The "Crappy Childhood Fairy": A unique resource for trauma/PTSD self-care and recovery?

[Gwenllian]

I also heard that EMDR, which is one of the most effective therapies modalities for trauma, seems to be effective on about 50% of the cases. That was interesting because even with that rate it is still considered one of the most effective but I hadn't thought of it in relation to OPs, that's food for thought.

Recently I talked to a psychologist who told me that EMDR doesn't really work with people who have very few memories (or none) of traumatic events. So, that could also be a reason for the 50% success rate?

I thought of another model, Internal Family Systems which is also a very effective modality, especially when integrated with EMDR and CBT. In this modality they literally get people to "talk" with their parts in order to sort out the internal system. The idea is that one has to build what they call the self in order to build self-leadership, and that self-leadership helps in healing and organizing the inner system. The 'self' is a vague concept and it varies from person to person but some people think of it as the essence, soul or that in us which is connected to source. And what's important is to unblend that 'self' from the parts in order to begin the healing process. Even though the field is plagued by LGBT stuff nowadays, I found the concepts interesting because it reminded me of the little Is as servants in a house and the need for a butler to organize them. But, if you can't have an inner dialogue with those 'parts', this definitely wouldn't work, would it?

(Yas posted the above in the Session 6 July 2024 thread, but I didn't want to go off topic in that thread, hence my post in this thread.)

Thank you for bringing this up, Yas.

I was thinking the same thing when I learnt of Internal Family Systems. Interestingly, I was told that IFS can be a reflection of external family systems which play an important role in Family Constellations. So, for those who are also grappling with issues that do not really belong to them, IFS and Family Constellations combined could be helpful, although it excludes past lives? That's my thinking at the moment anyway.

According to Amazon's review of Richard Schwartz's book No Bad Parts: Healing Trauma and Restoring Wholeness with the Internal Family Systems Model it has also been effective in areas such as addiction therapy and depression treatment. I haven't read the book yet, but it is on my wish list. FWIW.

Added: I detected a few well-known people who left a review:

“Internal Family Systems (IFS) therapy, and the understanding that we all contain valuable parts that are forced into extreme roles to deal with pain and disappointment, has been one of the great advances in trauma therapy. Understanding the role they have played in our survival and being able to unburden the original traumas leads to self-compassion and inner harmony. The notion that all of our parts are welcome is truly revolutionary and opens up a path to self-acceptance and self-leadership. IFS is one of the cornerstones of effective and lasting trauma therapy.” ―Bessel van der Kolk, MD, author of The Body Keeps the Score

“In this trim and highly readable volume, Dr. Richard Schwartz articulates and deftly illustrates his Internal Family Systems model, one of the most innovative, intuitive, comprehensive, and transformational therapies to have emerged in the present century.” ―Gabor Maté, MD, author of In the Realm of Hungry Ghosts: Close Encounters with Addiction

 

[4d candidate]

To be honest, I never thought that this post would even come into being and that I would be able to write what I am about to say about myself. Despite being on the forum for some time and reading articles about psychopathy and recommended books such as Political Ponerology, Mask of Sanity and a few others, and a whole lot of posts describing the behavior of psychopathic world elites, it was a shock to me to discover only 2 weeks ago that I have been living with a narcissistic and disturbed person for 50 years. I started watching YouTube channels of various psychotherapists who describe the behavior of narcissistic people and it was as if a bolt of lightning suddenly struck me because what I heard 100% and exactly referred to my mother. For as long as I can remember, I have been haunted by a huge sense of guilt and fear, a complete lack of self-confidence and the conviction that I never deserve anything good in life, which accompanies me all the time and it is as if someone had placed a huge burden on my heart and was constantly pressing it. My trauma is very strong and does not completely go away after undergoing psychotherapy at the age of 25, and what is important is that throughout this time to this day I have lived with a parasite under the same roof, although I have my own family. The scale of manipulation, invented dramas, constant criticism of me no matter what I did, lies, slander is unimaginable for a person who has not experienced it. Throughout childhood and adolescence I fought a huge battle with myself, because I was not able to love my mother and father like my friends, who talked about how cool their parents were, and again I saw all the blame only in myself. I was never too good to deserve any love from my parents and their demands have always been too much for me, and when I achieved something my mother's expectations grew again and I was still unable to meet them. I did very well at school, I followed all her instructions to the letter, I even did more than she wanted, I rose to the heights of my abilities as an 8-year-old, then a 10-year-old and as an adult man, but I was unable to bear her adult life problems, which she burdened me with, sometimes at work, sometimes in the family, sometimes in her environment. This enormity of her problems, which she burdened me with for all these years, and which I was unable to solve for her as a child, caused me constant tension, enormous stress for very long years, which accompanied me permanently, and I did not understand what was happening to me psychologically.

It was only recently that I became convinced that a narcissist uses various tricks so that the victim would never leave him, and I remember for a long time the invisible force that kept me in the family home, despite the inner voice telling me: move out. I have always been convinced and manipulated not to build my own house, apartment, because it is unnecessary, redundant and bad, and I already have a finished house built by my parents and in my old age I will be able to give my mother a proverbial glass of water and take care of her. According to her words, building this house cost her so much strength, sacrifice, work, money, care that leaving it would be almost equivalent to a sin, and in her opinion no one suffered as much as she did and suffered so many sacrifices in the entire Galaxy,


I think.My story begins 50 years ago when I was born and when I was 6 months old my mother gave me up to be raised by my grandparents (father's parents), who lived a few kilometers away, and she and my father lived separately while building our house. They never had a car, so apparently they visited me at my grandparents', but I don't really remember it, although yes, I saw them a few times.It was only years later that I understood how much she hated children and people who were unable to follow her orders and categorically comply with what she wanted. Suddenly, at the age of 5, she tore me away from the idyll and the surroundings I lived in, because they built a house and we could move in. She literally took me like her property and something that you could take, give away and do whatever you wanted with. It was 1979.

