Eye movement desensitization and reprocessing: Difference between revisions

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reorganize - trying to group sections according to logical relationships ... not perfect, but hopeuflly you understand my intention. There might be better ways to organize.
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===Training===
Shapiro was criticized for repeatedly increasing the length and expense of training and certification, allegedly in response to the results of controlled trials that cast doubt on EMDR's efficacy.<ref name="1999 Skeptic">{{cite journal|title=Eye Movement Magic: Eye Movement Desensitization and Reprocessing|journal=Skeptic|volume=7|issue=4|year=1999| vauthors = Rosen GM, Mcnally RJ, Lilienfeld SO | author-link3=Scott Lilienfeld | url=http://www.skeptic.com/eskeptic/14-05-21/#feature}}</ref><ref name="Herbert">{{cite journal | vauthors = Herbert JD, Lilienfeld SO, Lohr JM, Montgomery RW, O'Donohue WT, Rosen GM, Tolin DF | title = Science and pseudoscience in the development of eye movement desensitization and reprocessing: implications for clinical psychology | journal = Clinical Psychology Review | volume = 20 | issue = 8 | pages = 945–971 | date = November 2000 | pmid = 11098395 | doi = 10.1016/s0272-7358(99)00017-3 | s2cid = 14519988 }}</ref> This included requiring the completion of an EMDR training program in order to be qualified to administer EMDR properly after researchers using the initial written instructions found no difference between no-eye-movement control groups and EMDR-as-written experimental groups. Further changes in training requirements and/or the definition of EMDR included requiring level II training when researchers with level I training still found no difference between eye-movement experimental groups and no-eye-movement controls and deeming "alternate forms of bilateral stimulation" (such as finger-tapping) as variants of EMDR by the time a study found no difference between EMDR and a finger-tapping control group.<ref name="1999 Skeptic" /> Such changes in definition and training for EMDR have been described as "ad hoc moves [made] when confronted by embarrassing data".<ref name ="McNally2003">{{cite journal | vauthors = McNally RJ |title=The demise of pseudoscience |journal=The Scientific Review of Mental Health Practice |year=2003 |volume=2 |issue=2 |pages=97–101 |url=https://www.srmhp.org/0202/pseudoscience.html |archive-url=https://web.archive.org/web/20050211230751/https://www.srmhp.org/0202/pseudoscience.html |archive-date=2005-02-11 }}</ref>
 
== Criticism ==
EMDR is controversial among some scholars in the psychological community.<ref name="McNally1999">{{cite journal | vauthors = McNally RJ |author-link1= Richard McNally |title=Research on eye movement desensitization and reprocessing (EMDR) as a treatment for PTSD |journal=PTSD Research Quarterly |volume=10 |issue=1 |year=1999 |pages=1–7 |url=https://www.hsdl.org/?view&did=13105 }}</ref><ref name="Sikes_2003">{{cite journal | vauthors = Sikes C, Sikes V |title=EMDR: Why the controversy? |journal=Traumatology |date=2003 |volume=9 |issue=3 |pages=169–182 |doi=10.1177/153476560300900304 }}</ref><ref>{{cite journal | vauthors = Hasandedić-Đapo L | title = How Psychologists Experience and Perceive EMDR? | journal = Psychiatria Danubina | volume = 33 | issue = Suppl 1 | pages = 18–23 | date = February 2021 | pmid = 33638952 | doi = }}</ref> It is used by some practitioners for trauma therapy and in the treatment of [[complex post-traumatic stress disorder]].<ref name="Adler-Tapia">{{cite book | vauthors = Adler-Tapia R, Settle C |title=EMDR and The Art of Psychotherapy With Children |___location=New York |publisher=Springer Publishing Co. |page=228 |year=2008 |isbn=978-0-8261-1117-3}}</ref><ref name="isbn0-7619-2921-5">{{cite book | vauthors = Scott CV, Briere J |title=Principles of Trauma Therapy: A Guide to Symptoms, Evaluation, and Treatment |publisher=Sage Publications |___location=Thousand Oaks, CA |year=2006 |pages=312 |isbn=978-0-7619-2921-5}}</ref>
 
