View source for Talk:Eye movement desensitization and reprocessing/Archive 2

{{talk archive|period=March 2007-July 2009}}
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==all my comments were removed ==
The changes i made on Monday appear to have been removed without discussion.

I changed the previous content because it was out of date and inconsistent with emerging literature (last two years). This was necessary as the conclusions on the pages were firstly at odds with the findings of committees from around the world that EMDR is evidence based practise.  Hence the section titled ‘Effectiveness: expert consensus guidelines’.  Their resultant views are likely to present a more balanced view than what I read when I opened the page last week.  I think this section needs to stay and only be chaged when new guidelines emerge.

Secondly any suggestions that the treatment is not an empirically supported is absurd.  Especially given recent studies such as Van der Kolk's et al (2007) work published in the Journal of Clinical Psychiatry that EMDR out performed Fluoxetine, Rothbaums large and very rigorous study published in Journal of Traumatic Stress on EMDR versus traditional exposure, the most recent meta-analytic study by Shidler and Wagner (2006) in Psychological Medicine.  Any discussion on effectiveness needs to consider current studies. 

Thirdly the article ignores reviews and a process study by implying that EMDR works the same as traditional exposure.  WE now know this does not seem to be the case for details see 
Lee, C. W., Taylor, G., & Drummond, P. (2006). The active ingredient in EMDR; is it traditional exposure or dual focus of attention? Clinical Psychology & Psychotherapy, 13, 97-107.
Any discussion on mechanism of action needs to account for process studies on the methods.

Finally I found it very odd that a science based publication was describing the recent history of what happened to an institution that once provided training to a currently licensed practitioner.  Seemed liked a personal attack to me not a scientific argument. 

<small>—The preceding [[Wikipedia:Sign your posts on talk pages|unsigned]] comment was added by [[User:Dr Chris Lee|Dr Chris Lee]] ([[User talk:Dr Chris Lee|talk]] • [[Special:Contributions/Dr Chris Lee|contribs]]) 05:33, 21 March 2007 (UTC).</small><!-- HagermanBot Auto-Unsigned -->

I appreciate all the effort that you made, and agree that it is important Wikipedia articles be current. I suggest however that a section on CONTROVERSIES be added, as this is an important part of EMDR's history. Also there are still some individuals who are opposed to this therapy.  [[User:Lmaxfield|Lmaxfield]] 10:52, 21 March 2007 (UTC)

: the evalution section and the controversy section require integration I think. It is not relevant if someone supports or opposed the method, it matters that the presentation of material be npov.  [[User:Fremte|Fremte]] ([[User talk:Fremte|talk]]) 19:31, 9 March 2008 (UTC)


I am not sure if the evaluation section and the controversy section should be integrated. By the evaluation section I assume you mean the 'emperical evidence regarding EMDR' section.  I do not see how one would integrate these two sections.  The emperical evidence either demonstrates that EMDR is effective, or not, that it is either considered efficacious in the treatment of trauma, or not, that it is better, equal, or not as effective as other therapies and so on. This section requires a simple balanced presentation of the literature that describes the current status of these findings. - And as mentioned above, it is absurd to suggest here that EMDR is not emperically supported. EMDR has established efficacy in the treatment of PTSD. This is not a point of controversy.
  
The controversy, as is seems to be presented here, is a seperate issue from EMDR's effectiveness. The controversy is whether eye movements are a necessary component of effective treatment. The second controversial point is whether EMDR is similar to traditional exposure. A presentation of these issues should be kept seperate, as at this time, unlike evidence for EMDR's effectiveness, there is no clear evidence either way - although there is evidence now that EMDR is not exposure, and that using EMDR without eye movements results is less effective outcomes.  

What appeared to be missing from the controversy section was a presentation of the seperate body of literature that has explored what effects eye movements have on memory, cognition, and physiology during the process of EMDR.  I have added a summary of this.  I have also added some references of research that has demonstrated that eye movements are a necessary component to treatment(i.e. Wilson et al., 1996; Shapiro, 1989; Boudewyns et al., 1993; and Gosselin & Matthews, 1995).  I can see that I have added only research that supports the necesseity of eye movements in EMDR, but to date, I am not aware of any scientific research that has shown EMDR to be effective without the eye movement component. [[User:Sschubert|Sschubert]] ([[User talk:Sschubert|talk]]) 14:48, 2 April 2008 (UTC)

==Outside reader==

Hey, what happened to the debate, the criticism, the scientific research, the citations? Did that last editor Lmaxfield mean to remove it all?[[User:Fainites|Fainites]] 21:44, 25 February 2007 (UTC)

Hi
My effort was to remove the many errors in the article, and to update it with accurate scientific information.  EMDR is an established psychotherapy. I retained mention of the critics. I emphasized the scientific research and added citations.  I added many more citations than the original article contained. Do you want more citations? I would be happy to add more; I was not sure how many there should be. For example, there are about 20 randomized clinical trials on PTSD treatment with EMDR; 10 of these are recent. Do you want the citations for all these?  Also there are 5 meta-analyses showing EMDR and CBT equivalence.  I only cited 2.  SHould the others be added?  Also there are about 10-12 international treatment guidelines stating that EMDR is a level A recommended treatment for PTSD. SHould these be added as well? thanks Louise Maxfield

Maybe I was looking at it when you were in the middle of it all as yesterday evening all scientific citations had disappeared! I was just posting a warning in case it was vandalism. Glad to see them all back. I've added a link to Devilly 2002 [[User:Fainites|Fainites]] 18:24, 26 February 2007 (UTC)

Thanks. I notice that the footnotes are not showing up on the page.  Is there something I am missing about how to make that Happen?  Thanks Louise Maxfield

I've gone through the first paragraph and fixed the refs and given you a proper notes and references section. If you type out the refs properly (just copy what I did or look at this link cos it's different for books,[http://en.wikipedia.org/wiki/Wikipedia:Footnotes]) it does all the refs for you. Once you've fixed all the refs you can get rid of the previous ref section. You need to add in the full title and citation. The idea being than anybody can then look it up, either by googling the title and name, or preferably if you can add a direct link. If you want any more help, don't hesitate to ask, but I've not that long worked out how to do it myself! Also, your posts don't give your name and time and date. If you're logged in, just press 4 tildas and it does it automatically.
: on content, I don't think that if there are 5 meta-analysis you should only add two positive ones in the intro when the biggest, Devilly's, is not positive.[[User:Fainites|Fainites]] 22:19, 26 February 2007 (UTC)Also the Bradley one has huge limitations.[[User:Fainites|Fainites]] 22:35, 26 February 2007 (UTC)

By the way, there's a message on your talk page from one of the regular editors here.[[User:Fainites|Fainites]] 22:27, 26 February 2007 (UTC)

I've fixed all the refs in a proper notes and refs section which now link to all the little ref numbers in the article so the refs now work. They are not complete as they need PMID or ISSN numbers. Also the ones that are books should be set out differently to research or other peer reviewed papers. I haven't removed the old ref section as there are some articles in there that didn't have links to ref numbers so somebody needs to sort these out as proper refs.[[User:Fainites|Fainites]] 17:19, 27 February 2007 (UTC)

==Major rewrites==
Some anonymous user [[User:58.178.125.188]] has taken it upon himself to majorly rewrite the article... are we happy with the changes? [[User:Rainbow7180|Kat, Queen of Typos]] 00:09, 19 March 2007 (UTC)

Although I have not edited content, I did redo all your references in a workable form. I note the rewrite has removed the majority of references, including any that were mildly critical and also some meta-analysis, eg Lilienfield and Devilly, both major players in experimental psychology. The whole article is now an inaccurate advertising puff. Whoever did it has also scattered little numbers throughout which look like references but actually aren't and don't link to anything. I'd revert the whole lot and invite whoever did it to discuss on the talkpage first. I know nobody owns articles, but removing all controversy and verified and credible references wholesale is against wiki policies. [[User:Fainites|Fainites]] 18:05, 19 March 2007 (UTC)
:Maybe the entire article should be reverted to a version before that anon user edited this.  There are now footnotes (36) that are linked to nothing and no citations are provided.  I propose that we begin again with the version before anon user 58.178...  OK?[[user:DPeterson|<span style="color:red;">DPeterson</span>]]<sup>[[User talk:DPeterson|talk]]</sup> 22:03, 19 March 2007 (UTC)

