Being involved in a serious accident is a traumatic experience, and the feelings can linger even longer than the physical injuries.

It's one thing to be on high alert when you're driving again after an accident. Being extra careful is reasonable. But when the sounds of a roadway, the sight of a car, or the thought of being in a vehicle fills you with dread, triggers panic attacks, or causes repercussions throughout your life, it's time to seek treatment.

Fortunately, if you're looking into the concept of therapy, you've already taken the first step: recognizing that there's a problem you need to address.

There's good news, too: both EMDR and CBT have a proven track record for treating past trauma and PTSD. You can't really go wrong, but if you're wondering which is better, we can help you explore your options.

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 Are EMDR and CBT? How Do They Work?

First, it can be helpful to start from the top. What are these two therapies, how do they work, and what is the scientific backing behind them?

CBT: Cognitive Behavioral Therapy

Cognitive Behavioral Therapy is a form of structured, focused talk therapy. In sessions, your mental health specialist will work with you to go through the thoughts, feelings, and behaviors you experience in relation to the traumatic event you went through. CBT explores the relationship between these patterns, as well as the way you react to them, and how this impacts your life.

CBT isn't just talking about your feelings, though. It helps you identify the way these thought patterns can be negatively influencing your life, and how to pull yourself out of them when you recognize them.

You might identify times when:

• You catastrophize, feeling like every time you get in a car, something terrible is going to happen.
• You overgeneralize negative outcomes, such as focusing on how many people are involved in accidents or die in them every year, and extend that to every drive.
• You focus on negativity and diminish positivity, such as emphasizing one negative experience over all of the many neutral or positive experiences you had prior and since.

To be clear, none of this is entirely unreasonable, which is why trauma can be so difficult to treat. You had an undeniably terrible experience, and CBT is not going to minimize that experience.

The overall goal of CBT in the context of trauma is to build mental strategies to challenge the cycle of traumatic thoughts and beliefs. By breaking the negativity spiral, you can pull yourself away from that constant sense of high alert and start to feel more comfortable.

If you find yourself focusing on how dangerous everyone on the road is, on how inevitable it is that you lose control, on how likely you are to experience another severe accident, CBT can help you identify these thought patterns and challenge them to bring you into a healthier mindset.

Sometimes, CBT can involve exposure therapy. You might work with your therapist to feel more comfortable sitting in a car, going on short drives, and so on. This is up to you and your specialist to determine whether or not it's appropriate, and how to do it.

Along the way, CBT can also teach you coping mechanisms to help calm you down when you're in a situation where the anxiety, panic, and trauma start to overwhelm you. This can include breathing and grounding exercises, cognitive coping skills, and other techniques. There are many possibilities, and they don't all work for everyone or in every situation, so finding the ones that work for you is part of the CBT process.

The key to understanding CBT is knowing that it's very structured and goal-oriented. Trauma-focused CBT particularly emphasizes recognizing how trauma affects you, and building strategies to challenge it.

EMDR: Eye Movement Desensitization and Reprocessing

Eye Movement Desensitization and Reprocessing is a specialized therapy that is primarily used for cases of PTSD and trauma. It's only around 35 years old, and it almost sounds like science fiction.

The concept behind EMDR is to couple bilateral stimulation like side-to-side eye movement with mental recall of traumatic or distressing memories. The idea is that traumatic memories are stored by the brain in a different way than normal memories, so they stand out and become disconnected triggers, which can cause you to panic, shut down, or otherwise react negatively to situations that brush up against those traumatic memories.

EMDR uses adaptive information processing to force the brain to reassess those memories. The eye movement mimics the effects of REM sleep, which is when your mind is processing memories, and forces your brain to reprocess those traumatic memories.

This helps break the link between the trauma and the memory, and between the trauma and newer experiences. By reprocessing these memories, they can be filed away in a healthier way.

Despite the seemingly strange framework, EMDR does work. In fact, some studies show that it's better than CBT for trauma and anxiety, though not for depression. The biggest question is really just about whether or not the eye movements are entirely necessary.

In our view, if it works, who cares if you have to wiggle your eyes around? It doesn't hurt you or cause problems, and it's scientifically proven to help with PTSD, so you might as well give it a try.

Now that you have a rundown on CBT and EMDR, let's talk about how they compare to one another.

How Long Do These Therapies Take?

CBT is generally going to be a longer-term therapy. It takes time to build a full awareness of your trauma, learn how to recognize the signs and thought patterns you experience, and build coping strategies to deal with them.

Most trauma-focused CBT programs put you through somewhere between 12 and 20 sessions, ranging from once a week up to 2-3 times per week for certain complex cases. Since it's a long-term therapy, going through more sessions more rapidly isn't necessarily going to speed up your results.