The shock caused by the change of environment and the way I was treated by my own parents, whom I didn't really know, was indescribable. I literally felt like I was in a military barracks and only the orders given by the commanding officer, i.e. my mother, mattered.She was cold, haughty, absolutely intolerant of any criticism, and everything had to be done immediately and exactly the way she wanted it.The most interesting thing is how she subjugated my father, who was quite a tall and strong man and is still subordinate to her today, even though he is 77 years old. He does all her chores except cooking.I noticed that my father, partly out of fear of my mother, partly for peace of mind, partly to relieve his frustration, had been using physical punishment against me and my brother for a dozen or so years, beating us with a leather belt until my butt and legs were blue and blue and I didn't scream out loud because it hurt so much. The words of my mother were interesting, she was happy about this fact and she said to me when I was being beaten: oh you see how it is, how good it is, you see how you got hurt, and I told you not to laugh and don't be happy now, because in a moment you might cry and that's what actually happened. I wasn't allowed to laugh or be happy, so I wasn't happy, although sometimes I wanted to.I never knew in what mood my parents would come back from work and what might happen in a moment, so the beatings were at unexpected moments and there was no one I could complain to or ask for help, and I had nowhere to run.I remember my mother advising my father not to hit me on the back with a belt because it could damage my kidneys, only on the butt and legs, because someone might be interested. The biggest crime according to my mother was taking matters outside our home, because she was the one who created the image of our ideal family outside, according to her. The vulgar insults that I heard from my mother throughout my childhood about myself, that it was all my fault, that I was a bad child, that she had to suffer with me, that she had the right to me and could do anything with me, that she had such bad children many times are not suitable for mentioning here, but I had suicidal thoughts many times. From the age of five in my family home I felt like a wild animal that constantly had to hide, it was not certain when the punishment would come, whatever I did could result in emotional coldness, ignorance, disapproval or beatings. When I was maybe 10 years old, often sobbing and crying she would say to us (me and my brother): it's because of you sons of bitches that my heart hurts, it's because of you that I'm going to die soon and you're going to finish me off, and I took it deadly seriously and although I did everything and even more than I could, I was always that bad and ungrateful child. She never had heart treatment from any doctor, but she invented various imaginary diseases and liked to burden my conscience with them, and she does this to this day, although it doesn't affect me as much anymore.To make it interesting, my mother reached a high management position in the company while she was still working professionally and held it for many years, which shouldn't surprise anyone here.

She forced me to go to church, she forced my family, trying to influence my wife, although we don't feel such a need and if someone feels like praying, they can do it at home.I would only like to help myself and other people with my writing, who have similar or much worse experiences in life, and to give them encouragement and courage to always fight for themselves, for their independence, for their free will, which is constantly being disrupted and violated, and the dawn for the world will come soon.

 

[Gwenllian]

While

, I was interested in Henderson's description of the alleged "hidden" exercise of eyes described in the "Herald" and was looking for some supplementary material on this topic when I came upon a technique called "brainspotting" used for trauma therapy with good results. The therapy evolved from David Grand who was trained in psychotherapy and EMDR techniques. He admits that we do not know how it works but there is significant amount of empirical data to show that it does.

From what I understand brainspotting is a gentler form of EMDR suitable for people for whom EMDR is a bit too much. I heard from several sources that in some cases people were retraumatised, while doing EMDR.
I think this article gives a good idea of what it is and what it does. I'm reading David Grand's book about brainspotting and if I find anything useful I will post it in this thread.

Brainspotting is a relatively new psychotherapy approach that combines elements of psychodynamic, somatic, and mindfulness-based therapies to facilitate deep emotional healing and trauma resolution [1]. Developed by David Grand in 2003, brainspotting operates on the premise that “where you look affects how you feel” [2]. By guiding the client’s visual focus to specific external positions (brainspots), the therapist can help access and process unresolved traumatic memories that are stored in subcortical brain regions and expressed in the body [3].

While empirical research on the mechanisms and efficacy of brainspotting is still limited, a growing body of clinical evidence suggests it can be a powerful tool for treating a wide range of psychological conditions, including PTSD, anxiety, depression, addiction, and chronic pain [4, 5]. In this essay, we will take an in-depth look at the neurobiological underpinnings of brainspotting, exploring the brain regions and networks involved, the subjective phenomenology of the process, and potential neurophysiological markers that could help elucidate its mechanisms of action.

Brain Regions and Networks Involved in Brainspotting​

Brainspotting is thought to engage a distributed network of brain regions involved in visual attention, emotional processing, memory reconsolidation, and somatic awareness [6]. These include subcortical structures like the superior colliculus, amygdala, and hippocampus, as well as higher-order cortical areas like the anterior cingulate and prefrontal cortices.

The Superior Colliculus​

The superior colliculus is a small, bilateral structure in the midbrain that plays a crucial role in orienting visual attention and coordinating eye movements [7]. It receives direct input from the retina and sends projections to various regions involved in attention, arousal, and sensorimotor processing [8].

In brainspotting, the client’s visual focus on the external brainspot is thought to activate the superior colliculus, which then relays signals to the amygdala and other limbic structures involved in processing the traumatic memory [9]. This direct pathway from the visual system to emotional centers, bypassing higher cortical areas, may explain how brainspotting can access implicit, nonverbal memories that are not easily reached through talk therapy alone [10].

The Amygdala​

The amygdala is a key limbic structure involved in detecting, processing, and responding to emotionally-salient stimuli, particularly those related to fear and threat [11]. In PTSD and other trauma-related disorders, the amygdala can become hyperactive, leading to exaggerated emotional responses and dysregulation [12].
During brainspotting, the externally-focused visual attention may help downregulate amygdala activity, allowing traumatic memories to be reprocessed in a more regulated, manageable way [13]. As the client maintains the brainspot, the amygdala may gradually habituate to the associated emotional triggers, leading to a reduction in fear and distress [14].

The Hippocampus​

The hippocampus is a crucial structure for learning and memory, particularly the consolidation of short-term memories into stable, long-term representations [15]. In PTSD, hippocampal function is often impaired, leading to fragmented, overgeneralized traumatic memories that lack contextual details [16].
Brainspotting may facilitate the reconsolidation of traumatic memories by providing a safe, attentive context in which new, adaptive information can be integrated [17]. As the client focuses on the brainspot and processes the associated emotions and sensations, the hippocampus may help update the original memory trace with new experiential elements, gradually modifying its emotional valence and reducing its traumatic impact [18].

The Anterior Cingulate Cortex​

The anterior cingulate cortex (ACC) is a central hub for integrating cognitive, emotional, and interoceptive processes [19]. It is involved in monitoring for errors or conflicts, allocating attentional resources, and regulating emotional responses [20].
In brainspotting, the ACC may help maintain the mindful, focused attention on the brainspot and associated internal experiences [21]. As the client observes their thoughts, emotions, and sensations without judgment, the ACC may facilitate a state of open, flexible awareness that allows for deeper processing and insight [22]. The ACC’s connections with both limbic and prefrontal regions may also support the integration of bottom-up emotional processing with top-down cognitive reflection and meaning-making [23].