I agree with DP. [[User:Fainites|Fainites]] 22:16, 19 March 2007 (UTC)
::Thanks, Faintes.  So, unless I hear any comment to the contrary, I will do this in the next couple of days...leaving some time for others to comment. [[user:DPeterson|<span style="color:red;">DPeterson</span>]]<sup>[[User talk:DPeterson|talk]]</sup> 23:03, 19 March 2007 (UTC)

:I agree also.  Fainites, I wasn't referring to your edits. You were signed in. :) I posted on the anon user's talk page to invite him/her here, but apparently he/she hasn't come.  [[User:Rainbow7180|Kat, Queen of Typos]] 06:05, 20 March 2007 (UTC)

Actually some of the edits are very detailed, but unfortunately as there are no references it's impossible to check their validity. I did wonder if it was a newbie who just doesn't yet understand how to set up references and therefore needs assistance, but removing existing references does not bode well. On a quick check he's removed 7 out of 18 references including ''all'' the meta-analyses and any critical scientific analysis (except the sceptics dictionary which doesn't really count and he attempted to remove that [http://en.wikipedia.org/w/index.php?title=Eye_Movement_Desensitization_and_Reprocessing&diff=116213997&oldid=116211446]!). [[User:Fainites|Fainites]] 18:43, 20 March 2007 (UTC)
::I did the revert...maybe now we can add back what was relevant and sourced. [[user:DPeterson|<span style="color:red;">DPeterson</span>]]<sup>[[User talk:DPeterson|talk]]</sup> 22:50, 20 March 2007 (UTC)

I thought that the new editor did a nice job of polishing the material, bringing it up to date with factual information.  It looks to me as though the new references are now working. I'd like to suggest that we add a NEW SECTION -- called CONTROVERSIES so that controversial comments are not interspersed throughout the whole article, which will only foster dissension. That new section can contain the material from Devilly and Lillienfeld.  [[User:Lmaxfield|Lmaxfield]] 10:48, 21 March 2007 (UTC)

:That's a good idea Lmaxfield. [[User:Rainbow7180|Kat, Queen of Typos]] 11:45, 21 March 2007 (UTC)
::I'm on the same page with you two.  I like the recent edits...very good.  I was also thinking that something about any controversies needed to be added and creating a specific section for that is a great idea.  [[user:RalphLender|<span style="color:green;">RalphLender</span>]]<sup>[[User talk:RalphLender|talk]]</sup> 14:10, 21 March 2007 (UTC)

Sounds reasonable to me.[[User:Fainites|Fainites]] 17:54, 21 March 2007 (UTC)

==all my comments were removed ==
The changes i made on Monday appear to have been removed without discussion.

I changed the previous content because it was out of date and inconsistent with emerging literature (last two years). This was necessary as the conclusions on the pages were firstly at odds with the findings of committees from around the world that EMDR is evidence based practise.  Hence the section titled ‘Effectiveness: expert consensus guidelines’.  Their resultant views are likely to present a more balanced view than what I read when I opened the page last week.  I think this section needs to stay and only be chaged when new guidelines emerge.

Secondly any suggestions that the treatment is not an empirically supported is absurd.  Especially given recent studies such as Van der Kolk's et al (2007) work published in the Journal of Clinical Psychiatry that EMDR out performed Fluoxetine, Rothbaums large and very rigorous study published in Journal of Traumatic Stress on EMDR versus traditional exposure, the most recent meta-analytic study by Shidler and Wagner (2006) in Psychological Medicine.  Any discussion on effectiveness needs to consider current studies. 

Thirdly the article ignores reviews and a process study by implying that EMDR works the same as traditional exposure.  WE now know this does not seem to be the case for details see 
Lee, C. W., Taylor, G., & Drummond, P. (2006). The active ingredient in EMDR; is it traditional exposure or dual focus of attention? Clinical Psychology & Psychotherapy, 13, 97-107.
Any discussion on mechanism of action needs to account for process studies on the methods.

Finally I found it very odd that a science based publication was describing the recent history of what happened to an institution that once provided training to a currently licensed practitioner.  Seemed liked a personal attack to me not a scientific argument. 

<small>—The preceding [[Wikipedia:Sign your posts on talk pages|unsigned]] comment was added by [[User:Dr Chris Lee|Dr Chris Lee]] ([[User talk:Dr Chris Lee|talk]] • [[Special:Contributions/Dr Chris Lee|contribs]]) 05:33, 21 March 2007 (UTC).</small><!-- HagermanBot Auto-Unsigned -->

I appreciate all the effort that you made, and agree that it is important Wikipedia articles be current. I suggest however that a section on CONTROVERSIES be added, as this is an important part of EMDR's history. Also there are still some individuals who are opposed to this therapy.  [[User:Lmaxfield|Lmaxfield]] 10:52, 21 March 2007 (UTC)

:Dr Chris Lee may be new to Wikipedia and unsure of how it works, but I did warn him on his talk page that we were going to revert the edits because of the anonymous user's edits prior to his - so no, the edits were not reverted without discussion. [[User:Rainbow7180|Kat, Queen of Typos]] 05:09, 23 March 2007 (UTC)

==re reply to [User:Lmaxfield|Lmaxfield] ==

You are right a section on matters that are still controversial needs to be added I have done so and welcome any additional comments you wish to make Dr Chris Lee <small>—The preceding [[Wikipedia:Sign your posts on talk pages|unsigned]] comment was added by [[User:Fainites|Fainites]] ([[User talk:Fainites|talk]] • [[Special:Contributions/Fainites|contribs]]) 14:48, 22 March 2007 (UTC).</small><!-- HagermanBot Auto-Unsigned -->
:I like the additions...helpful.[[user:RalphLender|<span style="color:green;">RalphLender</span>]]<sup>[[User talk:RalphLender|talk]]</sup> 16:30, 22 March 2007 (UTC)

Devilly's 2002 meta-analysis concludes
''(1) There is overwhelming evidence that eye movements are neither a necessary nor a useful addition to the procedure; (2) there is strong and consistent evidence that EMDR is better than no treatment, yet only as good as any other treatment that utilizes some aspect of exposure therapy; and (3) there is strong evidence that a full-exposure-based intervention package is superior to EMDR. There is also some evidence that "reprocessing" is likewise superfluous to EMDR and that the effects of EMDR dissipate over time.''
I think a synopsis of this could go in the controversy section. [[User:Fainites|Fainites]] 22:45, 22 March 2007 (UTC)
:::Good points.[[User:SamDavidson|SamDavidson]] 23:20, 22 March 2007 (UTC)

How about, ''Devilly (2002) in a review and meta-analysis concludes that although EMDR is effective, it is because it operates as an exposure therapy for which the eyemovements are unecessary, and is neither as effective nor as long lasting as specific exposure therapy.''[[User:Fainites|Fainites]] 22:51, 24 March 2007 (UTC)
: I think you could add that and it would certainly be an improvement. [[user:DPeterson|<span style="color:red;">DPeterson</span>]]<sup>[[User talk:DPeterson|talk]]</sup> 00:08, 25 March 2007 (UTC)

Done. [[User:Fainites|Fainites]] 19:09, 25 March 2007 (UTC)

I also think for completeness sake the controversy section ought to contain a synopsis of the Herbert, Lilienfield meta-analysis. [[User:Fainites|Fainites]] 19:21, 25 March 2007 (UTC)

==Meta-analysis==
I have had to make changes to material reported in the devilly meta-analysis given we now have two more recent studies.  Both looked at  traditional exposure therapy and EMDR and found that they led to equivalent outcomes at follow-up (Bradley, Greene, Russ, Dutra, & Westen, 2005; Seidler & Wagner, 2006).   This now appperas in the effectiiveness section.  Also we do know that at 18 month follow-up treatment is still effective(Edmond & Rubin, 2004).  Recent studies suggest that traditional exposure treatments may not be so robust over time unless cognitive therapy is included in the package (Tarrier & Sommerfield, 2004). 

Bradley, R., Greene, J., Russ, E., Dutra, L., & Westen, D. (2005). A Multidimensional Meta-Analysis of Psychotherapy for PTSD. American Journal of Psychiatry, 162(2), 214-227.
Edmond, T., & Rubin, A. (2004). Assessing the Long-Term Effects of EMDR: Results from an 18-Month Follow-Up Study with Adult Female Survivors of CSA. Journal of Child Sexual Abuse, 13(1), 69-86.
Seidler, G. H., & Wagner, F. E. (2006). Comparing the efficacy of EMDR and trauma-focused Cognitive-Behavioral Therapy in the Treatment of PTSD:  a meta–analytic study Psychological Medicine 36 1515-1522.
Tarrier, N., & Sommerfield, C. (2004). Treatment of Chronic PTSD by Cognitive Therapy and Exposure: 5-Year Follow-Up. Behavior Therapy, 35(2), 231-246.

