Brainspotting vs PSIP
A side-by-side comparison: mechanism, evidence, the conditions each treats, philosophical roots, and where they actually disagree clinically.
At a glance
Brainspotting
- Tradition
- Trauma-Focused
- Founder
- David Grand (2003)
- Evidence
- RCT-supported
- Focus
- Processing + Somatic
- Format
- Individual
- Duration
- Short-medium
PSIP
- Tradition
- Psychedelic
- Founder
- Saj Razvi (2016)
- Evidence
- Emerging evidence
- Focus
- Experiential + Somatic
- Format
- Individual
- Duration
- Medium-term
How they work
Brainspotting
Core mechanism: Focused eye position accesses subcortical processing of trauma capsules; therapist attunement supports activation and discharge
Ontology: Trauma stored subcortically in body/brain; accessed through visual field-somatic connection
PSIP
Core mechanism: Cannabis or ketamine induces primary consciousness state + active therapist relational engagement with somatic defense cascade + completion of truncated survival responses reorganizes autonomic patterning
Ontology: Complex trauma is stored in autonomic nervous system defense patterns inaccessible to ordinary consciousness; psychedelic medicine provides access while relational attunement provides corrective experience
Conditions treated
1 shared · 3 Brainspotting-only · 3 PSIP-only
Both treat
Only Brainspotting
Only PSIP
What each assumes — and misses
Brainspotting
Philosophical roots: Merleau-Ponty (body-subject, perception); Levine (somatic trauma); Damasio (somatic marker hypothesis); Grand (subcortical processing thesis)
Blind spots: Very limited controlled research; proposed mechanisms largely speculative; training lacks standardization compared to EMDR
Therapeutic voice: Just notice where your eyes naturally want to go when you hold that feeling. Stay there.
PSIP
Philosophical roots: Merleau-Ponty (embodied consciousness); Porges (polyvagal theory — autonomic defense states); Levine (somatic experiencing — completing survival responses); van der Kolk (body keeps the score); Bowlby (attachment as organizing principle); psychodynamic transference theory
Blind spots: No controlled outcome research; proprietary training model without external accreditation; reliance on cannabis as primary medicine complicates legal and clinical standards; apprenticeship structure creates potential dual-relationship concerns; strong theoretical claims outpace empirical evidence
Therapeutic voice: I'm right here with you. What's happening in your body right now? Stay with that — I'll stay with you.
Choosing between them
Brainspotting (Trauma-Focused) and PSIP (Psychedelic) come from different traditions, which means they assume different things about what a person is, what causes suffering, and what the therapeutic relationship is for. The choice between them is often less about "which works better" and more about which set of assumptions fits the client and the therapist.
For deeper coverage: see the full Brainspotting and PSIP pages, or use the interactive comparison tool to add more modalities to this comparison.