EMDR or Somatic Therapy? What the Difference Actually Is
Two trauma therapies people often mix up. What each one involves, what the evidence says, and how to tell which might suit you.
A friend tells you EMDR changed her life. Someone else swears by somatic therapy. You have read both words a dozen times and still could not say what actually happens in the room.
They are different approaches, built on different ideas, with different amounts of research behind them. Here is the plain comparison, from someone who offers one and not the other.
The Short Answer
EMDR is a structured trauma therapy in which you recall a distressing memory while following a back and forth movement with your eyes, or another rhythm such as taps or tones. Somatic therapy is a broader family of approaches that work through the body: noticing sensation, breath and posture, and building a felt sense of safety before going near the hard memories. EMDR has the stronger research base for PTSD. Somatic approaches are more flexible and often gentler to begin with.
| EMDR | Somatic therapy | |
|---|---|---|
| What happens | Recalling a memory while following eye movements, taps or tones, in a set sequence of phases | Noticing body sensations, breath and posture, and building a felt sense of safety at your pace |
| Best known for | PTSD and distress after a specific event | Chronic stress, long-running trauma, feeling stuck or shut down |
| Research base | Strong for PTSD, recommended in Australian and international guidelines | Growing, with fewer controlled trials |
| Talking about the memory | Briefly, then mostly holding it in mind | Often not at first, and sometimes not much at all |
| Who offers it | Specially trained practitioners, often psychologists | Counsellors, psychotherapists and some psychologists |
What EMDR Involves
EMDR stands for eye movement desensitisation and reprocessing. It was developed by the American psychologist Francine Shapiro in the late 1980s, after she noticed that moving her eyes back and forth seemed to take some of the sting out of disturbing thoughts.
A course of EMDR follows set phases. You and the therapist prepare, choose a target memory, then hold it in mind in short sets while following their hand or a light, or listening to alternating tones. Between sets you notice what has shifted. Over sessions, many people find the memory loses its charge. They still remember it, but it stops feeling like it is happening now.
The evidence for EMDR in PTSD is solid. It sits among the recommended treatments in the Australian PTSD guidelines and in World Health Organization guidance. Less settled is why it works. Some research suggests the eye movements help by keeping your working memory busy, so the memory feels less vivid. Other research suggests the main ingredient is the structured, repeated recall itself. Either way, for many people, it helps.
What Somatic Therapy Involves
Somatic therapy starts from the body rather than the story. The idea, developed by people like the trauma researcher Peter Levine, is that trauma leaves its mark as patterns in the nervous system: bracing, startling, numbness, a body that cannot settle. Talking can only reach so much of that.
In a session you might notice where tension sits, track what happens in your body as you mention something difficult, then deliberately return your attention to a place in your body that feels steady. The work moves in small steps, coming close to a hard feeling and back again, so your system learns it can feel something without being overwhelmed.
The research is younger. There are encouraging trials, including one of Levine's Somatic Experiencing approach with people who had PTSD, but far fewer than for EMDR. I think that is worth saying plainly, as someone whose own work leans somatic.
The question is not which therapy is best. It is which one you can stay with long enough for it to work.
How to Tell Which Might Suit You
- If you have PTSD after a specific event and want a structured, well-researched treatment, EMDR with a trained psychologist is a strong choice.
- If your trauma is more about years than a moment, or talking about it feels impossible right now, a somatic approach can be a gentler place to start.
- If you feel numb, shut down or stuck rather than flooded, body-based work often helps you feel enough to do the rest.
- If you are unsure, start with whatever feels bearable. Many people begin with somatic work and move on to EMDR later, or use both.
Try it now · 30 seconds
Pause and notice where your body is touching the chair or the floor. Let your weight drop into it for three slow breaths. That small shift, from thinking to sensing, is the doorway somatic work uses. Notice whether anything settles, even slightly.
Cost and Medicare
EMDR delivered by a psychologist under a Mental Health Treatment Plan can attract a Medicare rebate, for up to 10 sessions a year. Somatic therapy with a counsellor has no Medicare rebate, though some private health funds cover counselling. The article on what counselling costs in Melbourne sets out the numbers.
Where I Fit
I do not offer EMDR. My work with trauma is somatic and nervous-system informed, as a PACFA registered counsellor. If EMDR sounds like the better fit for you, I can help you find a trained practitioner, and the EMDR Association of Australia keeps a directory.
A Realistic Expectation
Neither approach is a quick fix, and trauma work often feels harder before it feels lighter. What both offer, done well, is a way for an old experience to settle into the past, where it belongs.
None of this is a diagnosis, and it is not a substitute for individual assessment. If you are weighing up where to start, a free 15-minute call is a low-pressure way to talk it through. Stabilise is available in Carlton, Melbourne and online.
Free resources
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