Chris Lee

I would only quibble with the construction of that paragraph as it says ''since'' then and then quotes 4 studies that predate Devilly![[User:Fainites|Fainites]] 13:08, 26 March 2007 (UTC)

Hi Fainites. Yes, this page has turned into nothing but a promotional page for EMDR. It's pointless editing by experts in the area because people who have a vested interest in EMDR will just edit those comments back out again. The same goes for the NLP page and all the other powertherapies pages. From their perspective their income is at stake not science. Ho-hum. [[User:Devilly|Grant]]

:Would you not make such sweeping statements? I have no vested interest in EMDR, myself, and I watch this page.  Would you please just make your changes? Some of this stuff you guys talk about in here is over my head, but I try to understand... I don't understand doctor-speak sometimes, but I don't know that I see people editing out because they have a vested interest. [[User:Rainbow7180|Kat, Queen of Typos]] 21:11, 7 August 2007 (UTC)

:: Dear Kat, I have made edits and changes and they just get edited out - so it's pointless. And yes, I am the "Devilly" who has done all the research on this topic. That is my point. My question is: why would someone who doesn't understand "doctor-speak" be editing a page on treatment strategies? [[User:Devilly|Grant]]

:::Have you read Wikipedia's policy on not being too technical?  These articles need to be accessible to normal people - as it is it's already borderline too technical, IMO. [[User:Rainbow7180|Kat, Queen of Typos]] 07:12, 8 August 2007 (UTC)

== importance rating ==

EMDR is a pretty hot topic in psychology and is quickly becoming one of the most widely used (for better or for worse) methods in all of clinical psychology. it should at least be of medium if not high importance...[[User:128.239.158.219|128.239.158.219]] 04:57, 5 April 2007 (UTC)[[albwus]]
:Do you have a source for that? [[User:Rainbow7180|Kat, Queen of Typos]] 05:13, 5 April 2007 (UTC)
::I agree with a medium rating. [[User:SamDavidson|SamDavidson]] 17:11, 6 April 2007 (UTC)

Who decides the ratings? [[User:Fainites|Fainites]] 20:47, 6 April 2007 (UTC)

==Review of newest section needed==
[[User:68.146.133.56]] has added a long section on how post-traumatic stress causes an immediate reaction to past traumas - I think it needs a review, and may possibly be more appropriate in the article about PTSD. [[User:Rainbow7180|Kat, Queen of Typos]] 02:38, 10 July 2007 (UTC)

:Since no one seems interested in commenting, I've removed it - I don't think it fits this article well. [[User:Rainbow7180|Kat, Queen of Typos]] 21:22, 7 August 2007 (UTC)

==Reference edit needed==
I do not edit references well... at the end of the first paragraph, it says "Appendix A. Handbook of EMDR and Family Therapy Processes. New York: Wiley." - could someone edit that into a proper ref link? [[User:Rainbow7180|Kat, Queen of Typos]] 21:20, 7 August 2007 (UTC)

:Done.  As well, I'm changing the journal references to follow the tamplate on [http://diberri.dyndns.org/wikipedia/templates/?type=pmid&add_ref_tag=1 this page], for standardization as per [[WP:MEDMOS]].  One distinct advantage is having the link to the abstact of the article, which makes the research more accessible.  I'm just giving this heads-up so nobody thinks I'm making wild changes for no good reason. [[User:Absentis|Absentis]] 17:43, 14 August 2007 (UTC)

== Any relation to dianetics? ==

I read the Dianetics book quite a while ago, so I may be remembering incorrectly, but this therapy seems similar to the engram clearing talked about in that book. Was just wondering if anyone else knew of a connection between the two?[[User:Ronar|Ronar]] 17:25, 14 August 2007 (UTC)

:I don't know much about dianetics, but I've never heard them compared. [[User:Rainbow7180|Kat, Queen of Typos]] 07:23, 15 August 2007 (UTC)

::Only insofar as both are scientifically dubious concepts.  I.e., http://skepdic.com/emdr.html  EMDR is more New Age-y, Dianetics is more old-skool pulp sci-fi wacky with an undertone of fascism.  <small>—Preceding [[Wikipedia:Signatures|unsigned]] comment added by [[Special:Contributions/71.227.120.26|71.227.120.26]] ([[User talk:71.227.120.26|talk]]) 20:53, 24 October 2007 (UTC)</small><!-- Template:UnsignedIP --> <!--Autosigned by SineBot-->
:::Don't forget that both Dianetics and EMDR also put vast amounts of money into the pockets of people whose sole qualification to practice medicine is a $29 certificate from the originating body.  <small>—Preceding [[Wikipedia:Signatures|unsigned]] comment added by [[Special:Contributions/71.227.120.26|71.227.120.26]] ([[User talk:71.227.120.26|talk]]) 16:00, 29 October 2007 (UTC)</small><!-- Template:UnsignedIP --> <!--Autosigned by SineBot-->

::::I am wondering why you would make such a false statement...???!  To be trained in EMDR, a person must have the minimum of a masters degree and be licensed as a mental health professional by an association that ensures accountability to the public.    [[User:Lmaxfield|Lmaxfield]] 05:08, 4 November 2007 (UTC)

== Meta analysis criticism ==

Removed text: ''However, this analysis has a methodological flaw.<ref>Lee, C.W. Analysis of critical components and processes in treatment of trauma memories with EMDR. in EMDRIA 2005. Seattle USA: EMDRIA.</ref>   The degrees of freedom used to examine the level of significance of the effect was based on the number of studies rather than the number of participants which is the convention.<ref>Rosenthal, R. and M.R. DiMatteo, Meta analysis: Recent developments in quantitative methods for literature reviews. Annual Review of Psychology, 2001. 52: p. 59-82.</ref>  When this is corrected, the actual effect size obtained of r=.15 (eye movement over no eye movement) is significant.''

I doubt the veracity of these statements for a few reasons.  Firstly, the criticism comes from a source with a vested interest in EMDR, and was not published in an academic journal.  Secondly, a well-known researcher from the IoP stated that the meta-analysis was "well done".  Unfortunately, my knowledge of statistics does not (yet) cover meta analysis, so I can't really say one way or the other.  Is there an objective expert that can weigh in on this? [[User:Absentis|Absentis]] 18:46, 15 August 2007 (UTC)

== Eye movement controversy ==

Text: A recent review highlighted the evidence that the eye movement in EMDR does produce a differential effect.<ref>Servan-Schreiber, D., Eye Movement Desensitization and Reprocessing: Is Psychiatry Missing the Point? Psychiatric Times, 2000. XVII(7): p. 36-40.</ref> In contrast to no eye movement, eye movements produce changes in physiological measures including reductions in blood pressure, heart rate and galvanic skin response.<ref name="pmid8959423"/><br>
Some studies have supported a differential effect of eye movements over eyes stationary.  In comparison to no eye movements and a passive visual interference task, eye movements resulted in a greater reduction in vividness of undergraduate students emotional memories.<ref>Kavanagh, D.J., et al., Effects of visuospatial tasks on desensitization to emotive memories. British Journal of Clinical Psychology, 2001. 40(3): p. 267-280.</ref>  Similarly, memory recollections after eye movements were less vivid and less distressing compared to both a finger tapping and no dual-task control condition.<ref>van den Hout, M., et al., Autobiographical memories become less vivid and emotional after eye movements. British Journal of Clinical Psychology, 2001. 40(2): p. 121-130.</ref> Other dual tasks such as spatial tapping have also proven less effective than eye movements in reducing the distress and vividness of memories of personal experiences.<ref name="pmid9167862">{{cite journal |author=Andrade J, Kavanagh D, Baddeley A |title=Eye-movements and visual imagery: a working memory approach to the treatment of post-traumatic stress disorder |journal=The British journal of clinical psychology / the British Psychological Society |volume=36 ( Pt 2) |issue= |pages=209-23 |year=1997 |pmid=9167862 |doi=}}</ref> However this differential effect for eye movement was not found for non personal memories such as photographs that contained distressing content.<ref name="pmid9167862"/> 
Subsequent research has shown that eye movement facilitates memory processing for episodic memory but not semantic memory.<ref>Christman, S.D., et al., Bilateral eye movements enhance the retrieval of episodic memories. Neuropsychology, 2003. 17(2): p. 221-229.</ref>  In fact the mean effect size for each study that has investigated eye movement over no eye movement was found to increase from .15 to .28, when studies of contrived traumas were removed from the analysis.<ref>Lee, C.W. Analysis of critical components and processes in treatment of trauma memories with EMDR. in EMDRIA 2005. Seattle USA: EMDRIA.</ref><br>
The effects of eye movements compared to an eye stationary condition was also investigated for both positive and negative memories.<ref>Barrowcliff, A.L., et al., Eye-movements reduce the vividness, emotional valence and electrodermal arousal associated with negative autobiographical memories. Journal of Forensic Psychiatry & Psychology, 2004. 15(2): p. 325-345.</ref>  The eye movement condition yielded greater reductions than the eye stationary condition in vividness, subjective emotional arousal, and physiological arousal for memories connected with vivid images associated with fear and anxiety. The reduction in vividness also occurred with memories of positive experiences.

