What Is EMDR?
Eye Movement Desensitization and Reprocessing (EMDR) is a structured therapy that uses bilateral stimulation—usually eye movements, but sometimes tapping or tones—to help the brain reprocess traumatic memories.
Developed by Francine Shapiro in the late 1980s, EMDR doesn’t require clients to talk in detail about their trauma. Instead, it focuses on how the memory is stored and experienced in the brain and body.
During EMDR sessions, the therapist guides the client to recall distressing memories while simultaneously using bilateral stimulation. This process is thought to mimic what happens during REM sleep, allowing the brain to process and store emotional experiences more adaptively naturally.
What Is CPT?
Cognitive Processing Therapy (CPT) is a structured form of cognitive-behavioral therapy (CBT) that focuses on the beliefs and thoughts a person develops after trauma.
Developed by Dr. Patricia Resick, CPT helps individuals identify “stuck points”—rigid, unhelpful beliefs about themselves, others, or the world (for example, “I should have done something to stop it” or “I can’t trust anyone”).
Through cognitive restructuring, journaling, and skill-building, CPT helps clients challenge and replace these thoughts with more balanced, compassionate, and realistic beliefs.
It often includes writing about the trauma and exploring how it affected one’s sense of safety, control, trust, esteem, and intimacy.
Side-by-Side Comparison: EMDR vs. CPT
| Feature | EMDR | CPT |
|---|---|---|
| Primary Focus | Reprocessing traumatic memories through bilateral stimulation | Challenging and reframing trauma-related thoughts |
| Session Style | Brief trauma recall paired with eye movements or tapping | Talking and writing about trauma using structured worksheets |
| Client Involvement | Minimal verbal processing; focus on emotions and body | High cognitive engagement with regular homework |
| Homework | Not typically assigned | Frequently assigned (impact statement, stuck point logs) |
| Best For Clients Who… | Struggle to talk about trauma or feel emotionally flooded | Prefer cognitive structure and want to understand their trauma |
| Common Applications | PTSD, complex trauma, somatic symptoms, phobias, grief | PTSD, moral injury, childhood trauma, shame, and guilt |
| Training Required | EMDRIA-approved clinician certification | Formal CPT training recommended (not required) |
| Evidence Base | Supported by APA, VA/DoD, and WHO | Equally supported and widely researched |
Which One Should You Choose?
The right choice depends on your symptoms, comfort level, and therapy goals.
- EMDR is often best for people who experience intense physical or emotional responses when recalling trauma. It’s ideal for clients who don’t want to talk about every detail but still want relief from its emotional impact.
- CPT works well for those who want to make sense of their experiences, especially when shame, guilt, or self-blame are strong parts of their trauma story.
- Some individuals benefit from a combination of both therapies at different stages of healing.
Final Thoughts
Both EMDR and CPT are evidence-based, effective treatments for trauma and PTSD. The best fit depends on your needs, preferences, and how your trauma symptoms show up in daily life.
At The Well: Family Support, our trauma-informed clinicians are trained in both EMDR and CPT. We help clients find the approach that promotes lasting relief, emotional balance, and renewed connection with self and others.
Learn more about trauma recovery at thewellms.org.
References
American Psychological Association. (2017). Clinical practice guideline for the treatment of posttraumatic stress disorder (PTSD) in adults. https://www.apa.org/ptsd-guideline
Resick, P. A., Monson, C. M., & Chard, K. M. (2017). Cognitive processing therapy for PTSD: A comprehensive manual. The Guilford Press.
Shapiro, F. (2018). Eye movement desensitization and reprocessing (EMDR) therapy: Basic principles, protocols, and procedures (3rd ed.). The Guilford Press.
U.S. Department of Veterans Affairs. (2023). PTSD treatment decision aid. https://www.ptsd.va.gov/index.asp
