If you’ve been looking into trauma therapy, you’ve probably come across both of these names. And at some point you’ve probably thought: okay, but what’s actually the difference? They both involve eye positions. They both seem to bypass talking. They both get recommended for trauma. So why are there two of them?
It’s a fair question, and most of what’s written about it online either oversimplifies or gets so technical that it stops being useful. So here’s an honest attempt to explain what’s actually different between them, in a way that helps you figure out which one might make more sense for you.
They come from the same place
Brainspotting didn’t appear out of nowhere. It came directly out of EMDR.
EMDR was developed in the late 1980s by a psychologist named Francine Shapiro, who noticed that moving her eyes back and forth while holding a distressing thought seemed to reduce its intensity. That observation became a full clinical protocol, and over the next several decades it became one of the most research-backed trauma treatments in existence. The World Health Organization, the American Psychological Association, and the Department of Veterans Affairs all recognize it as a first-line treatment for PTSD. That’s not a small thing.
Brainspotting came about in 2003, when a therapist named David Grand, who was trained in EMDR, was working with a client and noticed something the EMDR protocol didn’t quite account for. While tracking her eye movements, he observed that when her gaze landed at a particular point in her visual field, something changed in her body. Something activated. He stayed there instead of moving on, and what happened next for that client felt different from what standard EMDR typically produced. He kept exploring that observation, and eventually built it into a separate method.
So Brainspotting grew out of someone asking: what happens if we stop moving and just stay here?
The core difference, in plain terms
In EMDR, the eyes move. Back and forth, rhythmically, while you hold a memory in mind. That back-and-forth movement is the mechanism. It seems to engage the same brain system that processes experience during REM sleep, which helps unstick memories that got lodged in the nervous system without completing their natural processing cycle.
In Brainspotting, the eyes find a spot and hold it. The therapist slowly moves a pointer across your field of vision while you stay connected to whatever you’re feeling in your body. At a certain point, something shifts, a small eye movement, a change in breathing, a subtle physical response that your therapist is watching for. That’s the brainspot. It corresponds to a location in the brain where a particular piece of distress is being held. Once that spot is found, you hold your gaze there and let whatever needs to happen, happen.
That’s really where the paths diverge. EMDR uses ongoing bilateral movement as the vehicle for processing. Brainspotting uses a fixed point as an access key, and then gets out of the way.
How different the actual sessions feel
This is where people who’ve experienced both really notice the contrast.
An EMDR session has more structure to it. Before reprocessing starts, your therapist will help you identify a specific memory to target, the emotions attached to it, where you feel it in your body, and the belief about yourself that’s gotten tangled up with it — something like “I’m powerless” or “I should have stopped it.” There’s a clear arc to each session and a defined protocol with multiple phases. Your therapist is fairly active, offering prompts, checking in, guiding you through stages. Some people find this structure grounding. It keeps the work focused and gives you a sense of where you are in the process.
A Brainspotting session is quieter. After finding the spot, your therapist mostly holds space while you go inward. There’s less dialogue. Less direction. Your therapist is present and attuned but not guiding you toward specific material. Whatever arises — a body sensation, an image, an emotion, sometimes nothing you can name — that’s what gets processed. The session doesn’t follow a predetermined sequence. It goes where the nervous system needs to go.
Some people find that spaciousness settling. Others find it uncomfortable, particularly if they’re used to more structure in therapy or if the lack of external direction makes it harder to stay grounded. Neither response means you’re doing it wrong. It means one format fits you better than the other.
What each one tends to be better at
Neither is better in an absolute sense. They’re just better suited to different things.
EMDR tends to be a strong fit when there’s a specific memory or set of memories driving the distress. Someone who was in an accident and keeps replaying it. Someone who experienced a single traumatic event that they can point to. Someone with clear intrusive memories, flashbacks with specific content, a defined narrative of what happened. EMDR’s memory-targeting approach is very effective here because there’s something concrete to work with, and the structured protocol helps the processing move in an organized way.
Brainspotting often reaches things that are harder to name. Trauma that accumulated over years rather than arriving in one event. Experiences from childhood that don’t attach to clear memories, just a felt sense of something being wrong, or a body that reacts in ways that don’t make logical sense. Shame that lives somewhere below the surface. Chronic tension that never fully releases. If what you’re carrying doesn’t have a clear narrative — if it’s more of a feeling, a pattern, a physical holding — Brainspotting’s body-first approach can access it in a way that the more cognitively oriented EMDR protocol sometimes doesn’t.
