What's the difference between EMDR and expressive writing?
STUB — fundamentally different mechanisms. EMDR (Shapiro): trauma memory is incompletely processed, bilateral stimulation enables reprocessing through dual attention. Expressive writing (Pennebaker): trauma is incompletely narrated, structured writing enables narrative coherence. EMDR has strong PTSD evidence (VA/DoD strong recommendation); generic expressive writing does not. WET sits between them, methodologically closer to exposure than to EMDR.
Is EMDR better than expressive writing for trauma?
STUB — by guideline evidence, yes for active PTSD. EMDR is one of three first-line trauma-focused treatments (with PE and CPT) per VA/DoD 2023; generic expressive writing is not a guideline-endorsed PTSD treatment. The comparison is not really like-vs-like; EMDR is a structured therapy delivered by trained clinicians, expressive writing is most often a self-directed practice.
Can expressive writing replace EMDR?
STUB — for active PTSD, no. For post-EMDR integration work, residual identity reorganization, or the symbolic/depth material that EMDR's reprocessing surfaces but does not always close, expressive writing can be useful adjunct. The protocols address different stages of the work.
Does the eye movement in EMDR actually do anything?
STUB — debated. Lee & Cuijpers 2013 meta-analysis of the bilateral-stimulation component: additive effect Hedges' g=0.41 in clinical samples, g=0.74 in lab samples — bilateral stimulation is not inert as some critics claimed. The mechanism is not fully understood; working memory taxation is the leading account.
Which should I try first, EMDR or expressive writing?
STUB — for diagnosed PTSD, EMDR (or PE, CPT, WET — the four first-line trauma-focused treatments). For subclinical distress or post-protocol integration, expressive writing makes sense. The presenting concern's clinical severity should drive the choice; popularity should not.