The Prefrontal Cortex​

The prefrontal cortex (PFC) is the brain’s executive center, responsible for higher-order cognitive functions like attention, working memory, decision-making, and emotion regulation [24]. In PTSD and other trauma-related disorders, PFC function is often compromised, leading to difficulties with impulse control, planning, and affect regulation [25].
Brainspotting may enhance PFC activation and its top-down regulation of limbic regions like the amygdala [26]. As the client maintains focused attention on the brainspot and processes the emerging experiences, the PFC may help reappraise traumatic memories, generate new insights and perspectives, and develop more adaptive coping strategies [27]. Increased PFC-amygdala connectivity may also reflect the client’s growing capacity for self-regulation and resilience [28].

The Phenomenology of Brainspotting​

From a first-person perspective, the brainspotting experience is often described as a state of deep, focused introspection [29]. As the eyes remain fixated on the external spot, the mind turns inward, allowing unconscious material to surface spontaneously [30].
Clients may report vivid sensory experiences, such as visual images, bodily sensations, or auditory fragments related to the traumatic memory [31]. These experiences can be intense and emotionally-charged, but the dual attentional focus on the brainspot and the inner process seems to provide a sense of grounding and safety [32].
Many clients describe entering a state of expanded awareness, in which they can observe their internal process with curiosity and equanimity [33]. This mindful, accepting stance may facilitate the desensitization and reprocessing of traumatic material, as the client learns to “be with” difficult experiences without becoming overwhelmed [34].
As the session progresses, clients often report a sense of release or discharge, as if the traumatic energy is being drained from the body [35]. This may be accompanied by spontaneous trembling, twitching, or other somatic releases, which are thought to reflect the completion of truncated defensive responses that were thwarted during the original trauma [36]. [Think Peter Levine.]
Insights, realizations, and new perspectives may emerge as the brainspotting process unfolds, often in a nonlinear, associative fashion [37]. Clients may suddenly make connections between past experiences and current struggles, or gain a new sense of meaning and coherence in their life narrative [38].
Ultimately, many clients report feeling a greater sense of wholeness, self-compassion, and empowerment after brainspotting [39]. The deep, transformative nature of the experience can lead to lasting shifts in emotional reactivity, behavioral patterns, and interpersonal relationships [40].

Neurophysiological Markers of Brainspotting​

While research on the neurophysiological correlates of brainspotting is still in its early stages, there are several potential markers that could help elucidate its mechanisms of action. These include event-related potentials (ERPs) measured through electroencephalography (EEG), as well as changes in functional connectivity and oscillatory dynamics captured through quantitative EEG (qEEG) methods.

Event-Related Potentials​

ERPs are time-locked electrical responses in the brain that are evoked by specific sensory, cognitive, or motor events [41]. Several ERP components may be relevant to the brainspotting process:

• The N200 is an early negative deflection that peaks around 200 ms after stimulus onset and is associated with automatic, pre-attentive detection of novel or salient stimuli [42]. In brainspotting, the N200 may reflect the initial orienting response to the brainspot and the detection of emotionally-relevant material that arises in the client’s awareness [43].
• The P300 is a positive wave that occurs around 300 ms post-stimulus and reflects higher-order attentional and memory processes [44]. P300 amplitude is thought to index the allocation of attentional resources and the updating of working memory representations [45]. In brainspotting, enhanced P300 responses may indicate the client’s sustained attention on the brainspot and the active processing of new emotional and cognitive material [46].
• The Late Positive Potential (LPP) is a slow, positive-going wave that emerges around 400-500 ms post-stimulus and can last for several seconds [47]. The LPP is thought to reflect the extended, elaborative processing of emotionally-salient stimuli and is often enhanced in response to both positive and negative material [48]. During brainspotting, increased LPP amplitudes may signify the deep, sustained engagement with emotionally-charged experiences and memories [49].

Quantitative EEG Markers​

qEEG methods involve the mathematical analysis of EEG data to extract patterns of functional connectivity, coherence, and oscillatory activity that may not be apparent in the raw signal [50]. Several qEEG markers could potentially shed light on the neurophysiological effects of brainspotting:

• Functional connectivity refers to the statistical dependencies or correlations between brain regions, reflecting their functional coupling and information exchange [51]. In brainspotting, increased connectivity between prefrontal and limbic regions (e.g., PFC-amygdala, PFC-hippocampus) may indicate enhanced top-down regulation of emotional processing and memory reconsolidation [52]. Increased connectivity within and between attentional networks (e.g., dorsal and ventral attention systems) may reflect the focused, sustained attention on the brainspot and associated internal experiences [53].
• EEG coherence is a measure of the synchronization or coupling of oscillatory activity between brain regions, which is thought to reflect their functional integration and communication [54]. Increased coherence between frontal and posterior regions in the alpha band (8-12 Hz) has been associated with top-down attentional control and emotional regulation [55]. In brainspotting, enhanced fronto-posterior alpha coherence may signify the PFC’s modulation of limbic and sensory processing [56]. Increased coherence within default mode network regions (e.g., medial PFC, posterior cingulate) may reflect the self-referential, introspective nature of the brainspotting experience [57].
• Oscillatory power refers to the amplitude or intensity of EEG activity within specific frequency bands, which are associated with different cognitive and emotional states [58]. For example, alpha power is often linked to relaxed, meditative states of inward focus [59], while theta power (4-8 Hz) is associated with memory processing, emotional regulation, and creativity [60]. In brainspotting, increased alpha power may reflect the calm, receptive state that facilitates the spontaneous emergence of unconscious material [61]. Enhanced theta power may indicate the active reprocessing and reconsolidation of traumatic memories, as well as the generation of new insights and adaptive meanings [62].

