Witnessing or experiencing a traumatic event is just that: traumatic. These kinds of events don’t have to be widespread or violent, necessarily, to leave their mark. Acts of violence, serious accidents, abuse, and other events can cause PTSD. It doesn’t have to fit the misguided public view as being something soldiers in war experience, and little else.

The truth of the matter is, over 70% of people who experience a traumatic event in the context of their life can develop the symptoms of PTSD. The feelings are valid, and the comparative minimization is a roadblock to proper treatment, but make no mistake: you can get treatment.

The two most common treatment options for traumatic events and PTSD are talk therapy and EMDR. If you’ve been exploring the idea of seeking help for PTSD or recovery from a traumatic experience, you may be struggling to decide which one is best. Today, we’ll discuss them both, their pros and cons, and how you might decide which to pursue.

DISCLAIMER: This article is for informational and educational purposes only and should not be considered medical or psychological advice. The information presented here is not intended to diagnose, treat, cure, or prevent any mental health condition or replace professional therapeutic care. Every individual's experience with trauma and mental health is unique. Please consult with a qualified mental health professional, therapist, or healthcare provider to determine the most appropriate treatment approach for your specific situation. If you are experiencing a mental health crisis or emergency, please contact your local emergency services or crisis hotline immediately.

What is Talk Therapy and How Does it Work?

Talk therapy is a category of therapy focused around talking, and is also known as psychotherapy. It might be one-on-one with a therapist, or in group sessions, and can involve using various different techniques depending on the practitioner and the needs of the patient.

One of the common kinds of talk therapy is CBT, or Cognitive Behavioral Therapy. This kind of talk therapy discusses events, reactions to those events, and behaviors developed in response. It helps a patient identify negative thought patterns and behaviors and find ways to correct them.

Other forms of talk therapy include humanistic therapy, which focuses on living life in a fulfilling way, and psychodynamic therapy, which digs into the unconscious root of various behaviors to identify their source and the patterns they express.

There are also forms of talk therapy meant as stress outlets, ideation and understanding, and identification of triggers.

The commonality across different forms of talk therapy is that they’re conducted through conversation. A therapist, social worker, psychiatrist, or other practitioner will use their preferred techniques and conversational navigation skills to help their patients navigate difficult emotions and stressful situations, find a way to ground them, and identify ways to redirect negative thoughts and behavioral patterns.

What Are the Pros and Cons of Talk Therapy?

There are many benefits and a couple of drawbacks to talk therapy.

One of the biggest benefits is simply that it’s effective for most people. Around 75% of participants in psychotherapy find some benefit from it, whether it’s addressing grief, helping with anxiety, acknowledging and addressing addiction, or any of a wide range of mental health concerns.

Talk therapy can help you gain a better grasp on your emotions, where they’re coming from, and how they’re affecting your behavior. If you find that mental health concerns are affecting your life in negative ways (as many trauma survivors recognize), talk therapy can help you process and build the framework necessary to alleviate those concerns.

Whether it’s emotional stability, confidence, stronger interpersonal relationships, or another goal, talk therapy can help lead you to better outcomes.

The downsides of talk therapy are generally minimal, but they are important.

One of the greatest downsides is that, with so many different practitioners across a range of different specialties and a laundry list of different therapy styles, it can be difficult and time-consuming to find a match for you and your needs.

Sometimes you don’t mesh with your therapist, sometimes the style doesn’t work for you, sometimes you have trouble being open and honest enough to get it to work. Often, you have a choice: either find another practitioner and try again, or try another kind of therapy.

In rare cases, talk therapy just doesn’t get the job done. While some 75% of patients get some benefit from talk therapy, it’s not a “cure” for everyone, and some people are resistant to it or don’t have enough of their own buy-in to work with it.

Talk therapy is also somewhat slow. Since it involves numerous discussions of complex mental and emotional states, along with ongoing conversations that unpack deep and potentially life-long concerns, it’s not a fast process.

Is Talk Therapy Effective for Trauma?

Traumatic events are often (though not always) single, sudden events. A bad car accident, an incident of violence or assault, a natural disaster; these things are sudden, intense, and leave a lasting impression.

Longer-term trauma, from abuse to illness, can also be part of trauma and PTSD; chronic trauma and complex PTSD are their own challenges, but related enough to discuss.

As mentioned above, talk therapy tends to be a “slow and steady” method of addressing mental health challenges. Because of this, it can be somewhat less effective for acute traumatic incidents and sudden PTSD.

That said, it’s an injustice to generalize. Some forms of talk therapy, such as cognitive processing therapy, trauma-focused cognitive behavioral therapy, dialectical behavioral therapy, and trauma systems therapy, are all designed for traumatic events and recovery, as well as addressing the challenges of PTSD.

The takeaway is not that talk therapy is ineffective for trauma; it’s that trauma often requires a specialized approach, so general talk therapy may not be appropriate.

What is EMDR and How Does it Work?

EMDR stands for Eye Movement Desensitization and Reprocessing. First studied in 1989, it involves using specific guided eye movements, alongside active recall of the traumatic event. The eye movements force engagement of parts of the brain that aren’t usually part of the process, and the brain is then effectively forced to reprocess the memories, generally in a healthier way.

