Brainspotting vs EMDR: Which Trauma Therapy is Right for You?

What is EMDR?

Eye Movement Desensitization and Reprocessing (EMDR) is a structured, evidence-based therapy developed by Francine Shapiro in 1987. It's one of the most well-researched trauma therapies and is recognized by organizations like the American Psychological Association and the World Health Organization as an effective treatment for PTSD.

EMDR works by having clients recall traumatic memories while following the therapist's finger or a light bar with their eyes in a side-to-side motion. This bilateral stimulation is thought to help the brain reprocess traumatic memories, reducing their emotional intensity.

What is Brainspotting?

Brainspotting is a newer therapy developed in 2003 by David Grand, Ph.D., who was originally an EMDR therapist. While working with a client, Dr. Grand discovered that holding the eyes in a specific position (rather than moving them) led to deeper emotional processing.

Brainspotting is based on the principle that "where you look affects how you feel." By finding and focusing on specific eye positions (brainspots), clients can access and process trauma stored deep in the subcortical brain—areas that traditional talk therapy may not reach.

Key Similarities

Before diving into differences, it's important to note what these therapies have in common:

• Both use eye positioning to access and process traumatic memories
• Both are somatic therapies that work with the body's natural healing abilities
• Both can work faster than traditional talk therapy for trauma
• Both are relatively low-talk compared to traditional psychotherapy
• Both are effective for PTSD and various forms of trauma
• Both may involve bilateral stimulation (though Brainspotting doesn't always use it)

Key Differences

1. Eye Movement vs. Fixed Gaze

EMDR: Uses rapid side-to-side eye movements while recalling trauma. The client's eyes follow the therapist's fingers or a light bar moving back and forth.

Brainspotting: Uses a fixed eye position. The therapist helps you find a specific spot in your visual field where you hold your gaze while processing trauma.

2. Structure and Protocol

EMDR: Follows a highly structured 8-phase protocol:

1. History taking and treatment planning
2. Preparation and teaching coping skills
3. Assessment of target memory
4. Desensitization using bilateral stimulation
5. Installation of positive beliefs
6. Body scan for residual tension
7. Closure
8. Reevaluation in next session

Brainspotting: More flexible and client-led. While there's a framework, the process adapts to what emerges naturally in each session. There's less emphasis on following a specific protocol.

3. Amount of Talking Required

EMDR: Requires moderate talking. You need to describe the traumatic memory, identify negative beliefs, and articulate positive beliefs you want to install.

Brainspotting: Requires minimal talking. You might start with a brief description, but much of the processing happens silently. This makes it ideal for people who struggle to verbalize their trauma or find talking about it retraumatizing.

4. Cognitive vs. Subcortical Focus

EMDR: Works with cognition—identifying negative beliefs ("I am powerless") and replacing them with positive ones ("I am capable").

Brainspotting: Focuses on the subcortical brain where trauma is stored, bypassing the cognitive mind. Less emphasis on beliefs and more on felt sense in the body.

5. Bilateral Stimulation

EMDR: Always uses bilateral stimulation (eye movements, taps, or sounds) as a core component.

Brainspotting: May or may not use bilateral sound (BioLateral sound through headphones). It's optional and depends on what the client needs.

6. Research Base

EMDR: Extensively researched with 30+ years of studies. Recognized by WHO, APA, and Department of Veterans Affairs as evidence-based for PTSD.

Brainspotting: Newer with growing but more limited research. Many case studies and clinical reports support its effectiveness, but fewer large-scale randomized controlled trials.

Which is More Effective?

Both therapies are highly effective for trauma, and the "best" choice depends on your individual needs:

Choose EMDR if you:

• Have a specific traumatic incident to target (car accident, assault, natural disaster)
• Prefer a structured, step-by-step approach
• Are comfortable talking about your trauma in moderate detail
• Want a therapy with extensive research backing
• Are seeking insurance coverage (more insurers recognize EMDR)

Choose Brainspotting if you:

• Have complex trauma or multiple traumatic experiences
• Struggle to talk about your trauma or find it retraumatizing
• Want a more flexible, client-led approach
• Are an athlete or performer working on performance blocks
• Have tried EMDR and want to go deeper
• Experience dissociation (Brainspotting may be gentler)
• Prefer minimal talking during processing

Can You Do Both?