Implications for Future Research​

The neurobiological and phenomenological underpinnings of brainspotting suggest a complex, dynamic interplay of attentional, emotional, and mnemonic processes that may facilitate deep, transformative healing from trauma. By engaging subcortical and cortical networks involved in visual orienting, emotional processing, memory reconsolidation, and somatic awareness, brainspotting seems to provide a powerful, integrative approach to accessing and resolving implicit traumatic material.
While more research is needed to fully elucidate the mechanisms and efficacy of brainspotting, the current evidence points to a promising, innovative therapy that harnesses the brain’s innate capacities for attention, emotion regulation, and adaptive information processing. As our understanding of the neurophysiological correlates of brainspotting continues to grow, we may gain valuable insights into the complex interplay of mind, brain, and body that underlies psychological healing and growth.
Ultimately, the power of brainspotting may lie in its ability to create a safe, focused, and deeply embodied context in which individuals can access, process, and transform the painful experiences of the past, leading to greater integration, resilience, and wholeness in the present. By tapping into the brain’s remarkable capacity for change and self-organization, brainspotting offers a hopeful and empowering path to recovery for those struggling with the impacts of trauma.

Comparing Brainspotting with Other Trauma-Focused Therapies​

Brainspotting is part of a larger family of trauma-focused therapies that aim to process and integrate traumatic memories and experiences. Two other prominent approaches in this field are Eye Movement Desensitization and Reprocessing (EMDR) and Somatic Experiencing (SE).

Eye Movement Desensitization and Reprocessing (EMDR)​

EMDR, developed by Francine Shapiro in the late 1980s, is a well-established and extensively researched trauma therapy that shares some common elements with brainspotting [1]. Both approaches involve the use of eye movements or other bilateral stimulation to facilitate the processing of traumatic memories.
However, there are some key differences between the two approaches. In EMDR, the eye movements are typically more structured and systematic, with the therapist guiding the client’s eyes back and forth in a rhythmic, saccadic pattern [2]. In brainspotting, the eye positions are more static and focused on specific points in the client’s visual field that are believed to correlate with underlying neural networks and emotional experiences [3].
Another difference lies in the theoretical frameworks underlying the two approaches. EMDR is grounded in the Adaptive Information Processing (AIP) model, which posits that traumatic experiences are stored in a maladaptive, fragmented manner in the brain [4]. The eye movements and bilateral stimulation in EMDR are thought to facilitate the reprocessing and integration of these dysfunctionally stored memories. Brainspotting, on the other hand, draws upon a more eclectic mix of theoretical influences, including neuroscience, somatic psychology, and mindfulness practices [5].

Somatic Experiencing (SE)​

Somatic Experiencing, developed by Peter Levine, is another trauma therapy that shares some commonalities with brainspotting in its emphasis on the embodied nature of trauma and the importance of accessing and releasing somatically-held experiences [6].
In SE, the primary focus is on helping clients develop greater awareness of their bodily sensations and experiences, and to gently titrate and discharge the trapped traumatic energy that is believed to underlie many trauma symptoms [7]. This process often involves a careful tracking of subtle physical sensations, movements, and impulses, and supporting the client in allowing these experiences to unfold and resolve in a safe, contained manner.
While brainspotting also attends to somatic experiences and may elicit similar processes of physical discharge and release, it places a greater emphasis on the use of focused eye positions and the activation of specific brain regions and networks [8]. In brainspotting, the body is seen as an important source of information and a vehicle for processing and integration, but the primary point of entry is often through the visual field and the brain.
Despite these differences, all three approaches share a common goal of helping individuals process and heal from traumatic experiences. They all recognize the profound impact of trauma on the mind, brain, and body, and seek to harness the innate healing capacities of the organism to facilitate recovery and growth.

Potential Applications of Brainspotting Beyond Trauma Treatment​

While brainspotting was initially developed as a treatment for trauma and PTSD, its potential applications extend far beyond this domain. The core principles and techniques of brainspotting, including focused mindfulness, somatic awareness, and the activation of adaptive neural networks, may be valuable in a wide range of contexts and populations.

Performance Enhancement and Creative Flow​

One promising area of application for brainspotting is in the realm of performance enhancement and creative flow states. The focused, mindful attention cultivated in brainspotting has been shown to enhance mental clarity, emotional regulation, and attentional control [9] – all key factors in achieving optimal performance across a variety of domains, from sports to the arts to business.
By helping individuals access and resolve underlying blocks or limiting beliefs, brainspotting may also facilitate greater access to states of creative flow and intuitive insight [10]. The process of allowing the mind to freely associate and wander while maintaining a grounded, embodied presence may be particularly conducive to tapping into the generative, non-linear aspects of the creative process.

Addiction and Compulsive Behaviors​

Brainspotting may also have valuable applications in the treatment of addiction and compulsive behaviors. Many individuals struggling with these issues have underlying experiences of trauma, stress, or emotional dysregulation that fuel their maladaptive coping strategies [11].
By providing a safe, focused space to process and release these underlying experiences, brainspotting may help individuals develop greater self-awareness, emotional regulation, and impulse control [12]. The somatic focus of brainspotting may also be particularly helpful in addressing the embodied nature of addiction and compulsion, helping individuals develop a greater sense of agency and choice in relation to their behaviors.

Chronic Pain and Somatic Disorders​

Another potential application of brainspotting is in the treatment of chronic pain and somatic disorders. These conditions are often associated with experiences of trauma, stress, or emotional suppression, and may involve maladaptive patterns of muscle tension, autonomic dysregulation, and neural sensitization [13].
The focused, mindful attention and somatic awareness cultivated in brainspotting may help individuals with chronic pain and somatic disorders develop greater insight into the mind-body connections underlying their symptoms [14]. By gently exploring and releasing somatically-held experiences of tension, bracing, or constriction, brainspotting may facilitate a greater sense of ease, flexibility, and resilience in the face of physical discomfort.

Spiritual and Personal Growth​

Finally, brainspotting may have valuable applications in the realm of spiritual and personal growth. The deep, transformative experiences of insight, release, and integration that can occur during brainspotting sessions are often described in spiritual or transpersonal terms [15].
By facilitating access to expanded states of awareness and self-understanding, brainspotting may support individuals in their journeys of personal and spiritual development. The process of letting go of limiting beliefs, emotional blocks, and habitual patterns of thinking and behavior can be a powerful catalyst for growth and transformation.
Of course, more research is needed to fully explore and validate these potential applications of brainspotting. As the field continues to evolve and expand, it will be important to conduct rigorous empirical studies to assess the efficacy and mechanisms of brainspotting across a range of populations and contexts.
However, the core principles and techniques of brainspotting – including focused mindfulness, somatic awareness, and the activation of adaptive neural networks – hold great promise as a transformative tool for healing, growth, and optimization across many domains of human experience. As our understanding of the complex interplay between mind, brain, body, and spirit continues to deepen, approaches like brainspotting may play an increasingly important role in unlocking human potential and fostering greater resilience, creativity, and well-being.

