Trauma can profoundly affect one’s mental health, influencing emotions, relationships, and overall quality of life. Fortunately, psychotherapy has advanced significantly beyond traditional talk therapy, developing specialized treatments to help individuals process and heal from traumatic experiences.

Eye movement desensitization and reprocessing therapy (EMDR) and Brainspotting are two approaches that have gained recognition for effectively treating trauma-related disorders. Mental health professionals should understand the key principles, similarities, and differences between these methods to provide the best care to clients.

This guide explores EMDR and Brainspotting, covering their origins, techniques, and clinical applications. Therapists who deepen their knowledge of these therapy approaches can make informed decisions when seeking training in a new modality or offering referrals for adjunctive treatment as part of an individual’s  treatment plan.

Understanding EMDR (Eye Movement Desensitization and Reprocessing)

EMDR was developed by Francine Shapiro in the late 1980s as a structured, trauma-informed approach designed to help individuals process and integrate distressing memories. Grounded in the Adaptive Information Processing (AIP) model, EMDR is based on the premise that psychological difficulties are often rooted in unprocessed or maladaptively stored memories. When these memories are appropriately processed, they can be integrated into a healthier cognitive and emotional framework.

The EMDR process involves identifying a target memory, bringing up associated thoughts, emotions, and body sensations, and then engaging in bilateral stimulation—typically through eye movements, tapping, or auditory tones. This stimulation is thought to support the brain’s natural healing mechanisms, allowing for adaptive resolution of previously overwhelming experiences.

Unlike traditional talk therapy, which often emphasizes insight and verbal exploration, EMDR focuses on accessing the brain’s innate capacity for healing without requiring detailed discussion of the traumatic event. Clients are encouraged to notice what arises during processing without needing to explain or analyze it, allowing for deep change at a neural level.

Understanding Brainspotting

Brainspotting was developed by David Grand, PhD, in 2003 as an offshoot of his work with EMDR. During an EMDR session, Grand noticed that clients appeared to access deeper emotional material when their gaze was fixed on certain points in their visual field. This observation led to the development of Brainspotting, a brain-body based therapeutic modality that uses sustained eye position to access and process unresolved trauma and emotional experiences.

In Brainspotting, the therapist helps the client locate a “brainspot”—a specific eye position correlated with the activation of a trauma or emotional response. Once the spot is found, the client holds their gaze on that point while tuning into internal sensations, emotions, and memories. The therapist offers attuned presence and support, but the process itself is largely nonverbal and internally guided.

Brainspotting differs from traditional talk therapy in that it minimizes cognitive processing and conversation in favor of somatic and subcortical engagement. It aims to bypass the neocortex and access deeper parts of the brain involved in storing trauma, allowing for organic and often non-linear resolution of emotional pain.

Similarities Between EMDR and Brainspotting

While EMDR and Brainspotting have distinct approaches, they share several fundamental principles and techniques that contribute to their effectiveness in treating trauma-related symptoms:

• Trauma processing focus: Both modalities aim to help clients process and resolve the emotional, cognitive, and somatic impact of traumatic experiences, ultimately reducing the intensity and frequency of trauma-related symptoms.
• Eye positioning and/or bilateral stimulation: EMDR and Brainspotting use eye positioning and/or bilateral stimulation as core components of their protocols. These techniques engage both hemispheres of the brain, promoting neural integration and facilitating the processing of traumatic memories.
• Mind-body connection: Both therapies recognize the intricate connection between the mind and body in trauma processing. They emphasize the importance of paying attention to somatic experiences and physical sensations during sessions, as the body often holds unprocessed trauma.
• Mindfulness and present-moment awareness: EMDR and Brainspotting incorporate elements of mindfulness and encourage clients to maintain present-moment awareness throughout the therapeutic process. This helps clients stay grounded and regulated while processing traumatic material.

The use of bilateral stimulation in both EMDR and Brainspotting offers several  benefits:

• Stress reduction and anxiety relief: Both approaches lead to activation of the parasympathetic nervous system, promoting relaxation and emotional balance.
• Neurobiological effects: The methods used in EMDR and brainspotting can improve emotional regulation and support better adaptability in processing past experiences.