:I've taken this text out of the section on 'eye movements' because it does not deal directly with whether or not eye movements are a necessary part of the therapy.  This text is better suited to the section 'How does EMDR work?', and should be integrated together. [[User:Absentis|Absentis]] 21:43, 18 August 2007 (UTC)

The above summary does not directly explain how EMDR works.  Rather it does appear to make a case for the necessity, and the role of eye movements in EMDR.  For example, it is stating that eye movements, compared to control conditions, create certain physiological responses, lead to negative autobiographical memories becoming less vivid and distressing, reduces overall subjective distress, and are more effective than other dual tasks such as tapping. Therefore I feel that this information is relevant to the controversy section re. 'are eye movements necessary', and should be integrated back into the section. [[User:Sschubert|Sschubert]] ([[User talk:Sschubert|talk]]) 16:33, 2 April 2008 (UTC)

== '''Effectiveness: expert consensus guidelines''' ==

I've hidden the text under this headline because I have trouble believing this kind of information belongs in an encyclopedia article.  
I could understand a reference to an organization in terms of the history of the therapy (like when the APA recognized it as a therapy) but to simply list all the organizations/associations that support the therapy is clearly POV pushing. Unless a clear consensus can be reached I'll delete the information in due time. [[User:Absentis|Absentis]] 21:55, 18 August 2007 (UTC)

:The APA never recognized it as a therapy. Read the text more carefully. [[User:FatherTree|FatherTree]] 14:19, 22 August 2007 (UTC)

:: Actually, this [http://www.psych.org/psych_pract/treatg/pg/ASD_PTSD_05-15-06.pdf American Psychiatric Association PTSD treatment guideline] (approved in June 2004) clearly shows they recognize EMDR as an effective therapy.  Sadly, it is you who needs to read the text more carefully.  [[User:Absentis|Absentis]] 14:52, 22 August 2007 (UTC)

::: Read the disclaimer at the top. [[User:FatherTree|FatherTree]] 00:49, 23 August 2007 (UTC)

:::: I've read more than just the disclaimer. So? [[User:Absentis|Absentis]] 01:02, 23 August 2007 (UTC)


The comment on the American Psychiatric Association Guidelines cited by Marssociety refers to '''prevention''' of PTSD and acute stress which there is considerable controversy over what works.

However this comment has been confused with what the guidelines say about treatment of PTSD.  On the same page as the quote (p14), and just 3 sentences latter the guidelines report that EMDR is effective as a treatment for core symptoms of both acute and chronic PTSD.

The misunderstanding is due to confusing prevention interventions with treatments.  Other interantional guidelines that assert that EMDR is science based practice for treatment of PTSD are from the United Kingdom by the National Institute for Clinical Excellence (2005) and in Australia by the Australian Centre for Posttraumatic Mental Health (2007).


National Institute for Clinical Excellence (2005). Post traumatic stress disorder (PTSD): The management of adults and children in primary and secondary care. London: NICE Guidelines.

Australian Centre for Posttraumatic Mental Health (2007). Australian guidelines for the treatment of adults with acute stress disorder and post traumatic stress disorder. ACPTMH, Melbourne, Victoria 

[[User:Dr Chris Lee|Dr Chris Lee]] 09:25, 24 September 2007 (UTC)


I noticed that under the emperical evidence regarding EMDR that the section on conclusions from international scientific committees was omitted.  I am of the opinion that it is worth noting that certain international guidelines regard EMDR effective in the treatment of trauma. The conclusions of international committees are based reviews of scientific evidence for the effectiveness of EMDR. I believe that this type of information would be of interest to readers of this page.  I have added this section to the page once again, however for a more balanced view it may be worth also adding some references to international guidelines that do not support the use of EMDR in treating trauma.  

What I am not sure about in this section is the following statement in the introductory paragraph...
"However, the evaluation of eye movements and other lateralized activities indicates that they are not required, thus the evidence for EMDR may actually evidence for trauma therapy in a more general sense and not for the unique eye movement component [20]"
Would such a comment be better suited in the section under "controversy" - "Are the eye movements necessary"?

[[User:Sschubert|Sschubert]] ([[User talk:Sschubert|talk]]) 17:37, 1 April 2008 (UTC)

== Not evidence based ==

Well I do not have to time to do this now. But I hope you realize that EMDR has never been proven to be effective. If you think it has please point me to the study. And many thousand if not millions of dollars will spent on it from a nearly bankrupt medical system so operators can make big bucks off of troubled people. [[User:FatherTree|FatherTree]] 14:19, 22 August 2007 (UTC)

: Please read citations 11-25 in the article.  These journal articles speak to the effectiveness of EMDR.  If there are problems with any of them, please bring it up.  Until then, Wikipedia is not your soapbox. [[User:Absentis|Absentis]] 14:44, 22 August 2007 (UTC)

And there are just as many sources that say EMDR is not effective. You have cherry picked and are pushing a POV. [[User:FatherTree|FatherTree]] 00:50, 23 August 2007 (UTC)

: Please add the sources you're talking about! Just don't remove any legitimate studies m'kay? My only problem with your edits is that you removed verifiable information.  [[User:Absentis|Absentis]] 01:02, 23 August 2007 (UTC)

::Absentis is also not the sole editor of the page.  If you feel EMDR is not effective, please feel free to expand the controversy section of the article, while remembering to cite your sources. [[User:Rainbow7180|Kat, Queen of Typos]] 05:46, 23 August 2007 (UTC)

I have removed the section on Devilly in that his particular meta-analysis that found that EMDR was not as effective or as long lasting as specific exposure therapy is at odds with every other meta-analysis that has ever been conducted  (Bisson et al., 2007; Bradley et al., 2005; Seidler & Wagner, 2006; van Etten & Taylor, 1998).  To include this outlier makes no sense.  Previous page notes above refers to the Herbert et al. paper as a meta-analysis.  This is not accurate.  The Herbert paper is an opinion only article not a statistical analysis of trends in the literature.  [[User:Dr Chris Lee|Dr Chris Lee]] 06:09, 24 September 2007 (UTC)

Bisson, J. I., Ehlers, A., Matthews, R., Pilling, S., Richards, D., & Turner, S. (2007). Psychological treatments for chronic post-traumatic stress disorder: Systematic review and meta-analysis. British Journal of Psychiatry, 190(2), 97-104.

Bradley, R., Greene, J., Russ, E., Dutra, L., & Westen, D. (2005). A Multidimensional Meta-Analysis of Psychotherapy for PTSD. American Journal of Psychiatry, 162(2), 214-227.

Seidler, G. H., & Wagner, F. E. (2006). Comparing the efficacy of EMDR and trauma-focused Cognitive-Behavioral Therapy in the Treatment of PTSD:  a meta–analytic study Psychological Medicine 36 1515-1522.

van Etten, M. L., & Taylor, S. (1998). Comparative Efficacy of Treatments for Post-traumatic Stress Disorder: A Meta-Analysis. Clinical Psychology and Psychotherapy, 5, 126-144.