EMDR adds a number of non-scientific practices to [[exposure therapy]].<ref name="non">{{cite book |page=292 |vauthors= Lohr JM, Gist R, Deacon B, Devilly GJ, Varker T |chapter=Chapter 10: Science- and Non-Science-Based Treatments for Trauma-Related Stress Disorders |publisher=Routledge |veditors=Lilienfeld SO, Lynn SJ, Lohr JM |title=Science and Pseudoscience in Clinical Psychology |edition=2nd |year=2015 |isbn=9781462517893|quote="...eye movements and other bilateral stimulation techniques appear to be unnecessary and do not uniquely contribute to clinical outcomes. The characteristic procedural feature of EMDR appears therapeutically inert, and the other aspects of this treatment (e.g., imaginal exposure, cognitive reappraisal, in vivo exposure) overlap substantially with those of exposure-based treatments for PTSD...EMDR offers few, if any, demonstrable advantages over competing evidence-based psychological treatments. Moreover, its theoretical model and purported primary active therapeutic ingredient are not scientifically supported."}}</ref> EMDR is classified as one of the "power therapies" alongside [[thought field therapy]], [[Emotional Freedom Techniques]] and others{{snd}}so called because these therapies are marketed as being superior to established therapies which preceded them.<ref name=ros2012>{{cite book |vauthors=Rosquist J |isbn=9781136915772 |publisher=Routledge |year=2012 |title=Exposure Treatments for Anxiety Disorders: A Practitioner's Guide to Concepts, Methods, and Evidence-Based Practice |page=92}}</ref>
 
EMDR has been characterized as [[pseudoscience]], because the underlying theory and primary therapeutic mechanism are [[Falsifiability|unfalsifiable]] and non-scientific. EMDR's founder and other practitioners have used [[Pseudoscience#Falsifiability|untestable hypotheses]] to explain studies which show no effect.<ref name=ps-in_promotion>{{cite book |chapter=Chapter 4: Pseudoscience in Treating Adults Who Experienced Trauma |title=Science and Pseudoscience in Social Work Practice |vauthors=Thyer BA, Pignotti MG |year=2015 |publisher=Springer |page=221 |doi=10.1891/9780826177698.0004 |isbn=9780826177681|quote=Nevertheless, to date, given that there is no evidence that anything unique to EMDR is responsible for the positive outcomes in comparing it to no treatment and the florid manner in which it has been marketed, we are including it in this book... Another way in which EMDR qualifies as a pseudoscience is the manner in which it was developed and marketed... EMDR proponents have come up with ad hoc hypotheses to explain away unfavorable results that do not support its theory, which is one of the hallmark indicators of a pseudoscience... This type of post hoc explanation renders her theory unfalsifiable and thus places it outside the realm of science, because to qualify as scientific, a theory must be falsifiable.}}</ref> The results of the therapy are non-specific, especially if directed eye movements are irrelevant to the results. When these movements are removed, what remains is a broadly therapeutic interaction and deceptive marketing.<ref name="Herbert" /><ref name=Devilly2002>{{cite journal | vauthors = Devilly G |title=Eye movement desensitization and reprocessing: a chronology of its development and scientific standing |journal=The Scientific Review of Mental Health Practice |date=2002 |volume=1 |issue=2 |pages=132|url=http://devilly.org/Publications/EMDR-review.pdf}}</ref> According to neurologist [[Steven Novella]]:
 