People who have done EMDR and felt like it helped significantly but left something incomplete sometimes find that Brainspotting reaches that remaining layer. The reverse is also true. Someone might try Brainspotting’s open-ended process and find that without more structure, they feel unmoored, and that EMDR’s protocol actually helps them stay regulated when they’re working with difficult material.
A lot of therapists trained in both will move between them depending on what a particular session calls for. The two approaches aren’t competitors. In skilled hands, they complement each other.
What about the research
EMDR has a larger and longer body of evidence. That’s just the reality. Decades of clinical trials across diverse populations have established its effectiveness for PTSD and a range of related conditions. The research is hard to argue with.
Brainspotting is newer, so its research base is smaller. But it exists, and it’s meaningful. A 2017 study comparing Brainspotting directly to EMDR found that both produced significant reductions in trauma symptoms, with Brainspotting showing faster results on some measures. Other studies have shown clinically significant effects for PTSD, anxiety, chronic pain, and performance anxiety. The evidence isn’t as voluminous as EMDR’s, but it’s credible enough that calling Brainspotting experimental or unproven would be inaccurate.
If you’re someone who needs to know a treatment has the most established possible evidence base before you try it, EMDR is the clearer answer on that criterion. If you’ve already tried EMDR and want to explore something that works differently, the research on Brainspotting is solid enough to give you confidence.
How to think about which one is right for you
Honestly, the most useful thing you can do is have this conversation with a therapist who knows both approaches well. Not every therapist is trained in both, and not every therapist who says they offer EMDR has the same depth of experience with it. The right fit depends on your history, how you tend to work in therapy, what you’ve tried before, and what your nervous system actually needs.
But in rough terms: if you know what the memory is, if you can point to the thing, if you have a narrative even if it’s painful, EMDR is often the place to start. If what you’re carrying doesn’t have a clear shape, if it’s more diffuse, more somatic, more pre-verbal, Brainspotting might reach it more directly.
And if you’ve done one and it helped but something still feels unfinished, it might be worth asking about the other.
Both are available at Vantage Mental Health
Vantage has therapists trained in EMDR and Brainspotting across its clinics in Stillwater, Edina, and St. Anthony, and through telehealth for people anywhere in Minnesota. If you’re not sure which direction makes sense for you, that uncertainty is a completely fine place to start the conversation. A good therapist will listen to what you’re actually dealing with before recommending anything.
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Frequently Asked Questions
Yes, and many trained therapists do. The two approaches are not mutually exclusive. Some therapists use EMDR to work through specific memories and Brainspotting when a client needs to access something more diffuse or body-held. Others integrate elements of both within a single session depending on what the moment calls for. What matters is that the therapist is trained in both and making intentional choices rather than switching methods arbitrarily.
This is one of the more common reasons people seek out Brainspotting specifically. EMDR's memory-targeting approach is effective for a lot of material, but it doesn't always reach what's held somatically or without a clear narrative. If EMDR moved significant ground but left something incomplete, that's worth exploring with a therapist who knows both methods well. Brainspotting's non-directive, body-first process can sometimes access exactly the layer that structured memory reprocessing didn't.
Brainspotting is newer than EMDR, and its research base reflects that. But newer doesn't mean unproven. It has peer-reviewed clinical studies documenting its effectiveness, and it's taught in formal training programs to licensed clinicians. The honest answer is that EMDR has more research behind it simply because it's been around longer. Brainspotting has enough evidence to be credible, and the therapists who use it regularly report consistent results. Calling it experimental would be inaccurate. Acknowledging that it has less accumulated research than EMDR is just being honest.
This varies by person more than by method. Some people find EMDR sessions more activating because the structured protocol moves through specific memories deliberately. Others find Brainspotting more intense because the open-ended format can surface things that weren't anticipated. Neither is uniformly harder. Your therapist's attunement and pacing matter as much as the method itself, and a good therapist will calibrate to what you can actually handle.
Yes. Both EMDR and Brainspotting have been adapted for telehealth delivery with comparable outcomes to in-person treatment for most people. EMDR uses screen-based eye movement guidance or tapping. Brainspotting uses screen-based pointer guidance and biolateral sound through headphones. Vantage Mental Health offers both through telehealth for people across Minnesota.
You don't have to know going in. A therapist trained in both will ask about your history, what you've tried before, and what you're currently experiencing, and they'll offer a recommendation based on that. You can share what you've read, ask questions, and be part of that decision. But you don't need to arrive with the answer already figured out.
