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How We Can Heal
A podcast to share deep conversations about How We Can Heal from life’s toughest circumstances.
How We Can Heal
Shock Before Trauma: The Science of Deep Brain Reorienting
Dr. Frank Corrigan joins us to share his groundbreaking approach to trauma healing called Deep Brain Reorienting (DBR). With his melodious Scottish accent and over 30 years of experience as a Consultant Psychiatrist in Scotland's National Health Service, Frank explains how his quest to help severely traumatized patients led to this innovative method that addresses trauma at its deepest neurobiological roots.
The magic of DBR lies in its focus on a critical moment most approaches miss – the milliseconds of "shock" that occur in the brainstem before emotions like fear, rage or shame ever emerge. Frank walks us through how traditional trauma therapies often overlook this crucial phase, potentially explaining why some people remain stuck despite years of treatment. Through fascinating explanations of brainstem structures like the periaqueductal gray and superior colliculi, he illustrates how DBR's sequence of processing works with our brain's natural healing mechanisms rather than against them.
What makes DBR truly revolutionary is its methodical, slow approach that begins with establishing "where self" – a neurological anchoring in present time and space – before identifying the subtle "orienting tension" that precedes shock. By attending to these early responses before emotions flood in, clients often experience processing that feels manageable rather than overwhelming. Frank shares moving clinical examples, including how DBR has helped people with traumatic bereavements that remained unresolved for decades despite trying numerous other approaches.
Ready to explore this transformative approach yourself? Whether you're a mental health professional interested in training or someone seeking healing from complex trauma, Frank's compassionate explanation offers hope that even the most deeply embedded trauma responses can be addressed when we understand the brain's natural healing sequence. Visit deepbrainreorienting.com to learn more about this exciting development in trauma therapy that's showing promising research results.
Welcome back to the how we Can Heal podcast. Today we welcome Dr. Frank Corrigan to the show. Throughout his career spanning over 30 years as a National Health Service Consultant Psychiatrist in Scotland, Frank combined his extensive clinical experience with research on the neurobiology of trauma and its underpinnings in major psychiatric disorders. His research broadly explored the intersection between affective neuroscience and the science of healing, culminating in the development of deep brain reorienting, or DBR, which we'll focus on today. Today you'll get to hear about DBR directly from Frank in his mellifluous Scottish accent. You can always follow along on YouTube too, if you'd like some visual support as well. I'm honored to have him here and I think you're really going to enjoy this healing conversation, so please join me in welcoming Dr Frank Corrigan to the show.
Lisa Danylchuk:I want to give a big shout out and extend a huge thank you to the International Society for the Study of Trauma and Dissociation, the ISSTD, for sponsoring this episode.
Lisa Danylchuk:If you've been listening to this podcast for any amount of time, you've heard me talk about ISSTD and the incredible researchers, clinicians and advocates I've met during my time as a member and a volunteer there. I even completed my DBR level one training with Frank Corrigan in person at the recent ISSTD conference in Boston, which we talk about in today's episode. The ISSTD has been delving into the science and best practice of treating trauma and dissociation for over 40 years now, and they have a rich catalog of educational offerings for both professionals and non-professionals on their website that's cfasisst-dorg. If you're a mental health professional, I highly recommend you consider becoming a member of ISSTD. I'd love to see you during the live educational offerings and at the annual conference in Portland, Oregon, in March of 2026. Visit ISST-Dorg to learn more.
Lisa Danylchuk:Awesome, Frank Corrigan, welcome to the how we Can Heal podcast. I'm so excited to have you here and to talk about you and your journey with DBR.
Dr. Frank Corrigan:Thank you for inviting me. I'm honored and pleased to be here.
Lisa Danylchuk:Yes! So for those who haven't listened to other episodes where we talk about DBR, DBR stands for Deep Brain Reorienting and it's something that you developed, and I'm curious just what led you to discover and create DBR.
Dr. Frank Corrigan:It's been an evolution of a process rather than a sudden insight. I think I've trained in many different trauma therapy modalities over the years and I've always been looking for something that was effective for the most seriously traumatized people without being overwhelming. And a lot of the difficulty I had with other modalities is that while they were very effective for many conditions, they were often overwhelming for those who were really severely traumatized. So I've been working on a way of understanding why that overwhelm occurred and looking to see if there were ways of preparing the processing, the healing process, in a way that flowed with less risk of overwhelm.
Lisa Danylchuk:Yeah, that's such an important point and I feel like I've talked about that with a lot of people on the show. I remember having a conversation with Kathy Steele, who you know, and you know, like finding that edge in clinical treatment of like what's just enough, where we're not overwhelming but we're not in avoidance or feeling stuck right, like how do we find that edge where there's progress but not so much quote progress that it's actually a backslide right, not so much overwhelm or digging into something that's traumatizing so that it's re-traumatizing.
