EMDR vs. Traditional Talk Therapy: What’s the Difference?
Clinically Reviewed by: Katie Moran, LCWS
Written by: Janelle Martel
With the increase in awareness of mental health over the past years, therapy has been growing in popularity. Therapy is an outlet for discussing any issue in your life, as well as a proven treatment for mental illnesses. It can help you process life events and manage everyday anxiety and stress, and it can also help reduce the symptoms of various mental health disorders.
This may seem like therapy is supposed to be a cure-all or panacea, which would justifiably provide grounds for skepticism. However, this is only because therapy is a catch-all term for a range of approaches. While all share commonalities, such as providing a safe space for discussing personal challenges, they can differ significantly in their philosophies and techniques.
Two popular approaches you may be considering are Eye Movement Desensitization and Reprocessing (EMDR) therapy and talk therapy. Both are effective despite their major differences. That said, each of these modalities are suited to particular scenarios.
We’ll be diving deeper into what is the difference between EMDR and talk therapy and how to decide which is the best option for you.
What is EMDR Therapy?
EMDR (Eye Movement Desensitization and Reprocessing) is a psychotherapy designed to treat issues related to trauma and other distressing life events. Studies have shown that it is highly effective in treating post-traumatic stress disorder (PTSD), complex trauma, and unresolved childhood experiences.
EMDR therapy was developed by Dr. Francine Shapiro, a clinical psychologist. In 1987, during a recreational walk in the park, she realized that rapid eye movements decreased her own distress when thinking about difficult memories. She worked on creating a therapy modality based on this discovery, trialling it with individuals with traumatic memories. Results supported her use of eye movements and other bilateral stimulation (including tapping), leading to the emergence of EMDR as a treatment for PTSD.
In the years since, EMDR has also been used to treat people grappling with distressing memories of all kinds.
How Does EMDR Work?
What does bilateral stimulation like eye movements and tapping have to do with mental health? And how are they actually used in an EMDR session?
To better understand how EMDR works, it is useful to compare the emotional injuries caused by trauma to physical harm. When you cut your finger, it bleeds and you feel pain. As time passes, your body works to close the wound. However, if something prevents the wound from closing, whether further injury or a foreign object, it festers and continues to cause you pain.
In the same way, our bodies and minds work to close the emotional wounds caused by trauma. Unfortunately, there are many obstacles that can get in the way. In some instances, the trauma is repeated or continuously present. In others, maladaptive coping mechanisms or the stresses of modern life become blocks to healing.
It is unclear exactly why, but bilateral movements facilitate better emotional processing. EMDR uses this mechanism to help the person process traumatic memories and replace negative beliefs about the event with positive associations.
How Does an EMDR Session Look?
Even with an understanding of how EMDR works, it can be difficult to envision how an EMDR therapy session looks.
EMDR therapy progresses in phases.
The first phase of EMDR therapy resembles the initial session of most other modalities. The person shares their history with the therapist. Together, they identify possible targets for therapy, typically including distressing memories as well as current events causing distress. They then develop a treatment plan, based on the client's needs and what they're ready for.
In the second phase of therapy, the therapist ensures the person has various ways of handling emotional distress, teaching them emotional regulation techniques. Only then does therapy progress to processing the actual memories.
In the following phases, the person imagines or talks about distressing memories and their effects while doing eye movements, finger tapping, or other bilateral stimulation techniques. They consider the negative beliefs that arise and focus on positive replacements.
The final stages include work to do at home, followed by an assessment of their progress towards meeting their goals.
Who is EMDR Best For?
EMDR has been used to great effect with survivors of trauma, including those with post-traumatic stress disorder (PTSD). It is also effective in treating people with distressing memories, even when they are not related to events considered traumatic.
What is Traditional Talk Therapy?
Traditional talk therapy is an umbrella term for therapy modalities which are largely characterized by dialogue between the therapist and client. Talk therapy includes psychodynamic, humanistic, cognitive, and behavioral approaches, among others.
Sigmund Freud is generally considered the father of talk therapy, but the field has evolved significantly over the past century, with approaches building on and diverging from his psychoanalytic techniques. Nonetheless, a number of major principles remain relevant, including the focus on gaining insight, symptom reduction, emotional processing, and developing healthy coping strategies.
Traditional therapy sessions are verbal and collaborative, with the person sharing experiences, thoughts, and feelings. Psychodynamic and humanistic therapy sessions tend to follow loose structures, with the process led by what comes up rather than external templates.
Cognitive and behavioral therapies (including CBT) are more structured. The therapist guides the client through techniques that help change thoughts and behaviors, leading to better emotional regulation.
