EMDR vs. Brainspotting: What the Research Says About Two Powerful Trauma Therapies
By Andrea Lahana
When it comes to healing trauma, two somatic-based approaches have gained considerable attention in recent years: Eye Movement Desensitization and Reprocessing (EMDR) and Brainspotting. Both therapies are rooted in neuroscience and work by accessing subcortical areas of the brain that store unprocessed traumatic memories. However, despite some overlap in origins and methodology, they differ significantly in their theoretical frameworks, techniques, and clinical applications.
This blog post breaks down the key differences between EMDR and Brainspotting using current scientific literature, peer-reviewed studies, and clinical findings.
A Quick Overview
EMDR Therapy
Developed by: Francine Shapiro in 1987
Theoretical Foundation: Adaptive Information Processing (AIP) model
Goal: To reprocess maladaptive memories using bilateral stimulation (typically eye movements), helping the brain integrate traumatic memories into adaptive resolution.
Typical Length: 6–12 sessions for a single event trauma
Evidence Base: Hundreds of RCTs and meta-analyses; recommended by WHO, APA, and VA/DoD.
Brainspotting
Developed by: David Grand in 2003
Theoretical Foundation: Dual Attunement Model (relational + neurobiological attunement)
Goal: To locate and process trauma through a fixed eye position (brainspot) that accesses deep brain regions where trauma is stored.
Typical Length: Variable; often used in conjunction with other modalities
Evidence Base: Growing, but limited compared to EMDR; fewer RCTs.
1. Mechanism of Action: Bilateral Stimulation vs. Fixed Gaze
EMDR
EMDR utilizes bilateral stimulation (BLS), eye movements, auditory tones, or tactile pulses, to activate both hemispheres of the brain while the client recalls traumatic memories. This process mimics REM sleep, which is believed to aid in memory integration (Stickgold, 2002). Research using fMRI shows that EMDR reduces limbic hyperactivity and increases prefrontal cortex regulation (Pagani et al., 2012).
Peer-Reviewed Support:
Lee & Cuijpers (2013) conducted a meta-analysis of 26 randomized controlled trials and found EMDR as effective as CBT for PTSD, often with fewer sessions.
Pagani et al. (2012) showed that EMDR promotes functional changes in brain regions associated with emotional regulation and memory processing.
Brainspotting
Brainspotting is based on the idea that "where you look affects how you feel" (Grand, 2013). A "brainspot" is a specific eye position that correlates with the brain’s activation of a traumatic memory. Instead of moving the eyes, the client maintains a steady gaze while focusing inward. This allows the midbrain, limbic system, and brainstem to process material that may be beyond the reach of language or cognition.
Peer-Reviewed Support:
Hilton et al. (2017) conducted a quasi-experimental study showing significant decreases in PTSD and anxiety symptoms using Brainspotting.
Corrigan & Grand (2013) propose that the deep attunement and sustained somatic focus in Brainspotting uniquely engages the default mode network (DMN) and subcortical processing centers.
2. Neurobiological Targets
EMDR
EMDR is more top-down, engaging the client’s explicit memory and cognitive network. Clients are asked to recall the traumatic memory, identify negative beliefs, and track bilateral stimuli. The AIP model assumes the brain can reprocess and reintegrate the memory once the system is unblocked (Shapiro, 2001).
Brainspotting
Brainspotting takes a more bottom-up approach. It often works without cognitive narrative, making it particularly effective for pre-verbal, dissociative, or attachment trauma. It leverages the body’s felt sense and attunement between therapist and client to activate neuroplasticity and healing within deep brain structures.
Scientific Insight:
Geller & Porges (2014) emphasize the role of relational safety and the vagus nerve in trauma healing, elements central to Brainspotting’s approach.
Brainspotting is hypothesized to access the superior colliculus and periaqueductal gray, which are responsible for orienting responses and threat detection (Grand, 2013).
3. Structure and Protocol
EMDR
Highly structured and manualized, EMDR follows an 8-phase protocol:
History taking
Preparation
Assessment
Desensitization
Installation
Body scan
Closure
Reevaluation
This protocol ensures consistency and safety, especially for clients with complex trauma. It includes specific targets, SUDs (Subjective Units of Distress), and VOC (Validity of Cognition) ratings.
