ART vs. EMDR: Which One Is Better?
Dr. Francine Shapiro (pictured left) and Laney Rosenzweig, LMFT (pictured right) are likely two of the most brilliant therapists ever to live. Both of these women created their own therapy models that help people overcome trauma using eye movements. (If you’re interested in learning more about using eye movements to treat trauma, you can click here).
Dr. Shapiro named her therapy “eye movement desensitization and reprocessing” (EMDR for short), while Rosenzweig calls her model “Accelerated Resolution Therapy” (ART). Both are backed by a plethora of research and client testimonials that confirm their efficacy.
Given that both of these therapies use eye movements to help treat trauma, it’s only natural to ask - which one is better? Whether you’re a client who’s weighing your treatment options or a therapist considering training in one of these models, this article will help you understand some of the meaningful differences between EMDR and ART. At the end of the article, I’ll weigh in as a therapist trained in both models with my thoughts on which one is better.
Similarities Between EMDR And ART
Before we starting comparing the differences between EMDR and ART, it might be helpful to explore some of the similarities they share.
For starters, both of these models are well known for utilizing eye movements to help people process traumatic events. Dr. Shapiro discovered how helpful eye movements can be by chance in 1987 during a walk in the park. Rosenzweig, who was trained in EMDR several years later, quickly realized the value of eye movements in therapy. She developed ART by combining the power of eye movements with interventions from some pre-existing therapies.
Another commonality between EMDR and ART is their focus on memories. Dr. Shapiro and Rosenzweig believed that traumatic memories were the foundation for many mental health problems such as PTSD, anxiety, and phobias. Both therapies have specific interventions to help clients identify which memories may be contributing to their current symptoms.
The final similarity we’ll discuss is that there is normally very little talking during an EMDR or ART session. It may feel counterintuitive for a therapy session, but both of these modalities promote change while the client is silently processing trauma while moving their eyes. When it comes to EMDR and ART, talking is seen as unnecessary at best and a barrier to change at worse.
Even though they share some similarities and may appear the same on the surface, EMDR and ART are actually very different. For starters, let’s talk about how structured each of these therapies is.
(Just to give credit where credit is due, I relied heavily on a document created by Rosenzweig to compare EMDR and ART. You can access a copy of this document by clicking here.)
Structure of Each Session
One of the key differences between EMDR and ART is how structured a session of each therapy will be.
EMDR uses free association to help clients process memories. Between each set of eye movements, an EMDR therapist will ask the question “What are you noticing now?” After the client responds, the therapist will instruct them to “go with that” before resuming the eye movements.
Because it relies heavily on free association, each EMDR session is going to look different. In fact, in her textbook about EMDR, Dr. Shapiro stated, “Because EMDR therapy is not a regimented approach, no two treatment sessions will be the same” (pg. 82).
In contrast to EMDR, ART is very regimented.
And I mean very. When I was trained in ART, we were not allowed to break from the protocol at all. ART therapists are provided with scripts that help them direct each session. While the content of the session will change, the process remains very much the same session to session.
Speed Of Recovery
Another difference between ART and EMDR is the speed at which recovery takes place.
One of the hallmarks of ART is that change is suppose to happen quickly (hence the word “Accelerated” being part of its name). The speed at which recovery takes place is one of the reasons why people often express that ART feels “too good to be true.” However, this rapid change is backed by client testimonies and research that shows that quick recovery is possible.
In most instances, clients begin to feel better after just one session of ART. One study showed that ART significantly reduced PTSD rates among a group of adults in just one to five one-hour sessions.
In contrast, Dr. Shapiro appeared to be less concerned about how quickly EMDR could help clients: “Clinicians…must refrain from viewing EMDR as a race to achieve treatment effects” (pg. 82-83).
The possible longevity of EMDR was one of Rosenzweig’s inspirations for creating ART. In her book “Too Good to Be True?” Rosenzweig wrote, “EMDR may be done in one session, but I have met many clients who had previously engaged in weeks, months, or years of EMDR and were still symptomatic” (pg. 55-56).
