From Abracadabra to Zombies
reader comments: EMDR
10 Mar 2012
Hello Dr. Carroll,
I unhappily read your essay on EMDR.
reply: Sorry to hear that. If you'd read it when you were happy, you might have read it differently
I was one of the first therapists trained in EMDR. I had seen Dr. Shapiro at a symposium at U.C. Berkeley and the presentation had made sense to me. I subsequently had EMDR from her, for troubling memories from a car accident, and the symptoms of flashbacks, intrusive memories, etc., had desisted.
reply: Nothing I say about EMDR conflicts with your account so far.
I have used this technique extensively with PTSD troubled people for many years now: victims of rape, child abuse, auto accidents, war, torture, etc. I worked in the U.S., Kosovo, Afghanistan, Pakistan, India, Germany, Canada, using this method and ALWAYS have had wonderful results for people.
reply: Always? That's amazing. I've never heard of any therapy for anything that was 100% effective for everybody. How much follow-up did you do on all these patients?
This particular form of tx is not easy to explain in terms of cause of efficacy. I myself use hand tapping, and I think the bilateral stimulation is one of the factors affecting the events that produce a positive outcome.
reply: Actually, there is an extensive literature on cognitive behavioral therapy, how it works and why it works. Hand tapping, making clicking noises, moving the eyes, and the like have yet to be shown to have any unique significance in the process. You may think "bilateral stimulation" is significant, but why not design a study to test your belief?
Once at a professional therapist's conference I attended, a man based his entire presentation on dumping on EMDR by attacking Dr. Shapiro's character. She was not present to defend herself. I inquired from the audience if he had taken the EMDR training, or ever had the EMDR tx, and he said "No". I calmly said that I thought his criticisms were not grounded.
reply: And you tell me this because...?
When this EMDR first came out, we had no research to back it up, but many of us therapists who were using it and witnessing the wonderful healing results for people, helped her in the trainings, unpaid, because we could see and heard from the recipients, of the healings.
reply: Again, nothing I write about EMDR conflicts with your claims. I never claim that PTSD patients aren't helped by this or any other therapy. I claim--and make it quite clear, I think--that the studies done in support of EMDR fail to provide evidence for the effectiveness of EMDR's eye movement component. We must distinguish the efficacy of a treatment from the effective mechanisms used in the treatment. My criticism is of the claim about the importance of eye movements, hand tapping, clicking, or other kinds of actions that have never been shown to be essential to effective cognitive behavioral therapy.
I have been to "serious" places like Afghanistan and Pakistan, Kosovo, and I am not interested in using methods with people greatly suffering if I am not convinced by grounded experience, that the methods work.
reply: Nor should you be concerned with methods that don't work. But you are speculating about hand tapping and bilateral stimulation. If you are as successful as you say you are, your success may be due to other things involved in your treatment of patients.
I have used this for gunshot victims, rape victims, torture victims, auto accident victims, etc., always with wonderful results.
reply: Always? I find such claims dubious and am very suspicious about claims regarding a treatment that works for everybody all of the time. How do you find the time to do the necessary follow-up work to justify your claims?
It seems that trauma memory is not stored the way normal memory is, it seems it may be stuck in short-term memory, vivid, intense as compared to other memories, like remembering the first grade. Somehow the process of the protocol and the bilateral stimulation seem to cause the "stuck" trauma memory to be processed by the body into history, into long-term memory. We know the event happened, it is part of our life experience, but no longer triggers strong anxiety responses. Interference with normal life does not continue. Things like nightmares, flashbacks, intrusive memories, etc., desist and don't return. People who haven't been able to sleep for months begin right away to sleep. Things that used to trigger anxiety reactions no longer bother people. People report feeling stronger and more peaceful.
reply: I await your study on memory to demonstrate that traumatic memories are "stuck" in short-term memory. We know which part of the brain is involved in emotional memories and that people can learn to avoid triggers of anxiety. Designing your study should be a snap, especially since you always get positive results. Before setting out on this path, however, you might want to read up on cognitive behavioral therapy and memory so you don't waste your time repeating what others have already done. I predict you will not find much evidece for the necessity of eye movement, belly tapping, tongue clicking, or crinkling paper to relieve suffering.