References​

1. Grand, D. (2013). Brainspotting: The revolutionary new therapy for rapid and effective change. Sounds True.
2. Grand, D. (2019). Brainspotting: How a new therapy is transforming the treatment of trauma. The Neuropsychotherapist, 7(3), 19-27.
3. Corrigan, F. M., & Grand, D. (2013). Brainspotting: Recruiting the midbrain for accessing and healing sensorimotor memories of traumatic activation. Medical Hypotheses, 80(6), 759-766.
4. Hildebrand, A., Grand, D., & Stemmler, M. (2017). Brainspotting–the efficacy of a new therapy approach for the treatment of posttraumatic stress disorder in comparison to eye movement desensitization and reprocessing. Mediterranean Journal of Clinical Psychology, 5(1).
5. Sack, M., Lempa, W., Steinmetz, A., Lamprecht, F., & Hofmann, A. (2008). Alterations in autonomic tone during trauma exposure using eye movement desensitization and reprocessing (EMDR)—Results of a preliminary investigation. Journal of anxiety disorders, 22(7), 1264-1271.
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Researching brainspotting I found another trauma therapy called Observed & experiential integration (OEI) where the eyes are involved. More information you can find here, but this video is also interesting where Dr. Rick Bradshaw explains what it entails:

​

 

[Oxajil]

I heard from several sources that in some cases people were retraumatised, while doing EMDR.

Do you know what they meant by "retraumatised"?

 

[Yas]

Do you know what they meant by "retraumatised"?

I also heard about EMDR being so powerful that it can retraumatize some people if not done carefully. What I understood from what I heard is that any form of trauma reprocessing done before the person is somewhat stabilized can be too much and sort of re-open the wound without the resources to help the person heal it. I don't think it is because of EMDR per se but because some therapists may do it before the person is ready to do that kind of work.

What some people say is that it mostly an issue related to attunement to the 'client' and pushing in a technique when that's not the right time for it or without making sure they have their own resources to self-soothe in a non-destructive manner once the therapy session ends.

 

[Oxajil]

I also heard about EMDR being so powerful that it can retraumatize some people if not done carefully. What I understood from what I heard is that any form of trauma reprocessing done before the person is somewhat stabilized can be too much and sort of re-open the wound without the resources to help the person heal it. I don't think it is because of EMDR per se but because some therapists may do it before the person is ready to do that kind of work.

What some people say is that it mostly an issue related to attunement to the 'client' and pushing in a technique when that's not the right time for it or without making sure they have their own resources to self-soothe in a non-destructive manner once the therapy session ends.

But how do you define "retraumatized" in this context and how would you define "stabilized"? How do you determine whether someone is ready and how do you know you're not enabling/encouraging their avoidant behavior? I do think support should be given after trauma therapy sessions with the advice to exercise and journal. If there's coping through addiction (self-harm), then I agree that that should be dealt with first.

 

[Bluefyre]

I can speak from personal experience with EMDR. I went through three years of therapy to recover/integrate from DID. The universe put a wonderful therapist in my path who was highly attuned, very caring and knew her stuff. We worked for several months on "building resources" before we went anywhere near EMDR. She was very attuned and knew when I was ready. I was the one who was a bit impatient to begin but she held her ground and glad she did.

A fragment of a memory would come up during my day-to-day life, triggered by a smell for example. I would write it down and we would start accessing the memory in the therapy session. Usually it took more than one session. The wisdom of my body amazed me - a memory would not surface until I was ready to deal with and heal it. I won't say it was fun. I would be exhausted afterwards, but always in the way one is exhausted/relieved after throwing up. I relived each horrible childhood event that we processed together, but in the present with a developed objective, adult observer and "champion", always aware of my objective of reframing every memory in the present, as an adult with choices. If that's being "retraumatized", I'll take it, because I released so much pain and terror to enable me, in my body, to live more in the present and to integrate. I still have sleep issues related to childhood and it seems that this old body has gone about as far as it can in that regard. I live with it. All the different kinds of information on the forum about sleeping in the dark, supplements, etc. have helped but never fully. As a friend of mine has said, "CPTSD, the gift that keeps on giving".

I also did a follow-up year of Neuroptimal with a woman who was very knowledgeable and that helped me to fully integrate all of the "parts" who had fragmented and split off.

So that my two cents worth/experience. I am very strong willed, else I would not be here, so I think EMDR is not for the faint of heart or will. My therapist at one point said to me "You just don't back down, do you?" To which I replied, "No! I want my life back" or some such. As stated, it's the quality of the therapist that makes the difference, I think. I can't imagine how an OP could go through this process, but not for me to determine.

 

[Yas]

But how do you define "retraumatized" in this context and how would you define "stabilized"?

I haven't heard an exact definition, but, for example, trauma reprocessing (of any kind) has to do with making contact with the traumatic memory, processing the feelings that come up with that contact and letting them settle. A lot of times, for many people, not all, making contact with those memories can be overwhelming and a big part of trauma is overwhelm. The idea of retraumatization is that the person becomes overwhelmed again, and not able to process the feelings appropiately because they aren't in the space where that's possible.

Even breathing exercises can retraumatize if not properly titrated as we know from our Éiriu Eolas research, that's why Peter Levine talks so much about titration and pendulation.

So it isn't necessarily about EMDR being a bad thing, it's about it being a tool that if not used properly can bring overwhelm, which can make a person be in a state which isn't conducive to healing.

As for 'stabilized', most people I heard, talk about focusing on resourcing the person with strategies that can help them not leave the window of tolerance when they experience distress, as they do when they contact the traumatic memory. A lot of people are resourced enough and will be able to do this without much help, but there are those who have more difficulties, so therapist must meet them where they are, so to speak.

In one EMDR training I did, they had a questionnaire to fill in with all sorts of questions that were designed to determine if the person is 'stabilized' or ready to engage in EMDR therapy, measuring dissociation scales, self-soothing ability and things like that, as an example.

How do you determine whether someone is ready and how do you know you're not enabling/encouraging their avoidant behavior?

It's a good question and it depends a lot on the process and person. What I'm learning is that sometimes you have to push a bit but also that the avoidant/resistant behavior is there for a reason and that dealing with it as part of the therapy is better than engaging in a fight with it. It isn't in all cases and each person is different, but generally speaking the avoidant behavior is there to protect the person from something and what helps usually is to approach it like that and not like the enemy.

