(image: Toa Heftiba: Unsplash)

When people begin looking for psychological support, Cognitive Behavioural Therapy, or CBT for short, is one of the most well-known and accessible forms of psychotherapy. Recently, more and more therapists are offering Eye Movement Desensitisation and Reprocessing (EMDR), particularly for trauma.Both are well established, evidence-based treatments that can help people move forward from distressing experiences — but they do so in quite different ways.

If you’ve been wondering what sets them apart, or which might be the best fit for you, this post aims to break down the differences in a clear and down-to-earth way.

Understanding CBT

Cognitive Behavioural Therapy (CBT) is arguably the most widely accessed and researched psychological approaches, particularly in the UK. It’s based on the understanding that our thoughts, emotions, physical sensations, and behaviours are all connected. When one of these areas becomes unhelpful — for example, when our thoughts become overly negative or worrisome — it creates a negative cycle that keeps us stuck and in turn maintains that distress.

CBT helps a person to notice these patterns and challenge them with practical, realistic alternatives. The aim is not to “think positively” but to think more accurately. For instance, if you often find yourself thinking “I always mess things up,” CBT would explore the evidence for and against that thought, helping you see the situation in a more balanced light.

Sessions are focused on the present and typically structured towards achieving mutually agreed goals. There is less emphasis on the past and childhood, although this can be useful to consider in relation to the development of a person’s belief system or how they see the world today. This, in turn, influences a person’s responses to distress. CBT continues outside of sessions as clients engage in task such as trying alternative response to distress, or journalling at challenging times. 

CBT for trauma focuses on making changes to the way a person thinks about a traumatic event, and themselves within that event. Re-living is a key element of CBT for trauma and enables the person to safely revisits the traumatic memory in a structured, supportive way with their therapist. This allows the brain to process the event as a memory, rather than something that is still happening now, which in turn reduces distress around the event and any associated flashbacks or nightmares. The overall aim is to reduce distress, restore a sense of safety and control, and help the person make sense of what happened so the trauma feels like something from the past — not something still happening in the present.

CBT is highly effective for anxiety, low mood/depression, panic attacks, phobias, obsessive-compulsive disorder (OCD), PTSD/trauma, poor sleep/insomnia and many other mental health difficulties.

Understanding EMDR

Eye Movement Desensitisation and Reprocessing (EMDR) might sound unusual at first — after all, what do eye movements have to do with mental health? Yet EMDR is a powerful, evidence-based therapy originally developed to help people recover from trauma.

The theory behind EMDR is that when something distressing happens, our brains sometimes struggle to process it properly. The memory can get “stuck,” remaining vivid and the person continues to experience the fear as if the event is happening again. EMDR helps the brain work through these memories so they can be stored more adaptively — as something that happened in the past, rather than something that continues to feel threatening now.

During EMDR sessions, the therapist will guide you through sets of bilateral stimulation — this could involve following their fingers with your eyes, hearing alternating tones through headphones, or feeling gentle taps on your hands. This process is thought to mimic the way the brain naturally processes memories during REM sleep.

One benefit of EMDR is that it’s not necessary to go into detail about the event if you don’t want to. The focus is on how it feels in your body and what comes up in the moment. Over time, people often report that distressing memories lose their emotional intensity, and the beliefs tied to those experiences begin to shift to something most positive and empowering, rather than fearful or critical.

Can CBT and EMDR Be Combined?

Absolutely. Many therapists are trained in both and will tailor the approach depending on your needs. For example, someone with trauma may start with CBT techniques to manage anxiety and develop coping skills, then move into EMDR once they feel more grounded and ready to process deeper memories. In some cases, EMDR can help resolve traumatic roots of long-standing patterns, while CBT provides the tools and strategies to maintain progress in day-to-day life.

It isn’t about one being “better” than the other — it’s about finding what works for you, at the right time and pace.

Which One Should You Choose?

If you’re feeling stuck in unhelpful thoughts or patterns — for example, overthinking, avoidance, or self-criticism — CBT can be a great place to start. It’s structured, practical, and gives you tools you can continue using long after therapy ends. If you’ve experienced trauma, flashbacks, or distressing memories that feel “frozen in time,” EMDR might be more suitable. It’s gentle yet powerful, and often helps people move on from experiences they’ve been carrying for years.

Ultimately, the best way to decide is to talk with a qualified therapist who can help assess your situation and guide you towards the most appropriate treatment.

Final Thoughts

Both CBT and EMDR offer genuine hope for change. Whether you’re learning to manage anxiety, heal from trauma, or simply understand yourself better, the right therapeutic relationship can make all the difference.

At its heart, therapy isn’t just about techniques — it’s about feeling safe, understood, and supported while you make sense of your experiences. Whether through CBT, EMDR, or a combination of both, the goal is the same: helping you feel more in control of your thoughts, emotions, and your life again.

This blog was written by UK therapist Andrew Kemp at www.clearmindcbt.com and contains sponsored links.