EMDR vs Brainspotting
Both use the brain-body link to process trauma; EMDR uses bilateral stimulation with an 8-phase protocol, Brainspotting uses fixed-eye position and is more process-driven.
EMDR is the more researched and protocolized of the two. Brainspotting (developed by David Grand, a former EMDR therapist) drops the 8-phase structure and bilateral stimulation in favor of holding the client's gaze on a specific point that activates the trauma material, then letting the brain process. Practitioners often use both.
Shared roots
Both assume that trauma is stored somatically and that activating the right material with the right conditions allows the brain to process. Both descend (Brainspotting more directly) from EMDR's Adaptive Information Processing framework.
Side by side
| Dimension | EMDR | Brainspotting |
|---|---|---|
| Protocol | 8-phase structured protocol | Less structured, more attuned and process-driven |
| Mechanism | Bilateral stimulation (eye movements, tactile, auditory) | Fixed eye position on an activating 'brainspot' |
| Pacing | Reprocessing sets with check-ins between | Sustained focused attention; longer 'dwell' time |
| Evidence base | Extensive RCT support for PTSD; recommended by WHO, APA, VA/DOD | Growing but limited RCT base; mostly case series and pre-post studies |
| Training pathway | Standardized EMDRIA-approved training, basic + advanced | Phase 1, 2, 3 trainings through Brainspotting Trainings |
| Client fit | Some find bilateral stim activating or distracting | Some find the sustained gaze too intense or hard to maintain |
- When you want a well-evidenced PTSD protocol
- When a client benefits from clear structure and predictability
- When insurance/setting requires recognized evidence-based treatment
- Complex trauma with strong preparation phase needed (EMDR has built-in resourcing)
- When EMDR's structure feels constraining for either client or therapist
- When the client struggles with bilateral stimulation
- When processing somatic material without explicit verbal narrative is the goal
- Performance work and creative blocks (Brainspotting has a following in athletic and creative populations)
Can they be combined?
Many therapists trained in both use them as different tools. Brainspotting can serve as the 'reprocessing' phase within an otherwise EMDR-style case formulation. Don't mix protocols mid-session without clear rationale.
EMDR has dozens of RCTs and is a first-line PTSD treatment in multiple international guidelines. Brainspotting's evidence base is much smaller — mostly pre-post and case study designs — though clinician satisfaction and case reports are strong.
FAQ
Should I get trained in both?
Many trauma therapists do. Start with EMDR for its evidence base and broad applicability, then add Brainspotting if it fits your style and clientele.
Is Brainspotting 'better' for somatic clients?
Anecdotally many therapists feel so; the RCT evidence to back that up isn't there yet. Use clinical judgment and client preference.
More comparisons
CBT vs DBT
DBT is CBT plus dialectics, mindfulness, and emotion-regulation skills — built originally for chronic suicidality and emotion dysregulation.
IFS vs Ego State Therapy
Both work with internal parts of the self; IFS adds a non-pathologizing parts taxonomy and the concept of Self as inherent.
ACT vs CBT
CBT targets distorted thoughts directly; ACT targets the relationship with thoughts via acceptance, defusion, and values-led action.
CBT vs Psychodynamic Therapy
CBT is structured, present-focused, and skill-based; psychodynamic is exploratory, relational, and focused on unconscious patterns and developmental origins.