Grand D. Brainspotting: The Revolutionary New Therapy for Rapid and Effective Change. Sounds True; 2013. https://www.amazon.com/Brainspotting-Revolutionary-Therapy-Effective-Change/dp/1604078901

7. Corrigan FM, Grand D. Brainspotting: Recruiting the midbrain for accessing and healing sensorimotor memories of traumatic activation. Med Hypotheses. 2013;80(6):759-766. https://pubmed.ncbi.nlm.nih.gov/23570648/

8. National Center for PTSD. How Common Is PTSD in Adults? U.S. Department of Veterans Affairs. https://www.ptsd.va.gov/understand/common/common_adults.asp

9. National Institute of Mental Health. Post-Traumatic Stress Disorder. https://www.nimh.nih.gov/health/publications/post-traumatic-stress-disorder-ptsd

Disclaimer

This article is for informational and educational purposes only and is not a substitute for professional diagnosis, treatment, or advice. Brainspotting is an emerging approach whose evidence base is still developing. Reading this content does not create a clinician-patient relationship. If you are in crisis or may harm yourself, call or text 988 (the Suicide and Crisis Lifeline) or seek emergency care. For guidance about your own situation, please consult a qualified clinician.