What is the difference between somatic therapy and EMDR?

Both somatic therapy and EMDR are body-aware approaches to trauma, but they work differently. EMDR uses bilateral stimulation — typically eye movements — to help the brain reprocess specific traumatic memories, reducing their emotional charge. Somatic therapy works with the body's sensations and nervous system responses directly, without necessarily targeting specific memories. Somatic approaches tend to work with the nervous system's baseline state, not just particular events.

Which is better for complex trauma — somatic therapy or EMDR?

Neither is categorically better. EMDR was developed primarily for single-incident trauma and has a strong evidence base for that. For complex or developmental trauma — which often doesn't involve discrete events but rather accumulated relational experience — somatic approaches may be more suited, as they work with the nervous system and attachment patterns rather than specific memory processing. Some people benefit from both, used together or sequentially.

Can somatic therapy and EMDR be combined?

Yes. Some therapists integrate elements of both. Somatic stabilization work is often used to build the nervous system's capacity before EMDR processing begins — particularly important when someone has complex trauma and needs more groundwork before approaching specific memories.

How do I choose between somatic therapy and EMDR?

Consider what you're working with. If your difficulty is connected to a specific event or series of events and you have some baseline stability, EMDR might be a good fit. If your experience is more diffuse — a persistent sense of something being off, relational patterns, chronic body symptoms, or a history of emotional neglect — somatic therapy may offer more traction. A good therapist can help you think this through.

Somatic therapy vs EMDR for complex trauma — what's the difference?

Q: Which works faster, EMDR or somatic therapy?

EMDR tends to be faster for specific traumatic memories. For complex or developmental trauma the comparison is harder — they address different things. Somatic therapy for complex trauma is a longer-term commitment.

Q: Can a therapist use both EMDR and somatic therapy?

Yes. Many trauma-specialized therapists integrate both depending on what a client needs. It is worth asking a prospective therapist about their approach and how they decide what to use when.

Q: What if I've tried EMDR and it didn't work?

Possible reasons: trauma was too diffuse for a clear target, the nervous system wasn't stable enough, or the approach wasn't the right fit. EMDR not working doesn't mean trauma therapy won't — somatic therapy is a useful next step.

Q: Is EMDR covered by insurance in Ontario while somatic therapy isn't?

Coverage depends on the therapist's credentials, not the modality. A Registered Psychotherapist or Registered Psychologist can provide services covered by extended health benefits regardless of whether they use EMDR or somatic approaches.

Mariya Garnet
Jun 22
5 min read

Updated: Jun 30

Both somatic therapy and EMDR work with trauma held in the nervous system and body, but they differ significantly in method. EMDR uses bilateral stimulation to process specific traumatic memories, while somatic therapy works with present-moment body experience and relational attunement, without requiring a discrete traumatic event to target. For complex and developmental trauma, the distinction matters.

Key takeaways

EMDR (Eye Movement Desensitization and Reprocessing) was developed by Francine Shapiro and uses bilateral stimulation — eye movements, tapping, or sound — to help the brain process traumatic memories
Somatic therapy works from the body up, tracking sensation, nervous system state, and relational experience in the present moment rather than targeting specific memories
EMDR tends to work best when there are clear, discrete traumatic events to process; somatic therapy is better suited for complex or developmental trauma where the trauma is relational and diffuse
Both approaches can complement each other; some therapists integrate elements of both
Neither requires you to describe traumatic events in detail or relive them
The therapeutic relationship plays a more explicit role in somatic therapy than in standard EMDR protocol

What EMDR actually does

EMDR was developed by Francine Shapiro in the late 1980s and has since accumulated a substantial evidence base, particularly for PTSD following discrete traumatic events. The core mechanism involves bilateral stimulation — typically guided eye movements, though tapping or auditory tones are also used — while the client holds in mind a specific traumatic memory, the associated body sensation, and the negative belief it generated.

The theory is that bilateral stimulation activates the brain's natural information processing system, helping it complete what got frozen during the traumatic event. For single-incident trauma, EMDR can work relatively quickly, sometimes in 6-12 sessions for a specific event.

NARM is another approach worth knowing in this comparison — what is NARM therapy and how does it work for complex trauma explains where it fits and how it differs from both.