Dr. Frank Corrigan:Yeah.
Lisa Danylchuk:So it's definitely a theme in the field, especially the more complex trauma we're working with.
Lisa Danylchuk:I'm curious too, just to backstep, how did you get interested in treating psychological trauma?
Dr. Frank Corrigan:Oh, being in psychiatry from 1977 onwards and being preoccupied often with those who were most seriously at risk of suicide, and observing that those who were not psychotic, who were actively suicidal, were usually those who had a severe trauma history, usually those who had a severe trauma history.
Lisa Danylchuk:Yeah, and you're talking about those two ends of the spectrum right away, between being overwhelmed and having too much come up too fast and being almost in avoidance. With PTSD, Avoidance is one of the key indicators or symptoms. So are we sort of colluding with that avoidance and just tiptoeing and not saying the words or not trying to evoke any emotion or fear or memory, or are we holding space for that and in a careful way, in a skillful way, helping people to process it? And I think that's what's so cool. I mean I just, you know, I just did my level one DBR training in Boston with you and so I'm really excited about this modality as an option for for a different point of entry. So you know, some folks listening may have done DBR training. They may have read your book already. Some folks, I'm sure, haven't. So how would you explain DBR in the most simplest terms to someone who's just hearing about it for the first time?
Dr. Frank Corrigan:I think the thing that's emerged over the years of doing DBR is the importance of shock. And in DBR we're defining shock as a brainstem and upper brain response that occurs before there's any activation of the peripheral nervous system. So during shock people may have experiences of cold shivers, shudders, emptying, electric charges, pressure in the head, pressure behind the eyes. There's all sorts of sensations that go with this shock, but there isn't a change immediately in the peripheral autonomic nervous system. And because there's been such a focus on the autonomic nervous system, I think that's why shock hasn't been recognized in this way. And it's become apparent through studying the brainstem neuroanatomy and studying the sequence of responses in the brainstem to a traumatic stimulus. And we've seen that there's the possibility of this shock response in the brain before there's any intense emotion, before there's any change in the peripheral autonomic nervous system.
Lisa Danylchuk:Right. So before there's what we're focusing so much on – fight, flight, freeze, collapse, all of that – you're honing in on the moment before that, right before those signals get transmitted through the rest of the brain, throughout the body, before we're in this, you know, hyper aroused or hypo aroused state, there's that moment of shock. So you're really defining the shock as those early I'm imagining seconds, right at the, at the very...
Dr. Frank Corrigan:Probably milliseconds. You know, it's probably really fast, and I think that's why it's so easily missed.
Lisa Danylchuk:Yes.
Dr. Frank Corrigan:Yeah.
Lisa Danylchuk:Because there's so much after those few milliseconds too right, all the flooding of what we're just talking about endorphins or adrenaline, or trying to get to safety or trying to work through whatever the the trauma or the struggle is like. It's easy to focus on those because those can be louder right?
Dr. Frank Corrigan:Yeah, they take the attention immediately. If you're hit by the sudden terror, you're not going to be thinking about the fleeting sensations that preceded that. You're going to be utterly preoccupied with the terror.
Lisa Danylchuk:And so with shock you just mentioned sensations in the back of the head or the eyes or the forehead. I'm wondering how you made that connection. Is that specific to neuroanatomy or is that something you observed clinically, that people were having these shock responses through, fluttering muscles around the eyes or having a lot of sensation in the brainstem area?
Dr. Frank Corrigan:The other key thing in DPR is the orienting tension and that comes from the brainstem as a response to a stimulus before there's any shock or before there's any emotional response. And what we've found, greatly to my surprise I have to say, is that if we can identify the orienting tension that comes before the shock, comes before the emotions, we've got an anchor in the subsequent processing that greatly reduces the risk of overwhelm. So if we get our orienting tension at the beginning and then slow everything down to separate out the shock from the emotions, we're then usually into a process in a way that's manageable, that's not overwhelming. So our first task in a DPR session is to find the orienting tension. The second is to look for the shock.
Lisa Danylchuk:So you find - and I know just from the training that even before that like getting connected to what you would call whereself - where the body is now, where our brain is in the moment. For a long time I've understood that as grounding and orienting, but I think you come at it from a bit of a different angle. So again, backing up, is there anything you want to say about the importance of that first preparatory step before finding orienting tension?
Dr. Frank Corrigan:This has proved to be another important feature of DBR, Again rather to my surprise. It was based on the idea that the brainstem, the superior colliculus in the brainstem, is a focal point for taking in information, for taking in immediate stimuli that may, of course, be threatening, and then organizing an immediate response to them. So the superior colliculi need to know where the body is, and the information about where the body is comes from systems in the brain that separate out the information about where the body is from what we are encountering. So we have tried to localize our self in a way that takes in brain systems for where the body is here now, with its mapping of the surrounding space according to the direction that we're facing, our awareness of gravity and so on.
