Brainspotting vs EMDR: How to Choose the Right Trauma Therapy

Brainspotting vs EMDR is a question I am asked regularly, and it deserves a careful answer. Both are body-based trauma therapies with supporting research. Both work with eye position and the nervous system rather than narrative alone. And both can produce meaningful change for people who have not found that change through talk therapy.

But they are not the same, and for some people the differences matter significantly. This post is an honest comparison – not a sales pitch for one over the other, but a clear account of how they differ and what those differences might mean for you.

I trained in Brainspotting and use it in my practice alongside IFS. I do not offer EMDR. That is a relevant disclosure – and it is also why I want to be genuinely fair in how I describe both approaches here.

In this article

What Brainspotting and EMDR Have in Common

Both approaches emerged from the observation that eye position and movement have a relationship with emotional and traumatic activation. EMDR was developed by Francine Shapiro in the late 1980s. Brainspotting was developed by David Grand in 2003, partly from his experience as an EMDR practitioner.

Both work at a level beneath language and conscious thought. Neither requires the client to construct a detailed narrative about what happened. Both are used for trauma, anxiety, and a range of presentations where physiological activation from past experience is shaping current responses.

Both have peer-reviewed research supporting their effectiveness. EMDR has a larger and longer-established evidence base – it has been studied extensively since the 1990s and is recommended by major mental health bodies internationally, including the World Health Organisation. Brainspotting’s evidence base is smaller but growing, with a number of comparative studies showing outcomes that are broadly comparable.

How Brainspotting vs EMDR Differ in Practice

The most significant difference is in structure and directiveness. EMDR follows a defined eight-phase protocol. Sessions have a clear structure, specific phases for assessment, preparation, desensitisation, and installation, and the therapist plays an active role in guiding the client through each stage. The bilateral stimulation – typically eye movements following a moving object, or tapping – is applied systematically.

Brainspotting is less structured. Once the brainspot is located, the therapist largely steps back and allows the client’s system to process in its own way, at its own pace, without a protocol directing what should happen next. The therapist holds dual attunement – tracking both the client’s external cues and their own internal experience – but does not direct the content of the processing.

A second difference is in the nature of the eye position work. EMDR uses bilateral stimulation – the eyes move back and forth following a stimulus. Brainspotting uses a fixed position – the eyes hold a single spot while processing occurs. The experience of the two is quite different, and clients who have tried both often describe Brainspotting as feeling more organic and less effortful.

A third difference is in what the approaches ask of the client cognitively. EMDR’s protocol involves active cognitive work alongside the bilateral stimulation – identifying negative cognitions, rating distress, installing positive beliefs. Brainspotting requires less cognitive engagement. The client stays with body sensation and internal experience without needing to simultaneously manage a structured assessment process.

The Evidence Base: An Honest Comparison

EMDR has a substantially larger evidence base than Brainspotting. It has been the subject of hundreds of randomised controlled trials and is endorsed by the World Health Organisation, the American Psychological Association, and the Australian Psychological Society among others. For PTSD in particular, it is considered a gold-standard treatment.

Brainspotting’s evidence base is smaller and more recent. The most rigorous independent comparison study to date – D’Antoni and colleagues (2022) – found Brainspotting and EMDR produced comparable outcomes for distressing memories. Hildebrand, Grand and Stemmler (2017) found both effective for PTSD, with EMDR showing slightly larger effect sizes in that study. The research is promising but not yet at the volume or methodological strength of the EMDR literature.

What this means practically is that EMDR has stronger institutional backing and a more established evidence base. Brainspotting has good and growing evidence and strong clinical outcomes, but a smaller research foundation. For someone who values evidence hierarchy, that distinction matters.

Who Tends to Suit Each Approach

Neither approach is universally better. The right fit depends on the person, the presentation, and sometimes simply on what feels right when they experience it. That said, some patterns emerge in clinical practice.

EMDR may be a stronger fit for women who:

Prefer a clear, structured process they can understand and follow
Want an approach with the largest possible evidence base
Have a clearly defined traumatic incident they want to target
Have found structured protocols helpful in other areas of their life

Brainspotting may be a stronger fit for women who:

Found EMDR effective but exhausting, or struggled with its structured format
Are carrying complex or relational trauma without a clearly defined single incident
Prefer an approach that follows their system’s natural pace rather than a protocol
Want trauma work integrated with an IFS framework for understanding their inner parts
Carry a body-based quality to their patterns that has not shifted through cognitive or talk-based approaches

Frequently Asked Questions

Can I switch from EMDR to Brainspotting if EMDR is not working for me?

Yes. The two approaches are compatible and prior EMDR work is not wasted if you move to Brainspotting. Some women find that EMDR takes them a significant way and Brainspotting reaches what remains. Others find the different quality of the process suits them better from the start. It is worth having an honest conversation with any new therapist about what has and has not worked before.

Is one approach faster than the other?

Not in any consistent way. Both can produce rapid shifts for some presentations and require longer-term work for others. The pace depends far more on the complexity of what is being worked on and the readiness of the nervous system than on the modality itself.

Why do you use Brainspotting rather than EMDR in your practice?

Brainspotting integrates particularly well with IFS, which is the primary framework I work within. The two approaches complement each other naturally – IFS providing the relational and psychological scaffolding, Brainspotting providing the somatic processing depth. I also find that the less directive quality of Brainspotting suits the women I work with, many of whom have spent years being told what to do and think and feel. Brainspotting trusts the system to know what it needs.

Should I try both before deciding?

If you have access to skilled practitioners in both, experiencing both is not a bad idea. Many people find that one approach has a quality that immediately feels more right than the other. If you are starting fresh without prior experience of either, the most important factor is usually the quality of the therapeutic relationship – the approach matters less than the skill and attunement of the person delivering it.

If Brainspotting Sounds Right for You

If what you have read here points you toward Brainspotting, I would welcome a conversation. I work exclusively with women, fully online, using Brainspotting alongside IFS to address trauma, anxiety, and emotional patterns at the level where they actually live.

You can read more about how I work on my approach page. When you are ready, get in touch directly to ask a question or enquire about availability. I aim to respond to all enquiries within two business days.

The right therapy is the one that reaches what needs to be reached. I hope this helps you find it – whether that is with me or with someone else.