Today, medical science still has too little to offer individuals who suffer with mental illness. Current treatments are generally safe but are rarely completely effective for every patient. This situation is mainly due to our incomplete knowledge of the neural mechanisms of these illnesses. Historically, whenever there is a vacuum of ignorance about the best way to treat a mental illness, the void is quickly filled by pseudoscientific nonsense. As expected, pseudoscientific methods have easily proliferated in the mental health field. A recent publication examined an egregious example pseudoscience, brainspotting, for its lack of plausible underlying neural mechanisms of psychopathology and for its promotion of a method of intervention that is literally impossible for a human therapist to implement.

The American Psychological Association has developed formal clinical practice guidelines to support a range of empirically supported treatments for psychiatric conditions. Unfortunately, there are many scientifically dubious interventions that are aggressively marketed for the treatment of mental illnesses. These treatments continue to have a seductive pull on general mental health practitioners who often lack a strong neuroscientific background (see Klepac RK, et al., 2012) or are resistant to evidence-based practice (see Lilienfeld et al., 2013).

The authors of a recently published analysis of brainspotting admit that claiming an intervention is based on pseudoscience is a serious accusation. Fortunately, for comparative purposes, there are numerous examples of mental health care that meet the criteria for being pseudoscientific. The hallmarks of pseudoscience include model loopholes that prevent falsification; emphasis on confirmation over falsification, with a corresponding ex post facto rationale for any seeming falsification; overuse of single-case studies and anecdotal evidence; excessive ‘science-ism’ (such as dramatic brain connectivity where none plausibly exists); and a general evasion of rigorous empirical tests.

Possibly the most common way that promoters of pseudoscience methods gain popularity in the absence of well-designed research is through a litany of case reports. This serves the purpose of creating the impression of widespread support without the benefit of careful tests against control groups. This is the case with brainspotting. Currently, the only supportive research for brainspotting are single case studies and a small-scale investigation that compared the method to eye movement desensitization reprocessing.

Brainspotting has emerged as a psychotherapeutic method aimed at engaging trauma memory and associated physical activation through indirect stimulation of specific brain areas. Brainspotting is a talk therapy that helps clients process trauma and negative emotions. It is based on the still unproven idea that eye positions correlate with activation of specific brain regions involved in unconscious, emotional experiences. fMRI studies do not support this hypothesis. Eye gaze can only indicate which brain hemisphere is active.

A typical session begins with the therapist using a pointer while asking the patient to follow it with their eyes. The patient is instructed to inform their therapist if the light settles in a spot within their visual field that generates any thoughts or feelings. The creators of the therapy claim that where a person looks affects how they feel. As someone extremely familiar with brain anatomy and the neurophysiology of visual processing, these claims make no scientific sense. The brain simply doesn’t work this way (for a more thorough explanation, see Wenk, 2017).

Supporters of brainspotting have articulated a series of brain areas associated with vision, sensorimotor processing, memory, and cognition, packaged in plausible-sounding hypotheses constructed to give brainspotting the appearance of being scientifically grounded. However, in the ten years since brainspotting was first promoted as a treatment, no evidence has been uncovered that any part of this brain circuitry is involved in posttraumatic stress or traumatic memories. Given the lack of causal mechanisms in the treatment approach for brainspotting, the authors concluded that it could be characterized as a form of scientific apophenia, effectively purporting to patterns of connectivity where none actually exists.

Brainspotting requires that the therapist identify very brief pauses in the patient’s eye movements while the patient is following a moving target. Essentially, the principal component of the treatment requires the therapist to accomplish a task that is impossible for humans to perform with the naked eye, namely to identify a brief pause in the ordinary course of saccadic eye movement. Saccades are rapid eye movements that allow for quick shifts in gaze toward visual stimuli. The peak angular speed of the eye during a saccade about 700 degrees per second. In addition, saccadic processing is highly variable within individuals, making the potential for identifying the ‘spot’ even more challenging.

This provides a loophole for the supporters of brainspotting if the treatment fails. The method emphasizes the absolute centrality of the clinician’s observing eye movements. Because this task is literally impossible, the treatment is shielded from disconfirmation. Treatment failures are fundamentally the fault of the clinician rather than the lack of any credible neural mechanisms of action to support the premise of brainspotting.

The authors of this thorough analysis (McKay D & Coreil A, 2024) concluded that brainspotting meets the criteria for a pseudoscience because it makes fantastic claims of outcome and has a built-in component that insulates the method from disconfirmation. Brainspotting is not an evidence-based treatment, furthermore, it is not grounded in any basic science that connects its purported mechanisms to neurobiological aspects of trauma.