Lisa Danylchuk:And that in my mind – from all the other trainings I've done, and I know you work with people who've done so many different trainings – is more about orienting to the present moment and the present space and the literal "where is my body? And connecting with, as you're saying, the superior colliculi. Through that connection and I know folks do I'm also in the yoga world and there's all kinds of ways we can start a session by grounding or orienting. We can find something to look at, we can touch, you know, feel the touch of the chair or the floor, all these different things. But some of those go in the direction of which I think is risky, with trauma of like close your eyes, go inside, let's drop in, but where self is different, right, rather than being like a dropping in and getting really focused internally like a hypnotic sort of induction, it's more about really connecting with gravity, and I know from doing the training even where's the position of your body in the room. ? Where are you hearing sounds from? Where is your position in the hotel that you're in or the room that you're in? It's so much more specific of an orientation practice than I've had before, and I appreciate the name too, like the where self. It's not about doing something, it's really about locating. About your brain and your body locating itself here and now. Is that fair? Is that a fair description?
Dr. Frank Corrigan:Absolutely, that's a g ood description.
Lisa Danylchuk:And then once someone has that and their body, their brain knows where they are, is oriented to that, is connected to a sense of where, then you would look for the orienting tension and then you would proceed once that's clear with the DVR process. So that's kind of the sequence of things. Um, I'm wondering if you want to say anything about how shock comes up and through the body. You've done I don't even know what a fair estimate is probably thousands, tens of thousands of sessions of this at this point. It's evolved over time. What do you notice about how shock emerges when we are paying attention to that orienting tension and to those milliseconds in response to the stimulus of the trauma?
Dr. Frank Corrigan:If I may just say a little bit more about where self before I come to that
Dr. Frank Corrigan:The study in Canada has really shown that the ability to locate where self is what allows a person to go on to do DBR processing. If somebody can't locate where self, then they're not yet ready to do DBR. So it's proved a really important threshold for crossing before doing the trauma processing with DBR. So we locate where self, we present the activating stimulus, we look for the orienting tension in the forehead, the muscles around the eyes or the muscles at the base of the skull, and then we have to slow down.
Dr. Frank Corrigan:This is where it's really difficult for everybody at the start, because we're slowing down to try to pick up these sensations that have been fleeting, that have happened probably in milliseconds. So we're having to slow it right down and the therapist has to be directive here to look for the shock and to ask is there any jolt or judder through your body? Is there any pressure behind the eyes, for example? So if the sensations aren't volunteered, so we slow down, give it space, and every individual's shock sensations are different. So every time I do a menu of shock sensations it's incomplete because there's always other possibilities that arise and we have to be open to whatever it is in a particular person.
Lisa Danylchuk:Yeah, so honing in and slowing down. I saw there was another training, I think it's someone you've worked with who does Alexander technique I'm forgetting the name at the moment, but he was talking about, you know, people wanting to go from A to C or A to Z in a session, and sometimes the session is just staying with A or maybe going from A to B. So it's really about honing in and slowing down, as you're mentioning, and picking up on these subtleties that can get overlooked but that I think warrant space, right.
Dr. Frank Corrigan:Yeah, this is the crucial thing with shock when we identify it, we need to sit with it. We don't try to do anything with it, so we would usually say to the person we're working with these sensations that you're describing to me are coming from the shock. We'll get to the fear or rage or grief or shame or whatever the emotions are when the time is right. If possible, can you stay with these shock sensations? Just let us be with them, and I think I don't know, but I think there's probably something important about being able to describe the shock sensations to another and be able to sit with them, with another also attending to them, and all being well that shock energy then dissipates, and the pressure in the head reduces, or the cold shiver down the spine disappears, or the weakness in the arms, to use an example from early attachment shock, the weakness in the arms clears and the power comes back into the arms. So we need to give the shock as much space and time as it needs for the energy of it to dissipate and clear.
Lisa Danylchuk:So you've described shock in terms of where it can show up, some examples in terms of pressure in the head or at the base of the skull or the eyes, jaw. There's a lot of it focused higher up in the body. You also mentioned the arms right now and saying that there's no right or wrong. We want to stay open to each person's body and response. We've also described the shock in terms of time. This is a very narrow millisecond or milliseconds that we're focusing on after the trauma is, at the very beginning of the trauma essentially, or when we first become aware of it at a deep brain level. Is there anything else that feels important about shock? I know questions come up around this because we're so focused on the latter parts of post-traumatic stress and complex trauma and how they show up relationally in all of this. Is there anything else that you feel like is important to communicate about w hat shock is, what that means?
Dr. Frank Corrigan:Yeah, when I first identified it it was to do with an attachment rupture.
