Talk:Eye movement desensitization and reprocessing

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Current status of EMDR in psychology[edit]

This article currently reads like a piece of advocacy for EMDR. The controversy section indicates there is or has been debate in the psychological community about the efficacy of this treatment, but this is buried deep within the article. The lead section is unclear about the current status of the treatment.

I am not an expert in this topic, but the promotional tone of the article is a big red flag, since articles on uncontroversial topics usually have no need to adopt such a tone. Preliminary research indicates that this treatment is still regarded with some uncertainty; for example, in 2013 the WHO recommended it for treatment of PTSD but stated that the quality of evidence was "low" and noted that "There is currently no consensus on the effectiveness of EMDR [...] between different clinical practice guidelines."[1]

Can someone in the field comment on the current scientific consensus (or lack thereof) on this topic? 67.188.230.128 (talk) 04:23, 4 April 2015 (UTC)

Thanks for getting this discussion going. The 2013 WHO report states under recommendation 14 on page 38 (referring to psychological interventions for adults with PTSD)

'Individual or group cognitive -behavioural therapy (CBT) with a trauma focus, eye movement desensitization and reprocessing (EMDR) or stress management should be considered for adults with PTSD.

Strength of recommendation: standard Quality of evidence: moderate for individual CBT, EMDR; low for group CBT, stress management'

The p37 quote 'There is currently no consensus on the effectiveness of EMDR [...] between different clinical practice guidelines' may be referring to clinical practice guidelines within WHO. But it is clear they later recommend EMDR as a treatment for PTSD in adults. Also see this WHO press release concerning the document: [2]
I'm qualified in psychology but I don't practice EMDR. In my opinion this Wikipedia article misrepresents the consensus on EMDR within the community of professional psychologists. Like I said in my comments, the treatment is considered to have efficacy for PTSD by many national professional psychologist boards including the American Psychology Association, the British Psychological Society and the Australian Psychological Society. It is an accepted and validated treatment, but you wouldn't be aware of that by reading the article in it's present state. There is far too much emphasis on the controversies, little on the mainstream acceptance. See this article from the British Psychological Society which states 'EMDR has now firmly taken its place as an established treatment for post-traumatic stress disorder (PTSD)': [3] Woodywoodpeckerthe3rd (talk) 05:03, 4 April 2015 (UTC)
The WHO paper supports that, see p189, 199. LeadSongDog come howl! 05:10, 4 April 2015 (UTC)
You're right, I misread that. The "low" quality was for the categories other than adult PTSD.
I did a bit more reading and It looks like the current views on the topic can be summed up as follows:[4][5][6]
  • Efficacy of EMDR as treatment for PTSD in adults is well-established
  • EMDR is about as effective as CBT and exposure therapy for treatment of PTSD
  • Efficacy of EMDR for other related conditions (e.g. PTSD in children) is not well-established
  • The mechanism of EMDR and role of eye movements remains a subject of debate
It seems like initial criticism focused on the lack of theoretical foundation, scant evidence (at the time), and rapid commercialization of the therapy by its inventor. As a response to this criticism, increasingly rigorous research was done which established the effectiveness of the therapy. But the theoretical foundations have yet to be fully elucidated.
Given that this is the case, the article should address this rather than simply listing the benefits of the therapy like a brochure. 67.188.230.128 (talk) 18:21, 4 April 2015 (UTC)
I complete disagree with all of this. It is a well-established treatment in that it is a structured therapy and you can receive reimbursement for it. But, that is all. Other studies have definitely shown how flimsy the research is for EMDR. The controversy is not so much whether or not EMDR works, it is whether or not the bilateral stimulation is the curative factor, or if the curative factor has absolutely nothing to do with EMDR and is more the heavy CBT and rapport-building built into the 8 phases. Having read much of the research myself, and knowing that the World Health Organization even admits to how controversial the efficacy is, I can tell you that general acceptance of EMDR is far from occurring. Furthermore, do not be surprised if research from the neurosciences completely debunks EMDR in the next decade or two. The neurosciences are demonstrating that memory more than likely does not work in the brain the way it is thought to in EMDR, which would turn the whole bilateral stimulation upside down on its head. See Antonio Damasio's book Self Comes To Mind: Constructing the Conscious Brain. Urstadt (talk) 00:51, 12 September 2015 (UTC)

References

  1. ^ http://apps.who.int/iris/bitstream/10665/85119/1/9789241505406_eng.pdf?ua=1
  2. ^ http://www.who.int/mediacentre/news/releases/2013/trauma_mental_health_20130806/en/
  3. ^ https://thepsychologist.bps.org.uk/volume-27/edition-7/emdr-more-just-therapy-ptsd
  4. ^ "Practice Guideline for the Treatment of Patients With Acute Stress Disorder and Posttraumatic Stress Disorder" (PDF). American Psychiatric Association. November 2004. 
  5. ^ Schubert, Sarah; Lee, Christopher W. (2009). "Adult PTSD and Its Treatment With EMDR: A Review of Controversies, Evidence, and Theoretical Knowledge". Journal of EMDR Practice and Research. doi:10.1891/1933-3196.3.3.117. 
  6. ^ Engelhard, Iris M. (June 2012). "Making science work in mental health care". European Journal of Psychotraumatology. doi:10.3402/ejpt.v3i0.18740. 