You've chosen to focus on something that has brought much relief and healing to at least, many thousands. Don't you think your ungrounded (you are ... not a trained therapist with experience in this right?) criticism has negative consequences on this now tried-and-true over many years healing technique? Chasing people away who are suffering and looking for valid means to heal from symptoms that are ruining and upsetting their lives by playing into their fears?
reply: You've chosen to focus on the same thing I have, so why don't you examine your techniques with a bit more scrutiny and skepticism. Drop the speculation about stuck memories and bilateral stimulation. Do the research. Try the therapy without the hand tapping. Try rubbing the patient's cheek gently with the back of your hand or giving an occasional foot massage. Vary the hand tapping routine and keep good records, do follow-ups, publish your results in a peer-reviewed journal.
Please give more thought, not a reaction. Give yourself some time to think about this.
reply: I have and I hope you will do the same. You might start by reading the comments from others below.
Best Regards,
(name withheld) M.S.
__________
22 April 2011
I would like to thank you for your insightful, and in my opinion accurate, depiction and evaluation of the effects of EMDR therapy.
While I tend to be a skeptic by nature, I do have an open mind. When I was given the opportunity to be treated with EMDR for post-traumatic stress disorder (which I acquired after a traumatic birth that resulted in the loss of my twin daughters), it seemed rather, well, silly. How could talking about the events while surrounded by all sorts of bells, whistles and lights, heal the emotional devistation I endured? But, I was willing to try it based on my therapists enthusiasim for the process and hopes of finally coming to peace with my loss.
I do realize, going into this, I had already somewhat formed an opinion that an individual trained in a process will tend to believe fully in its benefits, causing a placebo effect easily transferred to the client, almost infectious if you will. I hardly think, however, that if there is a true physiological component to EMDR that my skepticism could possibly affect the results. After completing the treatment, I'm afraid that I had no results, either positive or negative...the PTSD went on as usual until, a few years later, I found a very good therapist who was able to help me through my issues through traditional psychotherapy.
To be honest, my 'failure' at finding relief in EMDR left me feeling perhaps there was something wrong with me, so the therapy was ultimately counterproductive in my case. It wasn't until I read your discussion on the topic that I realized my results were probably the most logical, whether they were typical or not.
I read quite a few of the discussions wherein either providers or recipients touted the great success of EMDR and felt that the other side of the coin should be represented by one who had no success from the process. Thank you, not only for providing a logical explanation on this topic, but for your dedication to all things that deserve to be investigated by the eye of a skeptic.
Sincerely,
Cynthia L. Ward
_________
19 Sep 2004
I wanted to supply a refreshing perspective on the topic of EMDR. Placebo effect, real effect, whatever - after 48 years on the planet with 25+ of those in therapy as an abuse victim, I can honestly say the breakthrough to "reasonable normalcy" was timed with the start of EMDR two years ago. Now I close in on turning 50 with a newer view of life. I am a trained biologist, schooled in the ways of scientific method. Some things are just not worth waiting for. I am pleased my therapist learned EMDR. I appreciate your skeptic's forum, and the comments are interesting to measure against my real experience. It may never be known if it is EMDR itself or something else, but in my case my attitude is "who cares?" It works. Thanks and all the best.
D.
reply: I think it would be more accurate to say "I'm better" than "it works." Like you say, it may never be known if EMDR or something else contributed to your recovery. Your therapist believes in EMDR; otherwise, why train in it and use it? This belief may contribute to his/her overall confidence and effectiveness. So, in some sense it may be true that EMDR has contributed to your recovery. Most likely, your therapist employs some form of cognitive/behavioral therapy techniques, which are know to be effective. Is it likely that your therapist has a 100% success rate with patients? No. No matter how good your therapist is, I would be surprised if he/she has more than one-third satisfied customers. Like you, many of them might be willing to provide a testimonial for EMDR because "it works." Why does it matter that "it works" means no more than "I feel better"? It matters because many therapies are promoted solely because they work, i.e., have satisfied customers, when in fact these therapies are irrelevant to treatment or objectively ineffective. The testimonials attract more people into the therapy and provide false hope to many people. (This is especially dangerous if the therapy is some quack cancer cure or quack alternative treatment for the mentally ill.) Your therapist, using the same techniques as he/she uses today, might not have had any effect on you twenty years ago, when you were much younger. On the other hand, this therapist may have helped you greatly without EMDR twenty years ago. We can speculate about such things endlessly but the fact is that there is no evidence that having a patient follow a light with his or her eyes while undergoing treatment is anything more than a sideshow flourish.