What some people say is that it may also be the case that some people get well enough with resourcing and that they don't want to do any trauma reprocessing and that's also OK, I mean, "give what the person is asking and not what we think they should have", sort of thing.

I do think support should be given after trauma therapy sessions with the advice to exercise and journal.

True, but I've come to learn that it is good to check first if the person is capable of engaging in such activities between sessions, for which they need to be able to not get overwhelmed by their feelings. That brings me back to the idea of resourcing during the sessions, and using pendulation to see how the person handles a bit of distress first, then a bit more, following their rhythm and pushing a bit, yes, but just not so much that you cause overwhelm.

Of course, context is always important. When we're talking about work on oneself as we talk here in the forum, we can't expect to have that same approach, and pushing a bit more might be necessary. In that case, we're talking about people who are mostly 'stabilized' and can usually handle distress and feelings that come up with trauma reprocessing. Peter Levine and other people who work with trauma are referring to people who are so traumatized that they can't handle that sort of thing right away.

 

[Oxajil]

The idea of retraumatization is that the person becomes overwhelmed again, and not able to process the feelings appropiately because they aren't in the space where that's possible.

Okay, that makes it more clear. I personally find the term a bit confusing, because it gives me the impression that the person is being traumatized again (from the therapy) when that's not the case as far as I know. What happens is that they can experience a 'flashback' which is a PTSD symptom that can occur at any time outside or during therapy. Or they can experience intense emotions which can also be triggered outside therapy.

The whole purpose of trauma therapy is to open that wound in order to clean it out so that the wound can heal. But you're also right that you have to keep an eye on how the person is doing (re window of tolerance).

I think the approach to trauma therapy/protocol differs per country (as I've understood from my teacher), but we are generally taught that psychologists shouldn't be 'scared' to use EMDR. I was taught that the only contraindication could be with people with high suicidality. It would also be important that the person is in a safe living situation (eg not living with an abusive person).

I also agree that context is very important. In case you may be interested, here is the chapter on EMDR and stabilization from my EMDR book (translated by Perplexity):

According to national and international guidelines in the field of psychotraumatology, PTSD should be treated with evidence-based therapy, namely trauma-focused cognitive behavioral therapy (exposure or cognitive therapy) or EMDR (Van Balkom et al., 2013; National Collaborating Centre for Mental Health, 2005; World Health Organization, 2013). These guidelines do not explicitly distinguish between the nature of the trauma or between different types of PTSD ('complex' or not). However, in certain circles, there is clinical consensus around the idea that some patients dealing with the consequences of early traumatization are not immediately ready for processing (Cloitre et al. 2011, 2012). This would particularly apply to the population of patients with 'complex PTSD'. This term, along with disorders of extreme stress - not otherwise specified (DESNOS), is widely used for a specific variant of PTSD characterized by a wide variety of symptoms of disorders that would be typical for repeated and prolonged interpersonal traumatization in early childhood (Van der Kolk et al. 2005; Cloitre et al. 2012).

Clinicians often become confused about the terminology of complex trauma and complex PTSD. What exactly is complex: the traumatic experiences, their consequences, or the treatment? (See Ter Heide et al., 2014). To avoid confusion, it's more prudent to use the term complex trauma for patients where the quantity and chronic nature of the events are prominent ('Prolonged, repeated and severe traumatic events', American Psychiatric Association, 2013, p. 276), and the term complex PTSD when the symptoms are central. Although it was decided not to include the classification 'complex PTSD' in the latest version of the DSM (DSM-5, American Psychiatric Association, 2013; Resick et al., 2012), it will be included in the upcoming ICD-11. In the definition used by ICD-11, one must not only exhibit the core symptoms of PTSD (re-experiencing, avoidance behavior, and hyperarousal), but also meet criteria for the presence of relational skills and negative core beliefs to receive the diagnosis of complex PTSD (Cloitre et al. 2013; Maercker et al., 2013). People with complex PTSD thus also, by definition, meet the criteria for PTSD.

Regarding the treatment of patients with complex PTSD, guidelines were published in 2012 by the International Society of Traumatic Stress Studies (ISTSS), which advised that the treatment of people with early childhood interpersonal trauma and symptoms of complex PTSD should proceed in phases, according to the so-called three-phase model (Cloitre et al., 2012). This treatment approach begins with a stabilization phase, which focuses on safety, building a therapeutic relationship, teaching stress management and affect regulation skills, psychoeducation about the consequences of traumatic events, and cognitive restructuring in case of beliefs related to self-blame and anxiety thoughts. When the patient is stable enough, the phase follows in which traumatic memories are processed using evidence-based (trauma-focused) treatment methods. The final phase is aimed at 're-integration', (re)engaging in life in general and resuming daily activities.

Inserting a stabilization phase for patients with complex PTSD before proceeding to confront traumatic memories is based on the assumption that people who experienced interpersonal trauma in their youth, and are consequently struggling, generally lack sufficient psychological stability to face the memories and tolerate the associated arousal. Therefore, a premature confrontation with emotionally charged memories, at a time when the patient does not (yet) have the skills to handle them, could have undesirable effects. These could include worsening of symptoms, psychological dysregulation, and suicidality. To avoid being immediately overwhelmed by images, cognitions, and emotions, patients are first taught skills in self-control and affect regulation in a stabilization phase. It is assumed that after the phase focusing on stabilization, people are more motivated for the trauma-focused part of the treatment and can thus benefit more from this treatment. The term 'stabilization' can also refer to a standalone intervention aimed at reducing symptoms of complex PTSD and improving the functioning and quality of daily life of patients with this condition (Zlotnick et al. 1997; Dorrepaal et al. 2006). Against this background, several stabilization trainings have been developed for adults and children (Dorrepaal et al., 2018; Struik, 2010).

