EMDR (Eye Movement Desensitization and Reprocessing) and Brainspotting are both evidence-based therapies that can be used to treat trauma and other mental health conditions.

Both therapies use visual field to help clients access unprocessed material, integrate it and heal from traumatic experiences. However, there are some key differences between the two approaches in 3 areas: eye movement, focus and structure.

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Eye movements

EMDR uses rapid eye movements and it is based on the principle of bilateral stimulation. Clients are asked to follow their therapist's fingers with their eyes back and forth from left to right. Sometimes, the same effect is achieved with tactile stimulation by devices that emit light, sound or vibration. During an EMDR session a client would hold a buzzing device in each hand or follow the moving light with their eyes. Brainspotting, on the other hand, uses a fixed eye position. Clients are asked to focus on a specific spot in their visual field. A therapist helps the client to locate a suitable spot with a pointer that they hold in their hand, or by utilising a spot that the client’s gaze is naturally drawn to. While in Brainspotting the client processes material on fixed spots, sometimes more than one spot is used e.g. an activation and a resource spot can be used in the same session. Brainspotting has also many variations based on the core concepts e.g. body spotting or image spotting.

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Focus

EMDR is typically focused on specific traumatic memories. Clients are usually asked to identify a distressing event, image, thought, feeling, or physical sensation related to the trauma. They then focus on this target while engaging in bilateral stimulation and following the protocol with their therapist.

Brainspotting is more focused on the client's current experience. Clients are asked to identify a ‘brain spot’, which is a point in their visual field that is associated with the trauma e.g. a spot in their visual field in which they feel more activation as they are bringing up the trigger or a distressing topic. The focus shifts to the spot and noticing the client’s process in the present moment, such as emotional activation, changing bodily sensations or thoughts and memories that come up. These may or may not seem relevant to the topic that the client has chosen to work through, but they are part of the processing in the subcortical brain and the body. Sometimes, Brainspotting is enhanced with the use of bio-lateral or bi-lateral music.

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Structure

EMDR is a more structured and protocol-driven approach. Usually, there are 8 steps in the process: history taking, preparation, assessment, desensitisation, installation, body scan, closure and re-evaluation.

Brainspotting is a more flexible and client-centred therapy. Brainspotting therapists have more freedom to adapt the approach to meet the individual needs of the client, the main principle in Brainspotting are ‘the curiosity principle’ and ‘staying in the tail of the comet’. In practice, this means that the practitioner has expertise and experience, but they do not make assumptions and instead they try to tune in to the needs of the individual needs of the client’s nervous system.  

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Which therapy is right for me?

Both EMDR and Brainspotting are evidence-based therapies and can be highly effective treatments for trauma.

The choice of the best therapy for an individual will therefore depend largely on individual needs and preferences. If you are more comfortable with a more structured and protocol-driven therapy, EMDR may be a good option for you. If you are looking for a more flexible and client-centred approach, Brainspotting may be a better fit.

A strong therapeutic relationship is crucial for effectiveness of any psychotherapy, so ultimately finding a practitioner with whom you feel comfortable and safe may be more important than a choice between EMDR and Brainspotting.

Both EMDR and Brainspotting involve working with trauma, which can be emotionally challenging, so take your time in selecting a qualified and approachable therapist who can safely support you throughout the process. Some of the trained and qualified therapists in Lisbon include Alicja Szalinska from Lisbon Counselling (Brainspotting) and Joe Wetherell from Castelo Counselling.

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*The information provided in this blog post is for general educational and informational purposes only and should not be construed as medical or mental health professional advice. If you are struggling with any of the issues described in this post, please seek appropriate professional help from a qualified professional.

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Sources:

EMDR and Brainspotting: A Comparison of Two Trauma Treatments by F. Shapiro and D. Grand

Brainspotting: The Revolutionary New Therapy for Trauma, Anxiety, and Performance Anxiety by D. Grand

Eye Movement Desensitization and Reprocessing (EMDR): A Comprehensive Guide by F. Shapiro

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