21 April 2004
Nobody knows how aspirin works either, but it definitely works.
reply: Aspirin stops cells from making prostaglandins.
Are all of your books critical about things you know nothing about?
reply: All my books? You make it sound like I've written bunches of books. I've only written three, but it is true that one of the requirements for getting them published was that I not know anything about the subject matter. I'm especially proud of my doctoral dissertation. Getting that one published without knowing anything required skill.
EMDR worked for me and that's proof enough for me; my therapist tried visual and auditory and auditory worked better.
reply: Proof of what? That EMDR works? There are two meanings to "works." One is the one you are using. Those patients who went to an EMDR therapist and did not come away satisfied customers will say that EMDR doesn't work. The other meaning is the one used by scientists. To work in a scientific sense would mean that the therapy has been tested against some sort of control, perhaps another kind of therapy. For example, EMDR has been tested and compared with writing therapy and the two were found to be equally effective.
If you read my article carefully, you will find that I don't claim EMDR has no satisfied customers (works in sense one). Nor do I claim that EMDR is not an effective therapy (works in sense two). What I claim is that there are no studies that show that the eye movement aspect of the therapy is necessary.
Dr. Richard Spates has published several studies on EMDR. He has found that the success of the treatment is due to exposure to the feared stimulus. It has been known for several decades that exposure to a feared stimulus is effective in the treatment of the kinds of things that are generally referred to these days as post traumatic stress disorder. As noted in a letter below, "The eye movements and all other forms of wiggling are just artifact." Apparently, many EMDR therapists use various sounds as part of their therapy.
I've also spent a summer of my pre-med studies working with a neurologist on brain research. There are many plausible reasons why EMDR works -- diffusion and rerouting of connections for one/two. Besides, it's not just moving eyes -- it's what the therapist asks the patient to think about while the visual or auditory stimulus is happening. Just moving the eyes or listening to alternating clicks won't work. There are also exercises to do with your mind between the sessions. But, hey, you never took the training to learn that, did you? You never had PTSD so bad that every waking moment was agony, did you?
reply: No, I've never had PTSD. But what you write is what I am trying to convey in my entry on EMDR. My point is slightly stronger: the eye movements aren't needed at all. When you write "it's what the therapist asks the patient to think about while the visual or auditory stimulus is happening" you have hit the proverbial nail on its proverbial head.
I should have known you'd be a philosophy PhD, a breed of smarty that typically enjoys criticizing more than learning. Maybe you should actually learn about new studies about the role of the occipital lobe and hearing centers of the brain in PTSD and how they connect with the amygdala and hypothalamus before you go writing yet another book lumping EMDR with witchdoctors and voodoo.
reply: Now that you have the PTSD under control, you need to work on the anger.
As for success rates with EMDR with blind people, well there are degrees of blindness. Try this: facing a light, close your eyes. Wave your hand and move your fingers between the light and your closed eyes. You can see something, even though it's blurry. You can also feel differences in temperature and movement. It's not surprising at all that blind people could have success with visual EMDR.
If you can stand yet another anecdote: my 20 years of hell and agony is over and I'm now able to focus on goals, get some decent sleep without nightmares, don't break into cold sweat at triggers, and don't have an irregular heartbeat. No more terrifying flashbacks. Oddly enough, my blood pressure has gone down enough to cut usage of 2 of the meds in half.
You don't benefit anyone by trying to convince people that EMDR doesn't work. It doesn't work on everyone. Neither does Motrin. But EMDR does help enough people to at least offer it if a patient is suffering. It is always the patient's choice to participate.
reply: EMDR is another name for a type of cognitive/behavioral therapy, which is known to be a successful therapy for a number of emotional disorders. The eye movements, the music, the sounds, the taps, the lights, etc. are diversions and distractions from why the therapy works (i.e., has some satisfied customers).
Good grief, man. Your logic skills are atrocious. How on earth did you ever get a professorship in philosophy?