I have also updated the information on eye movement in the light of recent research. [[User:Dr Chris Lee|Dr Chris Lee]] 09:37, 24 September 2007 (UTC)

:I re-added the Devilly section.  Just because it does not agree with other studies, does not mean that we should take it out.  This is exactly why we have the controversy section. 
:As well, I took some information out of the introduction.  Some of the studies deal only with eye movement (and so should be considered later on in the article). [[User:Absentis|Absentis]] 14:16, 24 September 2007 (UTC)

Happy with the gist of your changes, however, if Devilly is left in, then all of the other meta-analyses references must also be included to fully reflect that it is a controversy. I have rewritten the controversy section because in its previous form it was disjointed, it seems to flow better now and references to both sides of the argument have been included. [[User:Dr Chris Lee|Dr Chris Lee]] 07:49, 8 October 2007 (UTC)

==POV tag added to evaluation of effectiveness==
The effectiveness section suffers from basic flaw of comparing EMDR with other treatments, but not presenting the research that discusses the controversy about the necessity of the eye movements.  The "controvery" section later and this evaluation section require integration to objectively present the evaluation of the EMDR method. [[User:Fremte|Fremte]] ([[User talk:Fremte|talk]]) 19:26, 9 March 2008 (UTC)

I think that there is some confusion here.  There is a difference between the efficacy of a therapy and its mechanisms of action.  The controversy is about the eye movements, not about whether EMDR is effective. 
 
The controversy is about whether eye movements are one of the mechanisms by which EMDR achieves its good outcomes.  There are those who argue that eye movements are superfluous, and there are those who point to a growing number of studies showing eye movements have valuable effects.  However at this time, there is no clear evidence either way.  It should be noted that we do not know why or how ANY psychotherapy works.  For example, although there are lots of theories about how cognitive behavior therapy works, there is no conclusive evidence to date to support any of these theories.   As Alan Kazdin (2005) wrote:  “Perhaps the most neglected question in therapy research is the mechanisms by which treatment leads to change. For even our most well-studied, evidence-based treatments (e.g., cognitive therapy for depression) we do not know why the treatment works (i.e., through what processes)” (p. 186). 

EMDR’s effectiveness is not controversial.   EMDR has established efficacy in the treatment of PTSD.  For example see the Cochrane Review and Bisson et al’s 2007 meta-analysis.  Although there are still some folks who just can’t believe that EMDR works (smile), the evidence is there to provide solid support for its efficacy.  It has been recommended in numerous treatment guidelines, as it achieves the same quality of outcome as the other highest rated treatment, cognitive behaviour therapy.

From the Cochrane Review:   “Psychological treatments can reduce symptoms of post traumatic stress disorder (PTSD). Trauma focused treatments are more effective than non-trauma focused treatments. This review concerns the efficacy of psychological treatment in the treatment of PTSD. There is evidence that individual trauma focused cognitive-behavioural therapy (TFCBT), eye movement desensitisation and reprocessing (EMDR), stress management and group TFCBT are effective in the treatment of PTSD. Other non-trauma focused psychological treatments did not reduce PTSD symptoms as significantly. There is some evidence that individual TFCBT and EMDR are superior to stress management in the treatment of PTSD at between 2 and 5 months following treatment, and also that TFCBT, EMDR and stress management are more effective than other therapies. There is insufficient evidence to show whether or not psychological treatment is harmful. Trauma focused cognitive behavioural therapy or eye movement desensitisation and reprocessing should be considered in individuals with PTSD.”

Cochrane Review:  http://www.mrw.interscience.wiley.com/cochrane/clsysrev/articles/CD003388/frame.html 

Kazdin, A. E. (2005). Treatment Outcomes, Common Factors, and Continued Neglect of Mechanisms of Change. Clinical Psychology Science and  Practice, 12, 184–188.

JONATHAN I. BISSON, ANKE EHLERS, ROSA MATTHEWS, STEPHEN PILLING, DAVID RICHARDS and STUART TURNER (2007).  Psychological treatments for chronic post-traumatic stress disorder Systematic review and meta-analysis.  BRITISH JOURNAL OF PSYCHIATRY, 190, 97-104.  http://bjp.rcpsych.org/cgi/reprint/190/2/97 
[[User:Lmaxfield|Lmaxfield]] ([[User talk:Lmaxfield|talk]]) 23:46, 15 March 2008 (UTC)

:It is misleading to say that EMDR is effective but that the central mechanism on which the therapy is based may be unsupported.  EMDR might be equivalent to singing with a patient during desensitization therapy; we would not accept that the singing was the ingredient that promoted the change, we would accept the desensitization as the change ingredient, even if the patient likes the singing due to the interesting theory of how singing activates a brain area that counteracts traumatic memories.   I am not being flip or joking about the singing example, I have heard it discussed this way.  Thus this article must present all of the perspectives on the method per [[WP:NPOV]] and not just the one you or any other contributor prefers.  Respectfully, [[User:Fremte|Fremte]] ([[User talk:Fremte|talk]]) 00:54, 16 March 2008 (UTC)


::The "central mechanism" for all therapies is unsupported - even exposure therapy and desensitization! No one knows what the mechanisms of action are, for even the most recognized treatments (Kazdin, 2005).  Your basic premise that the mechanisms of action must be empirically supported is invalid.  You are imagining a far greater knowledge about therapeutic components than currently exists.  For example, you keep inserting phrases saying that EMDR=imaginal exposure. Actually, there is evidence that EMDR is not exposure and evidence that removing eye movements results in poorer outcomes.  Please read the EMDR literature and cited studies before coming to conclusions based on things that you have heard "discussed this way".  In areas of controversy it is important to read the original documents and not rely on reviews conducted by others. [[User:Lmaxfield|Lmaxfield]] ([[User talk:Lmaxfield|talk]]) 16:25, 16 March 2008 (UTC)

I agree with lmaxfield as this section is not about whether the mechanisms of action are emperically supported, as this argument is invalid. The mechanisms of action underlying most therapies are unclear. This includes traditional exposure, as the exact critical processes that lead to recovery of truama with this form of therapy is also not entirely clear, and remains a point of controversy. Just because the mechanisms of action of a treatment are not entirely understood, does not mean that a treatment is not effective.  Think about pharmacological theories that propose to explain how SSRIs work. These theories are limited, but this does not detract from the research that demonstrates their effectiveness.  This section on 'emperical evidence regarding EMDR' should be reserved for evidence that demonstrates that EMDR either is, or is not, effective as a treatment for trauma or other disorders.  A discussion regarding the underlying mechanisms of action should be reserved for the 'controversy' section.  Is adding a tag directing the reader to the controversy section regarding these issues enough for the neutrality tag to be removed from this section?  [[User:Sschubert|Sschubert]] ([[User talk:Sschubert|talk]]) 06:56, 4 April 2008 (UTC)


As there has been no further response as to how to resolve this NPOV dispute, the tag has temporarily been removed from this section.  Await further discussion on how to work out a way to present competing views that is acceptable to all.[[User:Sschubert|Sschubert]] ([[User talk:Sschubert|talk]]) 13:29, 15 April 2008 (UTC)

== Deletion of false information ==

I deleted the following section from “Theoretical basis”. Fremte reinserted it, but I deleted it again because it is a gross defamation and inaccurate. It read:  “This treatment was developed by Francine Shapiro. She created the therapy after noticing that she felt better about stressful thoughts if she moved her eyes while thinking about them. She was sitting on a bench in the woods while thinking about stressful events. She felt better afterwards and recalled looking from place to place while sitting there (e.g. bird, tree, ground, cloud, etc.). She assumed there may be something advantageous to moving the eyes while thinking of stressful events. However, it turned out that this relationship (between moving the eyes and fear decline) was simply a correlation. Thus, the active ingredient in EMDR is the imaginal exposure.”
This is an inaccurate portrayal of Shapiro’s (1995) own description, in which she reported focusing on a distressing memory and noticing that her eyes were moving rapidly with resulting decreased distress.  She never stated that she “looked from place to place (bird, tree).  This is blatantly untrue and should not be included in the article. Furthermore,  the statement “It turned out that this relationship (between moving the eyes and fear decline) was simply a correlation” is simply an invention of the writer, and is untrue in this context.  Finally the conclusion that “active ingredient in EMDR is the imaginal exposure” is a theoretical statement that has no research evidence, and is therefore also false. [[User:Lmaxfield|Lmaxfield]] ([[User talk:Lmaxfield|talk]]) 15:44, 16 March 2008 (UTC)

