There are several different types of treatments that professionals use to address conditions like post-traumatic stress disorder (PTSD), as well as depression, or anxiety (the latter two which may or may not be trauma-related).   Traditional therapies such as Cognitive Behavioral Therapy (CBT) are frequently used but there are other, newer more “brain based” techniques that can also be utilized.  Two such therapies are Brainspotting and EMDR (Eye Movement Desensitization and Reprocessing). 

While there are several similarities between the two modalities, there are critical differences as well.  In this article, we’ll explore both in detail to help you decide which therapy may be more appropriate for your situation.

What is Brainspotting?

Brainspotting (sometimes abbreviated as BSP) is a kind of psychotherapy developed by Dr. David Grand in the aftermath of the 9/11 attacks.  Dr. Grand, a trained EMDR therapist, discovered the technique while using EMDR.  He noticed that the eyes of one of his clients became unsteady whenever they came across a specific area in her visual field.  Instead of instructing her to continue to move her eyes as per EMDR protocol, he decided to stay in that spot.  He found that by keeping her eyes stationary in the area of instability, a lot of unresolved traumas were processed.  Initially devised to address the trauma of survivors, today Brainspotting has wider applications that go well beyond PTSD or trauma

The main theme of Brainspotting is accessing deeper spots of the brain where unresolved traumas are maladaptively stored or “stuck”.  To do this, the therapist helps the client identify the problem area(s) in the visual field and then stays in that spot, allowing the brain to release what has become lodged.  By accessing the part of the brain where the trauma lingers, the client may be able to remember it, process it, and, eventually, heal from it. 

BSP targes the body’s limbic system. The therapist first helps focus on particular spots of the brain through eye movement and identifies the source of trauma in the brain through physical reflexes.  The therapy focuses on the hypothalamus, hippocampus, and amygdala of the brain, each of which plays a different role physiologically and psychologically.  These are the areas where the unprocessed trauma lies in, areas which the therapist helps identify and then work on with the client. 

There are typically five steps of BSP:

  • Locating/traversing brain spots
  • Focus on a particular brain spot
  • Processing the trauma
  • Releasing the trauma
  • Healing

What is EMDR?

EMDR (Eye Movement Desensitization and Reprocessing) is a therapy that uses eye movement or other bilateral stimulation (meaning “stimulation of both sides”) to reprocess trauma and help the client move past the traumatized state. Developed by Francine Shapiro in the 80s, it’s a well-documented and researched therapy used by therapists around the world to treat PTSD and other mental health issues.  EMDR consists of eight specific stages or phases that can take up to 12 sessions to complete.  Session last from an hour to an hour and a half. The idea behind Shapiro’s therapy is that when the person is distracted by an external stimulus, they are likely to feel less emotional stress while revisiting their trauma. This essentially helps them remember, process, and stabilize the memories of the trauma. 

A more technical explanation of EMDR is that the bilateral stimulation utilizes both sides of the brain to work on the trauma, so it can be stored in a more stable part of the brain. That way, even when a client is triggered, they are able to cope with their feelings and see the trauma in a new light. 

Similar to BSP, EMDR was originally developed to treat trauma. However, it’s now used for a number of conditions, including depression, anxiety, dissociation, addictions, grief, phobias, and even chronic pain

Similarities Between Brainspotting and EMDR

Let’s explore the similarities between the two modalities:  