Dr. Frank Corrigan:So it was attachment shock that I focused on initially and looked for the immediate impact of a rejection or a humiliation or an abandonment or something of that sort that would, coming out of the blue, potentially be quite shocking. So I initially focused on the attachment shock and then got as much of that processed as possible before picking up the pain of the abandonment or rejection and then the emotions that come in response to that pain. So we followed a sequence from the stimulus through the orienting tension, to the shock, to the pain, to the emotions. And if we'd slowed that down enough then by the time we got to the emotions they weren't overwhelming as a rule you know. They could process naturally because you'd taken the amplifier out of the system. The shock energy was the amplifier and when that was gone then the the affects, the emotions, process neatly. So that was the attachment shock. But then I find, similarly for interpersonal shocks or natural disaster shocks, that we've followed the same principles get the orienting tension and then look for the shock.
Lisa Danylchuk:Mm-hmm yeah there's so many places I feel like I can go with this, so I'm trying to slow myself down because I'm like we could go here, we could go there. I one question I have or comment too is, in popularized trauma awareness, maybe not so much in people whose expertise and professional life is devoted to trauma, but there's a lot of talk of the amygdala and the prefrontal cortex. We want to go to a very simple triune brain model. There's three parts, and this is all it does. So your model and deep brain reorienting aren't focused on the amygdala, right?
Lisa Danylchuk:This is more the deep brain and you've talked about and I love the periaqueductal gray and the superior colliculi – I just love saying them. Honestly, I'm not a neuroscientist and I did do some fMRI studies for a while in graduate school, but I'm interested how you got connected to these areas of the brain, what turned you on to it, and if you can just say a little bit to folks listening about why those areas – and maybe others if you'd like – are important when we're focusing on this shock, this early shock.
Dr. Frank Corrigan:Yeah, I was heavily influenced by the work of Jaak Panksepp. So you know, with treating trauma and I was seeing fear and rage and grief and panic and then I go to the literature to find out about them and they're all coming from the periaqueductal grey (PAG) in the hypothalamus, not the amygdala. So I focused in on the periaqueductal grey and when I was more focused on emotional responses I tended to look for what I thought was activity in the PAG during the processing. But one of the critical experiences for me was seeing that the affects, the emotions, could be completely cleared and yet there was still an activation there that would cause insomnia or rumination or hypervigilance to threat.
Dr. Frank Corrigan:So when I looked for the potential source of that shock, I came up with the locus coeruleus in the pons, which seemed to me to be the likely structure for mediating the impact of shocking experiences in those milliseconds after they're registered, and then later, with reading a book by Donald Pfaff, went deeper into the brainstem and hypothesized that the giant cell nucleus in the medulla oblongata is also significant in shock. So I see these structures as activating the upper brain, including the amygdala and the hippocampus, so you can get emotional memories formed if you've got enough activation of shock plus PAG, plus hypothalamus, all activation feeding into the amygdala, the hippocampus. Then you can get emotional memories for stimulus and for context. You can get those formed. But the key thing for me was that there had been a focus on the learning, without reference to where the activation of the learning came from. So that's why I thought when we get to the amygdala we've already gone too high up in the brain.
Lisa Danylchuk:So that's again where the slowing down and backing up before it gets to that point, before we're inundated with emotion or terror, rage, shame, grief, all of that really backing it up.
Dr. Frank Corrigan:Yeah, yeah. And we know, I think, from studies of fear learning that extinction models work with a relearning from the prefrontal cortex to the amygdala and that can take a long time and it doesn't necessarily generalise very well and we argue that that's because you've still got a sensitization at the brainstem level, so you've got a sensitivity to fear, for example with specific stimuli. And unless we get to that level, we're only doing a top-down regulating, we're not doing a clearing from the bottom up.
Lisa Danylchuk:Yes, that just tees up the next question, which is what might people be missing if they're not addressing shock or they're not addressing what happens in the deep brain?
Dr. Frank Corrigan:If I can give an example, one of the things that I've noticed is with traumatic bereavement, that people may have suffered a traumatic bereavement and then they've worked on it for years, decades even, and it's not cleared. And they've used all the available trauma therapies to get to it and it's not cleared. And when I've seen people with traumatic bereavements that have persisted in their clinical effects, I've found that it's because the shock in the first moment of realising when the body is hit by what has happened, when the brainstem is hit long, long, many milliseconds before the cortex catches up, that's the piece that we need to get to be with, that's the shock we need to identify and be with. And if we can be with that, then the amplification of the emotions disappears and people then can process their emotional responses in a more natural way.
Lisa Danylchuk:But have you found like a rhythm or some sort of predictability at all with integration time for folks in between sessions or after attending to this early shock, maybe for the first time?
