If you have been reading about trauma therapy, you have probably come across EMDR. You may have seen Brainspotting mentioned somewhere nearby, often described as similar but deeper. The two do share a family resemblance, and one grew directly out of the other.
We put this guide together because the differences between them matter when you are choosing care. They ask different things of you in a session, and they rest on very different amounts of research. Both of those are useful to understand before you book a first appointment.
We will walk through what each one is, what a session actually involves, what the evidence supports, and how to think about which might suit you.
What Is EMDR?
EMDR stands for eye movement desensitization and reprocessing. It is an individual therapy for PTSD in which you focus on processing your memory of a traumatic event.
In a session, you bring a difficult memory to mind while paying attention to something that moves back and forth. That might be your therapist’s finger, a light bar, tones that alternate between your ears, or taps on your hands or knees. This is called bilateral stimulation, which just means a signal that switches from one side to the other.
The thinking behind it is that trauma memories get stored differently from ordinary memories, which makes them hard to make sense of and easy to set off. Working through the memory while your attention is split is meant to help your brain file it more like a normal memory, one you can recall without it flooding you.
EMDR follows eight structured phases, and the early ones are all preparation. You and your therapist gather history, talk through what to expect, and build coping skills before any memory work starts.
What Is Brainspotting?
Brainspotting was developed in 2003 by David Grand, a therapist who had been practicing EMDR. He observed that where clients held their gaze seemed connected to what they were feeling, and he built an approach around that observation.
Instead of moving your eyes back and forth, a Brainspotting therapist helps you find and hold one fixed eye position that seems tied to a distressing feeling. That position is the brainspot. You stay with it while whatever surfaces gets processed, often with the therapist saying very little.
Its developers describe Brainspotting as a resource model, meaning it leans on the idea that people have their own capacity to work through distress when the conditions are right. The approach puts a lot of weight on the therapist staying closely tuned in to you.
What has not been established is the theory underneath it. Brainspotting is new by research standards, and much of what has been published about it is case description and hypothesis rather than clinical trials.
How Are EMDR and Brainspotting Different?
The two share a starting point and then part ways in a few concrete respects.
- Eye position. EMDR uses back-and-forth stimulation. Brainspotting uses a single fixed gaze.
- Structure. EMDR follows a standardized eight-phase protocol. Brainspotting is looser and more open-ended.
- Talking. Neither one requires you to narrate your trauma in detail, though EMDR does ask you to hold it in mind.
- Evidence. EMDR appears in national treatment guidelines. Brainspotting does not appear in them yet.
What Does the Research Say About Each One?
This is where the two genuinely separate, and it is the part most comparisons skip.
For EMDR, the evidence is substantial. The 2023 VA/DoD clinical practice guideline gives EMDR a strong recommendation for PTSD, and the Military Health System treats it as an initial treatment option. The VA’s National Center for PTSD lists it as one of three trauma-focused therapies with the most research support, alongside cognitive processing therapy and prolonged exposure.
Expert bodies do not agree completely, though. The American Psychological Association’s 2025 PTSD guideline places EMDR behind cognitive processing therapy, prolonged exposure, and trauma-focused CBT, treating it as a second-line option. Some researchers have argued that the APA underrated the evidence. The disagreement is about ranking, not about whether EMDR works at all.
For Brainspotting, the picture is much thinner. There are no large trials and no guideline recommendations. The most useful direct comparison so far is a small study of 40 adults who each recalled distressing memories and had a single 40-minute session of EMDR, Brainspotting, or a body scan meditation. Distress went down after all three. EMDR and Brainspotting came out about equal to each other, and both did better than the meditation.
That result is encouraging, and it is also limited. The participants were healthy volunteers rather than people being treated for PTSD, and one session is not a course of therapy. The fair summary is that Brainspotting looks promising and has not been tested enough to say more than that.
Does Anyone Know Why These Therapies Work?
Not fully, and that applies to EMDR too. Studies disagree about whether bilateral stimulation is a necessary ingredient or whether the benefit comes from something else in the process. Cleveland Clinic puts it plainly, noting that there is controversy about why EMDR works even though the evidence that it does work is strong.
This has a practical consequence for you. When a mechanism is uncertain, confident descriptions of what is happening inside your brain should be held loosely. A therapist who says one method reaches deeper, or pulls something out at the root so it can never return, is describing a belief rather than a finding. That does not make them a bad therapist. It does mean the claim is not something you should weigh heavily when deciding.
What Does a Session Actually Look Like?
EMDR sessions usually run 50 to 90 minutes. Once the memory work begins, you hold the image and any thoughts or body sensations in mind while following the back-and-forth signal for about 30 seconds at a time, then talk briefly about what came up. You repeat that cycle.
A full course is often about three months of weekly sessions, though many people notice a shift earlier than that. For a single disturbing event, Cleveland Clinic notes it often takes three to six sessions, while longer-term or more complex trauma may take eight to twelve or more.
Brainspotting sessions vary more, because the approach is less standardized. In general, you would find a spot in your visual field with your therapist’s help and stay with it while noticing what comes up, with less back-and-forth conversation than in most talk therapies.
Either one can stir up discomfort. With EMDR, those feelings tend to be brief, and most people who finish find the benefit outweighs the early unease.
How Do I Choose Between EMDR and Brainspotting?
There is no formula, and either could be a reasonable starting point depending on what you want. A few things can help you weigh it.
- How much the evidence matters to you. If you want the option with the strongest research support and the clearest guideline backing, that is EMDR.
- Whether you have already tried EMDR. Some people find it overwhelming, or feel it did not reach what they hoped it would. Wanting to try something built differently is a legitimate reason, as long as you go in with accurate expectations.
- How you feel with the therapist. This is not a tiebreaker to use at the end. Given how much the relationship shapes progress, it belongs near the top of your list.
Many therapists are trained in more than one approach, so this may be less of an either-or choice than it looks from the outside. A therapist can also start with one and adjust.
How Do I Find a Therapist Who Offers EMDR or Brainspotting?
You have several options. Your insurance company’s provider directory lets you filter by specialty and confirm what is covered before you call. Your primary care doctor may be able to refer you. The training organizations behind both approaches keep public directories of clinicians who have completed their programs.
Free tools such as Mental Health Match can take some of the guesswork out of it as well. We built it so you can answer a few questions about what you are looking for and then see therapists who fit, with detailed profiles that give you a sense of how someone works before you reach out. You can start with a few questions whenever you feel ready.
Whichever route you take, it is fair to ask a therapist how they were trained in the approach, how often they use it, and what they expect a course of treatment to involve. A good therapist will not mind the questions.
Disclaimer: This article is for informational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always talk to a qualified healthcare professional about any medical concerns. If you are in crisis, please call or text the 988 Suicide & Crisis Lifeline at 988.