What somatic therapy actually does

Somatic therapy doesn't target specific memories. Instead, it works with whatever is happening in the body and nervous system in the present moment — the chronic patterns of tension, numbness, activation, and shutdown that have become the person's baseline. The access point is sensation and present-moment experience, not memory retrieval.

In the work I do, we stay in the present — with whatever is present in the room, in the body, right now. We might not even talk about feelings in the conventional sense. We describe experiences: what happens in the chest when that thought arises, what changes in the breath. That distinction — feelings versus experiences — turns out to matter a lot for people who've spent years managing their feelings from a distance.

When EMDR tends to work better

EMDR is a strong choice when there are specific, identifiable traumatic events that carry charge; when the person has enough nervous system stability to tolerate activation during processing; and when the trauma is relatively circumscribed rather than diffuse. Survivors of accidents, assaults, medical trauma, or specific incidents do well with EMDR. So do people with phobias or single-incident PTSD.

When somatic therapy tends to work better

For people with complex trauma — particularly those who experienced ongoing abuse or neglect — going back into specific memories can be retraumatizing. The memories may not even be there; chronic misattunement doesn't leave clear timestamps. And for people with significant early relational trauma, the concept of a safe place that EMDR often starts with can feel genuinely inaccessible — not as a technique failure, but because safety was never reliably available.

Somatic therapy is a stronger fit when the trauma is developmental or relational — when it formed over years of a particular kind of environment rather than in a discrete event. With this kind of trauma, there often isn't a specific memory to target. The trauma is the absence, the pattern, the relational environment itself. Somatic therapy doesn't need a target. It works with the pattern as it's expressed in the body and in the therapeutic relationship right now.

Somatic therapy is also a better fit for people who have significant dissociation or emotional numbing, because the slow, paced, present-moment focus is less likely to overwhelm a nervous system that's already managing through disconnection.

Can you do both?

Yes, and many therapists integrate approaches. Some practitioners trained in EMDR also use somatic methods, either in sequence — stabilization and somatic work first, then EMDR for specific memories — or woven together. The approaches address different levels of the same underlying problem and aren't mutually exclusive.

If you're weighing somatic therapy after EMDR didn't fully reach the issue, I understand my trauma but nothing has changed — can somatic therapy help? explains what somatic therapy is actually addressing. Also: what to expect in a somatic therapy session and how long somatic therapy takes for complex trauma.

Frequently asked questions

Which works faster, EMDR or somatic therapy?

EMDR tends to be faster for specific traumatic memories — sometimes significantly so. For complex or developmental trauma, the comparison is harder to make because they're addressing different things. Somatic therapy for complex trauma is a longer-term commitment than EMDR for a single-incident trauma, but comparing them directly is like asking whether a 10km run or a swim is faster — it depends on what you're measuring and what you're training for.

Can a therapist use both EMDR and somatic therapy?

Yes. Many trauma-specialized therapists are trained in multiple modalities and integrate them depending on what a client needs at a given point. It's worth asking a prospective therapist about their approach and how they decide what to use when.

What if I've tried EMDR and it didn't work?

A few possibilities: the trauma was too diffuse to have a clear target, which is common with developmental trauma; the nervous system wasn't stable enough to tolerate EMDR processing; or the approach wasn't the best match for your presentation. EMDR not working doesn't mean trauma therapy won't work — it may mean a different approach is needed. Somatic therapy that doesn't require a discrete target memory is a useful next step for people in this situation.

Is EMDR covered by insurance in Ontario while somatic therapy isn't?

Coverage in Ontario depends on the therapist's credentials rather than the modality they use. A Registered Psychotherapist or Registered Psychologist can provide services that may be covered by extended health benefits regardless of whether they use EMDR, somatic approaches, or both. It comes down to the provider's registration and your plan's terms.

Mariya Garnet is a Registered Psychotherapist (Qualifying) in Ontario, CRPO# 22667, specializing in somatic therapy for complex trauma and childhood emotional neglect. She trained for nine years in the Peruvian Amazon and completed postgraduate studies in Expressive Arts Therapy at the CREATE Institute in Toronto. She works online across Ontario.

More about the approach I use is on my somatic therapy page.