While EMDR and Brainspotting have distinct protocols and techniques, their shared focus on trauma processing, use of eye positioning and bilateral stimulation, recognition of the mind-body connection, and incorporation of mindfulness make them powerful tools in the treatment of trauma-related disorders.

Key Differences Between EMDR and Brainspotting

While both EMDR and Brainspotting effectively address trauma, they differ in their approach, structure, and suitability for various clients:

Structure and Flexibility:

• EMDR uses a standardized eight-phase protocol, providing a structured and therapist-guided approach for trauma processing.
• Brainspotting offers a more adaptable, open, and intuitive approach, allowing for natural unfolding of the client’s exploration of traumatic experiences.

Therapist's Role and Client Experience:

• In EMDR, therapists actively guide clients through specific protocols, that often use rapid bilateral eye movements or other stimuli to help reprocess memories. This often involves more verbal processing and guided recall.
• Brainspotting therapists, support clients  in accessing and processing trauma through fixed eye positions. This method requires minimal talking, focusing on internal processing.

Processing Focus and Neuroscientific Foundations:

• EMDR emphasizes changing how traumatic memories are perceived based on the Adaptive Information Processing (AIP) model, which suggests that the brain has a natural ability to heal by reprocessing traumatic memories into more adaptive, less distressing forms.
• Brainspotting targets deeper brain regions related to emotional and physical responses, accessing specific "brainspots" to encourage more profound emotional and physical processing.

Comparative Effectiveness and Suitability:

• EMDR has substantial research backing and is considered an evidenced-based treatment for many conditions, including PTSD.
• Brainspotting, while newer and not as extensively researched, shows potential for treating trauma, complex emotional blocks, and clients who find traditional talk therapy challenging. 

Though their methods differ, both EMDR and Brainspotting engage the brain’s natural capacity to heal, offering distinct yet effective paths for processing trauma and supporting recovery. Ultimately, the decision between EMDR and Brainspotting may depend on personal preferences, emotional readiness, therapist availability, and client comfort.

Clinical Applications and Considerations

While EMDR and Brainspotting differ in structure and process, they share a core aim: accessing the brain’s natural capacity to heal from trauma and emotional dysregulation. In many cases, these modalities can be used complementarily rather than exclusively. Below is a breakdown of their respective strengths and considerations:

EMDR: Ideal for Structured Trauma Processing

• Anxiety, Phobias, and PTSD: EMDR's structured protocol works well for specific anxiety disorders, phobias, and post-traumatic stress disorder (PTSD), especially for single-incident traumas.
• Clients Preferring Structure and Direction: EMDR’s standardized, eight-phase protocol provides a clear therapeutic framework, which can be helpful for clients who find comfort in a predictable, therapist-guided process.
• Strong Evidence Base: EMDR is one of the most well-researched trauma therapies, endorsed by organizations such as the APA, VA, and WHO. It is considered a first-line treatment for PTSD and continues to show promising outcomes across other clinical presentations.

Brainspotting: Flexible and Somatic-Focused

• Complex, Chronic, or Developmental Trauma: Brainspotting’s less directive, client-led style allows for the nuanced processing often needed for early attachment wounds, preverbal trauma, and experiences that don’t easily translate into words.
• Somatic Symptoms and Nonverbal Clients: The focus on body sensations in Brainspotting is particularly useful for clients experiencing physical signs of trauma or those who find it challenging to verbalize their experiences.
• Potential for Rapid Progress: Some individuals may experience quicker and more significant results with Brainspotting, due to its ability to bypass cognitive defenses and target subcortical brain processes.
  
  

Factors to Consider When Integrating or Choosing Between EMDR and Brainspotting Modalities

• Client Preferences and Therapeutic Alliance: Some clients prefer a more structured protocol like EMDR, while others respond better to Brainspotting’s spacious, attuned approach. Understanding how a client regulates, processes emotion, and engages in therapy can help guide this decision.
• Presenting Issues and Treatment Goals: Evaluate the specific nature of the client's trauma, their primary symptoms, and their desired outcomes. Some may prefer the step-by-step processing of EMDR, while others might benefit from Brainspotting's more intuitive, body-focused approach.
• Therapist Training and Expertise: Make sure the therapist has proper training and certification in the chosen modality, as well as experience working with the client's specific trauma type and demographic.

