One question I hear often is: How do I know which kind of therapy I need?

It is an understandable question. The mental health field uses many overlapping terms—somatic therapy, Somatic Experiencing, EMDR, Brainspotting, Deep Brain Reorienting (DBR), Internal Family Systems (IFS), Cognitive Behavioral Therapy (CBT), Dialectical Behavior Therapy (DBT), psychodynamic therapy—and people are somehow expected to understand the differences while they may already be anxious, overwhelmed, or simply longing to feel better.

The truth is that no single approach is right for everyone and oftentimes it is several modalities in combination that are most effective. These therapies offer different ways of entering the healing process, and the boundaries between them are often less distinct in practice than they appear on paper.

Here is a guide to help you understand some of the differences—and begin noticing which approach feels most aligned with you.

Where to begin: words, body, or both?

Some therapies begin primarily with language. You talk about what happened, explore your emotions and relationships, identify patterns, and develop new ways of understanding yourself.

Other approaches begin more directly with your present-moment experience. They may invite you to notice sensation, breath, tension, posture, movement, imagery, or subtle shifts in your nervous system.

Neither pathway is inherently better. Insight can be deeply transformative. So can reconnecting with a body that has been bracing, shutting down, or protecting you for many years.

In reality, most effective therapy includes both.

We may be talking while also noticing that your breath has become shallow, your shoulders have lifted, or a part of you suddenly wants to disappear. The body does not replace the story; it gives us another way to listen to it.

Talk therapy

What it is: Talk therapy is a broad category of counseling conducted primarily through conversation.

Cognitive Behavioral Therapy, or CBT, explores relationships among thoughts, emotions, and behaviors. Psychodynamic therapy considers how early experiences and unconscious patterns may influence present relationships. Humanistic, existential, narrative, and relational approaches each offer their own ways of understanding emotional experience.

What it may help with: Talk therapy can support insight, meaning-making, decision-making, emotional expression, relationship patterns, depression, anxiety, grief, and life transitions. It can help you understand why you respond as you do and begin making more conscious choices.

Where some people feel stuck: You may understand your history beautifully and still notice that your body reacts before you have time to think. A raised voice may cause you to freeze. A delayed text may bring a wave of panic. You may know that you are safe while your body continues to prepare for danger.

That does not mean talk therapy has failed—or that you have failed at it. It may mean that insight is only one part of what your system needs. A body-centered approach can help bring awareness and compassion to responses that may not shift through understanding alone.

Somatic therapy: the larger umbrella

Somatic therapy is a broad category, not one specific method. 

Somatic therapy includes the body and nervous system in the counseling process. A session may involve noticing where you feel an emotion, tracking changes in sensation, becoming aware of the breath, exploring an impulse to move, or sensing how your body responds as you speak.

In my Santa Monica practice, somatic work is collaborative, gentle, and guided by curiosity rather than force. We might pause during a conversation and notice a tightening in your chest, warmth in your face, heaviness in your limbs, or the sudden absence of sensation. We may explore what helps you feel grounded without demanding that the experience change.

Sometimes we work with breath, imagery, mindful awareness, or gentle movement. At other times, the most important practice is simply learning to remain present with yourself without judgment.

What it may help with: Somatic therapy may be especially supportive for trauma, anxiety, chronic stress, burnout, emotional numbness, dissociation, attachment wounds, or the experience of living primarily in your head and feeling disconnected from your body.

Physical symptoms should always be evaluated appropriately by a medical professional. Somatic therapy does not assume that unexplained physical symptoms are psychological, but it can help you explore the relationship among stress, emotion, bodily experience, and nervous-system activation.

What to know: Somatic therapy does not have to involve yoga, touch, or large movements. Much of the work can happen while you are comfortably seated and simply noticing what is present. You remain in choice throughout the process.

Somatic Experiencing

What it is: Somatic Experiencing, often called SE, is a particular somatic method developed by Peter Levine.

SE understands trauma through the lens of survival responses and nervous-system activation. When the body has been unable to complete or recover from a protective response, patterns of activation, collapse, bracing, or disconnection may continue long after the original danger has passed.

Two terms you may hear are:

• Titration: approaching difficult material gradually and in manageable amounts rather than becoming flooded by it
• Pendulation: gently moving awareness between activation and experiences of greater steadiness, ease, or support

The intention is not to relive the trauma. It is to help the nervous system encounter what has been held in a way that feels paced and tolerable.

