Trauma informed care, trauma certified therapist, Eye Movement, De-sensitization, Re-processing (EMDR), Somatic Experiencing, Internal Family Systems, Sensorimotor Psychotherapy…. You may be familiar with these terms, but still have questions. What does it all mean, what is going to help me, and what do I really need to know?! This blog post aims to compare and contrast EMDR and Sensorimotor Psychotherapy (SP).
The field of trauma therapy has come a long way in recent years. This has led to many advancements in our understanding of the brain, behavior, and how traumatic experiences shape us. The basic explanation of the shift in trauma therapies is captured in the idea that we stopped treating trauma with a cognitive approach, and began treating trauma with more of a physiological, or somatic approach, given that trauma has significant physiological effects on humans. That is why you will see the words “somatic” or the term “body based” in trauma literature quite frequently. It is helpful to think of this as a shift from a top-to-bottom approach (when I change my thoughts and my trauma narrative, my body will feel better too), to a bottom-to-top approach (when I address the sensations that accompany my feelings, my cognitions and emotions will shift as well). This shift occurred due to an expansive body of research that came out of FMRI technology in the 1990s. FMRIs are MRIs that target neural function. This led to the development of new healing modalities, scientific backing for existing body-based modalities, and most importantly, an expansive dissemination of life-altering care. However, this shift has also led to confusion when it comes to choosing a therapist and a modality of therapy that is impactful for you. My hope is to clear up some of that confusion today.
I am a trauma therapist here at Cedar Counseling & Wellness, and I have been trained in Level One of Sensorimotor Psychotherapy, which is a somatic, bottom-to-top approach to treating trauma. I have also personally benefited from EMDR therapy, which is also a somatic, bottom-to-top approach to treating trauma. Both of these modalities, as well as all of the modalities of therapy listed above, are trauma focused therapies myself, and many of my fellow colleagues, strongly recommend. This blog post aims to compare and contrast EMDR and Sensorimotor Psychotherapy (SP) from my perspective, and the perspective of a close colleague of mine who is trained in EMDR. However, a word to the wise before we begin: THE most important element in therapy is that you feel connected to, safe with, fully heard by, and cared about, when in the presence of your therapist. Choosing a well trained therapist who specializes in what is bothering you is of course, important; but please know and trust that the relationship you form with your therapist is far more important.
To begin, it is important to note that EMDR and SP essentially serve the same purpose, but move at two different speeds, and affect the recipient at differing levels of consciousness. Meaning, both modalities of therapy use the body as a starting point to help the recipient re-process the frightening experiences that have happened to them. EMDR elicits more immediate results, particularly for acute traumatic events, but can leave the recipient a bit more emotionally spent or tired afterwards, as it by nature, moves at a faster pace than SP. SP, in contrast, elicits more gradual results, but is considered a more gentle approach that is often more appropriate for those who have suffered repeated or developmental trauma (trauma that occurred as a child was developing, otherwise known as childhood trauma). Does this mean that one should not pursue EMDR therapy if one has repeated trauma? Not necessarily, but it is important to know that EMDR will tap into multiple memories at once, whereas SP will move more slowly, focusing on a singular memory at a time. I could go into more detail regarding SP, but another wonderful therapist has already done a beautiful job describing what to expect from SP therapy in her article, Sensorimotor Psychotherapy, How it Works, Costs, & What to Expect. Link here.
Below is a brief description of what to expect from EMDR therapy from my colleague, Darla Sinclair, LCSW-C.
Dr. Bessel van der Kolk’s NY Times best-selling book, “The Body Keeps the Score”, showed us how disturbing, traumatic and/or adverse life experiences “live on” inside our systems and literally change the physiology of our brain and body. If left untreated, we can become susceptible to a host of conditions, both physical and mental, that have anywhere from mild to debilitating effects on our lives. That’s the bad news.