Dr. Frank Corrigan:It's hard to say. The study in Canada is only eight sessions of DBR and that is not what we would usually do in routine clinical practice. I mean most people, especially with severe, complex trauma disorders, would need many, many more sessions than that. But it is, I think, constructive that even eight sessions is showing a significant improvement in the PTSD score and other scores that are used in the study. And also Ruth Lanius has observed from the imaging data that are emerging that there are changes in the functional connectivity in the brain after even the eight sessions. So this is really impressive. I mean for me it's very exciting because it's bearing out the theory on which the clinical model is based. So it's great to have that validation. But I think in time, as the data get analyzed and published, it'll really add to this awareness that we've got to get to the shock, to reduce the shock impact on the upper brain structures if we want to clear the trauma impact at the deepest level possible.
Lisa Danylchuk:Yes, that's really exciting. Can you say what the functional connectivity is, or is it too soon?
Dr. Frank Corrigan:It's probably too soon.
Lisa Danylchuk:Leave us on the edge of our seats. Well, we did have Ruth Lanius talk about this study in the last season of this podcast, and that was episode one in the last season and it's been a very popular one. So I think it is interesting just to see the research that's coming out, and eight sessions is, in the context of things, not a lot of treatment, so it's exciting to see that, and it's exciting to see that it was done, because of the COVID-19 pandemic, largely online, and so, even though there is this nth element of being together that can be powerful, can be threatening, depending on the person, there's something about this technique that translates um that in terms of teletherapy and telehealth as well.
Dr. Frank Corrigan:I think it's nice that we have the evidence from study of online DBR, because and that would usually be more of a second line study, I think so it's nice, especially when there was restricted communication during the pandemic, to have these results coming from an online study.
Lisa Danylchuk:Yeah, now I can imagine some people might be listening. This might be the first time they've heard of DBR. They've been in a lot of trauma therapy or maybe a friend or family member has, and they're excited, right listening, and, saying, I want to jump in and I want to do it. What – well I guess the first question is kind of what would you say to folks who are interested in receiving treatment for themselves in DBR and what are maybe some preparatory things to think about or to look for if they're looking for support in this way?
Dr. Frank Corrigan:Yeah, and I'm aware that the availability of DBR is not yet widespread and we need to do more trainings. We need to have more trainers and we're working on that currently. It's just evolved so fast. The demand has evolved so fast, entirely by word of mouth. Yeah, especially in the early days, people are saying this works, learn more about it.
Lisa Danylchuk:Yeah, and what's the simplest way you would describe what happens in a DBR session or what people could expect if, even if their therapist happens to be trained in it and they're wanting to shift and try something new? It's a different experience, right. It's different than all the other modalities.
Dr. Frank Corrigan:One of the differences, I think, is that often the processing is in silence. So at the beginning of the session the therapist is really active. What do you want to work on today? Let me help you define the activating stimulus in as brief a way as possible. Let's define that. Now we'll go to where self present the activating stimulus, get the orienting tension, look for the shock, stay with the shock, if possible until the energy of it dissipates. Then the affect comes in and there may be a move between affect and shock. But a lot of the time, once we've identified and helped the person identify that sequence from the orienting tension to the shock, to the affect we're then letting it process because it's the person's brain that knows what's required. It's not the therapist that knows what's required. So the therapist has to be able to often sit in silence and be attentive without saying anything.
Dr. Frank Corrigan:And that's difficult for many therapists to do that because they feel they should be doing something. And actually a lot of the time, once we've got it set up, we stay attentive, we stay focused, but often we're not saying anything. We're letting that process flow and for many people that's quite refreshing to come to a talking therapy session and not have to talk about your trauma. They may not even need to tell much about it to the therapist. They're able to highlight a piece of it and then go into processing and during that processing other memories may come up, because it may be that this sequence of shock into pain in to affect underlies many different traumatic experiences in the person's life. So rather than having to pick those off one by one, we get the sequence and we stay with it and allow the brain to process in the way that it needs to, and the therapist is attentive and non-directive during that part of the session.
Lisa Danylchuk:Yeah, two things stand out to me from that. One is the attentiveness of the therapist and the temptation for therapists to feel like I have to be doing something, when being attentive is a very powerful thing to quote do or not do right, just being with someone and I've seen you offer demonstrations and I've participated in the practicum and you know we can feel when someone's with us and when they're not right you can kind of sense if someone's starting to get distracted or go away and there's something really powerful. It seems it'll be interesting in further studies too of just that presence and that sense of I'm here with you, right, and that's something I've heard people say in these sessions of just I'm here, you know, and maybe a little check-in, and if the person's still moving through something or processing, we just allow it and really give space for it.
Dr. Frank Corrigan:Yeah, yeah, and it can take a while for us as therapists to get it right because different people require different support during the processing. Some may like us to just check in every now and again. You know, are you doing okay with this? They can know to not come out of process, because we don't want to ask any question that would take the person out of their intrinsic process and up to the higher thinking level of the brain. We want to keep it at this deeper level yeah, yeah.
