Brainspotting vs. EMDR: Similarities and Differences

If you've been exploring trauma therapy options, you've probably come across Brainspotting and EMDR. Both go deeper than traditional talk therapy, and both have real research behind them. But they work differently — and understanding those differences can help you have a more informed conversation with a therapist about what might fit you best.

What Is EMDR?

EMDR — Eye Movement Desensitization and Reprocessing — was developed by Francine Shapiro in the late 1980s. The core idea is that traumatic memories can get "stuck" in the nervous system in a way that prevents normal processing. EMDR uses bilateral stimulation — guided eye movements, tapping, or auditory tones — to help the brain reprocess those memories and reduce their emotional charge.

Sessions follow a structured eight-phase protocol. The therapist helps you identify a target memory, the feelings connected to it, and what you'd prefer to believe about yourself. While holding the memory in mind, bilateral stimulation begins, and most people find distress gradually reduces over time.

EMDR has one of the strongest evidence bases of any trauma therapy. The World Health Organization, the VA, and the International Society for Traumatic Stress Studies have endorsed it for PTSD. EMDRIA documents more than two dozen randomized controlled trials supporting its effects, and a 2024 meta-analysis found EMDR comparable in effectiveness to other leading trauma-focused therapies.

What Is Brainspotting?

Brainspotting was developed by David Grand, Ph.D. in 2003, growing directly out of his EMDR work. The guiding premise: "where you look affects how you feel." Specific positions in a person's visual field correspond to areas of neurological and emotional activation — these are called brainspots.

In a session, the therapist helps you tune into a felt sense of the issue — a body sensation, an emotion, a level of activation — and scans your visual field to find where that activation is highest. Once the brainspot is found, you hold your gaze there while the therapist provides quiet, attuned presence. BioLateral sound (audio alternating between ears) is often played in the background.

Brainspotting doesn't require narrating a detailed account of what happened. Processing happens largely internally and nonverbally, which many people find more manageable. It's designed to access the subcortical brain — the brainstem, amygdala, and limbic system — regions that operate below language and conscious awareness. This makes it especially useful for trauma that is preverbal, body-based, or hard to articulate.

Research on Brainspotting is newer but growing. A 2017 comparative study by Hildebrand, Grand, and Stemmler compared the two approaches across 76 trauma survivors and found no statistically significant difference in PTSD symptom reduction between groups. A more recent study at Hanley Center found Brainspotting associated with a 44% decrease in trauma-related stress scores, a 40% reduction in depression, and a 57% reduction in anxiety.

How They're Similar

At their core, Brainspotting and EMDR share a lot:

●Both are body-informed. Neither relies on talking through trauma the way traditional therapy does. Both recognize that trauma lives in the nervous system, not just conscious thought.

●Both use the eyes. Whether through movement (EMDR) or a fixed position (Brainspotting), the visual field serves as a gateway to deeper neurological processing.

●Both track activation. Each approach uses the Subjective Units of Disturbance (SUD) scale to measure distress in the body throughout sessions.

●Both are trauma-focused. They're used for PTSD, complex trauma, anxiety, depression, and other conditions rooted in earlier experiences.

Key Differences

The meaningful differences come down to structure, processing style, and what each approach asks of you:

Structure. EMDR follows a defined protocol with specific steps at each phase. Brainspotting is less scripted — sessions unfold based on where you and your therapist locate activation.

Eye movement vs. fixed gaze. In EMDR, your eyes move back and forth following the therapist's hand or a light bar. In Brainspotting, your gaze rests at one point. That sustained hold is thought to allow deeper subcortical processing.

Verbal vs. internal processing. EMDR involves check-ins throughout — you report what came up, then continue. Brainspotting is more internally oriented. You may say very little; the therapist tracks your nervous system responses rather than guiding a verbal narrative.

Memory access. EMDR involves working with a specific identified memory. Brainspotting doesn't require naming or recalling events in detail — your nervous system's activation leads the process, which can help when memories are fragmented, dissociated, or preverbal.

Which One Is Right for You?

There's no universal answer. You might be drawn to EMDR if you prefer a clear structured process, are comfortable working with specific memories, or value a long-established research record.

You might be drawn to Brainspotting if other approaches haven't fully resolved things, if talking about the trauma feels too activating, or if your experience is more body-based than narrative. It fits naturally alongside somatic th

The right fit depends on your nervous system, your history, and your goals — and a good therapist can help you think through that.

Both Are Available at Health Allies Counseling

At Health Allies Counseling, we offer both EMDR and Brainspotting. Our founder, Tiffany Kettermann, LPC, LMHC, CADCI, is a Certified EMDR Therapist (EMDRIA), reflecting advanced training and consultation beyond standard certification. Our 36 therapists practice within a trauma-informed framework, and we serve clients across Oregon, primarily via telehealth. We accept OHP (all plans), Aetna, BCBS, Kaiser, Medicare, Moda, PacificSource, Providence, and United Healthcare.

If you're wondering which approach might suit you, submit an intake form at healthalliescounseling.com/contact and a staff member will reach out within one business day.

Sources:

EMDRIA. (2024). EMDR therapy: An overview of current and future research. https://www.emdria.org/resource/emdr-therapy-an-overview-of-current-and-future-research-european-review-of-applied-psychology/

Hildebrand, A., Grand, D., & Stemmler, M. (2017). Brainspotting – the efficacy of a new therapy approach for the treatment of Posttraumatic Stress Disorder in comparison to Eye Movement Desensitization and Reprocessing. Mediterranean Journal of Clinical Psychology, 5(1). https://doaj.org/article/7dae55fdaa03414f821118f6ffa29a0d

U.S. Department of Veterans Affairs, National Center for PTSD. Eye Movement Desensitization and Reprocessing (EMDR) for PTSD. https://www.ptsd.va.gov/professional/treat/txessentials/emdr_pro.asp

World Health Organization. (2013). WHO releases guidance on mental health care after trauma. https://www.who.int/news/item/06-08-2013-who-releases-guidance-on-mental-health-care-after-trauma

Grand, D. (2024). About Brainspotting. https://brainspotting.com/about-brainspotting/

Hanley Center. (2023). An examination of the efficacy of Brainspotting. https://www.hanleycenter.org/brainspotting/

Health Allies Counseling | 2950 SE Stark St, Suite 130, Portland, OR 97214 | (971) 270-0167 | Telehealth available statewide in Oregon