{{blockquote|[T]he false specificity of these treatments is a massive clinical distraction. Time and effort are wasted clinically in studying, perfecting, and using these methods, rather than focusing on the components of the interaction that actually work.<ref name = "SBM" >{{cite web | vauthors = Novella S | author-link = Steven Novella |title=EMDR and Acupuncture – Selling Non-specific Effects |url=https://sciencebasedmedicine.org/emdr-and-acupuncture-selling-non-specific-effects/ |department=Science Based Medicine |publisher=Society for SBM |date=March 30, 2011 |access-date=12 July 2020}}</ref>}}
 
Investigation into EMDR has been characterised by poor-quality studies, rather than tightly-controlled trials that could justify or falsify the mechanisms that have been proposed to support it. Novella writes that the research quantity nevertheless means that EMDR has claimed a place among accepted treatments and is "not likely going away anytime soon, even though it is a house of card built on nothing".<ref name="f445">{{cite web | title=EMDR Is Still Dubious | publisher=Science-Based Medicine | date=23 October 2024 | url=https://sciencebasedmedicine.org/emdr-is-still-dubious/ | vauthors=Novella S}}</ref>
 
EMDR has been characterised as a modern-day [[mesmerism]], as the therapies have striking resemblances, from the sole inventor who devises the system while out walking, to the large business empire built on exaggerated claims. In the case of EMDR, these have included the suggestions that EMDR could drain violence from society and be useful in treating [[cancer]] and [[HIV/AIDS]].<ref name="tsep">{{cite book |title=[[The Skeptic Encyclopedia of Pseudoscience]] |vauthors=Rosen GM, McNally RJ, Lilienfield SO |publisher=Bloomsbury |year=2002 |isbn=978-1-57607-653-8 |veditors=Shermer M, Linse P |volume=1 |pages=321–326 |chapter=EMDR: Eye Movement Desensitization and Reprocessing}}</ref> Psychology historian Luis Cordón has compared the popularity of EMDR to that of other cult-like pseudosciences, [[facilitated communication]] and [[thought field therapy]].<ref name=cordon/>
 
A parody website advertising "sudotherapy" created by a fictional "Fatima Shekel" appeared on the internet in the 1990s.<ref name="The Psychologist_2007">{{cite journal | vauthors = de Jongh A, ten Broeke E |title=A course in pseudoscience |journal=De Psycholoog |date=February 2007 |pages=87–91 |url=https://www.dousa.nl/DePsycholoogFebr2007letters.pdf |access-date=15 April 2023}}</ref><ref name="McNally_Dutch">{{cite journal | vauthors = McNally RJ |title=emdr en mesmerisme |journal=DTH Magazine |date=2001 |volume=3 |issue=21 |url=https://www.directievetherapie.nl/artikelen/jaargang21/emdr-en-mesmerisme-21-3-270/ |access-date=15 April 2023 |language=Dutch}}</ref><ref name=ps-in_sudotherapy/> Proponents of EMDR described the website as libelous, since the website contained an image of a pair of shifting eyes following a cat named "Sudo", and "Fatima Shekel" has the same initials as EMDR's founder, Francine Shapiro.<ref name=ps-in_sudotherapy/> However, no legal action took place against the website or its founders.<ref name=ps-in_sudotherapy>{{cite book |chapter=Chapter 1: Characteristics of Science and Pseudoscience in Social Work Practice |title=Science and Pseudoscience in Social Work Practice |vauthors=Thyer BA, Pignotti MG |year=2015 |publisher=Springer |doi=10.1891/9780826177698.0004 |isbn=9780826177681}}</ref>
 
== Research ==
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There is some evidence that EMDR can be as effective as [[trauma focused cognitive behavioral therapy]] (TF-CBT) for treating PTSD, though concerns have been raised about the poor quality of the underlying studies.<ref name = "Cuijpers 2020"/><ref name=Bisson2013/> In a 2021 systematic review of 13 studies, clients had mixed perceptions of the effectiveness of EMDR therapy.<ref>{{cite journal | vauthors = Shipley G, Wilde S, Hudson M |title=What do clients say about their experiences of Eye Movement Desensitisation and Reprocessing therapy? A systematic review of the literature. |journal=European Journal of Trauma & Dissociation |date=April 2021 |volume=6 |issue=2 |page=100226 |doi=10.1016/j.ejtd.2021.100226| issn=2468-7499 |s2cid=235544895 }}</ref>
 
