The Differences Between TMS and EMDR

By: Jayson Tripp, MD


Transcranial magnetic stimulation (TMS) and eye movement desensitization and reprocessing (EMDR) can both be used to treat the symptoms of major depression, post-traumatic stress disorder (PTSD), anxiety, and other mental health conditions. Both are also safe treatments with very little side effects. However, these treatments couldn’t be more different.

What Is EMDR?

Eye movement desensitization and reprocessing (EMDR) is a form of psychotherapy that is most commonly used to treat PTSD. But EMDR can also be used to treat depression, panic disorders, eating disorders, and addiction.

During an EMDR session, a patient will briefly recall a traumatic or disturbing event while the therapist directs their eye movements. This technique was developed in 1989 by psychologist Francine Shapiro. While taking a walk, she noticed that her negative emotions lessened as her eyes moved from side to side. She tried this technique with her patients and noticed the same positive results.

Since then, EMDR has grown in popularity but remained a controversial treatment method. Some mental health providers are skeptical of EMDR, despite its high success rates, because researchers are still unable to determine how it provides relief from symptoms.

How Does It Work?

EMDR is usually broken up into about 12 sessions, which are grouped into eight phases:

  1. History and treatment planning — before starting EMDR, the therapist will gather a thorough history of the patient and develop a treatment plan accordingly.
  2. Preparation — Again, before starting EMDR, the therapist teaches you coping mechanisms to help you deal with any uncomfortable emotions that may arise during the treatment.
  3. Assessment — The therapist targets the specific memories that the patient will recall during EMDR.
  4. Desensitization — During this first phase of treatment, the patient recalls a traumatic memory and the therapist guides them through while directing their eye movement.
  5. Installation — After processing the traumatic memory, the therapist helps the patient replace their negative thoughts and feelings with positive ones.
  6. Body Scan — The therapist will ask the patient to recall their traumatic event again to evaluate if causes any tension in the body. If it does, the therapist will target these areas in a future session.
  7. Closure — occurs at the end of every session. If the patient hasn’t fully processed their traumatic memory, the therapist will help the patient cope with their feelings and make sure they leave feeling better than when they came in.
  8. Re-evaluation — occurs at the beginning of every session. The therapist uses this time to make sure that the patient has maintained their progress and identifies any new areas that need to be targeted.

How long a session takes depends on the patient’s history and their response to treatment but usually takes about 90 minutes. Patients are known to feel relief within the first few EMDR sessions. However, it is vital to complete each phase of the treatment for the relief to be long-lasting.

What Are the Risks?

Studies show that EMDR is a safe therapy with no adverse side effects. And it is becoming a more popular form of therapy, especially for patients who suffer from PTSD. However, many mental health practitioners remain skeptical of EMDR as a valid form of treatment because there is not any scientific explanation for how it works.

Also, recalling disturbing and traumatic events is a vital part of the EMDR process. And even though your therapist will help you deal with the negative emotions that come with reliving these memories, it can be scary to face them. In fact, research shows that trauma-focused treatments like EMDR have a significant dropout rate because it can be emotionally draining and stressful to relive past traumas.

How Does TMS Differ From EMDR?

TMS and EMDR are completely different treatments. EMDR is a form of therapy done with a licensed psychologist, and TMS is a non-invasive, FDA-approved medical procedure prescribed by a psychiatrist. TMS uses magnetic pulses to stimulate and repair the neuropathways in the brain that are associated with mood control, reducing the symptoms of mental conditions like major depressive disorder.

During a typical TMS session, the patient wears a helmet with a magnet inside that delivers targeted pulses to specific areas of the brain. Patients can read, watch videos, meditate, or perform any other activity that can be done while sitting upright.

TMS works a lot more quickly than EMDR. Most TMS patients start to notice a significant reduction in their symptoms by the third or fourth week of treatment. A course of TMS treatment lasts about 6–8 weeks and consists of five 30-minute sessions per week. After that time, two out of three patients are in complete remission. EMDR, on the other hand, often takes 12 or more 60- to 90-minute sessions, which could mean months of treatment.

Although TMS is only FDA-approved as a treatment for major depression, many psychiatrists prescribe it as an off-label treatment for mental health conditions like anxiety and PTSD. Research also continues to be done on the effects that TMS has on PTSD patients, and the results are promising. A significant amount of PTSD patients who didn’t respond to medication and psychotherapy have found relief with TMS.

In summary, EMDR is an emotion-based therapy that shows promising results. However, because it remains unclear how EMDR provides such promising results in people with PTSD, anxiety, depression, and other conditions, many mental health providers remain skeptical of EMDR as a valid form of treatment. EMDR is also a long, emotionally draining process because the patient must relive past traumas.

TMS works to repair the areas in the brain that are affected by depression, anxiety, PTSD, and other mental illnesses. There is clear scientific evidence that TMS reduces the symptoms of these conditions because of its effects on brain function, which mental health providers can’t debate.

To learn more about TMS as an option for PTSD, anxiety, depression, or another mental condition, contact u s at Serenity Mental Health Centers.

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*All information subject to change. Images may contain models. Individual results are not guaranteed and may vary.