The key question is whether such a phased approach is necessary for the treatment of complex PTSD, and whether a direct treatment according to current guidelines, which focus on processing the trauma, could not be chosen just as well. Results from research on people undergoing evidence-based treatments for PTSD do not suggest that dysregulation or permanent worsening of symptoms is a phenomenon that occurs significantly more often in people who receive trauma-focused treatment than in those who receive no treatment (Van Minnen et al. 2012; Wagenmans et al., 2018; Zoet et al., 2018). This finding is perhaps most strongly supported by the results of research on the treatment of PTSD among 155 people with schizophrenia or psychosis. They were treated with EMDR without any form of stabilization prior to the trauma treatment (Van den Berg et al. 2015). Worsening of symptoms occurred remarkably infrequently, but four times more often in the group receiving regular psychiatric treatment (four people) than in the EMDR group (one person). More generally, standard treatments primarily aimed at processing traumatic memories appear to work not only for people with PTSD but also for those with symptoms of complex PTSD (De Jongh et al., 2016). In this sense, there are no indications that early childhood interpersonal trauma, severe dissociation, or other characteristic phenomena of complex PTSD influence the effectiveness of trauma-focused treatments (De Jongh et al., 2016; Wagenmens et al.; 2018; Van Minnen et al., 2016; Zoet et al., 2018; Van Woudenberg et al., 2018).

Despite these positive results from scientific research, there is still great uncertainty in the field about what the best treatment is for patients suffering from symptoms fitting complex PTSD. Treatment guidelines for this condition are still largely based on clinical experience. In 2018, the ISTSS issued a new treatment guideline for complex PTSD (ISTSS, 2018). The guideline committee no longer mentions the term phase-based, and the term 'stabilization' is also no longer used. Instead, they propose an approach they call personalized medicine, which should focus on the symptoms that are most prominent and most strongly related to the person's limitations and functioning. The guideline committee also acknowledges that the treatment of complex PTSD should actually focus on memories of traumatic events from early childhood, as research shows that these are central to the pathology of this condition. Which method or type of therapy is most suitable for this is still unknown, as no statements can be made about this based on existing research.

It should be noted that there is essentially nothing wrong with having patients with complex PTSD undergo a phase-oriented treatment. However, incorporating a stabilization phase - in which talking about the experienced trauma is discouraged - does signal to the patient that allowing traumatic experiences is (too) risky. Another potential risk of stabilization is that the patient may get the impression that the therapist themselves cannot or does not want to hear the story out of fear of details, which can disrupt the therapeutic relationship. If prior stabilization causes, confirms, or reinforces irrational fears of the patient, this will decrease rather than increase the chances of success of trauma treatment. Nevertheless, during ongoing trauma treatment - especially in an outpatient setting - the patient's ability to sustain the treatment should be continuously monitored, and supportive interventions should be offered if necessary. Interventions aimed at stability and symptom control are not taboo, but should primarily be aimed at facilitating trauma-focused treatment.

You may also be interested in this article (it's in Dutch however).

 

[Yas]

Yes, everybody talks about the importance of phases in therapy, including the founder of EMDR Therapy, Francine Shapiro, and another very well-know trauma expert, Janina Fisher.

That's the approach taught in most trauma trainings, including some of the ones I did, which are all evidence-based as well. But in some other trainings they do mention that what really matters is not the step by step approach but the therapeutic relationship and to be able to avoid overwhelm. I tend to go more towards that approach. Not necessarily that you need to follow a specific phase approach but to be present enough to follow each person's rhythm.

Here's Francine Shapiro, founder of EMDR, saying something of the sort:

What she says about the therapist being kind of the anchor that prevents overwhelm is important, I think. So, what truly seems to be evidence based is that no matter the type of therapy, what matters is how attuned the therapist is and the therapeutic relationship. What the "first phase" does in that 3-phase model, is that it gives a chance to develop that therapeutic relationship, but I myself agree that it isn't absolutely necessary with everyone.

What I heard in my trainings was that a lot of the problem people encounter with EMDR is that therapists seem to push it before there's enough trust and they feel as if it is too much. And I think that's a problem with ANY therapeutic tool or technique. If therapist rely so much on the technique, like a technician would, they can lose touch with the person and push their technique instead of focusing on the human they have in front of them. And that's not a problem with the model but with how it is applied. As with everything, I don't think there's a one-size-fits-all therapeutic technique because there are different people with different learning/coping styles which might benefit from different approaches, yet, it always amazes me how similar we are as well, so yeah, what works for one, works for a lot of people, just not all.

Even something with so much research as EMDR can be ineffective with some people. I once read that the latest studies have found that EMDR techniques have a 50% effectiveness ratio, unfortunately it was something I read very quickly so I don't have the reference but I'll look it up. I didn't pay much attention to it because to me it makes sense that even the most effective therapeutic tool won't be the panacea, so I wasn't so surprised by that information. And I've known so many people who have worked on their trauma very effectively without EMDR too, so it can't be the panacea, just another very good tool. There's also the Healing Developmental Trauma method, etc.

I also wanted to share this video of Peter Levine talking about titration:

Yes, trauma therapy is about touching the wounds, but there are ways and ways of doing that. Some decades ago, the idea was to "flood" the person in order to heal. Nowadays, a lot of researchers and therapists don't believe that approach is the best approach, it is believed that building resilience might be best than flooding with overwhelm, for most people... some others may be able to handle the flooding and it will work for them, so again, it depends.

Thanks for the references, I'll study them, because, as with studies about food and drugs, there's a need to examine the research well in order to actually draw good conclusions from what is being studied, the methods, etc.

 

[Yas]

Just a note that I made a mistake in the video posted and it isn't Francine Shapiro but Robin Shapiro who's speaking , she isn't the founder of EMDR, just another trauma expert.

 

[Oxajil]

Yes, everybody talks about the importance of phases in therapy, including the founder of EMDR Therapy, Francine Shapiro, and another very well-know trauma expert, Janina Fisher.

You mean the three-phase model, right? As it's written in the text I posted, there's no evidence that stabilization increases the effectivity. These are the latest updates as far as I know. At the same time, I don't think it hurts to do it that way, as long as the psychologist doesn't reinforce any fears.

That's the approach taught in most trauma trainings, including some of the ones I did, which are all evidence-based as well. But in some other trainings they do mention that what really matters is not the step by step approach but the therapeutic relationship and to be able to avoid overwhelm.

With EMDR, following the protocol as it's written out is important, though. The therapeutic relationship can be great, but if the right target isn't picked for example or if the memory-taxing task is too taxing or not taxing enough, or if a discussion takes place in between tasks, then it won't be as effective. In addition, the aim is actually to increase the distress in order to bring it down through processing. That's how I currently understand EMDR and what I was taught about it, but I might change my mind with more experience. I guess we'd have to agree to disagree on that one for now!

What she says about the therapist being kind of the anchor that prevents overwhelm is important, I think. So, what truly seems to be evidence based is that no matter the type of therapy, what matters is how attuned the therapist is and the therapeutic relationship. What the "first phase" does in that 3-phase model, is that it gives a chance to develop that therapeutic relationship, but I myself agree that it isn't absolutely necessary with everyone.