 
=== Treating conditions other than PTSD ===
EMDR has been tested on a variety of other mental health conditions with mixed results.<ref name = "Cuijpers 2020"/>
* A 2021 systematic review and meta-analysis found EMDR to have a moderate benefit in treating [[Depression (mood)|depression]], but the number and quality of the studies were low.<ref name="Carletto_2021">{{cite journal | vauthors = Carletto S, Malandrone F, Berchialla P, Oliva F, Colombi N, Hase M, Hofmann A, Ostacoli L | display-authors = 6 | title = Eye movement desensitization and reprocessing for depression: a systematic review and meta-analysis | journal = European Journal of Psychotraumatology | volume = 12 | issue = 1 | pages = 1894736 | date = April 2021 | pmid = 33889310 | pmc = 8043524 | doi = 10.1080/20008198.2021.1894736 }}</ref>
* Positive effects have also been shown for certain anxiety disorders, but the number of studies was low and the risk of bias high.<ref name="Cuijpers 2020" /> The American Psychological Association describes EMDR as "ineffective" for the treatment of [[panic disorder]].<ref name="APA_Panic_2010">{{cite book |last1=APA Work Group On Panic Disorder |title=Practice Guideline For The Treatment of Patients With Panic Disorder |date=2010 |publisher=American Psychological Association |page=13 |url=https://psychiatryonline.org/pb/assets/raw/sitewide/practice_guidelines/guidelines/panicdisorder.pdf |access-date=21 March 2023}}</ref>
* EMDR has been found to cause strong effects on [[dissociative identity disorder]] patients, leading to recommendations for adjusted use.<ref>Recommended Guidelines: A General Guide to EMDR's Use in the Dissociative Disorders (authored by the EMDR Dissociative Disorders Task Force and published in Shapiro, 1995, 2001)</ref><ref>p. 159, Guidelines for Treating Dissociative Identity Disorder in Adults, Third Revision, International Society for the Study of Trauma and Dissociation. 3 Mar 2011</ref>
* A 2023 systematic review of evidence found EMDR's effectiveness in treating mental health conditions of children and adolescents who have been sexually abused is limited.<ref name="Caro-2023">{{cite journal | last1=Caro | first1=Paola | last2=Turner | first2=William | last3=Caldwell | first3=Deborah M | last4=Macdonald | first4=Geraldine | title=Comparative effectiveness of psychological interventions for treating the psychological consequences of sexual abuse in children and adolescents: a network meta-analysis | journal=Cochrane Database of Systematic Reviews | volume=2023 | issue=6 | date=2023-06-05 | pages=CD013361 | pmid=37279309 | pmc=10243720 | doi=10.1002/14651858.CD013361.pub2 }}</ref>
 
=== Professional practice guidelines ===
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* The Dutch National Steering Committee on Mental Health Care has released multidisciplinary guidelines which describe "insufficient scientific evidence" to support EMDR in the acute period following a stressful event (2008),<ref name="Impact2008">{{cite book |last1=Impact, the Dutch knowledge & advice centre for post-disaster psychosocial care |title=European Multidisciplinary Guideline: Early psychosocial interventions after disasters, terrorism and other shocking events |date=2008 |___location=Amsterdam-Zuidoost, Netherlands |pages=40–41 |url=https://www.coe.int/t/dg4/majorhazards/ressources/virtuallibrary/materials/netherlands/guideline_English_incl.%20preamble%20_def_.pdf |access-date=21 March 2023}}</ref> but recommend EMDR's use in chronic PTSD (2003).<ref name="Dutch">{{Cite report |author=Dutch National Steering Committee Guidelines Mental Health and Care |year=2003 |title=Guidelines for the diagnosis treatment and management of adult clients with an anxiety disorder |___location=Utrecht, Netherlands |publisher=The Dutch Institute for Healthcare Improvement }}</ref>{{page needed|date=July 2020}}
 