Jackie Peterson
reply: I have good people skills, I'm very good looking, and I never respond to an ad hominem on an empty stomach.
18 Feb 2004
I came into contact with your website and publication(s) while doing
research on UFOs for a multimedia project our company was doing. Over
time, I have thoroughly enjoyed, and applauded, your work debunking
nonsense.
However, I must take issue with your "debunking" of EMDR. I know, through the experience of my wife, that this method -- or something close to it -- has made an incredible difference in her life. And mine. She suffers from PTSD and is a torture survivor. EMDR -- for whatever reason(s) -- works. I also know a Holocaust survivor who has made remarkable progress that didn't happen with 15 years of traditional therapy.
Whether any of the accompanying claptrap, or others versions of EMDR touted by others, have any validity at all, I don't know, nor care. I can only say that from a very personal experience, it is working wonders and deserves serious investigation into those specific reasons as to why it works and not into proving it doesn't.
C. L.
reply: I agree and the evidence so far seems to support the notion that what works in EMDR is what works in traditional cognitive/behavior therapy and has nothing at all to do with eye movements or brain restructuring.
2 Jan 2000
Dr. Richard Spates, a behavioral psychologist out of Western Michigan
University, presented a component study of EMDR at the annual convention
of the Association for Behavior Analysis, several years ago. He found that
the crucial component for therapeutic success was exposure to the feared
stimulus. This is consistent with over 40 years of published research in
behavior therapy. The eye movements and all other forms of wiggling are
just artifact.
Robert M. Stein, Ph.D.
Center for Neurobehavioral Health, Ltd. Lancaster, PA
1 Sep 1997
I read your material on EMDR questioning its validity and veracity. Whereby your skeptics
approach in many situations is refreshing and well needed, in this case you missed the
boat. I have been an EMDR therapist for the last four years, following 15 years as a
conventionally trained clinician, and I can prove to you it is an remarkably effective
clinical tool when correctly incorporated into a diagnostically sound treatment situation.
I have successfully treated 30 engineers from the Long Island Railroad in the last two years suffering from PTSD (Post Traumatic Stress Disorder) resulting from accidents and suicides in front of their trains (which occur every 2 to 4 weeks). In one two three extended sessions (1 1/2 to 2 hours) I have been able to resolve not only acute but chronic trauma, in some cases resulting from up to six such incidents. EMDR is now the accepted mode of psychotherapeutic treatment for PTSD by both the LIRR EAP (Employee Assistance Program) and the union local (Brotherhood of Engineers) and most importantly the engineers themselves. Any I have treated would be available to speak with you.
In addition, through the EMDR HAP (Humanitarian Assistance Program) I have led Pro Bono Trainings of 150 therapists in EMDR in Northern Ireland (in October 1996 and June 1997). So many trauma sufferers have accordingly been helped in such a short time that the Central Government of Northern Ireland and their Department of Health is recommending that EMDR should be available to all its citizens as a treatment for PTSD.
Dr. Bessel Van Der Kolk, a world famous Harvard University psychiatrist and researcher is conducting pre and post EMDR SPECT SCAN studies with PTSD suffers and is showing positive changes in brain activity after the treatment.
Bob, I have heard you on the radio and been very impressed by your observations. However, this time your arrow has missed the target completely. I am challenging you to either personally experience EMDR administered by myself or observe me working with a PTSD sufferer of your choice.
If you do not agree to this at a convenient time and place, perhaps you should have your skeptics spotlight turned on yourself!
Will you accept the challenge?
Sincerely,
David Grand
reply:Do you have evidence that the effects you observe are not due to chance, the placebo effect, patient expectancy, posthypnotic suggestion, etc. Have you done any controlled studies that demonstrate that any positive effects achieved by EMDR are not likely due to some other factor?
You mention the successful treatments you have witnessed. I don't doubt your claims. How can you be sure that what you are effecting is due to EMDR?
