Although much has been said and written about eye movement desensitization and reprocessing (EMDR), there’s far less discussion about the alternatives to EMDR. It’s true that EMDR can be highly effective and may heal past trauma at a faster rate than more conventional therapies.
However, it’s not an effective treatment for everyone, and it’s important for potential therapy clients to know the other approaches that may help them.
Who Might Benefit From EMDR?
EMDR is an evidence-based therapeutic approach that adheres to an eight-phase protocol. During an EMDR session, a therapist uses bilateral stimulation to support clients in processing distressing memories while engaging in rapid eye movement. When treatment is successful, clients note a significant improvement in how they relate to their past trauma. They don’t forget what happened, but there’s much less charge or reactivity.
EMDR tends to be the most effective when the following conditions are met:
The trauma is well-defined: Research shows that EMDR is more effective when processing a single traumatic event, like a car accident or sexual assault. However, it may not be as effective when past traumatic memories feel vague, abstract, or chronic (also known as complex trauma).
There are strong coping skills in place: EMDR can evoke strong emotional and physical reactions, causing many clients to feel dysregulated during or after sessions. While dysregulation is not necessarily bad or wrong, this treatment may not be appropriate for clients who need more support with grounding.
Mental health conditions feel relatively stable and manageable: EMDR may be more effective for clients who feel stable with their mental health conditions. However, when symptoms are acute or highly active, this type of trauma therapy could worsen them.
When Is EMDR Not Appropriate?
Although EMDR can be highly effective, it is not appropriate for all clients or presenting concerns. EMDR may not be the best option in the following cases:
Complex or prolonged developmental trauma: Complex or developmental trauma refers to continuous exposure to trauma. Because there usually isn’t a concrete beginning or end, this type of trauma can feel less defined. However, it can result in many mental health struggles, including emotional dysregulation, difficulties in relationships, low self-esteem, and chronic shame. While EMDR may improve those symptoms, many clients
Moderate or severe dissociation: EMDR therapy can feel dysregulating, and it may actually worsen dissociative symptoms. That’s because EMDR entails intense emotional processing, and people with dissociation may struggle to stay present during or after sessions. Therapy focused more on immediate grounding and integration may be necessary for cultivating a sense of safety.
Acute mental health crises or logistical crises: The effectiveness of EMDR also depends on a client’s baseline of emotional stability. People experiencing acute mental health crises (severe depression, substance abuse, suicidality, active eating disorders) often need a sense of stabilization before diving into trauma work. Furthermore, clients experiencing logistical concerns, such as medical flare-ups, financial distress, or significant life transitions, may have to address those immediate needs to cultivate a sense of safety.
Not ready to process trauma: Some clients come to therapy knowing or sensing they have some level of trauma. However, this does not inherently mean they seek to engage in trauma-focused treatment. If that’s the case, EMDR may be inappropriate, as it can be intense and overwhelming. Regardless of the presenting issue, clients have autonomy over their treatment plan, and it’s a therapist’s job to help them meet the goals that matter most to them.
Alternative Trauma Treatment Options Instead of EMDR
First things first- there is no one-size-fits-all treatment approach for trauma recovery. People respond to different modalities, and it’s important for therapists to understand each client’s personal preference when structuring care.
It may be helpful to ground yourself in this truth if you haven’t experienced much success with therapy in the past. This certainly doesn’t mean anything is wrong with you. Trauma recovery is delicate and complex. The healing can be slow and even a bit confusing. If you didn’t get the results you wanted from EMDR- or you sense you may not be a good candidate for this model- there is still immense hope for your recovery.
Some effective alternatives to EMDR include:
Somatic Therapies
Trauma is stored within the body at a cellular level, and that’s because trauma directly impacts the nervous system. Over time, your body reacts to stress in various trauma-based responses, potentially causing muscle pain, sleep problems, chest tightness, and internal feelings of dread or suffocation.
Somatic therapy aims to strengthen the mind-body connection. Unlike standard talk therapy, which is more of a ‘top-down’ approach focused on cognition, somatic work is rooted in a “bottom-up” approach. This can be particularly beneficial for clients who resonate with themes of intellectualizing, overthinking, or ruminating.