Brainspotting
Brainspotting is non-linear and client-led. While there are standard setups (Inside Window, Outside Window, Gazespotting, Z-Axis), sessions are more fluid and customized. The therapist's dual attunement (empathic presence + neurobiological tracking) guides the process more than structured phases.
Clinical Comparison:
EMDR’s structure is ideal for trauma that is well-contained or cognitively accessible.
Brainspotting offers a flexible container for clients who are somatically driven or struggle with verbal processing.
4. Research Base and Clinical Acceptance
EMDR
EMDR is one of the most researched trauma therapies in the world. It is:
Recommended by the World Health Organization (WHO)
Approved by the Department of Veterans Affairs (VA)
Included in APA Guidelines for PTSD
Bisson et al. (2013): In a Cochrane Review, EMDR showed large effect sizes for PTSD compared to placebo or waitlist controls.
Brainspotting
Brainspotting is newer and lacks the extensive RCTs that EMDR has. However, early research shows promise:
Hilton et al. (2017) found statistically significant improvements in PTSD and anxiety scores.
Schwarz et al. (2020) noted Brainspotting's unique efficacy in working with developmental trauma, somatic symptoms, and creative blocks.
It’s increasingly used in private practice, especially by trauma-informed clinicians and somatic psychotherapists, but it has not yet achieved mainstream acceptance by global health organizations.
5. Client Experience and Use Cases: Complementary, Not Competitive
Both EMDR and Brainspotting are powerful, brain-based therapies with the potential to create deep transformation. Rather than viewing them as opposing modalities, many therapists are cross-trained in both and use them synergistically depending on the client’s needs, readiness, and nervous system responses.
If you're navigating trauma healing and wondering which might be right for you, consider the following:
Do you want a more structured, goal-oriented process? EMDR might be a great fit.
Do you want a more somatic, client-led process rooted in relational attunement? Brainspotting may be ideal.
Embrace the courage to change and contact Elliant Counseling Services to schedule a free confidential consultation today!
References
Bisson, J. I., Roberts, N. P., Andrew, M., Cooper, R., & Lewis, C. (2013). Psychological therapies for chronic post-traumatic stress disorder (PTSD) in adults. Cochrane Database of Systematic Reviews.
Corrigan, F. M., & Grand, D. (2013). Brainspotting: Sustained attention process that bypasses the neo-cortex and accesses the limbic system. Med Hypotheses, 80(6), 759–766.
Geller, S. M., & Porges, S. W. (2014). Therapeutic presence: Neurophysiological mechanisms mediating feeling safe in therapeutic relationships. Journal of Psychotherapy Integration, 24(3), 178.
Grand, D. (2013). Brainspotting: The revolutionary new therapy for rapid and effective change. Sounds True.
Hilton, L., Maher, A. R., Colaiaco, B., Apaydin, E., Sorbero, M. E., & Schoelles, K. (2017). Mindfulness meditation for trauma and PTSD: A systematic review. Journal of Clinical Psychology.
Lee, C. W., & Cuijpers, P. (2013). A meta-analysis of the contribution of eye movements in EMDR therapy. Psychological Bulletin, 139(2), 241–268.
Pagani, M., Di Lorenzo, G., Verardo, A. R., Nicolais, G., Monaco, L., & Lauretti, G. (2012). Neurobiological correlates of EMDR monitoring–An EEG study. PLoS One, 7(9), e45753.
Shapiro, F. (2001). Eye Movement Desensitization and Reprocessing (EMDR): Basic principles, protocols, and procedures. Guilford Press.
Stickgold, R. (2002). EMDR: A putative neurobiological mechanism of action. Journal of Clinical Psychology, 58(1), 61–75.
Schwarz, D., Perry, S., & Federici, R. (2020). Treating developmental trauma with Brainspotting: Case studies and theoretical foundations. International Journal of Neuropsychotherapy, 8(1), 14–27.