Even if changes in brain activity are detected, how will you know that those changes were caused by EMDR or that they were significant changes in bringing about a "cure"? Changes in brain activity may indicate that memory has been restructured, but the issue is whether using eye movements, ear or hand taps, etc, had anything to do with it. The other aspects of the therapy may be more significant, particularly any attempt to change the patient's memory or belief system by encouraging association of pleasant or neutral thoughts with a traumatic experience or the dissociation of unpleasant thoughts with a traumatic experience. It may be that EMDR therapy is replacing or disconnecting the emotional memory of a traumatic experience. It may be that EMDR therapy is providing new associations with memory fragments that are now interconnected with emotional memory and that this diminishes the potential stimulation effect of the memory fragment to bring back horrible feelings. But the study which isolates the eye movement, hand taps, etc., from the other aspects of the treatment still needs to be done before we start speculating as to how EMDR works. For all we know, EMDR therapists may be doing things very similar to what is done in cognitive therapy, along with their eye movement treatment.
I don't deny that EMDR might in fact be doing all the things you say it does, but until we have more evidence, I will remain skeptical about what is effecting the cure.
2 Sep 1997
I don't know why you believe EMDR has not been validated by controlled studies. Many have been conducted (I can send you reprints) with the major study by Wilson, Becker and Tinker (Eye movement desensitization and reprocessing [EMDR] treatment for psychologically traumatized individuals) published in the Journal of Consulting Psychology in 1995 63(6) pp 928-937. They have also followed up with a larger sample yielding similar results.
People with EMDR expertise have observed that in addition to left/right eye movements, alternating tactile (hand tapping) or auditory (tones) elicit the same rapid reprocessing effect. I have recorded an stereo audiotape which has pleasant music with tones that alternate to the left and right ears. In error, a batch of these tapes were recorded in mono. When I used these defective tapes in session, unbeknownst to me, I received no clinical response. I was baffled and I checked the tapes to discover that the tones were not being delivered bilaterally. Dr. Sandra Shapiro (no relation to Francine Shapiro) a research psychologist in the graduate psych program at Queens College will be using the stereo and mono tapes to conduct research on the validity of EMDR.
You question whether chance, the placebo effect, patient expectancy, posthypnotic suggestion could result in the hundreds of patients who have brought full blown PTSD symptoms into my office and left without them, oftentimes in one or two sessions. These results have never been accomplished in the past, even by chance, the placebo effect, patient expectancy, posthypnotic suggestion. How can that be explained?
Face validity reflects the idea, I saw it with my own eyes. If you saw a man steal a
woman's purse in the street five feet away from you, would you need to prove to someone
that it happened. You could come up with alternate explanations (someone slipped you LSD
at lunch) but what we see in front of our eyes should carry some weight. Again, I invite
you to personally experience or observe me work with someone of your choosing. Can seeing
something with your own eyes have any validity to you?
David Grand
reply: Shapiro summarizes the Wilson, et. al. study as follows:
S. Wilson, Becker, and Tinker (1995). A controlled study randomly assigned 80 trauma subjects (37 diagnosed with PTSD) to treatment or delayed-treatment EMDR conditions and to one of five trained clinicians. Substantial results were found at 30 and 90 days and 12 months post treatment on the State-Trait Anxiety Inventory, PTSD-Interview, Impact of Event Scale, SCL-90-R, and the SUD and VOC scales. Effects were equally large whether or not the subject was diagnosed with PTSD.
Apparently not all psychologists agree that either these "substantial results" proved anything significant or that this study demonstrated the significant effectiveness of EMDR. You seem to think that the issue is whether subjects score lower on a stress inventory test or whether subjects report that they are better or whether you perceive them as better after treatment. My questions are not about those issues, but about what in the treatment, if anything, is effecting the "cure"? The treatment seems to involve many things, some of which are not new in treatment, and I am waiting for the evidence that controlled studies have isolated the "eye movement desensitization reprocessing" as the new and improved clinical method effecting these successes.
16 Oct 1997
Bob,
I picked up this quote on the internet: It may be a good illustration of the difference
between negative bias and skepticism.
Real skeptics would have been curious about unexpected findings, they would not have ignored them and they would not have been distressed by them. About 95% of the people I've encountered who described themselves as skeptics had committed themselves to a viewpoint way too early to claim the title. Real skeptics, people who are able to reserve judgment, are rare.
I am available for an open, honest comprehensive examination of all the data from
all sides of this issue. Are you?
David Grand
reply: I take it that your point is that I am not a "real" skeptic because I have come to a conclusion about EMDR (and many other things). Either that, or you are implying that I have ignored the "findings" of therapists such as yourself about the successes treating PTSD subjects and that I have come to my conclusions "way too early." I'll try to clarify my position one more time.