  • Eye Movements: Both EMDR and BSP were developed using eye movements to help process trauma, though the technique differs.  While BSP depends upon eye movements, EMDR may utilize auditory or tactile bilateral stimulation in addition to or instead of eye movements
  • External Stimulation: Both BSP and EMDR use external stimulation though it is mandatory in EMDR and optional in BSP.  EMDR relies on bilateral stimulation that can be visual, auditory, or tactile in nature.   This can be following a therapist’s finger or a dot moving across a screen with the eyes, listening to sounds that alternate between the ears, or tapping the palms alternately.  BSP, on the other hand, often uses bilateral music to relax and aid the process, but it is not a necessary component.  
  • Resourcing and Grounding: Resourcing is the process of instilling mechanisms and actions that can help a person deal with emotional or physical reactions that are linked to traumatic memories.  Both therapies use this technique and it is a distinct stage in the EMDR process.  Grounding focuses on reconnecting with the energy of the Earth to make one feel stable, supported, and at home in ones body.  Both BSP and EMDR implement this and want their clients to feel grounded at the end of a session.
  • Processing Thoughts, Emotions, and Physical Reactions: Therapists conducting either BSP or EMDR focus on the client’s thoughts, emotions, and physical reactions to revisiting trauma.  In BSP, the client is encouraged to simply pay attention to whatever arises as focus is maintained in a specific spot.  While this is performed differently with EMDR, the client’s experiences are also acknowledged.

Brainspotting vs. EMDR: Key Differences

Here are the most notable difference between EMDR and Brainspotting:

Different Kinds of Eye Movements

As previously mentioned, while both treatments rely on eye movements, the types of eye movements differ significantly.  Brainspotting usually uses a single eye position, whereas EMDR involves rapid eye movement from right to left or up and down.  In EMDR, the eye movements are bilateral and continuous, moving back and forth as a traumatic memory is recalled.  In BSP, the idea is to find a specific spot where the trauma is stuck and to keep the eyes steady at that point as the trauma is resolved.  Maintaining focus on a single area in BSP is sometimes called “mindful focusing”.  This is actually a major difference and shows that these therapies utilize different approaches to identifying and consequently processing trauma. BSP operates on the principle that trauma is stuck in a very specific part of the brain and by focusing on this area, the trauma will be released.  EMDR, on the other hand, utilizes bilateral stimulation to engage the whole brain and strengthen the connection between the hemispheres.  It is thought the rapid eye movements mimic REM sleep, a state in which thoughts and traumas are processed.

Different Stimulation Devices

Because BSP and EMDR have different methods, the tools they use also differ.  There are numerous bilateral stimulation devices that can be used in EMDR, such as light bar in which a light moves left to right repeatedly, or a machine that taps the palms in an alternate fashion.  BSP concentrates on keeping the eyes steady, so a BSP therapist may use a laser pointer to help focus the eyes at a specific point.  Both therapies may use bilateral sound which needs to be delivered via headphones.

EMDR Therapy Requires More Sessions

EMDR is an eight stage process that requires a minimum of eight sessions.  EMDR may last as long as twelve sessions.  Brainspotting, on the other hand, is a short-term modality and may last only four sessions.

EMDR is Older and More Rigid in its Protocol

Brainspotting was developed in 2003 is still considered a relatively new therapy.  EMDR was developed in the 1980s and has evolved over time into a formal, systematic set of stages.  Though there is some room for flexibility for therapists, EMDR therapy is supposed to be carried out according to the official guidelines.  Brainspotting is much more flexible and less focused on following a rigid set of protocols which allows therapists to make changes based on their clients’ needs.  This can be advantageous or disadvantageous depending on the case. 

Brainspotting vs. EMDR: Which One is Better? 

Research evidence supports both Brainspotting and EMDR as effective treatments for many mental health issues, especially PTSD. However, there hasn’t been extensive research comparing the two therapies directly

Brainspotting, being quicker, has the potential to deliver faster results than EMDR. On the other hand, EMDR may have longer-lasting results despite its duration.  BSP is more flexible which may make it ideal for trauma clients who aren’t responding well to EMDR or other therapies.  Many therapists consider EMDR as a primary choice and treat BSP as an alternative to EMDR.

If you’re dealing with PTSD or other trauma related mental health conditions, discuss your options with your therapist.  Your therapist will be able to guide you based on your symptoms and any previous experience with therapy, and ultimately help you decide which treatment is best for you.  Both EMDR and BSP can be conducted in-person or online, increasing both accessibility and convenience.