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How Brainspotting Helps Release the OCD Cycle and Strengthen ERP Treatment

Many people with Obsessive–Compulsive Disorder (OCD) describe feeling stuck, trapped in a loop of intrusive thoughts and repetitive behaviors that feel impossible to break. This isn’t a sign of weakness or lack of willpower. It’s actually a brain-based pattern, sometimes called “brain lock.”

Exposure and Response Prevention (ERP) is the most effective and well-researched treatment for OCD. According to a study published by the National Library of Medicine, about 50–60% of patients who complete ERP treatment show clinically significant improvement in OCD symptoms. Brainspotting is a newer therapeutic approach that can complement ERP by helping clients process emotional and physiological activation that contributes to the sense of being stuck.

This article draws on established neuroscience, available research, and clinical experience to explain how both approaches can work together to support meaningful and lasting change.

Understanding the OCD Cycle Through a Brain-Based Lens

OCD symptoms follow a predictable neurological pattern. Research has identified three primary brain regions involved in the cycle of intrusions, anxiety, compulsions, and temporary relief.

Orbitofrontal Cortex (OFC): The Internal Alarm System

This part of the brain detects when something feels wrong or out of place. In OCD, it’s overactive, constantly sending out error messages, even when nothing is actually wrong.

Anterior Cingulate Cortex (ACC): The Evaluator of Uncertainty

This region is involved in emotional regulation and deciding whether something is still a problem. In OCD, it becomes hyperactive, so the brain keeps focusing on the perceived issue without resolving it.

Caudate Nucleus: The Cognitive Gear Shifter

This is like the brain’s "filter" or "gear shifter." It helps us transition smoothly from one thought or action to another. In OCD, this part is under-functioning, which means the brain cannot shift gears easily and gets stuck in repetitive thought-action loops.

This combination creates the “brain lock”. It’s a cycle where intrusive thoughts trigger anxiety, which leads to compulsive behaviors to relieve that anxiety, which then reinforces the brain’s faulty alarm system.

How Brainspotting Addresses the Emotional and Neurological Roots of OCD

ERP helps retrain behavioral responses to intrusive thoughts. Brainspotting works within emotional and nervous system processes that can amplify distress and reinforce looping patterns.

Brainspotting is based on the observation that eye position corresponds with activation in specific areas of the brain and body. When clients focus on a specific gaze point linked to internal activation, the brain begins to process unresolved emotional material in a supported and regulated environment.

Emerging Research on Brainspotting

Preliminary research on Brainspotting shows encouraging outcomes. In a pilot study of 22 participants receiving Brainspotting for trauma-related symptoms, clients experienced significant symptom reduction after an average of three sessions (Hildebrand, Grand, and Stemmler, 2014). Although the research base is still developing, early findings suggest that Brainspotting can help reduce emotional and physiological activation that contributes to the sense of being stuck.

In my work with clients using Brainspotting, I’ve often seen a noticeable shift when we integrate Dr. Pie Frey’s OCD model. When clients can really anchor into the understanding that their OCD is a brain issue and not a personal failing, I watch a visible sense of relief come over them. From there, moving between the “OCD activation spot” and the “brain issue spot,” and eventually into a “positive resource spot”, helps clients step out of the content of their obsessions and into a healthier sense of distance and control. As they practice this back-and-forth process, the brain seems to gradually “unlock,” and ERP exposures become more manageable because the internal alarm system isn’t firing as intensely. Over time, I’ve seen clients feel less stuck, less overwhelmed, and more empowered to interrupt the OCD loop. Not by force, but through a calmer, clearer connection to their own brain’s ability to rewire.

Why Brainspotting and ERP Are Stronger Together

ERP remains the most effective treatment for OCD. Brainspotting does not replace ERP, but it can make ERP more accessible and tolerable by addressing internal experiences that often make exposure work challenging.

Helps regulate emotional activation during ERP

Brainspotting supports nervous system stability, which allows clients to participate in exposures with less overwhelm.

Processes the deeper emotional intensity behind intrusive thoughts

Intrusive thoughts often carry physical and emotional charge. Brainspotting helps reduce this internal pressure.

Reduces physical sensations that drive compulsions

Compulsions are often motivated by bodily sensations rather than thoughts alone. Brainspotting works directly with these sensations.

Supports clients who feel stuck or hesitant to begin ERP

Because Brainspotting accesses deeper neural processes, it can help clients move through barriers that talk-based approaches may not reach on their own.

Together, these approaches address both the behavioral and emotional aspects of OCD, creating a more comprehensive foundation for healing.

What a Combined Brainspotting and ERP Approach Can Look Like

Integrated treatment is personalized, but it often includes several core components.

1. Establishing Regulation and Internal Safety

Brainspotting helps create nervous system stability. This prepares clients for ERP work.

2. Mapping Your Individual OCD Loop

Together, therapist and client identify patterns, triggers, sensations, and beliefs that maintain the cycle.

3. ERP Supported by Brainspotting

ERP interrupts behavioral patterns. Brainspotting processes underlying emotional and physiological activation.

4. Integration and Long-Term Change

As the brain forms new pathways and releases old patterns, intrusive thoughts lose intensity, and compulsions lose their grip. Clients often report increased flexibility, reduced distress, and a stronger sense of agency.

A Path Forward

If you have felt stuck in cycles of intrusive thinking and compulsions that have negatively impacted your quality of life, you are not alone. These experiences reflect a brain pattern that can be changed with the right support.

ERP teaches the brain new responses to intrusive thoughts.

Brainspotting helps release what keeps older patterns in place.

Together, they offer a holistic and effective path toward long-term relief.