EMDR vs. CBT: What’s the Difference?
Takeaway: CBT and EMDR are two common forms of therapy. But what’s the difference between the two? And how do you know which one is best for you? In this post, I’ll break down the basics of CBT vs. EMDR so you can have the information you need to make an informed decision.
Whether you're a veteran of therapy or are seeking professional support for the first time, it can be overwhelming to make sense of all the different therapy approaches available. If you're not in the mental health field yourself, it might even feel intimidating to learn about the ins and outs of the various treatment modalities.
That's why I created this post. As a therapist, I value making mental health topics as approachable as possible. My goal here is to break down two of the more common therapy methods—EMDR and CBT—in a way that's accessible and easy to digest. Plus, I offer my professional insight to help you decide which method may be the best fit for your situation.
Let's dive in.
Understanding EMDR
Eye movement desensitization and reprocessing (EMDR) is a form of therapy that was pioneered by Dr. Francine Shapiro in the 1980s. It was first designed as a revolutionary treatment for post-traumatic stress disorder (PTSD). This review of several randomized controlled trials shows how effective it can be in improving PTSD symptoms.
While it's still commonly used to treat trauma, it's also an effective treatment for depression, anxiety, obsessive-compulsive disorder (OCD), addiction, and more, according to the Eye Movement Desensitization and Reprocessing International Association (EMDRIA).
EMDR therapy works by using a technique called bilateral stimulation to change how the brain reacts to stored traumatic memories. With bilateral stimulation, your therapist will guide you through exercises that stimulate both sides of the brain and body. This often takes the form of following a beam of light with your eyes, tapping your body, or holding vibrating buzzers.
Through this process, your brain will become less and less reactive to traumatic memories. You won't forget what happened to you, but you will be able to remember the traumatic events without experiencing intense PTSD symptoms like flashbacks, anxiety, and more.
For a more detailed explanation of the EMDR therapy process, check out my blog post on the 8 phases of EMDR.
Understanding CBT
Cognitive behavioral therapy (CBT) is another form of psychotherapy. While many professionals regard Dr. Aaron Beck as the creator of CBT, his work was influenced by many other behavioral therapists before him.
In CBT therapy, your therapist will help you explore the relationship between your thoughts, feelings, and behaviors. You'll identify how common negative thought patterns (also called thought distortions) influence the way to feel and act.
From here, you and your therapist will discover how you can shift those thought patterns to create positive changes in your day-to-day life.
CBT is used to help people with many different challenges and mental disorders. According to the American Psychological Association (APA), it's an effective treatment for depression, anxiety, substance abuse, eating disorders, and more. This randomized controlled trial even shows that it can help people who are at risk of experiencing psychosis.
5 main differences between CBT and EMDR
Now that you have a broad understanding of the basic concepts of EMDR vs. CBT, it's time to dig into the major differences between these two methods. Both EMDR and CBT are effective forms of therapy, but understanding the differences can help you decide which approach is best for you.
Let's take a look.
1. EMDR was created specifically for trauma survivors.
While both EMDR and CBT can be used to treat posttraumatic stress disorder, EMDR was created for the specific purpose of treating PTSD. It has since been used to help people struggling with different issues, but it remains a primary form of therapy for trauma survivors.
CBT, on the other hand, is used across a broad range of populations.
2. CBT therapy often requires more disclosure.
Cognitive behavioral therapy is a more traditional form of therapy that involves in-depth conversation between client and therapist. This allows your therapist to highlight your negative thought patterns and help you identify where you can make changes.
In EMDR, the focus is less on talking about what happened to you and how you view the world. Instead, your therapist will help you key in on how your body reacts to traumatic memories and guide you through nonverbal exercises to help you reprocess your experience.
3. EMDR may take less time.
While each person's experience with therapy is different, EMDR therapy can often work more quickly than CBT therapy. Some people can even start experiencing relief after just a few sessions.
Since cognitive therapy is a deep dive into your ingrained thought and behavior patterns, it can take more time to suss out the way your cognitive distortions show up and how you can change them.
4. CBT often involves homework.
All of the work for EMDR therapy is typically done in session, though you might continue processing your session even after it's over.
Many CBT therapists use tools like worksheets and handouts to support clients' learning outside of sessions. While not all CBT therapists will take this route, it is common.
5. Both use entirely different techniques.
At their core, EMDR and CBT are forms of mental health therapy. However, they are completely different in the techniques they use to help people heal (as you've likely gathered from what you've learned so far in this post).
To recap, EMDR therapists use bilateral stimulation to help you reprocess traumatic memories. You'll also tune into your bodily sensations throughout the process. In cognitive behavioral therapy, your therapist will focus on your thought and behavior patterns.
CBT vs. EMDR at a glance
Here's a brief overview of the main differences between EMDR vs. CBT.
| Aspect | EMDR | CBT |
|---|---|---|
| Main techniques used | Bilateral stimulation, grounding techniques | Cognitive restructuring, exposure therapy techniques, problem-solving |
| Role of therapist | Helps clients reprocess traumatic memories | Helps clients identify negative thought patterns and change thoughts/behaviors |
| Mental health conditions treated | Primarily trauma/PTSD, anxiety, though may be used with other disorders | A wide variety of disorders like anxiety, depression, OCD, substance abuse, and more |
| Timeline | A few to several sessions | Several sessions typically over months to years |
| Adaptability | Typically more structured | May be adapted and combined with other techniques |
Which approach is right for you?
Ultimately, choosing a therapy approach is up to each person's preference. There's no right or wrong decision when it comes to your own mental health needs.
However, if you're struggling to make a decision, consider these questions.
Why are you seeking therapy? If you have post-traumatic stress disorder or consider yourself a trauma survivor, I recommend EMDR. As both an EMDR therapist and trauma survivor myself, I've seen firsthand how impactful this approach can be. If you're grappling with other mental health disorders, you might consider trying CBT.
How much time do you have? While EMDR is by no means a quick fix, it often produces faster results than CBT, making it a good option for people who'd like to expedite their healing. However, if you need or prefer more time to process, CBT may be a better bet.
What do you want from your therapist? EMDR doesn't require as much trauma disclosure as CBT. In other words, you likely won't have to talk about your trauma as much, making it appealing to many people. Your EMDR therapist may ask for a general framework of what happened, but you don't need to describe your traumatic memory in detail. However, some people like to verbally process what happened. If this is the case for you, you may like CBT better.
Remember, it's up to you to decide whether cognitive behavioral therapy or EMDR (or another method altogether) is best for you.
Get the support you need to heal from trauma.
Interested in trying EMDR? I'm here for you.
I provide EMDR therapy in Tampa to adult trauma survivors from all walks of life. Since my practice is virtual, I can help people throughout the entire state of Florida.
I have an extensive background working with trauma survivors, and I'm a survivor myself. Through both my personal and professional experiences, I've developed a true passion for this work, and I'm dedicated to making the therapy space a supportive, nonjudgmental space where you can find true healing.
If you're still not sure whether EMDR is the right fit for you, or if you're ready to dive in, I invite you to connect with me. I look forward to hearing from you and supporting you on this journey.