Somatic work helps you identify and release pent-up tension that exists within you. It can also help you better understand what your body needs at a given time. This awareness strengthens your capacity to attune to yourself and regulate emotions before they feel too escalated.
Internal Family Systems or Parts Work
Does it ever feel like part of you wants to do something, and another part absolutely doesn’t want to cooperate? Parts work focuses on understanding the different emotions and needs that exist within your psyche. This is one of the most non-pathologizing alternatives to EMDR, and it facilitates a sense of wholeness within yourself.
For example, when it comes to trauma, you may recognize that there’s a part of you that hyper-functions to seek validation and a sense of control. You might also see that there’s another part of you that frequently uses substances to numb or escape your intense emotions.
Parts work focuses on welcoming these various needs and sensations. The goal isn’t to eliminate any part of you- rather, it’s learning how to communicate with them effectively, allowing you to feel more balanced and empowered.
Mindfulness and Acceptance Work
Mindfulness can be an integral part of any trauma work. Unresolved traumatic experiences can trigger flashbacks where you feel like you’re reliving your past. This can also magnify anxiety about the future, especially if you’re worried things will never improve.
In therapy, mindfulness is about learning how to slow down and be in the present moment. Sometimes, this is achieved through deep breathing or other forms of breathwork. Other times, it’s cultivated via guided imagery or a positive visualization that orients yourself into the here and now.
Acceptance can also be an important part of trauma recovery. It’s important to remember that acceptance never means condoning what happened, and it’s not the same as forgiving anyone who harmed you.
Instead, acceptance means allowing yourself to truly acknowledge what happened to you. It means knowing you can’t change it and that it’s in your past. It also means accepting that you may now have some related symptoms or feelings that result from those events. Acceptance is powerful because it allows you to really affirm yourself.
Self-Compassion Work
People with trauma histories often carry high levels of shame and self-loathing. For example, you may hold deeply-rooted beliefs that you’re not good enough or that you, on some level, deserve to suffer.
Self-compassion can be an important antidote for trauma. Where trauma symptoms are intense and often feel unforgiving, self-compassion is gentle. It gives you permission to feel without exacerbating your suffering.
Self-compassion is rooted in the idea of implementing self-kindness toward yourself. When you’re self-compassionate, you treat yourself gently and with a sense of nurturance and attunement. You aim to offer yourself patience and forgiveness when going through a tough time.
Creative Expression
Art therapy and other therapies rooted in creativity (journaling, dance, scrapbooking, and creating other forms of art) can help clients express what’s inside them without relying on words alone. These alternatives to EMDR can be used directly within therapy. However, many clients also prefer to use such interventions on their own.
Relational and Person-Centered Therapy
Unfortunately, trauma often distorts our capacity to give and receive love to others. Histories of betrayal or neglect make it hard to trust people or feel safe in the world. Vulnerability can be scary, and you may find yourself emotionally withdrawn or intensely seeking the approval of others.
Relational and person-centered therapies are rooted in honoring your needs. It’s about building a secure relationship that fosters trust and emotional connection. This means trusting that you’re the expert of your own life, and you deserve witnessing and respect at every point of care.
Relational therapists, in particular, focus on consistently offering the healthiest parts of a relationship, including attunement, validation, and safety. While this doesn’t “fix” the trauma, it ideally creates a new experience that you can internalize in your relationship with yourself and relationships with others.
EMDR and Alternatives to EMDR in Seattle, WA, and Washington State
Healing trauma can be an incredibly tender process full of various ups and downs. Regardless of your current circumstances today, you are so much more than what happened to you. As a trauma-focused therapist, I am dedicated to helping clients learn how to better take care of themselves and reclaim their emotional wellness.
While I am an EMDR-certified practitioner, I also fully believe in offering alternatives to EMDR, and I integrate parts work, self-compassion exercises, mindfulness, and a person-centered presence into my practice. If you’re not sure which treatment may be best for you, I am happy to discuss all these options. Together, we will collaborate on how we can work together to ensure your needs are met.
If my approach resonates with you or you’re curious about how trauma therapy can help you, please reach out today to schedule a complimentary consultation.