You appear to be taking a non-neutral point of view and evidently support EMDR.  This is inappropriate tone for wikipedia.  Wikipedia is supposed to represent all persepctives, not just the one you happen to like or support.  I've read enough to know that there is a controversy about the mechanism for EMDR and that eye movements may not be required.  There is only a theory about EMDR and the neurological and info processing explanations do not have an empirical basis. There are studies that indicate EMDR is equivalent to other forms of exposure therapy and there there is no specific bonus to using the eye movements.  For a balanced presentation, these must be present with at least the prominance given to the theory advanced by proponents.  Please look at [[WP:NPOV]] and apply this to your edits and contributions. You should also look at [[WP:AGF]].  I am not, nor is anyone else, your enemy when making edits and contributuions.  Claiming that some comments within an article are "defamation" is an example of the and emotional and non-npov motivation that seems evident in your contributions to this article.  Please calm down a little and learn how to contribute to wikipedia in the spirit intended and required. [[User:Fremte|Fremte]] ([[User talk:Fremte|talk]]) 17:33, 16 March 2008 (UTC)

I would suggest that you learn to contribute to a scientific article by reading the research and not posting opinions as though they are facts.  You have been making many statements that are untrue and unsupported.  Please read the literature, so that you can become informed about all sides of the issues and be current and up-tod-date in your knowledge. Knowing only one side is insufficent in a controversial area like this.  You also need to become familiar with the language and concepts in the literature. For example, when you write (above) "There are studies that indicate EMDR is equivalent to other forms of exposure therapy and there there is no specific bonus to using the eye movements" you misunderstand the meaning of that statement in terms of the literature.  That statement means that EMDR and exposure therapy are equivalent in results; it does not mean that they have equivalent processes or mechanisms of action because that question has only been evaluated in the 2 or 3 studies that compared the process of exposure and EMDR. These studies found that they were distinctly different processes (Rogers & Silver, 2002: Lee et al, 2006, 2007).  As I said previously the field has limited knowledge about any therapy's mechanism of action.  I completely agree that there is no clear evidence for the necessity of eye movements in EMDR. I have stated that previously in this Wikipedia article in several sections, and I have written widely about this deficit in scientific publications. However it should be noted that there is no evidence to show that they are superfluous either and it should be remembered that all of the research showing that EMDR is efficacious used eye movements. Nobody knows if the results would have been the same without eye movements until that type of research is conducted, which it has not yet been.  One cannot say that the results would have been identical without research proving that that is true.  You can only say that critics argue that the results would have been the same, but that that hypothesis has yet to be adequately tested.  [[User:Lmaxfield|Lmaxfield]] ([[User talk:Lmaxfield|talk]]) 21:34, 16 March 2008 (UTC)

===Spare the ''ad hominum'' attacks please!  We are all friends here!===
I've been a reviewer for funding for new techniques and EMDR was not accepted due to the data not meeting evidence based treatment requirements.  And, I've not been making statements in the article, rather looking at your deletes of things you disagree with.  I dug up some of the info we reviewed in committee. Conclusion, using the gold, silver, bronze eval scheme for emdr was that it was "below bronze", possibly promising, but the need for eye movements or lateralized activity questionable.  Is this enough to convince you of the need for a balanced presentation? 
*McNally RJ. EMDR and Mesmerism: A comparative historical analysis. Journal of Anxiety Disorders 13:225-236, 1999.
*Lilienfeld SO. EMDR treatment: Less than meets the eye. Skeptical Inquirer 20(1):25-31, 1996.
*Cusack K, Spates CR. The cognitive dismantling of Eye Movement Desensitization and Reprocessing (EMDR) treatment of Posttraumatic Stress Disorder (PTSD). Journal of Anxiety Disorders 1999; 13 (1-2):87-99.
*Maxfield L, Hyer L. The relationship between efficacy and methodology in studies investigating EMDR treatment of PTSD. Journal of Clinical Psychol 2002; 58 (1):23-41.
*Sharpley CF, Montgomery IM, Scalzo LA. Comparative efficacy of EMDR and alternative procedures in reducing the vividness of mental images. Scandinavian Journal of Behaviour Therapy 1996; 25:37-42.
*Cahill SP. Counterpoint: Evaluating EMDR in Treating PTSD. Psychiatric Times 2000; 17 (7).
*Devilly GJ, Spence SH. The relative efficacy and treatment distress of EMDR and a cognitive-behavior trauma treatment protocol in the amelioration of posttraumatic stress disorder. Journal of Anxiety Disorders 1999; 13 (1-2):131-57.
*Taylor S, Thordarson DS, Maxfield L. Efficacy, speed, and adverse effects of three PTSD treatments: Exposure therapy, relaxation training, and EMDR. Canadian Psychology 2002; 43:139.
*Ironson G, Freund B, Strauss JL et al. Comparison of two treatments for traumatic stress: a community-based study of EMDR and prolonged exposure. Journal of Clin Psychol 2002; 58 (1):113-28.
*EMDR not mentioned: http://www.semel.ucla.edu/adc/AnxietyCD/PTSD/Consensus-PTSD_'04.pdf
*EMDR problems - expert testimony: http://www.cochranexpertestimony.com/publication_2002.htm
[[User:Fremte|Fremte]] ([[User talk:Fremte|talk]]) 16:20, 17 March 2008 (UTC)

:It seems strange that your committee only rated EMDR as "bronze" when it has been rated as a "gold" PTSD treatment by the American Psychiatric Association (2004), the International Society for Traumatic Stress Studies (2007), the USA Departments of Veterans Affairs and Defense, the Cochrane Review (2007), the UK NICE guidelines, and the treatment guidelines from many countries including Israel, Ireland, Sweden, etc.  EMDR is not a "new treatment"; its first randomized clinical trial was published in 1989, the first year for any randomized clinical trial (RCT) for PTSD. Here is a list of the randomized clinical trials which investigated EMDR treatment for PTSD:
*Carlson, J., Chemtob,C.M., Rusnak,K., et al (1998). Eye movement desensitization and reprocessing (EMDR): treatment for combat-related post-traumatic stress disorder. Journal of Traumatic Stress, 11, 3-24.
*Chemtob, C. M., Nakashima, J., & Carlson, J. G. (2002). Brief-treatment for elementary school children with disaster-related PTSD: A field study. Journal of Clinical Psychology, 58, 99-112.
*Devilly,G. J. & Spence, S.H. (1999). The relative efficacy and treatment distress of EMDR and a cognitive behaviour trauma treatment protocol in the amelioration of posttraumatic stress disorder. Journal of Anxiety Disorders, 13,131-157.
*Ironson,G. I., Freund, B., Strauss, J. L., et al (2002). Comparison of two treatments for traumatic stress: a community-based study of EMDR and prolonged exposure. Journal of Clinical Psychology, 58,113-128.
*Lee,C.,Gavriel,H., Drummond, P., et al (2002). Treatment of post-traumatic stress disorder: a comparison of stress inoculation training with prolonged exposure and eye movement desensitization and reprocessing. Journal of Clinical Psychology, 58, 1071-1089.
*Marcus, S.,Marquis, P. & Sakai,C. (1997). Controlled study of treatment of PTSD using EMDR in an HMO setting. Psychotherapy, 34, 307-315.
*Marcus, S., Marquis, P. & Sakai, C. (2004).  Three- and 6-month follow-up of EMDR treatment of PTSD in an HMO setting.  International Journal of Stress Management, 11, 195-208.
*Power,K.,McGoldrick,T., Brown, K., et al (2002). A controlled comparison of eye movement desensitisation and reprocessing versus exposure plus cognitive restructuring versus waiting list in the treatment of post-traumatic stress disorder. Clinical Psychology and Psychotherapy, 9, 299-318.
*Rogers, S., Silver, S., Goss, J., Obenchain, J., Willis, A., & Whitney, R. (1999). A single session, controlled group study of flooding and eye movement desensitization and reprocessing in treating posttraumatic stress disorder among Vietnam war veterans: Preliminary data. Journal of Anxiety Disorders, 13, 119–130.
*Rothbaum, B. (1997). A controlled study of eye movement desensitization and reprocessing in the treatment of post-traumatic stress disordered sexual assault victims. Bulletin of the Menninger Clinic, 61, 317-334.
*Rothbaum, B.O., Astin,M.C. & Marsteller, F. (2005). Prolonged exposure vs.EMDR for PTSD rape victims. Journal of Traumatic Stress, 18, 607-616.
*Scheck,M., Schaeffer, J. A. & Gillette,C. (1998). Brief psychological intervention with traumatized young women: the efficacy of eye movement desensitization and reprocessing. Journal of Traumatic Stress, 11, 24-44.
*Van der Kolk, B. A., Spinazzola, J., Blaustein, M. E., Hopper, J. W., Hopper, E. K., Korn, D. L., & Simpson, W. B. (2007). A randomized clinical trial of EMDR, fluoxetine and pill placebo in the treatment of PTSD: Treatment effects and long-term maintenance. Journal of Clinical Psychiatry, 68, 37-46.
*Vaughan, K., Armstrong, M.F., Gold, R., O'Connor, N., Jenneke, W., & Tarrier, N. (1994).  A trial of eye movement desensitization compared to image habituation training and applied muscle relaxation in post-traumatic stress disorder.  Journal of Behavior Therapy & Experimental Psychiatry, 25, 283-291.
*Wilson, S. A, Tinker, R. H., & Becker, L. A. (1995). Eye movement desensitization and reprocessing (EMDR) treatment for psychologically traumatized individuals. Journal of Consulting and Clinical Psychology, 63, 928-937.
*Wilson, S. A., Becker, L. A., & Tinker, R .H. (1997). Fifteen-month follow-up of eye movement desensitization and reprocessing (EMDR) treatment for PTSD and psychological trauma.  Journal of Consulting and Clinical Psychology, 65,1047-1056.
 
