Exposure Therapy vs. emdr therapy

Emotional and psychological trauma is the result of extraordinarily stressful events that shattered an individual’s sense of security, making them feel helpless in a dangerous world. Traumatic experiences often involve a threat to life or safety, but any situation that leaves an individual feeling overwhelmed and isolated can be traumatic, even if it doesn’t involve physical harm. Emotional and psychological trauma can be caused by one-time events such as an accident, an injury, a natural disaster or a violent attack. Emotional and psychological trauma can also be caused by ongoing, relentless stress such as dealing with sexual harassment at work, living in a crime-ridden neighborhood or living with a chronic medical condition. Additionally, commonly overlooked causes of emotional and psychological trauma include the loss of a loved one, a recent surgery, the loss of a job, a breakup from a significant relationship, or a deeply disappointing experience. Many mental health and substance abuse disorders are directly linked to traumatic events. Eating disorders, obsessive-compulsive disorder, phobias, panic attacks, generalized anxiety disorder, post-traumatic stress disorder, depression, schizophrenia are some of the mental health disorders that have a direct relationship to a past traumatic event. Many individuals who have been diagnosed with one of the above disorders may not even recognize that their past history of trauma is the root cause for their current disorder. Center For Discovery is a nationwide leading treatment center that works to treat teenagers and adults who have an eating disorder, a mental health disorder or a substance abuse disorder. Center For Discovery supports the belief that trauma is often an underlying trigger for mental health disorders and therefore incorporates trauma therapy when necessary. Recognizing and treating the underlying traumatic triggers can help treat the present disorder.

Exposure Therapy

Exposure therapy is a component of cognitive-behavioral therapy that works to re-experience the individual’s past traumatic event in order for them to overcome their trauma. The therapist will ask the client to write down or discuss the traumatic events where you will re-tell your trauma. You will explore your thoughts and feelings associated with these traumatic events and may even re-create the experience through in-vivo or imaginal exposure. You may be asked to list specific sights, sounds, and locations that you avoid due to this past experience and will rank them in order according to the amount of distress they cause you. The hope if for individuals to dissociate their thoughts, feelings, and emotions with that particular sense of smell, sight, location or memory. By confronting feared situations, thoughts, and emotions, a person can learn that anxiety and fear will lessen on its own.

In vivo exposure

In vivo exposure refers to the direct confrontation of feared objects, activities or situations by a person under the guidance of a therapist. For example, a woman with PTSD who fears the location where she was assaulted may be assisted by her therapist in going to that location and directly confronting those fears (as long as it is safe to do so).

Imaginal exposure

In imaginal exposure, a client is asked to imagine feared images or situations. Imaginal

exposure can help a person directly confront feared thoughts and memories. Imaginal exposure may also be used when it is not possible or safe for a person to directly confront a feared situation. For example, it would not be safe to have a combat veteran with PTSD directly confront a combat situation again.


In the Rapid Eye Movement portion, the client focuses on a troubling memory and identifies the belief he has about himself connected to this negative memory (for example, in dealing with a rape, the person may believe “I am dirty”). The individual then formulates a positive belief that he would like to have about himself (“I am a worthwhile and good person in control of my life.”). All the physical sensations and emotions that accompany the memory are identified. The individual then goes over the memory while focusing on an external stimulus that creates bilateral (side to side) eye movement. This is most often achieved by watching the therapist moving a finger. After each set of bilateral movements, the individual is asked how he feels. This process continues until the memory is no longer disturbing. One advantage of using emdr therapy is that the individual does not need to be re-traumatized by bringing up all the details of the trauma. EMDR therapy sets up a learning state that allows these experiences to be stored appropriately in the brain. This is the main difference between exposure therapy and EMDR; in other words, the individual is not re-exposed to the trauma.

In EMDR therapy, the individual is processing the trauma with both hemispheres of the brain stimulated. The chosen positive belief is then installed, via bilateral movement, to replace the negative one. Each session normally lasts for about one hour. It is believed that EMDR therapy works because the “bilateral stimulation” by-passes the area of the brain that has become stuck due to the trauma and is preventing the left side of the brain from self-soothing the right side of the brain.

During this procedure, clients tend to “process” the memory in a way that leads to a peaceful resolution. This often results in increased insight regarding both previously disturbing events and long-held negative thoughts about the self that have grown out of the original traumatic event. For example, an assault victim may come to realize that he was not to blame for what happened, he is now safe, that the event is really over, and, as a result he can regain a general sense of safety in his world.