EMDR tends to be a shorter kind of therapy, lasting around 6-12 sessions, usually once or twice a week. Many patients report results in just a few sessions, though it takes longer to fully address PTSD, and more complex cases can require multiple sets of sessions to address different kinds of trauma.

If time is of the essence, EMDR is likely to be the better choice, as long as it works for you.

Are CBT or EMDR Guaranteed to Work?

Unfortunately, no; there can be no guarantees in this kind of thing. CBT and EMDR are both very effective, but they aren't 100% effective for everyone and every situation. Some people, particularly people with complex cases, may not find it effective.

It's not really well understood why some people don't respond to certain kinds of therapies. As more and more studies are performed into them, and as our societal awareness of mental health grows, we'll certainly learn more. But that doesn't really help you now in the moment, does it?

One piece of good news is that just because one doesn't work for you, it doesn't necessarily mean nothing will. If you've tried trauma-focused CBT and haven't had much success, EMDR may still be very effective. Conversely, if EMDR hasn't done much for you, CBT might still work well. You can also explore other options beyond these two therapies if they don't work for you.

Will Insurance Cover CBT or EMDR in Michigan?

Generally, yes; insurance in Michigan will cover mental health treatment, as long as it's a proven treatment and you're diagnosed with PTSD. That said, it's not necessarily simple.

Different insurance providers may have different rules for authorizations, and they may prefer you try one therapy over another first. You may have to try CBT for some number of sessions before they will approve EMDR, for example. Similarly, insurance often requires attempting therapy before they will approve medications.

You also have to be aware of provider networks. Even if CBT or EMDR are covered in general, you still likely have to work with a mental healthcare provider who is a participant in your insurance's plans; otherwise, you can be billed for out-of-network service.

We recommend calling your insurance or seeking their provider directory on their website to look for local mental healthcare specialists who participate in your plan and are available to you locally.

The rules can also be slightly different for Medicaid plans.

Which is Better: CBT or EMDR for a Serious Accident and Trauma?

There's no one answer to this question. Some people will respond better to one over the other. Some will respond to both, and some perhaps to neither. There's no way to tell without giving them a solid attempt.

Generally speaking, both CBT and EMDR can be effective for PTSD and trauma after a serious accident. If you experience traumatic flashbacks, intrusive memories, and similar thoughts, if you avoid places, conversations, or reminders of traumatic experiences, or if you continually feel on edge, especially in situations related to your accident, these therapies can be effective.

CBT tends to shine most when you have a combination of anxiety and depression surrounding your traumatic experiences. If you're capable of thinking about and verbalizing your experiences, you can try CBT to see if the coping strategies it can give you can help.

EMDR, on the other hand, tends to be better when you aren't really able to verbalize your trauma. In fact, one key aspect of EMDR is that it can help you "unlock" deeper and more repressed memories, working through your trauma from what you do remember to things you might have forgotten, but which are still traumatic triggers for you.

That said, EMDR has not really been proven effective for depression, nor can it help with related issues like substance use disorder, at least not directly. If reducing the traumatic memories helps you no longer experience the triggers of your depression or the issues that lead to substance use, then that's a great bonus along the way.

There's more good news: you aren't necessarily limited to just one or the other.

In fact, more and more modern mental health experts are shifting towards integrated views of treatment, where therapies like EMDR and CBT are used in conjunction with one another, as well as alongside other options like group therapy, medication, and exposure therapy.

It's increasingly common for EMDR to help reprocess traumatic memories, CBT to help with the negative thought patterns, and medication to help with certain mental and physiological symptoms along the way.

How Soon Should You Seek Therapy After a Serious Accident?

There's no single answer here, but in general, you want to seek therapy whenever you can. Some specialists even recommend starting mental health therapy as soon as possible after an accident, even if you haven't recovered from the physical effects of the accident. The sooner you can start processing and coping with what happened, the less it will affect you as time goes on.

That said, both CBT and EMDR can be very effective at handling years-old or even decades-old traumatic events and PTSD. Many people seek therapy for childhood trauma, and it works just as well for them. There's no deadline or cutoff on seeking therapy: only your need and the help that is available to you.

Are You Interested in Seeking Treatment for a Serious Accident?

Here at BMC-Troy, we're more than happy to work with you to help you on your journey. We offer a range of therapy options, including EMDR and CBT, group therapy, trauma release exercises, medication management, and more in our office here in the Detroit area. We also accept most major insurances, though specific providers work with specific networks, so please verify when scheduling.

To get started, you can contact our office by calling during business hours at 248.528.9000, or by filling out our new patient intake form directly. Either way, we'll be in touch and can get you scheduled for an initial consultation and intake.

Help is available, regardless of how simple or complex your trauma, how recent or old it may be, or how minor or severe you feel it is.