I do not challenge the claim that many people with PTSD are helped significantly by EMDR. I am skeptical of the explanations given for the successes, both theoretical and practical. The theoretical explanations as to how EMDR "might" work are, to be charitable, unconvincing. They amount to little more than contrived speculation with no basis in research or testing. The practical explanations, however, are what I most take issue with. Let's start at the beginning.
Francine Shapiro announces she has a "new" therapy which can be a tremendous help to millions of people around the globe who suffer emotional distress due to witnessing or experiencing severely disturbing events such as acts of war, violent deaths, etc. She hasn't done any scientific research yet, but she has studies underway. This great new therapy which can help millions is not announced in a reputable scientific journal, backed up by reputable scientific studies. Instead it is announced as an invitation to get in on the ground level. The therapy is for sale. You pay your money to get trained and certified by the founder and you promise not to teach others this latest boon to all humankind. Eventually some studies get done but they are all done by those who have paid their fees and got trained in EMDR. What a shock that all the studies validate the therapy and have not the slightest bit of skepticism in them! Every one of us has to be concerned about selective perception, but researchers who set out to validate what they are doing are especially prone to ignoring counter-evidence because they simply are not looking for it. They don't try to disconfirm a hypothesis but to prove one. If you do not understand why this is not considered good method, then I am probably wasting my time communicating with you. Not only did the cart get put before the horse, but because this therapy has not been explained in detail in reputable scientific journals, independent researchers can't test it. By the time independent researchers get enough information about this therapy to do some meaningful testing, it is already well-established and can point to the fact that it is successful. What it can't point to is evidence that this "new" therapy isn't just an "old" tried and tested therapy wrapped in some new metaphysical swaddling or psychobabble gobbledygook. When one tried to find a controlled study where a group of PTSD patients are given EMDR treatment and others are given exactly the same treatment minus the eye movements, ear taps, or knee taps, one searches in vain. Instead, one sees study after study which show that compared to some other treatment, EMDR is more successful.
I don't know who you got your quote from, but I wonder what kind of skeptic admires a person who claims she can help humankind with her new treatment but won't reveal it unless you pay her to take her course in the treatment and agree not to teach anyone else the method? Does this sound like a "real" scientist to you? Is this the kind of person you admire and wish to follow? I guess so.
24 Nov 1997
I read with interest your correspondence regarding EMDR. You appear to be basing your views on a great deal of misinformation.
1) EMDR was not offered as a treatment without research. EMDR was announced to the field of psychology with the publication of a controlled study published in the Journal of Traumatic Stress (Shapiro, 1989). The data were subsequently reported in another article in the Journal of Behavior Therapy and Experimental Psychiatry (Shapiro, 1989). At the time of these publications there were few studies of treatments for post traumatic stress disorder (PTSD) and all the other reviewed treatments (Solomon, Gerrity and Muff, 1992) were regarded as marginally effective.
reply: from Hearst & Milkewicz: "Although her research was encouraging, there were limitations to this study. All of the treatment and assessment was done by Shapiro, hence demand or other non-specific effects could account for part of the treatment effect. Heart rate was only monitored for the treatment group, which may have created a difference in expectations. Furthermore, the diagnostic criteria were unclear and the only standardized measures were self-reports (Greenwald, 1994)."
2) The instructions regarding the method were not hidden. Both Shapiro articles contained instructions regarding the procedure as it had been developed at that time. At that point it was viewed simplistically and called EMD.
3) EMDR was not offered as "therapy for sale" or held hostage. Specialized training was deemed mandatory for client protection when the complexity increased and sufficient feedback was received (see Shapiro, in press, Innovations in Clinical Practice). This need for training was declared ethical and preferable by an independent discussant at an APA symposium (Nurse, 1996). People were asked not to teach others when it was found that participants had taught their versions to lay hypnotists and massage therapists and clients were getting hurt. As a psychological method, EMDR should only be used by a trained and licensed mental health professionals.
reply: ibid. "Soon after EMDR’s discovery, Shapiro began holding workshops at hotel conference centers around the country. These workshops included the eye-movement technique, a package of clinical skills, and 7 hands-on practice sessions. Since 1991, the training has been revised to include "Level I Basic" and "Level II Basic". Shapiro’s possessiveness of EMDR techniques has been controversial. She insists on personally conducting the workshops and having the trained individuals sign a contract stating that they will not teach anyone else these skills. This restriction has been viewed negatively by many clinicians. For example, Herbert and Meuser (1992) argued that ". . . such a restriction of information runs counter to the principle of the open and free exchange of ideas among scientists and professionals" (p. 173, as cited in Acierno et al., 1994)."