I'm in the field and am glad to see the lively debate here in the talk section. I see grad students and early career psychologists uncritically look to EMDR as a solution for PTSD and trauma which creates an increasing groundswell of support. Although this is probably elucidated in the articles referred to above, Shapiro reported a success rate of around 90% for EMDR as described her dissertation. This level of success is rare for any psychological treatment. It is astounding that there is so little discussion about a therapy which reported a remarkable initial efficacy but has evolved over the years only to have parity with other treatments for PTSD. As critical attention focused on EMDR she has altered the training and broadened the eye movement component to "bi - lateral stimulation" which in practice can be tapping on a client's knee's. There is not, in fact, any eye-movement desensitization happening at all. When one also considers that Shapiro alone trains those who run the workshops, EMDR looks more like a brand of treatment which has been carefully managed into legitimacy as a kind of treatment. Therapists, even psychologists, know that clients recognize the EMDR label and also know they can get paid for using it. There is little to no incentive to criticize EMDR as long as it can make the claim that it is no worse than other treatments. I also would not be surprised to see neuroscience debunk EMDR but it is crucial to remember that EMDR is a moving target. If eye-movement was dropped as a necessary component in the face of mounting criticism it would not be surprising to see the bi-lateral stimulation similarly dropped. — Preceding unsigned comment added by 172.56.42.68 (talk) 01:13, 27 October 2016 (UTC)

My understanding from a presentation that Iris Engelhard give recently (December 2016), is that many secondary working memory tasks are as good as eye movement. Additionally, I think I'm correct in saying that bi-lateral stimulation is no longer considered a satisfactory explanation, because up and down eye movements were shown to be as good as left to right. I don't think she's written a review paper yet, but part of the story is in her more recent publications (https://www.uu.nl/staff/imengelhard/0#tabPublicaties) Earcanal (talk) 10:24, 20 December 2016 (UTC)

Quality of sources[edit]

Recent edits have cited a meta-analysis from Explore: The Journal of Science & Healing. This is a crackpot journal whose editors-in-chief are leading crackpots specialising in crackpottery. It does not meet WP:MEDRS. Famousdog (c) 10:12, 7 December 2016 (UTC)

Thank you Famousdog whom i have never before encountered. Jytdog (talk) 10:19, 7 December 2016 (UTC)
Was that a pre-emptive strike against accustions of sockpuppetry? ;-) Famousdog (c) 11:07, 7 December 2016 (UTC)
no, was just saying "hi" and "very pleased to meet you!" Jytdog (talk) 18:12, 7 December 2016 (UTC)
Well, hi right back at your bad self! Famousdog (c) 08:46, 8 December 2016 (UTC)
Can only find one such edit (48) referencing half a sentence --Iztwoz (talk) 12:06, 7 December 2016 (UTC)
Fine, replace "edits" with "edit" in my previous comment - but wait, now you're citing a book as a source for EMDR being "evidence-based"? I think the threshold for sources needs to be a bit higher than that considering the arguments raging in the "Controversy" section. Famousdog (c) 13:44, 7 December 2016 (UTC)

Maybe I Don't Understand Wikipedia: What Is EMDR? with the emphasis on "is"[edit]

After a couple of years of near-elation in what I learned using Wikipedia, I now find I am notably disappointed in our articles at least half of the time. This article introduces a new type of article failure by failing to tell me What EMDR Is. I'm reminded of how I heard something like 15 radio reports of "3-D printing" about what what it could do, without hearing anything concrete of what it was. Then I stumbled upon a 3-D printer at a library that told me what the talking hadn't bothered to describe. That's exactly the problem here! Anyone able to include a photo of someone giving EMDR?

Paragraph one calls it first a form of psychotherapy. Okay. No problem there, but I knew that, and there are, oh, either 26 or 89 forms, differing greatly. Para. 1 goes on: this form does something with distressing memories to help with mental illness. All psychotherapy does that, doesn't it? We have three pages of text here that tell me Very Little of what that "something" is. Anyone care to help with this? I can't, since I don't know. No one else can learn what EMDR really IS on this page, either, as of Apr, 2017.

Maybe the article should be retitled "Effects and Controversies about EMDR." That way no one pretends to be telling me what is in any detail.


Paragraph 3 may come closest. It talks of having "the patient recall distressing images while receiving one of several types of bilateral sensory input, such as side to side eye movements." How is such normal movement of eyes "bilateral sensory input?" Para. 3 also speaks of 8 phases. Is side-to-side eye movement one of these phases, or is it really the whole technique?

Yet later we write of EMDR without eye movements: "no difference between control no-eye-movement control groups and EMDR-as-written experimental groups." Again "no difference between eye-movement experimental groups and no-eye-movement controls." Soon it speaks of "finger-tapping," but--Guess What--nobody bothered to spell out what that is. This isn't supposed to be an article by therapists, for therapists.

To conclude: suppose my 10-year-old wanted to know what EMDR was. We'd need a demonstration. Nothing in the article today would help us know What or Where (on the body or elsewhere?) or How to demonstrate something, except that maybe it had something to do with the eyes, except that some versions don't. If my 10-year-old had never seen an orchestra conductor, we could show a video of one and say it was an example of EMDR and nobody could prove us wrong by concrete, specific info given on dear Wikipedia's article on Apr 2, 2017. — Preceding unsigned comment added by Moabalan (talkcontribs) 17:12, 2 April 2017 (UTC) I forgot to sign