If you've started looking into trauma therapy, you've probably run into both EMDR and somatic therapy, often described in ways that make them sound almost interchangeable. They do share something important: both treat trauma as something the body holds, not just a story the mind tells. They come at that body from opposite directions, though, and the difference matters when you're deciding where to start.
Here's how they actually differ, what the research shows, and how we think about which one fits.
What EMDR is
EMDR, which stands for Eye Movement Desensitization and Reprocessing, works by having you briefly bring a distressing memory to mind while you follow a form of bilateral stimulation, usually side-to-side eye movements, taps, or tones. The working theory is that bilateral stimulation occupies the brain's working memory just enough to drain the memory of its charge, so the brain can re-file it as something that happened rather than something that's still happening. One of its most useful features is that you don't have to narrate the trauma in detail for it to work. EMDR moves through eight structured phases, and you can read more on our EMDR therapy page. It's one of the most researched trauma treatments we have, recommended as a first-line option for PTSD by the APA, the World Health Organization, and the VA/DoD.
What somatic therapy is
Somatic therapy is an umbrella term for body-based approaches to trauma. The best known are Somatic Experiencing, developed by Peter Levine, and Sensorimotor Psychotherapy, developed by Pat Ogden. Instead of starting with the memory, somatic work starts with what the body is doing right now: the bracing in your shoulders, the held breath, the urge to flee or freeze that never got to finish. The idea is that trauma leaves the nervous system stuck in a survival state, and that gently tracking sensation, movement impulses, and nervous-system shifts lets the body complete what it couldn't complete at the time and settle. The work is slow and mindful on purpose, using techniques like titration (approaching a little at a time) and pendulation (moving between activation and calm) so you don't get flooded.
The core difference: top-down versus bottom-up
The cleanest way to hold the distinction is direction of travel. EMDR is top-down: it starts with a memory and its meaning, engages the brain's processing system, and lets the body settle as the memory loses its grip. Somatic therapy is bottom-up: it starts in the body, with sensation and nervous-system state, and lets understanding follow.
This matters because of what trauma does to the brain. In a traumatic moment, the thinking part of the brain tends to go offline while the survival parts take over, which is part of why talking about trauma sometimes doesn't touch what the body is still holding. Both approaches work around that in their own way: somatic work goes straight to the body, and EMDR gets at the stored memory through bilateral stimulation rather than through analysis. Both also aim to keep you inside your window of tolerance, the zone where you can feel something hard and stay present with it instead of getting overwhelmed or shutting down.
What the research actually shows
This is where honesty matters, because the two aren't on equal evidentiary footing. EMDR has a large, well-established research base and sits on the first-line list in every major PTSD treatment guideline. Somatic therapy is a promising newer field. The first randomized controlled trial of Somatic Experiencing for PTSD was published by Brom and colleagues in 2017, and a scoping review of the somatic experiencing literature found encouraging results, with moderate-to-strong effect sizes, alongside a clear caveat: the studies so far are fewer and smaller, the overall quality is mixed, and long-term follow-up data is limited. More trials are underway.
In plain terms, EMDR has more proof behind it, while somatic therapy has meaningful and growing support but is earlier in its research life. That doesn't make somatic work unproven, and it doesn't make EMDR automatically the right call for you. It means EMDR is the safer bet when you want the most-studied option, and somatic work is often chosen for reasons that have more to do with fit than with head-to-head evidence.
Which one tends to fit when
EMDR often fits well when your trauma is relatively identifiable (a specific event or period, like a crash, an assault, a medical trauma, or a particular relationship), when you have insight into what happened but the feeling hasn't shifted, when you'd rather not narrate the trauma out loud in detail, or when intrusive images, flashbacks, and body-level reactions are what you most want to target.
Somatic therapy often fits well when the trauma is developmental or relational, spread across years with no single memory to point at; when what you notice most is chronic nervous-system dysregulation, like anxiety that lives in the body, numbness, a persistent freeze, or feeling disconnected from yourself; when memory-focused work feels like too much right now; or when you first need to build regulation and a sense of safety in your own body before any deeper processing.
Why it's usually not either/or
In practice, the two are less a fork in the road than two tools that work well in sequence. A common and clinically sound pattern is to use somatic work first, to build the capacity to stay grounded and tolerate strong emotion, and then bring in EMDR to reprocess specific memories once that foundation is steady. For complex trauma, the field's consensus is exactly this kind of phased approach: stabilize, then process, then integrate. The label on the modality matters less than whether your therapist knows how to pace the work.
How we work at My Mental Climb
Our EMDR and trauma work is led by Jalyse Stewart, AMFT #153712, an associate marriage and family therapist supervised by Christina Mathieson, LMFT #115093. Jalyse is EMDR-trained and also draws on somatic practices, which is what lets her blend the two rather than apply one from a manual. She works especially with women, with Black women and BIPOC clients, and with people carrying developmental trauma and childhood abuse. Sessions are held by secure telehealth across California, and virtual EMDR has outcome data comparable to in-person. For the bigger picture of how we approach this, see our EMDR therapy and trauma therapy pages.
Bottom line
Both EMDR and somatic therapy treat trauma as something held in the body, and both can help. EMDR has the stronger evidence base and tends to be efficient when there's a memory to target. Somatic therapy is often the better starting point when the trauma is developmental, when the nervous system is chronically dysregulated, or when going straight at a memory feels like too much. For a lot of people, the answer is some of both, sequenced with care.
If you're not sure which fits your situation, that's what the free 15-minute consult is for. Our intake coordinator will ask a few questions about what happened, what's live for you now, and how you tend to respond to different styles of therapy, then match you with the therapist who fits. Telehealth across California.
Related from My Mental Climb: EMDR vs CBT for Trauma · EMDR vs Brainspotting · What to Expect in Your First EMDR Session · Understanding Trauma: How the Nervous System Responds
Further reading: EMDRIA: About EMDR Therapy · APA Clinical Practice Guideline for PTSD · VA National Center for PTSD: EMDR · Somatic Experiencing International · Scoping review of Somatic Experiencing (2021)
Common questions
- Is EMDR or somatic therapy better for trauma?
- Neither is categorically better; they suit different situations. EMDR has the stronger research base and is a recommended first-line PTSD treatment per the APA, WHO, and VA/DoD, and it tends to work efficiently when there's an identifiable memory to target. Somatic therapy has a smaller but growing evidence base and is often a good fit for developmental or complex trauma, chronic nervous-system dysregulation, or when talking about the memory feels like too much. Many clinicians use them together.
- What is the difference between EMDR and somatic therapy?
- The main difference is direction. EMDR works from the top down, starting with a specific memory and its meaning and using bilateral stimulation to reprocess it. Somatic therapy works from the bottom up, starting with body sensations, nervous-system states, and unfinished survival responses, and moving toward insight from there. EMDR is memory-focused; somatic therapy is body-and-regulation-focused.
- Can you do EMDR and somatic therapy together?
- Yes, and they're often combined. Many trauma therapists use somatic work first to build a client's capacity to stay regulated, through grounding, resourcing, and tracking body sensation, then use EMDR to reprocess specific memories once that foundation is in place. For complex or developmental trauma, this phased, blended approach is common.
Tagged
Last clinically reviewed: by Christina Mathieson, LMFT #115093.