I agree that building a therapeutic relationship is important, but I think it naturally happens as you talk to the person about their symptoms, their past, etc. ie the preparation phase and making sure EMDR is the right approach. I think that phase will also give an idea on whether there's a 'click'. I also think it depends on the person and their specific needs.

Even something with so much research as EMDR can be ineffective with some people. I once read that the latest studies have found that EMDR techniques have a 50% effectiveness ratio, unfortunately it was something I read very quickly so I don't have the reference but I'll look it up.

I've seen studies with over 70% effectivity:

Of particular note with respect to general clinical practice is a study conducted at Kaiser Permanente that reported that 100% of single-trauma victims and 77% of multiple-trauma victims no longer had PTSD after a mean of six 50-minute EMDR therapy sessions, demonstrating a large and significant pretreatment versus posttreatment effect size (Cohen’s δ = 1.74). This is consistent with 2 other RCTs that found that 84% to 90% of single-trauma victims no longer had PTSD after three 90-minute EMDR sessions. Most recently, a study funded by the National Institute of Mental Health evaluated the effects of 8 sessions of EMDR therapy compared to 8 weeks of treatment with fluoxetine. EMDR was superior for the amelioration of both PTSD symptoms and depression. Upon termination of therapy, the EMDR group continued to improve, whereas the fluoxetine participants who had reported as asymptomatic at posttest again became symptomatic. At follow-up, 91% of the EMDR group no longer had PTSD, compared with 72% in the fluoxetine group.

At the same time, the effectivity doesn't seem to differ much from other methods as described in this recent meta-analysis (I used Perplexity to summarize):

The study by Wright et al. (2023) titled "EMDR v. other psychological therapies for PTSD: a systematic review and individual participant data meta-analysis" presents several key findings regarding the effectiveness of EMDR compared to other psychological treatments for PTSD:

Key Findings:​

1. Overall Effectiveness:
   • The meta-analysis included 15 randomized controlled trials (RCTs), with 8 contributing to the individual participant data meta-analysis (IPDMA), totaling 346 patients.
   • The analysis found no significant difference between EMDR and other psychological treatments in terms of:
     • PTSD symptom severity: β = -0.24
     • Achieving treatment response: β = 0.86
     • Attaining remission: β = 1.05
     • Reducing treatment dropout rates: β = -0.25
2. Treatment Response and Remission:
   • The results indicated that both EMDR and comparator treatments led to significant improvements in PTSD symptoms, but there was no statistical evidence that EMDR was more effective than the other therapies.
3. Dropout Rates:
   • There were no significant differences in dropout rates between EMDR and other treatments, suggesting similar levels of acceptability and adherence among participants.
4. Moderating Factors:
   • Moderator analyses suggested that unemployed participants receiving EMDR had higher PTSD symptom severity at post-test, while males were more likely to drop out of EMDR treatment than females.
5. Clinical Implications:
   • The findings emphasize that while EMDR is effective, it does not demonstrate superiority over other established psychological therapies for PTSD, suggesting that various treatment options may be equally viable for patients.

Conclusion:​

The study concludes that EMDR is an effective treatment for PTSD, but it is not significantly more effective than other psychological therapies. This highlights the importance of considering patient preferences and specific clinical contexts when selecting treatment modalities.

Yes, trauma therapy is about touching the wounds, but there are ways and ways of doing that. Some decades ago, the idea was to "flood" the person in order to heal. Nowadays, a lot of researchers and therapists don't believe that approach is the best approach, it is believed that building resilience might be best than flooding with overwhelm, for most people... some others may be able to handle the flooding and it will work for them, so again, it depends.

Imaginal exposure, which is an effective trauma therapy method, is basically flooding. I've used it when people don't like EMDR. I'm not sure what to think of the titration approach, but I think if the result is the same, it doesn't really matter and if it's something that the person feels more comfortable with then it's completely understandable.

Thanks for the references, I'll study them, because, as with studies about food and drugs, there's a need to examine the research well in order to actually draw good conclusions from what is being studied, the methods, etc.

Yes, thank you too!

 

[Yas]

That's how I currently understand EMDR and what I was taught about it, but I might change my mind with more experience. I guess we'd have to agree to disagree on that one for now!

Oh, no. I don't see it as disagreement, just an interesting discussion. I myself think EMDR is a very good tool for therapy, not a therapy in itself. And I just don't think it is the panacea either. As you yourself say, it is as effective as other types of therapies, perhaps because it depends a lot on the person, the therapist and things like that.

As you say, EMDR is a very precise method that has very precise steps and what might not help is when people apply it differently than how it is supposed to be applied.

For example, I noticed that some people focus on the eye movement part of the therapy, as if that is the only part that is important, and thinking that by just doing that, they are processing trauma. There are even videos on the internet with an object moving so that you can follow with your eyes. I think that even that may work for some people, but that's not EMDR therapy, yet, it might be the type of thing that can be 'retraumatizing' for some.

I agree that building a therapeutic relationship is important, but I think it naturally happens as you talk to the person about their symptoms, their past, etc. ie the preparation phase and making sure EMDR is the right approach. I think that phase will also give an idea on whether there's a 'click'. I also think it depends on the person and their specific needs.

That's the important part, IMO.

 

[Oxajil]

Oh, no. I don't see it as disagreement, just an interesting discussion. I myself think EMDR is a very good tool for therapy, not a therapy in itself. And I just don't think it is the panacea either. As you yourself say, it is as effective as other types of therapies, perhaps because it depends a lot on the person, the therapist and things like that.

As you say, EMDR is a very precise method that has very precise steps and what might not help is when people apply it differently than how it is supposed to be applied.

For example, I noticed that some people focus on the eye movement part of the therapy, as if that is the only part that is important, and thinking that by just doing that, they are processing trauma. There are even videos on the internet with an object moving so that you can follow with your eyes. I think that even that may work for some people, but that's not EMDR therapy, yet, it might be the type of thing that can be 'retraumatizing' for some.

That's the important part, IMO.

Yeah, just following an object move won't do much unless you follow the entire protocol, and apparently eye movement is not even necessary (although it seems to be the best one), but sounds or solving a math problem, counting or spelling can also be useful tasks for memory taxation. That's assuming the working memory hypothesis is true (it seems to be the one that people are going with in the Netherlands)!