:Here are some of the research studies which have investigated the mechanism of eye movements in EMDR:  
*Andrade, J., Kavanagh, D., & Baddeley, A. (1997). Eye-movements and visual imagery: a working memory approach to the treatment of post-traumatic stress disorder. British Journal of Clinical Psychology, 36, 209-223.
*Barrowcliff, A. L., Gray, N. S., Freeman, T. C. A., & MacCulloch, M. J.  (2004). Eye-movements reduce the vividness, emotional valence and electrodermal arousal associated with negative autobiographical memories. Journal of Forensic Psychiatry and Psychology, 15, 325-345. 
*Barrowcliff, A. L., Gray, N. S., MacCulloch, S., Freeman, T. C. A., & MacCulloch, M. J. (2003). Horizontal rhythmical eye-movements consistently diminish the arousal  provoked  by auditory stimuli.  British Journal of Clinical Psychology, 42, 289-302.
*Christman, S. D., Propper, R. E., & Brown, T. J. (2006). Increased Interhemispheric Interaction Is Associated With Earlier Offset of Childhood Amnesia. Neuropsychology, 20, 336–345.
*Christman, S. D., Garvey, K. J., Propper, R. E., & Phaneuf, K. A. (2003). Bilateral eye movements enhance the retrieval of episodic memories. Neuropsychology. 17, 221-229. 
*Kavanagh, D. J., Freese, S., Andrade, J., & May, J. (2001). Effects of visuospatial tasks on desensitization to emotive memories. British Journal of Clinical Psychology, 40, 267-280.
*Kuiken, D., Bears, M., Miall, D., & Smith, L. (2001-2002). Eye movement desensitization reprocessing facilitates attentional orienting. Imagination, Cognition and Personality, 21, (1), 3-20.
*Lamprecht, F., Kohnke, C., Lempa, W., Sack, M., Matzke, M., & Munte, T. (2004). Event-related potentials and EMDR treatment of post-traumatic stress disorder. Neuroscience Research, 49, 267-272.
*Lee, C. W., Taylor, G., & Drummond, P. D. (2006). The active ingredient in EMDR: Is it traditional exposure or dual focus of attention? Clinical Psychology and Psychotherapy, 13(2), 97-107.
*Lee, C. W., & Drummond, P. D.. (2007). Effects of eye movement versus therapist instructions on the processing of distressing memories. Journal of Anxiety Disorders. 
*Parker A., & Dagnall, N. (2007). Effects of bilateral eye movements on gist based false recognition in the DRM paradigm. Brain and Cognition, 63, 221-225. 
*Ruth E. Propper, Jenna Pierce, Mark W. Geisler, Stephen D. Christman, & Nathan Bellorado. (2007). Effect of Bilateral Eye Movements on Frontal Interhemispheric Gamma EEG Coherence: Implications for EMDR Therapy. The Journal of Nervous and Mental Disease, 195, 785-788. 
*Sharpley, C. F. Montgomery, I. M., & Scalzo, L. A. (1996). Comparative efficacy of EMDR and alternative procedures in reducing the vividness of mental images. Scandinavian Journal of Behaviour Therapy, 25, 37-42.
*Van den Hout, M., Muris, P., Salemink, E., & Kindt, M. (2001). Autobiographical memories become less vivid and emotional after eye movements. British Journal of Clinical Psychology, 40, 121-130.
:[[User:Lmaxfield|Lmaxfield]] ([[User talk:Lmaxfield|talk]]) 03:39, 19 March 2008 (UTC)

:: Again, the issue is that the eye movements are not required for the treatment effect.  The situation as you represent is not the way the data stands when it is considered in toto.  We also reviewed "therapeutic touch", Reiki and acupuncture.  Some forms of the latter were accepted (deep tissue needling), naught else.  Subsequent reviews have continued to indicate to the medical panels that EMDR will not achieve funding status.  The group looked at the issues of expectancy, persuasion and healing (which is also the title of Jerome Frank's seminal book from the 1960s - may I recommend it), therapist effects, and (you will not like this phrasing) EMDR's pseudo-scientific theory about neurological effects that simply are not verifiable nor in keeping with neurological knowledge. I do not foresee that the decision will be reversed, in fact, it has gained solidity as time has passed and outcomes have been tracked (I am absolutely aware of the this data on an ongoing basis from matched comparison of groups which do accept EMDR.  You may by now understand that my exposure to the data is through a number of insurance schemes).  It has also appeared that less qualified practitioners turn to manualized and technique oriented methods such as EMDR, in contradistinction to those with other mainstream psychological therapy approaches. The EMDR advocates have also appeared to enthused to the point of evangelism (sorry if that is a little insensitive a term also), and also wanting to use the method (?misapply) with all sorts of other diagnoses.  You must also realize that appeals to the authority of the various other organizations you list does neither persuade groups which possess a lot of data, nor provide any sort of evidence for effectiveness.  (Appeal to authority being a rhetorical argumentation method.) 
::: So I must say, that this wikipedia article does not manage quite to balance the presentation.  [[User:Fremte|Fremte]] ([[User talk:Fremte|talk]]) 03:36, 19 March 2008 (UTC)


I would be really interested to read your review on EMDR, and the reasons why is does not achieve funding status.  I am also interested to read research that demonstrates your claim that EMDR is effective when eye movements are not used, as I have not come across any controlled research that has clearly demonstrated this. [[User:Sschubert|Sschubert]] ([[User talk:Sschubert|talk]]) 06:42, 3 April 2008 (UTC)

: I agree with editor Sschubert. -  Fremte, since you are basing your non-neutrality position on your review, you need to provide this review to the other editors so that we can evaluate your position, and respond appropriately. Please provide access information.  Where is it published?  Thank you [[User:Lmaxfield|Lmaxfield]] ([[User talk:Lmaxfield|talk]]) 15:59, 6 April 2008 (UTC)

== Intro section is non-neutral ==

This section could either be shortened and leave the info that says this method works to later where it is already reviewed, or needs to add some few sentences and words to represent the controversy about EMDR.  I thus put the banner on the intro section until this is fixed. Respectfully, [[User:Fremte|Fremte]] ([[User talk:Fremte|talk]]) 18:46, 29 March 2008 (UTC)


==  POV tag added to page ==
I noticed that a NPOV tag was added to the page, but there appears to be nothing here on the discussion page outlining why the tag was added.  I thought that it was a policy of wikapedia that if such a tag was added to an article then you needed to "at least leave a note on the article's talk page describing what you consider unacceptable about the article. The note should address the problem with enough specificity to allow constructive discussion towards a resolution, such as identifying specific passages, elements, or phrasings that are problematic."

