Compare Popular Therapy Techniques: CBT, DBT, EMDR and Somatic

As a starting point, we’ll talk about popular modalities that fit into these two broader categories: cognitive (mind) and somatic (physical). 

Cognitive vs. somatic modalities

Cognitive therapies are about the mind and how thoughts relate to your emotions and behaviours. It’s about finding patterns and working on skills to improve those thought and behaviour cycles for more positive outcomes. 

Somatic therapies are about addressing the impact that mental health distress has on our nervous system. These practices draw from evidence that we carry trauma in our bodies, and that there are physical cues of stress that our consciousness might sometimes miss. By understanding the physical signals our bodies give us, we can better regulate stress and heal.

CBT vs. DBT

Within the broader category of cognitive therapies, we’re going to focus on the difference between cognitive behaviour therapy (CBT) and dialectical behaviour therapy (DBT). 

Cognitive behaviour therapy (CBT) teaches you new ways of thinking, acting, and reacting to certain situations. A therapist will help guide you through understanding distorted thought patterns, how our thought patterns create our view of the world around us, and how that impacts our behaviours and emotions. CBT is usually more structured than traditional talk therapy, it’s usually limited to a certain number of sessions, and will often involve homework to do between sessions. 

Dialectical behaviour therapy (DBT) is a form of CBT that is shown to be more effective for patients who experience heightened emotional responses, or who exhibit more self-destructive or impulsive behaviours compared to the average person. The word dialectical refers to opposing forces existing; two different things may be true at once. It helps patients move out of all-or-nothing thinking that leads to emotionally intense responses. There is a focus on social interactions and relationships in DBT, so this often involves group therapy as well as one-on-one sessions. 

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Somatic therapy vs. EMDR

Have you ever had an upset stomach when you’re stressed? Somatic therapy relies on the knowledge that we carry trauma in our physical selves and there is a connection between our bodies, minds and behaviours. Within that category, Somatic experiencing and ​​eye movement desensitization and reprocessing (EMDR) are common techniques.

Somatic therapy or somatic experiencing looks at the interconnection of our nervous system and mental health. Our body reacts to stressors as what’s commonly described as our fight, flight or freeze response—think reactions like muscle tension, increased heart or breathing rates, becoming flush, etc. Our bodies release certain hormones during times of stress, and prolonged physical reactions like this can have long lasting impacts on how our bodies work. We can get stuck. Somatic therapy focuses on the freeze response, and aims to move out of that trapped feeling. At a high level, somatic therapy involves recognizing body sensations and learning how to discharge them to calm the body and address the mind.‍

​​Eye movement desensitization and reprocessing (EMDR) was initially developed to treat post-traumatic stress disorder (PTSD). Traumatic past experiences or memories can manifest in unwanted ways in the future, such as anger or panic, anxiety, or depression. This can occur consciously or unconsciously. EMDR treatment will first involve identifying these sources. Then, when recalling those memories, a therapist will guide you through eye movements (perhaps following the movements of a pen in front of you). This is said to help create new thoughts about that memory or event at a neurological level, helping you process and move past them.