Brainspotting Therapy: Understanding Outside vs. Inside Window and Z-Axis
Brainspotting is a somatic psychotherapy technique increasingly used in trauma therapy, anxiety treatment, and other forms of emotional healing. By combining focused visual attention, body awareness, and a supportive therapeutic relationship, Brainspotting may help clients access and process distressing experiences that can feel difficult to reach through traditional talk therapy alone. Although the overall evidence base remains relatively small compared with established trauma treatments, the research is promising (D'Antoni et al., 2022; Horton et al., 2024).
What is Brainspotting therapy?
Brainspotting was developed by psychotherapist David Grand and is based on the observation that particular eye positions may correspond with changes in emotional or physiological activation. During a Brainspotting session, a therapist helps a client identify a specific point in the visual field while maintaining mindful awareness of thoughts, emotions, and bodily sensations. The client then focuses on that position while allowing their internal experience to unfold without needing to force a particular outcome (Corrigan & Grand, 2013).
This approach is sometimes described as a brain-body psychotherapy because it emphasizes both psychological experience and somatic awareness.
What is Outside Window Brainspotting?
Outside Window Brainspotting relies primarily on the therapist's observation of the client's involuntary responses while the client's eyes track a pointer across the visual field. Subtle changes—such as blinking, eye wobbles, facial movements, or shifts in breathing—may help the therapist identify a potentially meaningful Brainspot (Corrigan & Grand, 2013).
The therapist then holds the pointer at the identified position while the client mindfully observes what happens internally. For some people, this externally observed approach can be useful when emotional activation is difficult to identify or describe verbally.
What is Inside Window Brainspotting?
Inside Window Brainspotting places more emphasis on the client's own felt sense. Rather than relying primarily on the therapist's observation of reflexive responses, the therapist guides the client through the visual field and asks where they notice the greatest emotional or bodily activation.
Once the client identifies the position that feels most significant, they maintain their gaze there while observing their internal experience. A comparative study of EMDR, Brainspotting, and body scan meditation specifically used the Inside Window method and found significant reductions in subjective distress following the interventions (D'Antoni et al., 2022).
The distinction between Outside and Inside Window is therefore simple but clinically meaningful: Outside Window emphasizes what the therapist observes, while Inside Window emphasizes what the client experiences.
How does the Z-Axis technique work in Brainspotting?
The Z-Axis technique expands Brainspotting into the third dimension: depth. After identifying a relevant eye position, the therapist may explore whether looking at a closer point or a more distant point produces a meaningful difference in the client's activation or sense of resource.
Brainspotting literature describes this as three-dimensional processing, adding depth to the horizontal and vertical dimensions of the visual field. The technique may involve gently shifting attention between near and far visual points while the client remains aware of bodily sensations and emotional responses (Grand, 2013). The proposed neurobiological explanations for Brainspotting—including attention, visual orientation, and midbrain pathways—remain hypotheses rather than established mechanisms (Corrigan et al., 2015).
Why might these Brainspotting techniques be helpful?
Outside Window, Inside Window, and Z-Axis Brainspotting offer therapists different ways to individualize trauma-informed psychotherapy. Some clients may respond strongly to observable reflexes, while others may have a clearer internal sense of where emotional activation is located. Adding depth through the Z-Axis may provide another avenue for exploring the client's response.
For individuals seeking trauma therapy, anxiety treatment, or support with distressing memories, Brainspotting may be one option. Contact me to learn more about how Brainspotting may be an effective treatment for you.
References
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. https://doi.org/10.1016/j.mehy.2013.03.005
Corrigan, F. M., Grand, D., & Raju, R. (2015). Brainspotting: Sustained attention, spinothalamic tracts, thalamocortical processing, and the healing of adaptive orientation truncated by traumatic experience. Medical Hypotheses, 84(4), 384–394. https://doi.org/10.1016/j.mehy.2015.01.028
D'Antoni, F., et al. (2022). Psychotherapeutic techniques for distressing memories: A comparative study between EMDR, Brainspotting, and body scan meditation. International Journal of Environmental Research and Public Health, 19(3), 1142. https://doi.org/10.3390/ijerph19031142
Horton, L. M., Schwartzberg, C., Goldberg, C. D., Grieve, F. G., & Brdecka, L. E. (2024). Brainspotting: A treatment for posttraumatic stress disorder. International Body Psychotherapy Journal, 22(2), 57–72.
