Most trauma treatments focus on fight, flight, freeze and fawn responses. DBR goes deeper — targeting the shock that precedes these responses. Shock is the moment of realisation during a traumatic event that something is about to go wrong. It's the sudden gasp while falling, or the bracing right before impact.

DBR theory holds that if this shock is left unprocessed, it interferes with the processing of overwhelming emotions that follow trauma. By addressing shock first, the other painful emotions and trauma reactions become more accessible and easier to process.

Because DBR works below the emotional and cortical brain, most clients find it easier to tolerate than more intense trauma therapies — and clients are not required to talk about or relive the specifics of their trauma.

To begin, the therapist and client identify an "activating stimulus" — a moment of realisation just before the sense of overwhelm. Importantly, this does not require revisiting the worst moment of the trauma.

The therapist then helps the client connect to their "where self" — the part of themselves that notices where their body is in space. From there, the client briefly connects to the activating stimulus, which elicits an "orienting tension" — subtle sensations in the forehead, base of the neck or around the eyes that reflect the brainstem's first response to the past threat.

The therapist guides the client to notice and "be with" sensations associated with shock — tension behind the eyes, shivering, shuddering, a feeling of hollowness or tingling. At the end of a session, clients often report feeling relief, a sense of lightness and a renewed perception of themselves.