=== OtherCriticism conditions ===
EMDR is controversial among some scholars in the psychological community.<ref name="McNally1999">{{cite journal | vauthors = McNally RJ |author-link1= Richard McNally |title=Research on eye movement desensitization and reprocessing (EMDR) as a treatment for PTSD |journal=PTSD Research Quarterly |volume=10 |issue=1 |year=1999 |pages=1–7 |url=https://www.hsdl.org/?view&did=13105 }}</ref><ref name="Sikes_2003">{{cite journal | vauthors = Sikes C, Sikes V |title=EMDR: Why the controversy? |journal=Traumatology |date=2003 |volume=9 |issue=3 |pages=169–182 |doi=10.1177/153476560300900304 }}</ref><ref>{{cite journal | vauthors = Hasandedić-Đapo L | title = How Psychologists Experience and Perceive EMDR? | journal = Psychiatria Danubina | volume = 33 | issue = Suppl 1 | pages = 18–23 | date = February 2021 | pmid = 33638952 | doi = }}</ref> It is used by some practitioners for trauma therapy and in the treatment of [[complex post-traumatic stress disorder]].<ref name="Adler-Tapia">{{cite book | vauthors = Adler-Tapia R, Settle C |title=EMDR and The Art of Psychotherapy With Children |___location=New York |publisher=Springer Publishing Co. |page=228 |year=2008 |isbn=978-0-8261-1117-3}}</ref><ref name="isbn0-7619-2921-5">{{cite book | vauthors = Scott CV, Briere J |title=Principles of Trauma Therapy: A Guide to Symptoms, Evaluation, and Treatment |publisher=Sage Publications |___location=Thousand Oaks, CA |year=2006 |pages=312 |isbn=978-0-7619-2921-5}}</ref>
EMDR has been tested on a variety of other mental health conditions with mixed results.<ref name = "Cuijpers 2020"/>
 
* A 2021 systematic review and meta-analysis found EMDR to have a moderate benefit in treating [[Depression (mood)|depression]], but the number and quality of the studies were low.<ref name="Carletto_2021">{{cite journal | vauthors = Carletto S, Malandrone F, Berchialla P, Oliva F, Colombi N, Hase M, Hofmann A, Ostacoli L | display-authors = 6 | title = Eye movement desensitization and reprocessing for depression: a systematic review and meta-analysis | journal = European Journal of Psychotraumatology | volume = 12 | issue = 1 | pages = 1894736 | date = April 2021 | pmid = 33889310 | pmc = 8043524 | doi = 10.1080/20008198.2021.1894736 }}</ref>
EMDR adds a number of non-scientific practices to [[exposure therapy]].<ref name="non">{{cite book |page=292 |vauthors= Lohr JM, Gist R, Deacon B, Devilly GJ, Varker T |chapter=Chapter 10: Science- and Non-Science-Based Treatments for Trauma-Related Stress Disorders |publisher=Routledge |veditors=Lilienfeld SO, Lynn SJ, Lohr JM |title=Science and Pseudoscience in Clinical Psychology |edition=2nd |year=2015 |isbn=9781462517893|quote="...eye movements and other bilateral stimulation techniques appear to be unnecessary and do not uniquely contribute to clinical outcomes. The characteristic procedural feature of EMDR appears therapeutically inert, and the other aspects of this treatment (e.g., imaginal exposure, cognitive reappraisal, in vivo exposure) overlap substantially with those of exposure-based treatments for PTSD...EMDR offers few, if any, demonstrable advantages over competing evidence-based psychological treatments. Moreover, its theoretical model and purported primary active therapeutic ingredient are not scientifically supported."}}</ref> EMDR is classified as one of the "power therapies" alongside [[thought field therapy]], [[Emotional Freedom Techniques]] and others{{snd}}so called because these therapies are marketed as being superior to established therapies which preceded them.<ref name=ros2012>{{cite book |vauthors=Rosquist J |isbn=9781136915772 |publisher=Routledge |year=2012 |title=Exposure Treatments for Anxiety Disorders: A Practitioner's Guide to Concepts, Methods, and Evidence-Based Practice |page=92}}</ref>
* Positive effects have also been shown for certain anxiety disorders, but the number of studies was low and the risk of bias high.<ref name="Cuijpers 2020" /> The American Psychological Association describes EMDR as "ineffective" for the treatment of [[panic disorder]].<ref name="APA_Panic_2010">{{cite book |last1=APA Work Group On Panic Disorder |title=Practice Guideline For The Treatment of Patients With Panic Disorder |date=2010 |publisher=American Psychological Association |page=13 |url=https://psychiatryonline.org/pb/assets/raw/sitewide/practice_guidelines/guidelines/panicdisorder.pdf |access-date=21 March 2023}}</ref>
 