Consensus is not possible, and making this page acceptable to those involved is not possible if the problems with the page are not clearly outlined.  Once specific problems are identified, then editors can discuss and resolve them. Is it possible for the person who added the tag to outline the changes they would like to see on the page for the tag to be removed? or is it fair to remove the tag until the probems are outlined on this page?  [[User:Sschubert|Sschubert]] ([[User talk:Sschubert|talk]]) 06:56, 4 April 2008 (UTC)

I understand that EMDR is a topic on which there are conflicting points of view and ongoing debates and controversy, however the NPOV tag has been removed from this page on the grounds that no clear exlanation has been put forward on this talk page that highlights exactly which part of the article does not seem to have a NPOV and why. Also no suggestions have been made by the editor who added the tag as to how one can improve the article. It goes against Wikapedia's NPOV policy to add a tag to a page without initiating such discussion.  I hope these reasons for removing the tag are acceptable to other editors.  [[User:Sschubert|Sschubert]] ([[User talk:Sschubert|talk]]) 13:17, 15 April 2008 (UTC)

==Was Shapiro the original developer?==
The following comment was removed as the statement was not referenced:
"[[John Grinder]] has claimed that he gave the technique to Shapiro after she asked him for help with a victim of rape." [[Special:Contributions/165.118.1.50|165.118.1.50]] ([[User talk:165.118.1.50|talk]]) 09:05, 13 May 2008 (UTC)

==Two mechanism sections?==
Hey, anyone who is paying attention to this page: there are two sections labeled "Mechanism".  Surely this needs to be fixed.  If you could help with that, that'd be awesome.  (By the way, there really ought to be a "History" section in this article, no?).  Cheers, [[User:Doctormatt|Doctormatt]] ([[User talk:Doctormatt|talk]]) 06:38, 9 September 2008 (UTC)

== Capitalization ==

Please weigh in on the general discussion of capitalization of therapeutic systems – "Eye Movement Desensitization and Reprocessing" vs. "eye movement desensitization and reprocessing" [[Wikipedia_talk:WikiProject_Psychology#Capitalization_for_therapeutic_systems_and_similar|at the psychology WikiProject]]. /[[User:Skagedal|'''<tt style="color: #030">skagedal</tt>''']][[User_talk:Skagedal|<sup style="color: #030">talk</sup>]] 09:00, 28 November 2008 (UTC)

== Evidence discussion ==

:''The following was moved from [[Talk:Eye Movement Desensitization and Reprocessing/Comments]], which is for comments on article review, not general discussion, which belongs here /[[User:Skagedal|'''<tt style="color: #030">skagedal</tt>''']][[User_talk:Skagedal|<sup style="color: #030">talk</sup>]] 22:03, 28 November 2008 (UTC)''

Just going over some of the references that purportedly support EMDR as an efficacious therapy, even a superior therapy to cog. behavioral thereapy, desensitization therapy, and pharmacotherapy.  Every article I bring up seems to say the opposite.  I'm a little confused.  Is this an advertisement page for EMDR?  The science is not very good.  Here for example, is what reference 12 says about the therapy: "No controlled studies of psychodynamic psychotherapy, eye movement desensitization and reprocessing (EMDR), or hypnosis have been conducted that would establish data-based evidence of their efficacy as an early or preventive intervention for ASD or PTSD." This reference was from the American Psychiatric Association guidelines on PTSD, and was cited in a statement by the author that EMDR was SUPERIOR to other treatments. Am I missing something here?
Sandy
[[User:Marssociety|Marssociety]] 23:07, 4 May 2007 (UTC)

:This is a treatment that is strongly recommended for use in the treatment of trauma by some of the major researchers in the field, such as Van der Kolk and Briere (See, for example, Principles of Trauma Treatment, edited by Biere & Scott, 2006 or the White Paper on Complex Post Traumatic Stress Disorder by the National Trauma Center. [[user:DPeterson|<span style="color:red;">DPeterson</span>]]<sup>[[User talk:DPeterson|talk]]</sup> 00:54, 14 May 2007 (UTC)

There is some misunderstanding here.   There is a difference between (1) treating people who have been diagnosed with PTSD to reduce/eliminate their symptoms and (2) treating people who have been exposed to trauma to prevent them from developing PTSD.  It is true that EMDR has not been tested to see if it will stop the development of PTSD in people who are exposed to trauma.  However, there are more than 16 randomized clinical trials that have investigated EMDR’s effectiveness in the treatment of PTSD. Almost all found that EMDR is very effective in reducing/eliminating symptoms of PTSD for people already diagnosed with that disorder.  [[User:Lmaxfield|Lmaxfield]] ([[User talk:Lmaxfield|talk]]) 23:01, 15 March 2008 (UTC)

:But the usefulness of the eye movements are apparently not seperated from the other parts of the therapy.  EMDR may well be effective but not ''because'' of the eye movements, but due to EMDR being a desensitization therapy.  Both the perspective that eye movements are (1) needed, and, (2) not needed, for the therapy to be effective must be present in the article for a balanced presentation per [[WP:NPOV]] policy. [[User:Fremte|Fremte]] ([[User talk:Fremte|talk]]) 00:44, 16 March 2008 (UTC)

You are confusing two different constructs -- mechanisms of action and efficacy.  We don't even know the mechanisms of action in CBT therapies, or in imaginal exposure.  Research has yet to specify why and how any psychotherapy works.  With EMDR, all the research studies that found elimination of PTSD diagnosis used eye movements.  You cannot say that EMDR-without-eye-movements would achieve the same result because this is not known. The research has not been done.  You cannot make statements that are not supported by research. You can say that the use of eye movements is controversial, but not that EMDR would achieve the same effects without them. Neither can you say that the mechanism of action is desensitization.  That is a theoretical statement, not a proven statement. [[User:Lmaxfield|Lmaxfield]] ([[User talk:Lmaxfield|talk]]) 15:14, 16 March 2008 (UTC)

I think there is a concern here which is being peripherally addressed: If one cannot really prove the efficacy of any mechanism of psychotherapy, what sense is there in putting forth theories and opinions in that regard, especially if any criticism of such theories simply leads back to an assertion that such criticisms are unfounded? I grow increasingly weary of the (still) physics-envy-saturation of our field. I would like to see more rational and realistic approaches to addressing the practical effects of our considerations, rather than considerations on the practical effects of our treatments. Do you follow?  <span style="font-size: smaller;" class="autosigned">—Preceding [[Wikipedia:Signatures|unsigned]] comment added by [[Special:Contributions/76.126.1.180|76.126.1.180]] ([[User talk:76.126.1.180|talk]]) 09:02, 3 October 2008 (UTC)</span><!-- Template:UnsignedIP --> <!--Autosigned by SineBot-->

== Requested move ==
{{polltop}} '''Move''' should be uncontroversial. [[User:Parsecboy|Parsecboy]] ([[User talk:Parsecboy|talk]]) 13:57, 4 December 2008 (UTC)


I request that this is moved to [[Eye movement desensitization and reprocessing]], per [[MOS:CAPS]] and discussion [[Wikipedia_talk:WikiProject Psychology#Capitalization for therapeutic systems and similar|here]]. Reliable sources do not seem to capitalize it, for example the authoritative ''Bergin and Garfield's Handbook on Psychotherapy and Behavior Change, 5th ed'' ({{ISBN|978-0-471-37755-9}}) and several journals in the field: ''Journal of Clinical Psychiatry'' ({{PMID|17284128}}), ''Psychiatry Research'' ({{PMID|18336919}}), ''Journal of Traumatic Stress'' ({{PMID|16568469}}, however in 2005: {{PMID|16382428}}), ''Journal of Anxiety Disorders'' ({{PMID|18314305}}), etc... /[[User:Skagedal|'''<tt style="color: #030">skagedal</tt>''']][[User_talk:Skagedal|<sup style="color: #030">talk</sup>]] 22:30, 28 November 2008 (UTC)

{{pollbottom}}

==additions to the introductory paragraph made without discussion==
This article on EMDR has developed following extensive discussions regarding the status, effectiveness, and processes involved in EMDR. The following statement appears to have been added to the article without initiating a discussion or offering an explanation for statement on this page: "However, the effectiveness of the mechanisms behind EMDR has been questioned, with most leading researchers concluding that cognitive restructuring (which is common in most therapies for PTSD), rather than the eye movements, are responsible for change. It is generally believed that it works because of the exposure therapy it provides, as well as a robust placebo effect." This statement is also not referenced, thus, the statement has removed from the introduction paragraph.
Past discussions have led to the development of a controversies section on the EMDR page. I suggest this comment may be more appropriate in this section, if referenced appropriately.  <small><span class="autosigned">—Preceding [[Wikipedia:Signatures|unsigned]] comment added by [[User:Sschubert|Sschubert]] ([[User talk:Sschubert|talk]] • [[Special:Contributions/Sschubert|contribs]]) 15:51, 7 May 2009 (UTC)</span></small><!-- Template:Unsigned --> <!--Autosigned by SineBot-->

== Mechanism sections ==

Two section with the same name.. Let's unify or?--[[Special:Contributions/151.50.154.167|151.50.154.167]] ([[User talk:151.50.154.167|talk]]) 09:48, 28 July 2009 (UTC)
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