EMDR vs. Prolonged Exposure: Beyond the “Buzz”
Published August 15, 2025
If you’ve looked into trauma therapy lately, you’ve probably heard about EMDR (Eye Movement Desensitization and Reprocessing). It’s all over podcasts, TikTok, and even celebrity interviews. Some call it a “miracle” treatment for trauma, while others dismiss it as just the latest fad. So how does EMDR actually compare to one of the most established trauma treatments, Prolonged Exposure Therapy (PE)? Let’s break down the differences and what the science really says.
What is EMDR?
EMDR involves recalling distressing memories while engaging in bilateral stimulation. This often involves using rapid eye movements or gentle tapping, all of which is guided by the therapist. Proponents argue that this process helps the brain reprocess trauma and file the memories in a less overwhelming way.
Part of EMDR’s popularity comes from its mechanisms for change: It doesn’t require talking through every detail of the trauma out loud. That makes it more appealing for some, but some researchers note that EMDR’s rise has outpaced the science in the public imagination. In fact, studies suggest it may be the exposure element—not the eye movements themselves—that drives much of the healing (Cuijpers et al., 2020).
What is Prolonged Exposure (PE)?
PE has been around much longer and has a deep base of evidence. It asks clients to face their trauma memories directly by retelling the story repeatedly (“imaginal exposure”) and gradually approaching real-life situations they’ve been avoiding (“in vivo exposure”).
It’s more structured, less flashy, and sometimes more emotionally demanding. But decades of research show PE reliably reduces PTSD symptoms and improves quality of life (Watts et al., 2023). While it may sound more challenging for newcomers to therapy, an experienced therapist can help people with trauma learn to literally re-envision they way their pasts impact the present.
The Research: Both Work, But in Different Ways
Recent meta-analyses confirm that both EMDR and PE are effective for treating PTSD (Watts et al., 2023). EMDR may feel faster or easier to engage with, leading to lower dropout rates in some studies (Lewis et al., 2020). PE, on the other hand, has some of the strongest long-term evidence behind it.
The key point? EMDR’s buzz doesn’t make it less valid, but it’s worth remembering that the therapy’s popularity may rest as much on its cultural appeal as on its mechanisms of change. PE, while less trendy, remains one of the most solid, time-tested treatments.
Takeaway
EMDR and PE are both powerful, evidence-backed tools for healing trauma. EMDR may feel more approachable in today’s quick-fix culture, while PE offers the slower, rigorous path that’s stood the test of time. The best choice depends on your needs, your preferences, and the fit with your therapist, not the trend cycle. Be sure to find a therapist who fits well, because, ultimately, the research shows that rapport is the best indicator for healing!
References
Cuijpers, P., Veen, S. C. van, Sijbrandij, M., Yoder, W., & Cristea, I. A. (2020). Eye movement desensitization and reprocessing for mental health problems: A systematic review and meta-analysis. Cognitive Behaviour Therapy, 49(3), 165–180. https://doi.org/10.1080/16506073.2019.1703801
Lewis, C., Roberts, N. P., Andrew, M., Starling, E. J., & Bisson, J. I. (2020). Dropout from psychological therapies for post-traumatic stress disorder (PTSD) in adults: Systematic review and meta-analysis. European Journal of Psychotraumatology, 11(1), 1709709. https://doi.org/10.1080/20008198.2019.1709709
Watts, B. V., Schnurr, P. P., Mayo, L., Young-Xu, Y., Weeks, W. B., & Friedman, M. J. (2023). Meta-analysis of the efficacy of treatments for posttraumatic stress disorder. Journal of Clinical Psychiatry, 84(2), 22r14695. https://doi.org/10.4088/JCP.22r14695