How it differs from somatic therapy generally: Somatic Experiencing has a defined training pathway and framework. A practitioner who has completed the full training may use the SEP credential.

All Somatic Experiencing is somatic work, but somatic therapists may also draw from mindfulness, movement, attachment theory, Internal Family Systems, Sensorimotor Psychotherapy, trauma-informed yoga, or other experiential and relational traditions.

What to know: An SEP credential does not necessarily mean that someone is a licensed mental health professional. When seeking treatment for PTSD, dissociation, depression, or another mental health condition, ask about both somatic training and clinical licensure.

Sensorimotor Psychotherapy

What it is: Sensorimotor Psychotherapy was developed by Pat Ogden and integrates body awareness with attachment, cognition, emotion, and trauma treatment.

It pays close attention to the ways experience may be reflected in posture, gesture, muscular tension, movement, and protective responses. A therapist might help you notice the impulse to turn away, push back, reach out, or make yourself smaller—and explore that response without forcing it.

How it compares with Somatic Experiencing: There is meaningful overlap between the two. Sensorimotor Psychotherapy often places particular emphasis on developmental and attachment patterns, while Somatic Experiencing is commonly described through nervous-system regulation and survival responses.

The actual experience will also depend greatly on the therapist. No method is practiced in exactly the same way by every clinician.

EMDR

What it is: EMDR stands for Eye Movement Desensitization and Reprocessing. It is a structured trauma therapy that typically uses bilateral stimulation—such as guided eye movements, alternating sounds, or tapping—while a person attends to aspects of a distressing memory.

EMDR includes preparation and stabilization before trauma processing begins. During the processing phases, the therapist helps the client notice images, beliefs, emotions, and bodily sensations associated with the memory.

What it may help with: EMDR has been studied extensively for PTSD and is recommended in multiple clinical practice guidelines. It is often considered when a person has a particular traumatic event or disturbing memory that continues to feel emotionally present.

However, EMDR is not limited to single-incident trauma. Skilled EMDR therapists also work with developmental and complex trauma, although treatment may require more preparation, careful pacing, and attention to dissociation, attachment, and internal resources.

How it differs from broader somatic therapy: EMDR follows a defined eight-phase framework and usually identifies specific memories or themes for processing. Integrative somatic work may be less protocol-driven and may begin with what is happening in the body right now, even when there is no single memory attached to it.

EMDR also includes attention to bodily sensation, so it should not be thought of as entirely separate from body-based work.

What to know: EMDR has a substantially larger research base than the newer modalities described below. That is important information—but it does not tell us which approach will feel most supportive or effective for every individual. The quality of the therapeutic relationship, the clinician’s skill, and the pacing of the work continue to matter.

Brainspotting

What it is: Brainspotting was developed by psychologist David Grand. It uses a person’s visual field as an entry point into emotional and bodily experience.

During a session, you and the therapist may identify a particular point in your field of vision that appears connected with activation, emotion, or a felt sense related to the issue you are exploring. You then maintain gentle visual attention around that point while noticing what unfolds internally.

The process may involve sensations, emotions, memories, images, movement impulses, or periods of quiet. The therapist offers an attuned, steady presence without trying to direct every part of the experience.

How it differs from EMDR: Both approaches use aspects of vision and focused attention, but Brainspotting does not follow the same eight-phase protocol or use repeated sets of bilateral eye movements in the way EMDR typically does. It is generally more open-ended and may feel quieter or less structured.

Why it deserves consideration: Brainspotting may appeal to people who have difficulty putting their experience into words, who feel constrained by a highly structured protocol, or who naturally connect with internal sensation and imagery.

Early studies and clinical reports are promising, but the research base remains smaller and less developed than the evidence supporting EMDR. “Newer” or “less researched” does not mean without value; it means we should describe what is known with honesty and continue learning.

When considering Brainspotting, look for a licensed clinician with appropriate training and substantial experience working with trauma, especially if you experience dissociation or become overwhelmed easily.

Deep Brain Reorienting

What it is: Deep Brain Reorienting, or DBR, is a newer trauma therapy developed by Scottish psychiatrist Frank Corrigan.

DBR is based on the idea that, before fear, anger, grief, or another recognizable emotion arises, the body first orients toward—or away from—something important. This very early orienting response may be felt as subtle tension around the eyes, forehead, face, or neck.