Yes! Some therapists are trained in both modalities and may use elements of each depending on what works best for you. Additionally, some people start with EMDR and later try Brainspotting for deeper work, or vice versa.

David Grand himself developed Brainspotting while practicing EMDR, recognizing that different clients need different approaches.

What Does the Research Say?

EMDR Research

EMDR has robust research support:

• 30+ randomized controlled trials demonstrate effectiveness for PTSD
• WHO and APA recommend EMDR as a first-line treatment for trauma
• Studies show 84-90% of single-trauma victims no longer have PTSD after 3 sessions
• Effective for depression, anxiety, phobias, and chronic pain

Brainspotting Research

Brainspotting has a growing but smaller research base:

• Studies show significant reduction in PTSD symptoms
• Effective for treating survivors of natural disasters and war trauma
• Case studies demonstrate effectiveness for anxiety, depression, and addiction
• Research on athletes shows improved performance and reduced performance anxiety
• Neuroimaging studies show it activates deeper brain regions than talk therapy

Cost and Insurance

EMDR: More widely covered by insurance due to extensive research and longer history. Many insurance plans explicitly list EMDR as a covered treatment for PTSD.

Brainspotting: Growing insurance acceptance, but may be billed under general psychotherapy codes rather than as a specific modality. Check with your insurance provider.

Both therapies typically cost $100-250 per session, depending on your location and the therapist's experience.

Finding a Qualified Therapist

For both modalities, it's crucial to find a properly trained therapist:

EMDR Therapists

• Should be trained through an EMDR International Association (EMDRIA) approved program
• Look for "EMDRIA Certified" status for most experienced practitioners
• Search the EMDRIA directory

Brainspotting Therapists

• Should complete Phase 1 training at minimum (3-day intensive)
• Phase 2 and 3 training indicates deeper expertise
• Many Brainspotting therapists are also trained in EMDR and other modalities

Real Client Experiences

EMDR Success Story

"After a car accident, I had flashbacks every time I got behind the wheel. After 6 EMDR sessions, I can drive without panic. The structured approach helped me feel safe as we worked through the trauma."

Brainspotting Success Story

"I tried talk therapy for years for childhood trauma, but couldn't articulate what happened. Brainspotting let me process without having to find the words. The healing happened in my body, not my head."

Bottom Line: Which Should You Try?

There's no wrong choice—both EMDR and Brainspotting are powerful trauma therapies with strong track records. Your decision might come down to:

• Your trauma type: Single incident vs. complex/ongoing trauma
• Your communication style: Comfortable talking vs. prefer non-verbal
• Your preferences: Structured protocol vs. flexible approach
• Insurance coverage: EMDR may be easier to get covered
• Therapist availability: EMDR therapists are more common

Many people find success with either approach. The most important factor is finding a qualified therapist you trust and feel safe with.

Frequently Asked Questions

Can I switch from EMDR to Brainspotting or vice versa?

Absolutely. Some people start with one and later try the other. Many therapists are trained in both and can adapt based on what's working for you.

How many sessions will I need?

For single-incident trauma: Often 3-12 sessions for either modality. For complex trauma: May require 6 months to 2+ years of regular sessions.

Are there any risks or side effects?

Both therapies are generally safe when practiced by trained professionals. Some people experience temporary emotional intensity, vivid dreams, or fatigue after sessions. This is normal and usually indicates processing is happening.

What if I dissociate during sessions?

Brainspotting may be gentler for people prone to dissociation, as it allows you to stay more grounded. EMDR therapists are also trained to help you stay present, but the structured protocol can sometimes feel overwhelming for highly dissociative clients.

Do I need to relive my trauma?

Neither therapy requires you to relive trauma in detail. EMDR asks you to briefly recall the memory, while Brainspotting often works with minimal or no discussion of the traumatic event.