EMDR vs CBT: What's the Difference?

Aarushi Pant

Which one better suits your needs?

Main image courtesy of Los Angeles Times.

When it comes to mental health treatments, there are a variety of options available to you, ranging from therapy to medication. Even when only exploring therapy options, there are so many different fields and approaches. Some of the more common forms of therapy include dialectical behavior therapy (DBT) or client-centered therapy (CCT).

If you have post-traumatic stress disorder (PTSD) or another panic-related disorder, cognitive behavioral therapy (CBT) or eye movement desensitization and reprocessing (EMDR) are viable treatment options for you. If you’re trying to decide between the two, here’s some more information about their uses and benefits.

Eye Movement Desensitization and Reprocessing (EMDR)

diagram of the EMDR process: history, prep, assess, and desensitize
The goal of EMDR is to help you process, heal, and recover from traumatic experiences. Image courtesy of Integrative Psychotherapy and Trauma Treatment.

EMDR is a psychotherapy treatment designed to alleviate the distress associated with painful, traumatic memories. It is used in patients with PTSD, anxiety, depression, and panic disorders. 

EMDR takes advantage of the natural way that our brains process and recover from traumatic memories and events. This process involves communication between the amygdala, which manages emotional responses to stimuli, and the prefrontal cortex, which plays a role in behavior and decision-making. EMDR facilitates the natural healing process by allowing the experience itself to be remembered, but not the response to it. 

An EMDR therapy session can last anywhere between 60 and 90 minutes. It uses a three pronged protocol: past memories, present disturbances, and future actions. EMDR therapy involves eight phases: 

1. History and Treatment Planning

This takes 1 or 2 sessions and involves a discussion of the event that caused the problem, the present situations that are causing the patient distress, and the skills that the client wants to learn for the future. 

2. Preparations

This phase takes between 1 and 4 sessions and is where the therapist will teach you specific techniques to deal with any emotional disturbances that may arise. The therapist will explain the EMDR therapy, the process, and what to expect during and after the treatment. It is important to establish trust between the therapist and the patient so that they are able to accurately and freely report what they’re feeling and what is going on in their lives and in their minds. 

3. Assessment 

This is where you would pick a specific image or mental picture from the event that caused the trauma. Then, you would choose a statement that expresses a negative belief associated with that event, such as “I am helpless.” Another positive statement that would rather be believed is picked, such as “I am capable.”

The therapist will ask you to estimate how true the positive belief feels to you using the 1-7 Validity of Cognition (VOC) scale. The negative belief is also rated on a different scale, the Subjective Units of Disturbance (SUD), from 1-10. 

4. Desensitization 

The therapist will lead you in sets of eye movements, sounds, or taps with the goal of reducing your SUD level.

5. Installation 

The goal here is to increase your VOC level to replace the negative belief you associate with yourself to the positive one you picked. 

6. Body Scan

The therapist will bring up the initial target event and see if any tension or negative physical responses are present in the body. It will be considered successful if the original target can be brought up without feeling any body tension. 

7. Closure

This will end every treatment session. You’ll also be told what to expect between sessions, how to use a journal to record these experiences, and what calming techniques you can use to cope with other situations in your life. 

8. Reevaluation

This is what every new session begins with. You’ll be guided through the treatment plan and the success of the plan will be evaluated. The goal is to replace your negative self-statement with a positive one associated with the traumatic event or memory that occurred. 

Cognitive Behavioral Therapy (CBT)

CBT impacts thoughts, behaviors, and emotions
CBT aims to shift your perspective, moving away from negative thoughts and actions to positive ones. Image courtesy of CreakyJoints.

CBT is a blend of behavioral and talk therapy that focuses on thought patterns and the processes that lead to different behaviors in different situations. CBT targets negative thoughts and mindsets and helps you take control of your mind instead of feeling helpless or lost. 

CBT is used for a wide range of mental health conditions, ranging from depression and anxiety to obsessive compulsive disorder (OCD) and PTSD. 

CBT involves talking through your problems with your therapist and understanding your thoughts, feelings, and responses to things that happen in your life. The goal is to move away from toxic, impulsive behaviors to more constructive ones, and to be able to approach potentially emotionally triggering situations with a clearer, more unbiased perspective

What’s the difference?

visual of the brain
CBT and EMDR can both treat a wide range of mental health conditions, but they do differ in their approaches. Image courtesy of Cleveland Clinic Health Essentials

Although CBT and EMDR are both effective at treating mental health conditions such as PTSD, there are some key differences. CBT is a form of therapy that involves you talking out your problems and discussing any emotions you may be experiencing. EMDR does not place such a heavy emphasis on verbalizing feelings. 

Both aim to change negative mindsets and beliefs into positive ones, but take very different approaches. EMDR involves eye movements, sounds, and taps in its procedure while CBT does not. EMDR takes eight phases to complete and you may see results more quickly than you would when receiving CBT treatment instead, which is ongoing and involves regular therapy sessions as well as possible work to do in between. 

Overall, CBT and EMDR are both valid, effective treatments that can help alleviate any symptoms of mental illnesses that you may be struggling with. Be sure to meet with a mental health professional to discuss your needs and goals and decide which treatment would work best for you!

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