Focusing on Thoughts and Sensations
In her article comparing EMDR and ART, Rosenzweig explained this next difference very succinctly:
“EMDR focuses on cognitions. ART does not focus on cognitions.”
In the Installation phase of EMDR, clients are asked to identify a positive belief (aka “cognition”) that they would like to believe about themselves. These can include beliefs like “I am lovable” or “I did the best I could.”
In ART, there is no focus on changing a client’s beliefs. Instead, ART focuses on changing mental images and body sensations. When it comes to dealing with beliefs, Rosenzweig asserts that “cognitions normally will change naturally on their own as the targeted images and sensations are changed.”
Reducing negative body sensations is one of the main focuses of ART and is part of almost every step of its protocol. In contrast, EMDR has one specific step that focuses on reducing negative body sensations.
Desensitization and “Positization”
During an EMDR session, clients are asked to rate how distressing a memory is before reprocessing it. When their distress rating becomes 0, the memory is considered “desensitized” and they proceed to the next step of the protocol.
ART takes desensitization one step further into something Rosenzweig calls “positization.” (No, “positization” is not a real word, but it does a good job of describing ART’s goal).
Instead of leaving a memory neutral, ART aims to create a positive mental image for clients to respond to.
For example, let’s imagine a therapist is working with a client who was in a car accident.
If they used EMDR, treatment would be considered successful if the client could remember the accident without any distress.
In contrast, ART wouldn’t be considered successful until the client had a new, positive mental image to replace the image of the accident. The new image could be one of them steering down a peaceful country road or driving home without the accident ever happening, and it would be the image they remember the accident with for the rest of their life.
On an important side note, clients will always remember the facts of what happened to them even if after they create a replacement image. This is why ART’s motto is “Keep the knowledge, lose the pain.”
Relationship With the Client
“I often tell my trainees that I do not need a close relationship with my dentist. ART, like dentistry, is procedural in nature.”
Rosenzweig’s quote clearly explains ART’s philosophy on the therapist/client relationship. More emphasis is placed on following the ART protocol than on building a strong relationship with the client.
In contrast, Dr. Shapiro emphasized the importance of “a firm therapeutic alliance” (pg. 114).
The first two stages of EMDR create space for the client and therapist to establish a solid relationship together. This process can go quickly or slowly depending on several factors. Reprocessing trauma using EMDR doesn’t begin until a strong therapeutic bond is created.
Is ART or EMDR Better?
We’ve compared the similarities and differences between EMDR and ART.
So, which one is better?
After being trained in and consistently using both modalities, I can say that I believe ART is the clear winner for several reasons.
First, the speed at which ART works is unmatched by any other modality I’m aware of. I’ve personally witnessed clients reprocessing entire childhoods of abuse in two sessions, which is something I have never seen using EMDR.
Second, clients seem to get better results when the focus is on changing their sensations rather than their cognitions. Many of my clients struggle with the Installation phase of EMDR, but none of them have had a difficult time changing negative body sensations.
Lastly, Rosenzweig’s concept of “positization” has been life-changing for many of my clients. Not being able to see the worst part of a trauma offers sweet relief after years of being tortured by it.
One aspect of EMDR that I appreciate is its insistence on establishing a strong therapeutic relationship with clients. While ART is procedural and doesn’t technically require an alliance between the client and therapist, I believe that clients are able to engage with the process more effectively if they feel comfortable with their therapist.
I also can’t emphasize enough how indebted we are to Dr. Shapiro for introducing eye movements into therapy. EMDR is still a great form of therapy, and I would still happily use it if it was my only option.
Too Good to Be True?
Does ART sound like something that’s too good to be true? It did to me until I saw it in action. If you want to test it out, why not schedule a session at Trailhead Counseling Services? We believe you’ll be blown away with the results.
Sources
Rosenzweig, L. (n.d.). Differences Between EMDR and ART. Accessible here.
Rosenzweig, L. (2021). Too Good to be True? Archway Publishing.
Shapiro, F. (2018). Eye Movement Desensitization and Reprocessing (EMDR) Therapy. Basic Principles, Protocols, and Procedures (3rd ed.). The Guilford Press.