The good news is our bodies have an instinct to heal, not only from physical injury but also from emotional and mental injury. And just as we seek the help of a doctor to assist with major bodily injuries that cannot heal on their own, a well-trained, trauma informed therapist will help our system clear the “congestion” left behind in our brain and body after exposure to traumatic, toxic, or high intensity stress events.
In the years since Dr. van der Kolk wrote his seminal book, neurobiologically based therapies that not only focus on the body and the brain in the therapeutic process but therapies that also specifically target the dynamic, instinctual relationship between the two have become crucial methods for helping people get past their past. Eye Movement Desensitization Reprocessing (EMDR) Therapy is one such highly effective treatment.
EMDR Therapy uses a combination of Bilateral Stimulation (BLS: back and forth eye movements, alternating sounds and/or alternating taps) and Dual Attention (paying attention to the BLS AND whatever simultaneously comes up internally, like images, beliefs, emotions, sensations, etc.) to jumpstart our own brain and body’s capacity to heal. Although EMDR Therapy cannot change what happened to us, it can change how what happened to us is stored in our brain and body. It clears the “congestion” left behind in our systems, enabling us to live more freely, easily and happily in the present moment.
How is EMDR Therapy different from Sensorimotor Psychotherapy? As a therapist who is trained in both, I describe the difference as follows: While they are both transformational therapies making use of “the unfolding” that occurs moment by moment within the therapy hour,
- EMDR Therapy works at an accelerated pace and on several levels simultaneously (the conscious, the pre-conscious [that which is juuuust outside of conscious awareness] and the subconscious).
- Sensorimotor Psychotherapy tends to work in the conscious and pre-conscious realms by using mindfulness to track “the unfolding” in real time but doing so more slowly and, well, mindfully. That’s not to say subconscious material isn’t accessible by way of Sensorimotor Psychotherapy because I believe it can be. It’s more so that such material moves gently from the subconscious realm into the realms of pre-consciousness or consciousness whereas EMDR Therapy can work in the subconscious realm by rewiring neural networks and can do so without the subconscious material moving into conscious awareness (the person is just aware that what bothered them no longer does).
- The difference between the two is more clearly illustrated with the following metaphors: Client #1 is safely riding on a train traveling down a track (EMDR) whereas Client #2 is mindfully walking in the forest (Sensorimotor Psychotherapy). The views of both clients will be impacted by the speed at which they travel and by that to which they look while traveling: Are they choosing to look at things up close or further away, off into the distance? EMDR captures the “up close”, even when the client is looking at far away things and vice versa. Whereas, Sensorimotor Psychotherapy tends to capture the “up close.”
Making the choice between the two means assessing each Client’s comfort with their thinking, feeling and body “brains” as well as assessing their capacities for resourcing, trust in the therapeutic relationship and their skill sets for emotional and somatic (body) regulation. When choosing between these two modalities, it is important to follow your gut instinct about which pace works best for you, and to also discuss the choice extensively with your therapist, as their assessment is invaluable.
My hope is that this post has provided you with some clarity regarding which modality of trauma therapy to pursue. If you are ready to begin your healing journey, or would like to discuss which modality of therapy may be most helpful for you, please feel free to reach out.
References:
- van der Kolk, B. A. (2014). The body keeps the score: Brain, mind, and body in the healing of trauma. Viking.
- https://acestoohigh.com/aces-101/
Servan-Schreiber, D. (2004). The instinct to heal: Curing stress, anxiety, and depression without drugs and without talk therapy. Rodale Press.
Shapiro, F. (2012). Getting past your past: Take control of your life with self-help techniques from EMDR therapy. Emmaus, Pa: Rodale Books.
About the Author:
Caroline Fowler is a Maryland Board approved Licensed Certified Social Worker – Clinical (LCSW-C) therapist at Cedar Counseling & Wellness. Caroline specializes in providing compassionate care to individuals who have experienced direct trauma, secondary trauma, and/or chronic stress.
