EMDR vs. somatic therapy: Which is right for you?

Eye movement desensitization and reprocessing (EMDR) and somatic therapy are two forms of mental healthcare. They’re frequently compared because they’re both used to treat trauma-related conditions. And unlike traditional talk therapy, these approaches incorporate physical sensations to encourage healing in the mind and body at the same time. 

While both these approaches might be used to treat trauma, they have some key differences. For example, somatic therapies tend to maintain a present focus. But EMDR helps people change how they respond to traumatic memories from the past. 

Learning more about what these interventions have in common and what sets them apart can help you decide if one (or both) might be right for you.

The connection between EMDR and somatic therapy

One of the biggest connections between EMDR and somatic therapy is a focus on trauma. 

They’re similar in other ways too, including: 

• Treatment focus. Both approaches can be used to treat post-traumatic stress disorder (PTSD) as well as depression, anxiety, and other concerns. In sessions, you may be asked to reflect on your trauma and notice what emotions or physical sensations come up.  

• Rationale. Trauma is often stored in the body or the subconscious, so simply talking about it may not help some people. Instead, these types of therapies incorporate a mind-body connection.

• Benefits and goals. Both EMDR and somatic therapy are designed to help you address the emotional and physiological responses to trauma. Over time, you might find relief from psychological symptoms.

The differences between EMDR and somatic therapy

While EMDR and somatic therapy have many similarities, they’re not exactly the same. 

These approaches have some important differences, like: 

• Treatment structure: Somatic therapy can include all sorts of body-based activities and movement — like breathwork or body scans. There’s no set timeline or treatment length for somatic therapy, so it can be highly flexible. EMDR, however, is more structured. It follows a specific 8-phase protocol over 6 to 12 sessions. 

• What happens in sessions: In somatic therapy, you might do breathwork, grounding exercises, body scans, or other forms of gentle movement. During these activities, your therapist will help you notice and release physical or emotional tension. In EMDR, you’ll be asked to recall a traumatic memory while the therapist introduces bilateral stimulation. For example, you might watch a therapist’s finger move back and forth, or feel light taps on your left and right hands in an alternating pattern. Research shows that bilateral stimulation ^[1] can reduce your sensitivity to traumatic memories.  

• Accessibility: EMDR might be less accessible than somatic therapy depending on where you live, your insurance coverage, and other factors. This is because it requires specific training. Somatic therapy encompasses a much broader umbrella of body-based techniques. So you might have an easier time finding someone who practices it.

Can you combine somatic and EMDR therapy?

Yes, you can combine somatic therapy and EMDR. For some people, this approach might be even more beneficial than experiencing a single approach at a time. 

For example: Let’s say you survived a hurricane that devastated your community and took the life of a friend. In the aftermath, you’ve been diagnosed with PTSD. You start to shake and sweat during heavy rainstorms, dream of natural disasters, and find yourself avoiding anything that reminds you of your loss. 

In this situation, the effects of trauma might show up in both your mind and body. EMDR could help you reprocess your painful memories so they’re less upsetting. That way, you won’t feel like you’re reliving your trauma anytime there’s a bad storm or you think of your friend. At the same time, somatic therapy could help you address the physical effects of trauma. It could help you learn to use breath and movement to calm your nervous system when you feel triggered or unsafe.

Like all types of therapy, EMDR and somatic therapy can be incredibly helpful for some people. But they’re not necessarily right for everyone. For example, EMDR should be used with caution in people with dissociative disorders ^[2] and with vulnerable populations ^[3], like people with disabilities, children, and refugees. Similarly, somatic therapy may not work for someone with certain physical limitations. 

Both approaches should be avoided during active psychosis or if a person is under the influence of mind-altering substances.

How to choose which one’s right for you

If you're unsure whether to choose EMDR or somatic therapy, the following questions can help you make a decision.

• What are your current symptoms? If you’re experiencing flashbacks, nightmares, hypervigilance, irritability, or other PTSD symptoms, EMDR could be a better fit. If you experience physical tension or discomfort, and you have a sense that it’s tied to your emotions, somatic therapy could help you explore that connection.

• How much time would you like to devote to therapy? Somatic therapy is more flexible and can be open-ended. EMDR has a set number of phases over around 6 to 12 sessions. However, you can return for additional rounds of EMDR if needed and your provider thinks it would be helpful. 

• What are your goals for therapy? If you’re struggling with a reaction to traumatic memories, EMDR can help provide relief. If you’re more interested in learning to attune to your body and increasing mind-body awareness, somatic therapy could be a better choice.

Clinician’s take

When the two are combined, somatic work often helps build safety and regulation early on. EMDR is then used later to process specific memories once the nervous system feels more stable, with somatic skills supporting integration along the way.

Brandy Chalmers, LPC

Clinical reviewer