Lisa Danylchuk:And the other point that came to me as you're talking is just the fact that silence can be overwhelming, like even in yoga or meditation, like close your eyes, go inside. Like that's a very loose instruction for someone who has a lot of trauma and so silence can be challenging for folks but when we're really focused on this short small window of time and there is a very strong container with deep brain reorienting of what we're doing, how we're focusing, and I know, even for myself as a participant, as a client, I can go right up to storytelling and emotion really quick, I'm doing like more of an EMDR thing in my brain and and my, my practitioner is like "can we come back to what you're you know, can we come back?" And that's really helpful.
Lisa Danylchuk:So, it's an attentiveness and it's also not just going along for the ride. There's, there's some of that, but there's also some of like are we really addressing the thing we're trying to address right now? And that can be a big challenge. But it's also quite clear, once there's an emotion coming up that's big or that's coming in at all, we know, okay, we're moving to a different part of the brain. Let's back up, let's reorient, if you will.
Dr. Frank Corrigan:But if the shock is cleared, we would often stay with the emotion because we would often want to validate that, to use my traumatic bereavement example. Once the shock is cleared, then the sadness comes in in a way that it's possible for the person to process. So naturally, we're going to give space for that too. And again, as we're sitting with that, it's the therapist being human, being present rather than doing something you know, applying a technique or particular words that you know should be said every now and again .
Lisa Danylchuk:And anytime there's a model and there's training, we can, as therapists, like what's the right way and what's the right thing to say, and I love and appreciate coming back to the humanness of it and there's often intuitive signals we're picking up on or senses that we're coming to, especially if it's a long-term client that we know very well, that can be powerful information for processing or for the work.
Dr. Frank Corrigan:Yeah, if it's people we know very well, then we're able to adjust our input to an optimal level. But of course it can change over time too, depending on whether the person is working on something from very early in life, when perhaps there was not an attuned presence, or when a silence was threatening or suggestive of aggression coming in. So we have to adjust how much input we have according to what the person needs in relation to what they're processing.
Lisa Danylchuk:Yeah, Can you speak to how – you mentioned attachment earlier and even finding the orienting tension from that place – can you speak to how attachment shows up in this work?
Dr. Frank Corrigan:I argue that the basic connection to another comes from a sensory orienting to the other and then usually from an affective r esponse to that, so that before there's any attachment there's this sensory affective connection at the midbrain level. And if we don't have that or if there's a disruption of that, we can also have the conflict in relation to the other at that level.
Dr. Frank Corrigan:So the infant may, for example, want to reach out and then see that mother's face is completely still and get blocked in the movement of reaching out with shock and then with the pain of what is experienced as rejection. So there's then a conflict at the collicular level between reaching out and pulling back. And when we get the orienting tension in relation to that conflict and we would usually use a present day trigger as a way in then we get the orienting tension. We can explore, or what arises rather is that conflict between reaching and recoiling, for example, and then the shock and the pain that go with that, and so we can get into these conflicts that have arisen even from very early in life, we can get into the brainstem manifestations of them, I hypothesize by using a present-day trigger of – It might be a relatively small stimulus in comparison with many others, but just some moment in an interaction that's felt rejecting or abandoning. We can use that as a way into an underlying conflict.
Lisa Danylchuk:Another thing you talk about is this core aloneness pain. Is that something that you find specific to attachment work or is that something you find in most or all clients comes up?
Dr. Frank Corrigan:I tend to go with the idea that attachment to others is the most fundamental mammalian need and so if that need is not met, then the experience, the internal experience, is likely to be painful and, depending on the circumstances, there can be a huge variety of responses to that pain which I call, as you say, core aloneness pain, and often even with severe trauma history, there are moments within the traumas when the aloneness is the most painful aspect of it.
Lisa Danylchuk:So I'm assuming, then that focusing on the initial shock of that moment of aloneness pain whether you're starting with a you know non-response to a text message or you're ending up at that reaching and leaning back conflict of the infant, like you were describing, that clearing those really initial deep brain responses to, to those moments will help. Because when I say something like core aloneness pain, I'm like whoa, that's big, right, that's big. So, in order to get there, from this perspective, it's important to focus on the initial shock that then preceded that deep pain in order for it to be less overwhelming.
Dr. Frank Corrigan:Yes, yeah, I think that the shock usually precedes the pain, which in turn, precedes the emotional responses to that pain. So that's what we're looking for in relation to those aversive attachment experiences the shock, the pain then the emotions.
Lisa Danylchuk:Another important thing here and I know we're talking level two, level three stuff in terms of how you train mental health professionals in deep brain reorienting but dissociation is something that I've worked with for a long time and I think people are becoming more aware of in the clinical world and valuing as an adaptive response. Can you speak to how DBR addresses dissociation or even dissociative identity?