Can a Therapist Use Both?
Yes. Many therapists trained in both EMDR and Brainspotting integrate the two approaches based on client needs. Some may begin with EMDR for clients who benefit from structure, then shift to Brainspotting when deeper, nonverbal material arises. Others may use Brainspotting to build initial safety and regulation before introducing EMDR protocols. The choice to blend modalities should be grounded in clinical judgment, informed consent, and adequate training in both methods.

Training and Certification Requirements

To maintain competence and ethical practice, both EMDR and Brainspotting have specific training and certification requirements. Here's what you should know:

EMDR Training:

• EMDRIA-Approved Programs: To become an EMDR therapist, therapists must complete training through an EMDR International Association (EMDRIA) approved provider, which involves at least 50 hours of instruction, practice, and consultation.
• Structured Curriculum: EMDR training covers the theoretical foundations, methodology, and clinical applications of the therapy, focusing on adherence to the standardized eight-phase protocol.
• Supervised Practice: Participants engage in extensive supervised practice sessions to improve their skills and ensure they can competently deliver EMDR therapy.

Brainspotting Training:

• Phased Approach: Brainspotting training is divided into three phases, with each phase building on the skills and knowledge from the previous one.
• Experiential Learning: Training emphasizes hands-on experience, allowing participants to practice Brainspotting techniques and develop attunement skills.
• Certification Process: After completing the required training hours, therapists must meet additional requirements, such as supervised practice and case consultations, to obtain certification through recognized Brainspotting organizations.

Both EMDR and Brainspotting training programs aim to equip therapists with the necessary skills, knowledge, and practical experience to effectively incorporate these methods into their clinical practice. Ongoing consultation and supervision are key components of both training pathways, providing therapists with guidance and support in handling the complexities of trauma treatment.

Advancements in training delivery have made these programs more accessible. Many approved providers now offer hybrid or fully online training options, allowing therapists to complete the required coursework and supervised practice from home or office. These flexible formats have opened up opportunities for mental health professionals worldwide to receive high-quality training in EMDR and Brainspotting, ultimately increasing access to effective trauma treatment for those in need.

Key Takeaways

As trauma therapy develops, EMDR and Brainspotting remain two effective approaches that offer unique benefits for clients seeking healing and recovery. Each modality taps into the brain’s natural capacity to process and resolve distressing experiences but does so through distinct frameworks and client experiences.

• EMDR uses a structured, protocol-driven approach, which is well-suited for clients who benefit from a clearly defined treatment process. It is particularly effective for PTSD, anxiety disorders, and phobias, with a strong base of clinical research supporting its use across diverse populations.
• Brainspotting allows for a more fluid and internally guided process, offering space for clients to access and process trauma at their own pace. Its emphasis on body-based awareness and minimal verbalization makes it especially useful for complex trauma, somatic symptoms, or clients who struggle to articulate their experiences.
  

While different in structure and process, both approaches aim to facilitate deep emotional healing. Many clinicians find value in integrating both, tailoring treatment to the unique needs and preferences of each client.

Although both methods are often successfully integrated with one another, there may be cases where a choice must be made on whether the referral or recommendation will be for EMDR or brainspotting. When making this decision, therapists need to carefully consider each client's individual needs, preferences, circumstances, and presenting issues. Factors such as the nature of the trauma, therapist availability, desired outcomes, and client comfort with different therapy styles should guide the decision-making process.

Looking ahead, trauma therapy shows promising advancements that aim to enhance accessibility, personalization, and holistic care:

• Integration of technology, including telehealth platforms, mobile apps, virtual reality therapy, and digital tools, is expanding remote access and improving treatment effectiveness.
• Personalized treatment approaches that combine various methods, including brainspotting, CBT, EMDR, neurofeedback, and mindfulness, are increasingly tailored to address specific symptoms and goals.
• Holistic and integrated care focuses on treating the whole person by considering mental, emotional, physical, and sometimes spiritual health. This type of thorough, person-centered care is supported well by both brainspotting and EMDR modalities. 

Regardless of the chosen method, ongoing training and supervision are necessary for therapists to maintain competence, stay updated with the latest research and techniques, and ensure ethical practice in trauma treatment. As the field changes, mental health professionals must remain dedicated to providing compassionate, evidence-based care that fosters lasting recovery and resilience for their clients.