EMDR vs somatic therapy: what the difference is and how they work together in trauma therapy

If you’ve been elbow-deep in researching trauma therapy, you’ve most likely come across both EMDR and somatic therapy. They’re often mentioned together. Sometimes they’re compared, and occasionally they’re positioned as alternatives to each other. But the idea that they are separate from each other, to be compared or viewed as alternatives, misses something important…

These two approaches to trauma therapy have a lot of overlap with one another.

In many ways, EMDR and somatic therapy are complementary.

In this post, we’re going to cover what each approach actually is, how they differ, and why many trauma therapists, including those here at Radish Counseling, use both.

What is EMDR?

EMDR, which stands for Eye Movement Desensitization and Reprocessing, was developed by Francine Shapiro in the late 1980’s. 

The core idea is this: when something overwhelming happens, the brain doesn't always get the chance to fully process it. Instead of being stored as a completed memory, the experience stays "stuck", held with the full emotional and sensory charge of the original event. So rather than feeling like something that had happened, it can feel like something that's still happening.

This is where EMDR comes in. It works with the brain's natural memory processing system to change that. During a session, you hold a distressing memory in mind while following a series of guided eye movements, or sometimes tapping or audio tones. This is called bilateral stimulation, and it's the part that tends to confuse people most. You don't need to fully understand why it works to benefit from it, but the leading theory is that it mimics the brain's natural overnight memory consolidation process, the same kind of processing that happens during REM sleep. The goal is to help the brain file the memory away as something that happened in the past, rather than something that's still active and threatening.

EMDR sessions are structured and intentional. There's an assessment phase, a preparation phase, and then active processing, so you're not just dropped into difficult material without support. And you don't have to share every detail of what happened for it to be effective.

As a treatment, EMDR tends to work especially well for processing specific traumatic events, reducing the emotional charge tied to a distinct memory, and addressing PTSD symptoms where there's a clear "before and after."

Curious what a session actually looks like? Our post How Does EMDR Work walks through it in more detail.

What is somatic therapy?

Somatic therapy is a body-based approach to healing. One of the most widely practiced forms is Somatic Experiencing (SE), developed by Dr. Peter Levine, and it starts from a foundational insight that often surprises people: trauma isn't just a psychological event, it's also a physiological one.

When something threatening happens, the body mobilizes a survival response: fight, flight, or freeze. But when that response gets interrupted, when we can't complete it, the energy doesn't just disappear. It stays stored in the nervous system, continuing to activate long after the original threat is gone. That's why you can know, logically, that you're safe, and still feel braced, on edge, or shut down.

Rather than focusing on the memory itself, somatic therapy works by gently tracking bodily sensations and helping the nervous system slowly, safely complete those interrupted responses, without requiring you to retell your trauma story in detail. Exposure to difficult material is carefully paced, meaning you're never pushed into more than your nervous system can handle at a given moment.

In practice, sessions feel more like a conversation with body-awareness woven in. A therapist might ask "what do you notice in your chest as you say that?" or invite you to slow down and feel what's happening physically before moving on. It's exploratory, relational, and present-moment focused. It’s less about processing a specific memory and more about restoring the nervous system's capacity to regulate itself.

This approach tends to work especially well for chronic nervous system dysregulation, developmental and relational trauma (the kind without a single clear event), dissociation, physical symptoms of trauma, and people for whom memory-focused processing feels too activating or overwhelming.

Curious what a somatic therapy session actually feels like? Our post on What Somatic Therapy Offers walks through it in more detail.

How EMDR and somatic therapy are different

Trauma lives in two places: in memory, and in the body. EMDR and somatic therapy each address one of those locations with particular precision, which is why understanding the difference can help you get a sense of what might fit best for you.

Although EMDR is actually a form of somatic therapy in its own way, it works more top-down: it accesses and reprocesses traumatic memory at the level of the brain's information processing system. Somatic therapy works bottom-up: it starts with the body's physiological responses and works upward toward cognitive integration. With their differences, both stand on the foundation that the body and brain are interwoven with one another.

In practice, this means they each tend to shine in different situations. For single-incident trauma like a car accident, a medical emergency, an assault, EMDR can be faster and more direct, because there's a clear memory to target. For complex, early, or relational trauma, where the wounds aren't stored as discrete memories but as nervous system patterns, somatic therapy tends to be the gentler and more fitting entry point.

Neither approach is superior to the other. They're different doors into the same space.

The good news is that you don't have to choose. A therapist trained in both can move between them fluidly, drawing on EMDR when there's a specific memory ready to be processed, and shifting to somatic work when the body needs to settle first. Often, the two work better together than either does alone.

How EMDR and somatic therapy can work together

In practice, these two approaches aren't separate treatment tracks. They're woven together based on what you need in a given moment, and that integration is where the work tends to go deepest.

Here's what that can look like in practice. Somatic work often comes first. Before processing traumatic memories, your nervous system needs enough capacity to tolerate the activation that memory work brings. Somatic therapy builds that foundation, helping you develop what therapists call a "window of tolerance," the space in which processing can actually happen without becoming overwhelming.

From there, the approaches move together. During EMDR processing, if something becomes too activating—if you start to feel flooded or disconnected—somatic tools bring you back: noticing your breath, feeling your feet on the floor, orienting to the room around you. These aren't interruptions to the work. They're part of it.

And the relationship runs the other direction too. Once EMDR clears the emotional charge on a specific memory, somatic work can often go deeper because the body is no longer bracing against that particular threat. Something that felt locked begins to soften.

The process is iterative rather than linear. A single session might move between body awareness, memory processing, and somatic grounding several times, responding to what you need most in that moment.

What clients often describe, sometimes for the first time after years of treatment, is that the work finally landed. Not just understood intellectually, but actually felt. That's what becomes possible when the memory and the body are addressed together, rather than separately.

What to expect when you work with both…

You don't need to arrive with a plan or even a preference. Part of a trauma therapist's job is to help figure out what's right for you, taking time in early sessions to understand your history, your nervous system patterns, and what you're hoping to feel differently.

No one dives straight into difficult material. Early sessions are about building safety and relationship first, because without that foundation, the deeper work can't happen well.

Progress is gradual, and you set the pace. If something feels like too much, that's important information, and a good therapist will want to know. You're not expected to push through.

It's also normal for the work to shift—between approaches, between sessions, and sometimes within a single session. If that feels disorienting at first, trust that the movement is intentional. Your therapist is tracking more than you may realize, and following their lead is part of how the integration does its work.

Trauma therapy works best when it meets you where you are…

In your mind and in your body.

At Radish Counseling, Becca and Abbi are trained in EMDR. Abbi is trained in both EMDR and somatic therapy and draws on both to support each client’s unique path to healing. If you'd like to learn more about how we approach trauma therapy, you can explore our trauma therapy services page.