* EMDR has been found to cause strong effects on [[dissociative identity disorder]] patients, leading to recommendations for adjusted use.<ref>Recommended Guidelines: A General Guide to EMDR's Use in the Dissociative Disorders (authored by the EMDR Dissociative Disorders Task Force and published in Shapiro, 1995, 2001)</ref><ref>p. 159, Guidelines for Treating Dissociative Identity Disorder in Adults, Third Revision, International Society for the Study of Trauma and Dissociation. 3 Mar 2011</ref>
EMDR has been characterized as [[pseudoscience]], because the underlying theory and primary therapeutic mechanism are [[Falsifiability|unfalsifiable]] and non-scientific. EMDR's founder and other practitioners have used [[Pseudoscience#Falsifiability|untestable hypotheses]] to explain studies which show no effect.<ref name=ps-in_promotion>{{cite book |chapter=Chapter 4: Pseudoscience in Treating Adults Who Experienced Trauma |title=Science and Pseudoscience in Social Work Practice |vauthors=Thyer BA, Pignotti MG |year=2015 |publisher=Springer |page=221 |doi=10.1891/9780826177698.0004 |isbn=9780826177681|quote=Nevertheless, to date, given that there is no evidence that anything unique to EMDR is responsible for the positive outcomes in comparing it to no treatment and the florid manner in which it has been marketed, we are including it in this book... Another way in which EMDR qualifies as a pseudoscience is the manner in which it was developed and marketed... EMDR proponents have come up with ad hoc hypotheses to explain away unfavorable results that do not support its theory, which is one of the hallmark indicators of a pseudoscience... This type of post hoc explanation renders her theory unfalsifiable and thus places it outside the realm of science, because to qualify as scientific, a theory must be falsifiable.}}</ref> The results of the therapy are non-specific, especially if directed eye movements are irrelevant to the results. When these movements are removed, what remains is a broadly therapeutic interaction and deceptive marketing.<ref name="Herbert" /><ref name=Devilly2002>{{cite journal | vauthors = Devilly G |title=Eye movement desensitization and reprocessing: a chronology of its development and scientific standing |journal=The Scientific Review of Mental Health Practice |date=2002 |volume=1 |issue=2 |pages=132|url=http://devilly.org/Publications/EMDR-review.pdf}}</ref> According to neurologist [[Steven Novella]]:
* A 2023 systematic review of evidence found EMDR's effectiveness in treating mental health conditions of children and adolescents who have been sexually abused is limited.<ref name="Caro-2023">{{cite journal | last1=Caro | first1=Paola | last2=Turner | first2=William | last3=Caldwell | first3=Deborah M | last4=Macdonald | first4=Geraldine | title=Comparative effectiveness of psychological interventions for treating the psychological consequences of sexual abuse in children and adolescents: a network meta-analysis | journal=Cochrane Database of Systematic Reviews | volume=2023 | issue=6 | date=2023-06-05 | pages=CD013361 | pmid=37279309 | pmc=10243720 | doi=10.1002/14651858.CD013361.pub2 }}</ref>
 
