EMDR or CBT for Anxiety?

Let’s understand the two neural pathways of anxiety in the brain so your anxiety can be effectively reduced using either EMDR (Eye Movement Desensitisation and Reprocessing) or CBT (Cognitive Behavioral Processing), or both. For simplification, we are going to call them the Cortex pathway and the Amygdala pathway.

• Rewiring each pathway requires different methods, but both can be modified to reduce anxiety.

Cortex pathway

The cortex is the conscious part of the brain where sensations, logic, imagination, planning and risk assessment occur. Typically the anxiety that originates in the cortex is caused by:

1. worrying about what will happen and repetitively searching for solutions (“If they ask me why I left my last job, I will say it was a toxic environment or my boss did not like me or…”)
2. imagining catastrophic scenes (“I will be dumbstruck in an interview”)
3. Interpreting a neutral situation in a negative way (“One of the interviewers stopped making eye contact, he hates me”)

There is good evidence that CBT and mindfulness work for cortex-based anxiety. Your therapist will help you to challenge your thoughts and habitual thinking. However, your therapist should also check and treat fear, anxiety and panic that arises in the amygdala.

Amygdala pathway

This pathway produces rapid and substantial body reactions to protect us and, sometimes we may not know why (I suddenly feel anxious or angry and, I don’t know why).

For example, if a dog has previously bitten you, the circuitry in your amygdala may fire up every time a dog comes near you without consciously thinking about it.

If your anxiety makes no logical sense, i.e., not every dog bites, your anxiety arises in the amygdala pathway.

Modifying the amygdala pathway is where EMDR is very effective. See What happens during EMDR sessions?

Whenever my clients have anxiety, I screen for fear, anxiety, and panic and modify both pathways by using EMDR and CBT to get you better sooner.

“I’ve spent most of my life and most of my friendships holding my breath and hoping that when people get close enough they won’t leave, and fearing that it’s a matter of time before they figure me out and go.” ― Shauna Niequist, Bittersweet: Thoughts on Change, Grace, and Learning the Hard Way

“Understanding the difference between healthy striving and perfectionism is critical to laying down the shield and picking up your life. Research shows that perfectionism hampers success. In fact, it’s often the path to depression, anxiety, addiction, and life paralysis.” ― Brené Brown, The Gifts of Imperfection

“Chronic anxiety is a state more undesirable than any other, and we will try almost any maneuver to eliminate it. Modern man is living in anxious anticipation of destruction. Such anxiety can be easily eliminated by self-destruction. As a German saying puts it: ‘Better an end with terror than a terror without end.” ― Robert E. Neale, The Art of Dying

“Temperamentally anxious people can have a hard time staying motivated, period, because their intense focus on their worries distracts them from their goals.” ― Winifred Gallagher, Rapt: Attention and the Focused Life

I know it’s hard but come, let’s find out what can make you better. Nothing is worth poisoning yourself into stress, anxiety, and fear. Pick up the phone, be brave, and I will walk the journey with you.

Warmly,

Desné Doman

Clinical Psychologist

Accredited EMDR Practitioner