Dr. Frank Corrigan:Yeah, and I'm sure it's an oversimplified model in the eyes of many but it's clinically useful. So what we use is a model in which we are seeing dissociation as a response to that pain of aloneness, that if it starts very early in life then there's a capacity at the mid-brain level to turn away from it. And this is not happening to me. This is not my pain. So the primary dissociation from the pain would be that kind of involuntary turning away from it.
Dr. Frank Corrigan:And of course, if the pain has been so intense and often if it arises from very early life, it's described as unbearable and unending. So those two words often are used around that core pain. It just feels unbearable and it's never going to end. So if the brain has found that too much to turn to and has turned away, then if we're turning back towards it, we have to do it very carefully and just take our time with it. But as we do it carefully and slowly, then it gives that underlying pain a chance to clear and resolve.
Dr. Frank Corrigan:We also use the idea of neurochemical dissociation for the cannabinoids when emotions are so intense that they need to be capped by the midbrains, so the cannabinoids come in and cut them off at a high level but prevent them getting too high and then endogenous opioids coming in and shutting down and making sleepy and drowsy and dropping the heart rate and the blood pressure and so on. So we've got that neurochemical dissociation. We also describe what I call intracortical dissociation as the result of shock activating the cortex in a chaotic way, so that then the cortex loses the coherent sense of a self in relation to the world and in relation to others. So I see that intracortical dissociation as linked to experiences chronically often of derealization and depersonalization.
Lisa Danylchuk:Yeah.
Dr. Frank Corrigan:And then finally the structural dissociation, where we have parts of self split off and I see those as arising from circuitry from the cortex through the basal ganglia striatum and thalamus and back to cortex. So those circuits I think have separated off from the brainstem activations that probably gave rise to them. And when we're working with structurally dissociated states we're trying to keep below the level of those parts of the self and work with the underlying shock and pain and emotion.
Lisa Danylchuk:Yeah, I'd imagine that could be complex if different parts are showing up in session of, needing a sense of collaboration amongst parts before you go to the deep brain. I mean, that's maybe a more advanced clinical question here.
Dr. Frank Corrigan:Yeah, but usually I would explain it on the basis that we're not working specifically with the parts. We're trying to help with a clearing of an underlying shock and pain that probably affects all parts of the system. So we present the argument we're not working with specific parts, we're trying to get underneath to something that will help every part of the system feel better. Of course that as you know will sometimes provoke controversy within the brain, but we do what we can to work around that and keep working at the deeper level, below the level of the of the parts of self,
Lisa Danylchuk:And with all of that, starting with where self, and that as the foundation right.
Dr. Frank Corrigan:Absolutely yeah, yeah, yeah, yeah. We never go into DPR without starting with and, as I said at the beginning, it's a good guide to whether someone is ready for DPR processing or not.
Lisa Danylchuk:Yeah, there's so many questions in terms of dissociation, but I'll just enroll in level three for that.
Dr. Frank Corrigan:Right, okay.
Lisa Danylchuk:Level two is attachment focus. Level three is dissociative focus. Okay, yeah. I know our training
Dr. Frank Corrigan:Yeah, and I know this is an oversimplified model, but, as I say, it works clinically, so that's why I think it's worth pursuing.
Lisa Danylchuk:What's the leading edge for you now? What are you interested in? I know you're working to get up to speed and get people trained, and that's plenty, but I'm curious if there's just questions you're wanting to pursue in terms of research or ideas, thoughts you have right on on the edge of this as it's growing.
Dr. Frank Corrigan:Even if it's not got the 7 Tesla neuroimaging, just to test out the clinical application in another centre would be great. So there's a few people interested and I'm hoping one of them will get the funding to go with this in time, because that would really. If we got support from a second study, it would help to change national guidelines on treating PTSD, for example, and I think on treating dissociative disorders, given the proportion of participants in the study who also had a comorbid dissociative disorders. So it could, once that's published, I think it could help to change available treatments for complex PTSD and dissociative disorders.
Lisa Danylchuk:Yeah, and is there a population you feel like DBR is best for in terms of clients?
Dr. Frank Corrigan:Yeah, yeah, it's fairly difficult to identify inclusion and exclusion criteria, particularly based on diagnoses which are often not really very precise. So I tend to think that if somebody has a clinical disorder that's based in traumatic experience or traumatic experiences, it's worth thinking about
Dr. Frank Corrigan:And because we can do it gradually just by ourselves. Make sure that's possible. Can we get an orienting tension? Do you feel able to go on into the shock of this relatively minor present day trigger that we select so we can go into it carefully and slowly and with full collaboration of the client or patient, and that then lets us see, I think, whether we can or can't do DPR with that person.
Lisa Danylchuk:Yeah, and so the capacity to access where self is one thing I'd imagine. Just in terms of age, I don't know if there's been a lot. I think there's been some work with kids too, right with younger people, so there's obviously maybe like a language threshold at least, where young people would need to understand the process and be able to go along with it. Is there anything else that shows up in terms of exclusion or limitation or caution?