Generally, EMDR is a set of sessions progressing through a series of stages. It begins with history-taking, where you discuss the traumatic event, the repercussions and symptoms of PTSD, an inventory of triggers, and anything else the therapist needs to know.

After that, the patient is informed about how the therapy will work and armed with information and resources to help encourage its success, such as Safe/Calm Place exercises.

The third phase is assessment, which guides the patient through recall of the memory and evaluates its effect on their mental state across a pair of measures called the Validity of Cognition and the Subjective Units of Disturbance scales. These help evaluate the impact of the traumatic memories and serve as a benchmark to assess progress through the therapy.

The next phase is desensitization, which is where the eye movements come into play. This helps reprocess the traumatic memory, replace negative cognition with positive cognition, and help reduce the impact the memory has. This process repeats until the measurements of the memory report it to be no longer distressing.

Finally, sessions round out with a body scan, which is a physical inventory of sensations and responses that helps identify somatic distress. This can be addressed if it’s present. Then, the closure process helps end the session and leave things in a safe space for future sessions. All of this is repeated until the traumatic memories are processed or no further progress can be made.

What Are the Pros and Cons of EMDR?

EMDR, like any therapy, has its pros and cons.

One of the biggest benefits of EMDR is that it’s been proven to be effective specifically for PTSD. While various studies into the details have been mixed, and scientists aren’t exactly sure why it works, the fact is, it does work. It is proven to reduce many of the symptoms of PTSD, including flashbacks, nightmares, and acute distress.

It’s also significantly faster than traditional talk therapy. EMDR is a framework with standardized practices that have been proven to work, and can often be completed in as little as a couple of months. This is not to say the memory will “go away” or be forgotten; rather, the aim of EMDR is to reduce and remove negative associations with the memory, and reduce the impact it has on your life, while allowing you to better process it long-term.

Another benefit of EMDR, and a key difference between it and talk therapy, is that EMDR doesn’t require you to talk through and relive painful memories. While you will need to recall and think about them, which can be uncomfortable, you don’t need to actively discuss them with your therapist. This can help a lot with people who find it hard to trust anyone and open up about their trauma.

There’s also a small benefit in that EMDR is both short-term (generally lasting only a couple of months of sessions) and self-contained. Talk therapy usually asks you to journal or practice mindfulness and self-care outside of sessions by building it into your lifestyle, while EMDR is a treatment you undergo and don’t have to keep doing at home.

On the other hand, there are a few downsides to EMDR.

As with talk therapy, EMDR requires a trusting relationship with a therapist, and the buy-in from the patient to make it work. Someone who is skeptical and doesn’t trust their provider might find it less effective or ineffective.

Part of this might also come from a stigma that surrounds EMDR. Some people find the idea that something like eye movements can help to be nonsensical, and the fact that science can’t yet explain how it works doesn’t help. If you approach EMDR with too much skepticism, you’ll resist what it’s trying to do, and you won’t get the benefits you otherwise could get from it.

Perhaps the biggest downside, though, is that it doesn’t work for everything. Talk therapy is flexible and can be tailored to the specific needs of the patient. EMDR is very effective for things like trauma, and can also be effective for anxiety, depression, dissociative disorders, OCD, and eating disorders. However, it doesn’t work as well for complex or chronic trauma where there aren’t individual focal memories, or mental health conditions that stem from physical injury or inherited conditions.

Is EMDR Effective for Trauma?

Unquestionably yes.

EMDR was essentially an accidental discovery, but a fortuitous one; it has been proven over the last 30+ years to be a very effective treatment, especially for acute trauma and PTSD. It’s fast, it’s stable, and it’s effective for what it’s intended to treat.

Research is still ongoing across many different studies around the world, as EMDR is explored in greater detail. Eventually, we may learn why it works, and we can find other mental health concerns that it can address. However, it was invented specifically for PTSD and has the most proof as an effective treatment for trauma, making it one of the best recommendations for those eligible to receive it.

Which is Right for You: Talk Therapy or EMDR?

The choice between talk therapy and EMDR has as many different answers as there are people seeking treatment.

In part, it depends on what mental health concerns you’re facing and what your goals are in addressing them. When it comes to trauma, often acute PTSD is getting in the way of your life in many ways, and EMDR is an ideal therapy to take care of it. In other cases, different concerns may mean that talk therapy is better on an ongoing basis.

In part, it can depend on your insurance. Different insurance providers have different limitations on what they will cover, and some don’t wholly cover newer therapies like EMDR.

In part, it can depend on your ability to access therapy. Talk therapy can be performed remotely via a Zoom call or in other ways. EMDR is generally an in-person treatment.

In order to find the right answer, we encourage you to contact us. At BMC-Troy, we’re proud to offer EMDR alongside a variety of other counseling and therapy services, both in our office and remotely. You can learn more about the services we offer and reach out to contact us about getting started right here on our website.

You can also get started right away by filling out our new patient information form here directly.

What you feel and experience is valid, and there’s no shame in seeking help; it’s why we’re here.