4) Validation was not produced because researchers were biased by fee payments. Pro bono EMDR training has been provided to all researchers upon request.
reply: I haven't suggested that validation was produced because researchers were paid. In fact, I haven't questioned that EMDR has helped many people. What I have questioned is whether EMDR really is a "new" therapy or just old wine in a new skin. I have no doubt that EMDR works as well as or better than most psychotherapies. I guess I should have asked what other discipline would have granted a doctoral student a Ph.D. on the basis of such work? I have also questioned the validity of all the hype that EMDR is a panacea: "Another controversial point has been the proliferation of EMDR workshops for a wide variety of clinical problems (Marquis, 1991). The list includes agoraphobia and panic disorder, child trauma, learning difficulties, sexual abuse, multiple personality disorder, somatic disorder, obsessive-compulsive disorder, smoking cessation, and eating disorders (Greenwald, 1994)." [ibid.]
5) EMDR has not been inadequately researched. The fourteen controlled studies completed on EMDR as a treatment for PTSD make it the most heavily researched and supported method for the treatment of trauma.
6) The four most recent, rigorously controlled studies consistently indicate that 84-90% of single trauma victims no longer have PTSD after the equivalent of three 90 minute sessions (Marcus, Marquis & Sakai, in press, Psychotherapy; Rothbaum, 1997, Bulletin of the Menninger Clinic; Scheck, Schaeffer & Gillette, in press, Journal of Traumatic Stress; Wilson, Becker & Tinker, 1995 and in press, Journal of Consulting and Clinical Psychology)
reply: Yes, but there are studies which are not so supportive: "However, several studies attempting to replicate earlier findings of EMDR’s apparent efficacy failed to do so. Oswalt, Anderson, Hagstrom and Berkowitz (1993) reported that the technique was successful with only 3 of 8 people volunteering for treatment to relieve traumatic memories or anxiety related to traumatic memories. Furthermore, the most seriously disturbed participants, whose intrusive memories included scenes of chronic child abuse and being raped at knifepoint, showed the least benefit. In fact, 4 of the 5 hospitalized participants failed to complete the single-session treatment because their memories were too distressing and the EMDR was having no ameliorative effect. The 3 college student participants who reported significant decreases in their SUDS ratings had much milder memories of breaking up with a boyfriend, witnessing a confrontation between family members, and fainting during an operation on an animal." [ibid.]
7) EMDR is not currently viewed as merely a simple eye movement technique. EMDR has been described at an integrated method of treatment that contains a blend of the major psychological orientations (Hyer, 1997; Shapiro, 1995; Shapiro & Forrest, 1997). The stimulation such as eye movements, handtaps or tones is simply one component of a complex method. Component analyses to consider the weighting of this one factor in the therapy have nothing to do with its overall effectiveness. Since no other peer reviewed studies of PTSD treatments reveal the substantial clinical treatment effects consistently reported in independent controlled studies of EMDR, explanations such as placebo, expectancy, or "old wine in new bottles" is untenable.
reply: Perhaps EMDR therapists could get the same dramatic results without the eye movements, handtaps or tones. If so, that would indicate that it is the other elements of the therapy that are efficacious. But no one has claimed any of those other elements are unique to EMDR.
8) Training is no longer restricted since standards of practice have been established and since it is no longer considered experimental. The EMDR International Association is a non-profit professional organization independently established by EMDR clinicians and researchers (www.emdria.org). It now oversees EMDR training policies worldwide. In addition to multiple training organizations, numerous graduate programs have incorporated EMDR courses.
I hope you will take the initiative in checking the veracity of this information, and informing your readers.
Charles Shapiro
reply: Suffice it to say that studies are ongoing.
EMDR