Talk therapy is recommended for people facing day-to-day stresses or struggling with anxiety and mood disorders (such as depression and bipolar disorder), individuals and couples looking to effectively navigate and build healthy relationships, and people processing trauma or looking to change long-term emotional patterns. It is also useful for those who are searching for meaning and purpose.
| EMDR | TALK THERAPY | |
|---|---|---|
| FORMAT & STRUCTURE | Processing memories with bilateral movements. Highly structured, with distinct phases. |
Dialogue; conversational. Often open-ended. Modalities like CBT are more structured and goal-oriented, although less so than EMDR. |
| FOCUS AREAS | Trauma; PTSD; distressing memories. Fear associated with negative beliefs. | Emotional exploration; insight; symptom reduction. |
| TIMELINE | Short term and targeted for efficient symptom relief. | Ongoing; as long as the individual prefers. More structured therapies like CBT tend to be short-term with a more definite endpoint. |
| TOOLS & TECHNIQUES | Bilateral stimulation, including eye movements and tapping. Imagery and visualization to form safe spaces. Formation of new beliefs associated with the memories. |
Client-led conversations. Reflection. Exploration of childhood and interpretation of thoughts and feelings. CBT: skills including cognitive restructuring, behavioral activation, problem solving, and mindfulness. |
Can EMDR and Talk Therapy Be Used Together?
As we’ve seen, EMDR and talk therapy are distinct modalities with vastly different approaches and techniques. But what if you relate to both therapies? Can EMDR and traditional therapy be used together?
Many modern therapists take an eclectic approach to therapy, drawing on various approaches when appropriate. With expertise in a range of modalities, they assess what each individual needs. They may use EMDR with a person with PTSD and talk therapy with someone dealing with depression.
They may also use a combination of approaches with an individual, even in a single therapy session. It is common for people who have experienced trauma to have other concerns as well. Whether they are struggling with stress at the office, looking to explore ideas of meaning and purpose, or have been diagnosed with a mental illness, one approach alone may not address all their challenges.
A therapist specializing in both EMDR and traditional talk therapy can use a blended approach. In some sessions, they will primarily use talk therapy techniques, while in others they will focus on bilateral stimulation. Often, techniques from one therapy will be integrated with techniques from another.
For example, Sally decided to see a therapist as she was struggling to cope with anxiety around her family responsibilities. The therapist began with talk therapy to explore the factors underlying her anxiety.
A few sessions in, Sally suddenly remembered an incident from childhood. Her mother had been late to pick her up from school. Then, her dad’s car pulled up and he greeted her with a somber face, explaining that her mother was in hospital for a “big kind of sadness” called depression. He told Sally that they were going to visit and cautioned her to not overwhelm her mother by looking worried or talking about things she needed.
In therapy, it became clear that Sally had internalized the message that she was at fault for her mother’s condition. She had developed anxiety around the idea that she was bad for expressing her emotions and having needs, and that something terrible would happen to her mother if she wasn’t careful and responsible around her.
This insight helped Sally understand her patterns of behavior and begin to change them. However, the distress from the memory remained, continuing to reinforce the old messaging. Her therapist decided to use EMDR sessions to process the memory and change the beliefs Sally had associated with it.
With the benefits of both types of therapy, Sally was able to change her patterns without facing resistance from the memory of the distressing event.
How to Decide What’s Right for You
Without having gone to therapy before, it can be difficult to know which therapy is right for you. Some questions you can ask yourself include:
Do I want to talk about my issues or process memories more directly?
Are my challenges related to traumatic memories or more general?
Am I looking to focus primarily on symptom relief or do I want ongoing insight-based sessions?
If you’re still unsure about which therapy is right for you, an expert opinion can prove very helpful. When searching for a therapist through Octave, you can ask for guidance in selecting an approach.
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Octave’s Approach to Therapy
Therapy can change your life and it is therefore important that you get the best help from an experienced expert. Octave places an emphasis not just on providing highly credentialed therapists, but also on finding the right fit for each individual. This includes both determining the appropriate modality and matching you with someone who resonates with you.
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FAQs
Q: Is EMDR better than talk therapy?
A: Neither EMDR nor talk therapy are better than one another. They serve different purposes and you should choose the approach most suitable to your needs.
Q: How long does EMDR take compared to talk therapy?
A: EMDR is generally a shorter term therapy with a focus on targeted symptom relief. It can take anywhere from six to twelve sessions (or more as needed), with standard sessions of sixty to ninety minutes. In contrast, talk therapy can continue indefinitely. New insights often emerge and people choose to delve further into their psyche.
Q: Can I do both types of therapy together?
A: Some therapists offer a blend of EMDR and traditional talk therapy. They draw on techniques from both modalities, ensuring the person has the opportunity to process traumatic memories as well as gain further insight into their life as a whole.
Choose the Therapy That is Best For You
EMDR and talk therapy are two very different modalities. EMDR therapy is best suited to clients dealing with trauma, PTSD, and distressing memories. Talk therapy can help with these issues, but is a more open-ended process focused on self-exploration and gaining insight. Some therapists may use a blend of both therapies to best fit your particular needs.
Not sure which therapy is right for you? Schedule a consultation with a licensed Octave therapist today.