In 2017, I wrote an article for Adoption TODAY titled Brainspotting: The Preferred Power Therapy for Adoption, in which I tried to explain why I see foundational aspects of Brainspotting as particularly beneficial for working with the adoption constellation. After more than five years and countless hours studying Brainspotting, it is well past time for an update. I still see it as an excellent read for someone interested in considering Brainspotting for therapy with the adoption constellation*; however, I hope that I can express it more succinctly now. The things about Brainspotting that I believe make it ideal for working with the adoption constellation are elements foundational to good adoption therapy. These include being individual, relational, experiential, and neurological.
We have lots of phrases in Brainspotting that all focus on this principle: no assumptions, anti-oppression, liberation, empowerment, uncertainty, etc. It is important that Brainspotting is not a protocol because, as Gabor Maté writes in The Myth of Normal, “no one can plot somebody else’s course of healing because that’s not how healing works.” This makes it difficult to design research that would grant the title of “evidence based”, but instead we focus on the individual client, their process, and their potential for the highest possible healing – not on following steps.
Instead, we are taught to flex and encouraged to experiment and follow the client’s lead. Therapists are traditionally taught that they have a position of power, they are an expert, and even that they know more about the client than the client does. Given how much uncertainty, how many unknowns are encountered in every part of the adoption experience, and how many variables and different experiences there are, there is just no way a therapist could know more than a client about themselves or what will be most helpful to them. Yes, as a therapist, I may have ideas to share with my clients, but they are best positioned to know what will be helpful and what they are ready for.
As an anti-oppression model of therapy, we recognize the client as the biggest expert on their own experience, the person best positioned to understand their own brain and body, and the one who is actually navigating their own experience. For those who have experiences where they were told not to trust their own emotions (which is common in adoption both explicitly and implicitly), this therapeutic mindset is liberating and healing in itself.
It is only from an individualized perspective, that we can form a true relationship with the client that can support healing. Research confirms that the factor that is most predictive of effective therapy is the quality of the therapeutic relationship. We know that unconditional positive regard is an important factor in healing. It is only in a relationship that sees the client as an individual that we create the alliance that makes it safe enough for the client to process deep in the subcortical brain. It is only from relationship that we can see the client as an individual and be flexible in the process, providing them agency and choice.
“The exercise of agency is powerfully healing.” Gabor Maté (The Myth of Normal)
When working with adoption, we have to pay special attention to the client’s experience of attachment and relationships, including transference in the therapeutic relationship. Understanding through an attachment lens is essential for any modality when working with early parental separation.
Brainspotting is a relational therapy that emphasizes relational attunement. It is known as a brain-body-mindfulness-based relational therapy. As Lisa Floyd, adoptee therapist says, “in Brainspotting, it’s not the techniques, it’s the attunement”.
Experiencing something new is helpful in changing beliefs and behavior and in instilling hope. Experiencing emotion with the support of an attuned therapist can make it more tolerable. Experiential therapies can include both active experiences (adventure therapy, play therapy, psychodrama) and internal experiences and imagery. Brainspotting utilizes internal mindfulness in processing; however, with the influence of Somatic Experiencing on the development of Brainspotting, focusing on the body experience is a part of the mindfulness and movement is encouraged when it makes sense for the client as well.
“There is a very high standard of evidence for the effectiveness of experiential psychotherapies with depression, medical conditions and unresolved relationship concerns.” (Mullings, 2017) The most consistently positive outcomes for experiential therapies are associated with clients who present with relational distress (Elliott et al., 2013) which is a major component of adoption therapy.
In addition to relational attunement, Brainspotting also focuses on neurobiological attunement. With between one and four quadrillion synaptic connections in the brain, it is impossible to know exactly what is happening in any individual brain, but “you don’t have to know what it is to know that it is” according to Dr. David Grand. In working with adoption, we are often working with implicit and sometimes in utero experiences; we may not know what it is, but it is possible to process what the body remembers.
A brain-based approach is important when working with foster care and adoption. As Dr. Bruce D. Perry explains, “because the majority of brain growth and development takes place during these first years, early developmental trauma and neglect have a ‘disproportionate influence on brain organization and later brain functioning.’” We have to understand how trauma impacts neurological development and methodologies that can help re-organize the brain and encourage regulation.
Using the brain-body connection, Brainspotting aims to work with the parts of the brain involved in regulation, rather than the thinking brain which is not involved with regulation. It is a bottom up approach rather than top down talk therapy. This regulation allows individuals to go deeper into their processing and make more connections. Brainspotting utilizes the eyes to increase internal focus because the retina is a part of the central nervous system; our eyes develop as offshoots from the brain.
For Brainspotting trainings with Brooke Randolph, LMHC, LPC, LPCC-S, please check out the trainings pages.
*I would no longer use the term “resistance” when discussing a client’s response to therapy, although I would still be curious with clients about the parts of them uncomfortable with any particular thing.
Maté, G., & Maté, D. (2022). The myth of normal: trauma, illness & healing in a toxic culture . Avery, an imprint of Penguin Random House.
Mullings, B. (2017). A literature review of the evidence for the effectiveness of experiential psychotherapies. Melbourne: PACFA
Elliott, R. Greenberg, L. S., Watson, J., Timulak, L., & Freire, E. (2013). Research on humanistic-experiential psychotherapies. In M. J. Lambert (Ed.), Bergin & Garfield’s Handbook of psychotherapy and behavior change (6th ed., pp. 495-538). New York, NY: Wiley