226. Effect of brainspotting in PTSD patients: clinical efficacy and neuropsychopharmacological considerations

Abstract

Abstract Background Post-traumatic stress disorder (PTSD) is characterized by hyperarousal of emotional memory, avoidance behaviors, and autonomic instability. It is thought to involve an imbalance in the norepinephrine, dopamine, and serotonin neurotransmitter systems mediated by amygdala hyperactivity and functional deficits in the prefrontal cortex and hippocampus. Standard treatments include pharmacological therapy and psychotherapy, and a complementary combination is recommended, but some cases are ineffective. Brainspotting (BSP) is a psychotherapy that facilitates access to deep brain regions through eye fixation and supports the reprocessing of emotional memories. It is believed to be effective in processing traumatic events that are difficult to verbalize. This report presents two cases in which symptom relief was achieved through BSP and discusses its implications from neuropsychopharmacological and psychological perspectives. Aims & Objectives This study clarifies the clinical efficacy of BSP while examining its mechanism of action from a psychological perspective and incorporating neuropsychopharmacological considerations. Method The subjects were two individuals diagnosed with PTSD or complex PTSD. Each individual underwent six to ten BSP sessions. Psychological indices were assessed using the IES-R and STAI before and after treatment, and physical sensations and emotional changes during the sessions were recorded. Results In both cases, a decrease in IES-R scores and an improvement in STAI state anxiety were confirmed. Furthermore, the patients described their memories as "less vivid and more vague" and "feeling less anxious and more secure," suggesting a relationship between eye position and emotional responses. Discussion & Conclusions The suppression of amygdala overactivity and reintegration of the prefrontal cortex by BSP may have contributed to the reconstruction of the emotion regulation network. The connection between the visual cortex and the brainstem via eye fixation may have alleviated hyperarousal of the noradrenergic system and promoted stabilization of the serotonergic system. Psychologically, the BSP's emphasis on nonverbal processing enabled access to difficult-to-verbalize emotional memories and improved self-regulation. This case suggests that emotion integration via somatic sensations is effective in reducing PTSD symptoms, and BSP has clinical significance as a new intervention that can complement pharmacotherapy.