ART vs EMDR: Which approach is right for you?

What Is Accelerated Resolution Therapy (ART)?

Accelerated resolution therapy (ART) is a trauma-focused therapy that uses side-to-side eye movements to help you process difficult memories while replacing disturbing mental images with more positive ones.

Developed in 2008 by Laney Rosenzweig, LMFT, ART focuses on changing how your brain stores traumatic memories without requiring you to talk about the details out loud.

“When people go through experiences that cause emotional upset, anxiety, and stress, those experiences are not really captured by language alone,” explains Marsha Mandel, LMHC, a master level ART clinician in New York. ART is considered a “bottom-up therapy,” meaning it focuses more on body sensations and emotions rather than language and words, she explains. “The somatic component is essential because these things are felt in the body and the emotional part of the brain.”

How ART Works

The process happens in two main steps:

Step 1: Desensitization. While making guided eye movements, you’ll silently visualize the traumatic memory. This bilateral (side-to-side) stimulation helps reduce the emotional intensity associated with that memory.

Step 2: Voluntary image replacement. This is ART’s unique component, known as “positization”. Working with your therapist, you’ll create new, more positive mental images of your own choosing to replace the disturbing ones linked to your trauma. You’re in control of what these replacement images look like.

“The facts are always going to be there, but the images are very closely linked to the intensity,” Mandel says. “By desensitizing, erasing, and replacing images, the memory can feel very different.”

Research Support for ART

Despite being relatively new, research shows promise for ART’s effectiveness. A 2024 systematic review found that ART significantly reduced PTSD symptoms, with most participants receiving three to four sessions of 60 to 75 minutes each. The review also found significant improvements in symptoms of anxiety, depression, and sleep problems.

In 2015, the federal government’s Substance Abuse and Mental Health Services Administration (SAMHSA) officially recognized ART as an evidence-based treatment for trauma-related disorders.

What Is EMDR?

Eye movement desensitization and reprocessing (EMDR) is a trauma therapy that uses bilateral stimulation—usually eye movements—to help your brain reprocess traumatic memories so they no longer cause distress.

Developed in 1987, EMDR is based on the idea that traumatic memories get “stuck” in your brain in a way that keeps triggering emotional and physical reactions.

“When we encounter significant stressors, we take in these experiences based on our current abilities at the time,” explains Mahendran Radhakrishnan, a licensed independent clinical social worker and EMDR practitioner with Thriveworks. “How a person takes in the experience will affect how this memory is stored in the mind.”

How EMDR Works

EMDR integrates two core components throughout the therapy process:

Memory recall with bilateral stimulation: You’ll recall the traumatic memory while following your therapist’s finger with your eyes (or experiencing other forms of bilateral stimulation like tapping, sounds, or vibrations). This helps your brain reprocess the memory and store it in a less distressing way.

Installation phases: The therapy includes sessions that help you develop more positive beliefs about yourself, replacing negative thoughts that developed around the trauma.

Unlike ART’s focus on image replacement, EMDR works by helping your brain’s natural healing processes kick in to resolve the trauma.

Research Support for EMDR

EMDR has extensive research support, with multiple meta-analyses showing significant effectiveness for PTSD. Recent studies demonstrate that EMDR significantly outperforms other approaches, making it one of the most researched trauma therapies available.

Key Differences Between ART and EMDR

When considering ART vs EMDR, there are some key similarities and differences to know.

“Both ART and EMDR use bilateral stimulation to change the way you respond to traumatic memories,” explains Michelle Parrella, a licensed clinical social worker trained in both approaches. They help calm your body’s stress response so you no longer feel like you’re reliving the trauma when you think about it. “Instead of heading into fight-or-flight mode, you will feel safe,” Parrella says.

So what sets them apart? Here’s a detailed comparison:

How to Decide Which Is Right for You

Both ART and EMDR are effective, evidence-based treatments for trauma. The choice often comes down to your personal preferences, trauma type, and individual needs.

Questions to Ask Yourself

1. Do I want to talk about the traumatic event(s) in detail?

If you prefer to keep trauma details private, ART might be more appealing. In ART sessions, you can share as little as you want, Mandel says. EMDR requires some discussion of the traumatic situation and related beliefs, though not as extensively as traditional talk therapy.

2. Do I feel connected to my body and physical sensations?

If you’re not well-connected to physical sensations, EMDR might be a better starting point. “When you aren’t connected to your physical self and are unable to fully attune to the sensations you feel, ART can be difficult,” Parella says. You can always transition to ART later once you’re more body-aware.

3. Can I easily visualize images in my mind?

Strong visualization skills are crucial for ART’s image replacement technique. If you have trouble creating mental pictures (a condition called aphantasia), EMDR would likely be more effective. “With ART, you have to be able to not only visualize the trauma, but also visualize a new, more positive or neutral image,” Parrella notes.

4. Do I want to dive right in, or take time to build coping skills first?

ART can start immediately, often within the first or second session, Mandel explains. EMDR typically includes several preparation sessions to build relaxation tools and establish safety before processing traumatic memories. This slower pace can feel gentler if you’re hesitant about starting trauma work.

5. What type of trauma am I dealing with?

Research suggests ART may be particularly effective for single-incident trauma, while EMDR has strong evidence for both single-incident and complex trauma. If you experienced ongoing or multiple traumas, EMDR’s comprehensive approach to addressing core beliefs might be more beneficial.

You Don’t Have to Choose Alone

Consider scheduling consultations with therapists who specialize in either or both approaches. Many mental health professionals can help you determine which therapy might work best based on your specific situation, trauma history, and personal preferences.

It’s also worth knowing that these approaches can work together. Some therapists blend techniques or might start with one approach and transition to another. “Sometimes I’ll start with ART and then transition into EMDR to address core negative beliefs that may be permeating, in addition to the negative traumatic experience,” Parrella explains.

A qualified professional can help build a treatment plan tailored to your comfort level, needs, and goals.

The Bottom Line

ART and EMDR are both valuable options for trauma survivors—especially those who haven’t found success with traditional talk therapy and are looking for approaches that work with both mind and body.

There’s no universal “right” choice. Some people respond better to ART’s image-focused approach, while others prefer EMDR’s comprehensive reprocessing method. Your healing journey is unique, and what works best may depend on factors like your trauma type, communication style, visualization abilities, and personal preferences.

The most important thing is taking that first step toward healing. Both approaches offer hope for processing trauma and reclaiming your life. With qualified professional guidance, trauma recovery is within reach.

Frequently Asked Questions

Can I do ART and EMDR at the same time?

Yes, you can do both ART and EMDR, though it’s more common to focus on one approach at a time. Some therapists trained in both methods may incorporate elements from each, or you might do several sessions of one therapy and then switch to the other based on your progress and needs.

Can EMDR include ART techniques?

While possible, it’s not standard practice for EMDR sessions to include ART’s image replacement techniques. Each therapy has its own specific protocol and theoretical approach. However, some therapists trained in both may adapt techniques when clinically appropriate.

What happens in an ART session compared to EMDR?

Both involve recalling traumatic memories while engaging in bilateral stimulation (usually eye movements). The key difference is that ART includes a specific phase where you create new, more positive mental images to replace disturbing ones, while EMDR focuses on helping your brain naturally reprocess the memories without necessarily changing the images themselves.

Do you have to use eye movements in ART and EMDR?

Not necessarily. While both therapies were developed using eye movements, alternative forms of bilateral stimulation can be used if you’re more comfortable with them. Options include alternating tapping (like crossing your arms and tapping each shoulder), holding vibrating devices, or listening to alternating sounds through headphones. These alternatives are more commonly used in EMDR than in ART.