In DBR, the therapist first helps the client become grounded in the present. The work then carefully tracks this orienting tension and the sequence that may follow: orienting, shock, emotion, and defensive response.

Rather than beginning with the most intense emotion, DBR attempts to approach the experience at an earlier and often quieter point in the sequence. This may provide a steadier anchor as traumatic material is processed.

What it may be especially relevant for: DBR was developed with trauma and attachment disruption in mind. It may be worth considering when someone experiences profound shock, early attachment wounds, dissociation, or trauma that seems to live beneath a coherent verbal story.

How it differs from EMDR and Brainspotting: EMDR generally works with selected trauma targets and bilateral stimulation. Brainspotting uses a point in the visual field while allowing internal processing to unfold. DBR focuses on subtle orienting tension and the proposed physiological sequence that precedes emotional and defensive reactions.

All three approaches involve focused attention, bodily awareness, and careful contact with traumatic material, but the therapist’s role and the process followed are different.

What to know about the research: DBR’s evidence base is still emerging. A 2023 randomized controlled trial involving 54 people with PTSD found encouraging reductions in PTSD symptoms following eight telehealth sessions, with benefits maintained at a three-month follow-up. Those findings are promising, but larger studies and direct comparisons with established treatments are still needed.

DBR should not be dismissed simply because it is less familiar than EMDR. It should also not be presented as though its evidence base is already equivalent. It is a thoughtful, developing approach that deserves both clinical consideration and continued research.

So how do you choose?

There is no formula, but these questions may help:

Have you developed insight without feeling a corresponding shift in your body?

A somatic approach may help you bring attention to the protective responses, sensations, and nervous-system patterns that insight alone has not changed.

Is there a particular memory or experience that still feels vividly present?

EMDR may be worth considering. Brainspotting or DBR may also offer ways of approaching the experience, particularly if a more open-ended or body-led process appeals to you.

Are your wounds more relational or developmental than event-based?

Look for a clinician who understands attachment and complex trauma, regardless of the modality listed after their name. Somatic Experiencing, Sensorimotor Psychotherapy, Brainspotting, DBR, EMDR, Internal Family Systems, and relational therapy may all be adapted for this work when practiced with appropriate training and care.

Do you tend to shut down, become numb, lose time, or feel disconnected from yourself?

Ask specifically about the therapist’s experience with dissociation. The name of the modality is less important than whether the clinician recognizes dissociative responses, prioritizes stabilization, and knows how to pace the work without overwhelming you.

Do you prefer structure or spaciousness?

EMDR may feel reassuring if you appreciate a clearly organized process. Somatic therapy or Brainspotting may appeal if you prefer a more intuitive and emergent approach. DBR is carefully sequenced, but much of the attention is directed toward very subtle internal experience.

These are general tendencies—not rigid rules. The therapist’s individual style will shape the experience just as much as the modality.

The relationship still matters

These categories are useful, but healing does not occur because you selected the perfect acronym.

It occurs within a relationship where you feel seen, respected, and accompanied. An exceptional therapist knows when to listen and allow space, when to offer guidance, and when to gently invite your attention toward something you may not yet have noticed.

In my own work, I integrate conversation with somatic awareness, mindfulness, Internal Family Systems, and humanistic and experiential approaches. We may talk quite a lot. We may also pause to notice your breath, a sensation, an image, an internal part, or the subtle impulse to move closer or farther away.

The body-centered work does not replace conversation. It gives the conversation somewhere deeper to land.

You do not need to choose a modality perfectly before making a consultation call. Begin with a licensed clinician who has meaningful experience with what you are facing. Ask how they work, how they respond to overwhelm or dissociation, and how they will know whether the approach is helping.

Most importantly, pay attention to yourself. Do you feel that there is room for all of you? Does the therapist seem grounded, curious, and able to meet you without judgment? Can you imagine slowly building trust here?

Sometimes healing begins with something very small: one breath, one sensation, one moment of feeling less alone.

Stefani Reitter, LMFT #50714, is a Licensed Marriage and Family Therapist and somatic practitioner in Santa Monica, California. Drawing from more than 25 years of experience with mindfulness, yoga, dance, holistic counseling, and body-centered healing, she offers in-person counseling in Santa Monica and telehealth throughout California.