June 30, 2026 · by John Bieda Jr., LMFT
CBT or EMDR? How I decide which to start with
People often arrive asking for a specific method they read about. That’s useful information, and I take it seriously. But the question that usually settles it is simpler: when the symptom fires, is it about now or about then?
If the anxiety is about a real, current problem (a job, a deadline, a health scare) CBT gives you tools that work this week. If your body is reacting to a present situation the way it once reacted to something in the past, no amount of reframing will fully reach it, and we go to the memory with EMDR or Flash.
Most of my clients end up with both. Skills keep you steady while we do memory work; memory work makes the skills easier to use.