Dr. Frank Corrigan:Nothing specific. I think there are conditions like traumatic brain injuries, for example. I think there are conditions like traumatic brain injuries, for example, where it may be that the processing capacity has been altered and we would need to go carefully just to make sure there's enough processing capacity. People have asked about psychosis. Don't have enough information on that just now. I think if a psychosis were well regulated by medication, it may be possible to do useful work on any trauma history that there is, and whether it would impact on the severity or the intensity or the frequency of episodes of psychosis.
Dr. Frank Corrigan:I don't know. It needs a study. If I may say, though, when you're asking about further developments, the thing that I think really needs studied, as well as another study of straight DBR and complex PTSD, the thing that we really need is a study of DBR in acute situations like war zones and so on, to see if processing the shock of a very recent event, like one's house being shelled the day before or something like that, if processing the shock of that, reduces the long-term risk of PTSD. I think that's a hugely important question, so maybe somebody listening will have the ability to follow that one up.
Lisa Danylchuk:Yes, we can always ask, we can always hope. So if people want to get trained, where would you send folks? Would it just be deepbrainreorienting. com?
Dr. Frank Corrigan:Yeah, it's good if they go there register interest there.
Lisa Danylchuk:Okay, and most of the trainings are being done online these days.
Dr. Frank Corrigan:Yes, Most of them are done online.
Lisa Danylchuk:Yeah, okay great and your book, together with Hannah Young, Jessica Christie Sands, Deep Brain Reorienting: Understanding the neuroscience of trauma, attachment wounding and deep brain reorienting psychotherapy. That's available through Routledge, pretty much anywhere people get books online.
Dr. Frank Corrigan:Yeah, that was recently published. That's good to have it out there.
Lisa Danylchuk:Yes, yeah, that's a great project.
Dr. Frank Corrigan:No, I think....
Lisa Danylchuk:That's plenty!
Dr. Frank Corrigan:I think there's a lot going on and there's a lot of potential for more developments here. So I hope I've outlined enough to to give people an idea of what's involved here
Lisa Danylchuk:And if people want to connect with you, it's deepbrainreorienting. com.
Dr. Frank Corrigan:Yeah.
Lisa Danylchuk:Wonderful, I usually ask people at the end of these interviews what brings you hope, but I feel like your work is just bringing plenty of hope. I don't know if there's anything you want to add, but when we find things that are working, I think that's inherently energizing and instilling of hope.
Dr. Frank Corrigan:I think that's a huge factor in this, because when somebody has a very complex history of serious trauma, even a small shift within a session can give hope, and so repeated sessions, even with small shifts, are giving hope for eventual change. That's really experienced as a change in capacity for a sense of well-being, for happiness, for joy in life. So I think seeing the results of the sessions, hearing from people who've told me different parts of the world what a difference it's made, that gives hope for continuing um ways of approaching trauma and and taking healing from the adverse effects of it.
Lisa Danylchuk:At the end of our in-person training in Boston, there was just this feeling in the room and everyone was. You know, it was a very regulated feeling and sometimes, with trauma processing, we don't always wrap up in that place. Sometimes there's a sense of, oh, I got to sleep on this or oh, I really got to go back to therapy with that, and there was very much a sense of connection and appreciation and the things I think most of us want in life, right, Just to feel connected to each other, regulated with each other. I think we can all use more of that these days.
Dr. Frank Corrigan:Yeah.
Lisa Danylchuk:Well, I want to thank you for your work, for your dedication over the years to creating this model, to sharing it with us. I know it's a lot of work in the background and in the foreground, so I want to just appreciate and celebrate you, Dr. Frank Corrigan, for being here and sharing all this with us. Thanks for coming on the show!
Dr. Frank Corrigan:Thank you for having me. Thank you.
Lisa Danylchuk:Thanks so much for listening. My hope is that you walk away from these episodes feeling supported and like you have a place to come to find the hope and inspiration you need to take your next small step forward. For more information and resources please visit HowWeCanHeal. com. You'll find tons of helpful resources There you'll and the show notes for each show. Thanks for your messages, feedback
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Lisa Danylchuk:Before we wrap, I want to be clear that this podcast isn't offering any prescriptions. It's not advice or any kind of diagnosis. Your decisions are in your hands and we encourage you to consult with any healthcare professionals you may need to support you through your unique path of healing. In addition, everyone's opinion on this show is their own and opinions can change right. Guests share their thoughts, not that of the host or sponsors. I'd also like to send a huge thanks to everyone who helps support this podcast, directly and indirectly. Alex, thanks for taking care of the babe and the fur babies while I record. Lastly, I'd like to give a shout out to my big brother, Matt, who passed away in 2002. He wrote this music and it makes my heart so happy to share it with you here. Thank you.