{{blockquote|[T]he false specificity of these treatments is a massive clinical distraction. Time and effort are wasted clinically in studying, perfecting, and using these methods, rather than focusing on the components of the interaction that actually work.<ref name = "SBM" >{{cite web | vauthors = Novella S | author-link = Steven Novella |title=EMDR and Acupuncture – Selling Non-specific Effects |url=https://sciencebasedmedicine.org/emdr-and-acupuncture-selling-non-specific-effects/ |department=Science Based Medicine |publisher=Society for SBM |date=March 30, 2011 |access-date=12 July 2020}}</ref>}}
 
Investigation into EMDR has been characterised by poor-quality studies, rather than tightly-controlled trials that could justify or falsify the mechanisms that have been proposed to support it. Novella writes that the research quantity nevertheless means that EMDR has claimed a place among accepted treatments and is "not likely going away anytime soon, even though it is a house of card built on nothing".<ref name="f445">{{cite web | title=EMDR Is Still Dubious | publisher=Science-Based Medicine | date=23 October 2024 | url=https://sciencebasedmedicine.org/emdr-is-still-dubious/ | vauthors=Novella S}}</ref>
 
EMDR has been characterised as a modern-day [[mesmerism]], as the therapies have striking resemblances, from the sole inventor who devises the system while out walking, to the large business empire built on exaggerated claims. In the case of EMDR, these have included the suggestions that EMDR could drain violence from society and be useful in treating [[cancer]] and [[HIV/AIDS]].<ref name="tsep">{{cite book |title=[[The Skeptic Encyclopedia of Pseudoscience]] |vauthors=Rosen GM, McNally RJ, Lilienfield SO |publisher=Bloomsbury |year=2002 |isbn=978-1-57607-653-8 |veditors=Shermer M, Linse P |volume=1 |pages=321–326 |chapter=EMDR: Eye Movement Desensitization and Reprocessing}}</ref> Psychology historian Luis Cordón has compared the popularity of EMDR to that of other cult-like pseudosciences, [[facilitated communication]] and [[thought field therapy]].<ref name=cordon/>
 
A parody website advertising "sudotherapy" created by a fictional "Fatima Shekel" appeared on the internet in the 1990s.<ref name="The Psychologist_2007">{{cite journal | vauthors = de Jongh A, ten Broeke E |title=A course in pseudoscience |journal=De Psycholoog |date=February 2007 |pages=87–91 |url=https://www.dousa.nl/DePsycholoogFebr2007letters.pdf |access-date=15 April 2023}}</ref><ref name="McNally_Dutch">{{cite journal | vauthors = McNally RJ |title=emdr en mesmerisme |journal=DTH Magazine |date=2001 |volume=3 |issue=21 |url=https://www.directievetherapie.nl/artikelen/jaargang21/emdr-en-mesmerisme-21-3-270/ |access-date=15 April 2023 |language=Dutch}}</ref><ref name=ps-in_sudotherapy/> Proponents of EMDR described the website as libelous, since the website contained an image of a pair of shifting eyes following a cat named "Sudo", and "Fatima Shekel" has the same initials as EMDR's founder, Francine Shapiro.<ref name=ps-in_sudotherapy/> However, no legal action took place against the website or its founders.<ref name=ps-in_sudotherapy>{{cite book |chapter=Chapter 1: Characteristics of Science and Pseudoscience in Social Work Practice |title=Science and Pseudoscience in Social Work Practice |vauthors=Thyer BA, Pignotti MG |year=2015 |publisher=Springer |doi=10.1891/9780826177698.0004 |isbn=9780826177681}}</ref>
 
== Society and culture ==