EMDR vs. CBT: Why EMDR is more than ‘tricking your brain’
Someone curious about Eye Movement Desensitization and Reprocessing (EMDR) therapy recently said to us that they were hopeful for relief because EMDR was all about “tricking your brain.” But as EMDR therapists, we know that’s not the true goal of EMDR therapy. Let’s break down what that statement is missing.
Many therapy modalities are rooted in behavioral and cognitive framework - modalities like Cognitive Behavioral Therapy (CBT), Dialectical Behavior Therapy (DBT), Exposure Response Prevention (ERP), and many other forms of talk therapy. It’s where language like “tricking your brain” originated! In this blog, we will focus on Cognitive Behavioral Therapy (CBT) because it is often the first approach for nearly any mental health concern. Most research into mental health focuses on CBT and many other modalities are compared to CBT when being tested for efficacy. And we also see it as many of our clients first steps toward building skills and capacity for deeper trauma therapy like EMDR.
So, how are CBT and EMDR different?
what is cbt?
CBT is a therapy modality that emphasizes thoughts and actions. It is effective in increasing insight and the ability to identify negative thought patterns that contribute to unwanted behaviors. CBT incorporates coping skills and intellectual understanding of our behaviors. CBT has been rigorously studied and is often the first modality people interact with when seeking therapy. CBT centers thoughts as the driver of change.
what is emdr?
EMDR is a therapy modality designed to help individuals experience and digest the emotional distress and the symptoms associated with undigested stored traumatic material. In this sense, traumatic material includes body sensations, emotions, images or movies, and thoughts to shift how one relates to their past in a more adaptive, digested way. EMDR was intitally intended for both PTSD and more complex PTSD associated with childhood attachment wounds, but it also has been shown to help address anxiety, depression, OCD, attachment wounding, and more. EMDR emphasizes the past, present, and the future. To learn more about EMDR, click here.
how are they different?
In short, CBT focuses on conscious thought patterns, helping you identify and restructure cognitive distortions through talk and behavioral exercises. EMDR focuses on somatic and emotional processing, using bilateral stimulation to help the brain reprocess traumatic memories without requiring extensive verbal discussion.
Keep reading for a full breakdown, including how CBT sessions compare to EMDR sessions.
emdr vs. CBT in session: The body
In an EMDR session, a therapist will ask a client “What do you notice in your body when you bring your attention to that memory?” or “what do you feel in your body as you notice that belief about yourself?”
EMDR operates from a “bottom-up" premise: traumatic and distressing memories are held implicitly in the nervous system as visceral experiences that exist beneath conscious thought. You cannot think your way out of a physiological reflex that began in the survival centers of the brain.
A standard CBT therapist approaches physical sensations as a byproduct of your thoughts. Because CBT is a “top-down" approach, the therapist works to regulate the body through the mind.
CBT usually incorporates body awareness or coping skills. In EMDR, the body and the information it carries is essential to healing.
emdr vs. CBT in session: The Thoughts
Both modalities recognize the importance of our thoughts—how they shape our perspective, behaviors, emotions, etc. But the approach is distinct.
The EMDR therapist will help to identify a negative belief, such as “I am worthless” or “I am unlovable.” The therapist and client assess the related memories, body sensations, etc., and work to reduce the validity of the thought through desensitization and reprocessing. EMDR then integrates new, adaptive information to the neural network.
In CBT therapy, the therapist helps you catch and examine automatic thoughts (i.e. “something bad is about to happen” or “I am a failure.” The therapist helps you examine the evidence for and against them, and systematically replace them with balanced, realistic perspectives.
Thoughts are challenged through perspective, insight, and homework exercises.
emdr vs. CBT in session: The mechanisms
EMDR is an eight-phase protocol-based therapy modality that uses a distinct mechanism: bilateral stimulation. In a session, an EMDR therapist will ask you to bring up a “target” memory or sensation and then engage with eye movement, tapping, or some other form of bilateral stimulation.
The BLS helps us to remain in the present while also taxing the working memory. Research suggests BLS reduces the intensity or “charge” of the past experience. The therapist will also assess the impact of the memory on the past, your present, and integrate the reduction of distress into your future.
CBT relies on cognitive restructuring and behavioral activation via coping skills. Rather than zeroing in on stored somatic memories, CBT maps the direct feedback loop between your thoughts, emotions, physiological reactions, and behaviors.
What approach is best for you?
Both modalities have a shared goal—to improve functioning and live a more desirable life.
CBT is often the first type of therapy people encounter, frequently categorized as “talk therapy.” In some cases, CBT is the right fit for those looking for solution-focused, actionable therapy that focuses on the present. CBT can also improve insight and understanding of larger patterns or themes from childhood.
We routinely support individuals who have done CBT but recognize that their body does not feel the same safety they cognitively know is possible. In fact, CBT often complements EMDR. You come with insight, coping skills, and clear goals. EMDR takes the processing to a more visceral level.
You might be ready for EMDR if you:
Feel limited with talk therapy
Want to explore your entire system in depth
Recognize patterns but feel powerless to change them with only your thoughts
Are open to experiential therapy
Value the information stored in your mind and body
We especially love combining EMDR with Internal Family Systems (IFS) to further improve the relationship with oneself in order to respond to distress with compassion and curiosity. This heals our systems in ways that logic fails. To learn more about IFS-informed EMDR, click here.
About the Author: Katy Levine, LCSW, is a trauma therapist licensed in Washington, D.C., Maryland, Virginia, and Pennsylvania. She focuses on supporting women with complex trauma history, attachment wounding, anxiety, and perfectionism, using IFS-informed EMDR. Katy sees ongoing clients virtually and offers single-day virtual intensives. She offers multi-day intensives in person to established clients.
Disclaimer: The information in this blog is provided for educational and informational purposes only. It is not intended to be a substitute for mental health care nor a recommendation or endorsement for any particular treatment plan, organization, provider, professional service, or product. The information may change without notice. No claims, promises, or guarantees are made about the completeness, accuracy, currency, content or quality of information linked. You assume all responsibility and risk for any use of the information.
IFS EMDR Therapy Group is an outpatient therapy group founded by Morgan Levine. We specialize in IFS-Informed EMDR to help adults struggling with the effects of living in dysfunctional systems move toward healing and wholeness. Our therapists work virtually with clients living throughout Maryland, Washington D.C., Virginia, Pennsylvania, Colorado and Florida. Morgan Levine also provides consultation to therapists worldwide.
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