Eye movement desensitization and reprocessing: Difference between revisions

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'''Eye movement desensitization and reprocessing''' ('''EMDR''') is a form of [[psychotherapy]] thatdesigned is a recommended treatmentto fortreat [[post-traumatic stress disorder]] (PTSD), but remains controversial within the psychological community. It was devised by [[Francine Shapiro]] in 1987 and originally designed to alleviate the distress associated with [[traumatic memories]] such as PTSD.

EMDR involves focusingtalking onabout traumatic memories in a manner similar to [[exposure therapy]] while engaging in side-to-side eye movements or other forms of bilateral stimulation.<ref name="Blum_2022" /><ref name="Rodenburg2009" /> It is also used for some other psychological conditions.<ref name="Carletto_2021" /><ref name="Cuijpers 2020" />

EMDR is recommended for the treatment of PTSD by various government and medical bodies citing varying levels of evidence, including the [[World Health Organization]], the UK [[National Institute for Health and Care Excellence]], the Australian [[National Health and Medical Research Council]], and the US Departments of [[Department of Veterans Affairs|Veteran Affairs]] and [[Department of Defense|Defense]]. The US [[National Institute of Medicine]] found insufficient evidence to recommend EMDR.<ref name=NAS_IOM_2008/> The American Psychological Association suggestsdoes EMDRnot may be useful for treating adult PTSD.<ref name=apa2017/> Treatment guidelines noteendorse EMDR effectivenessas isa statistically the same as traumafirst-focusedline behavioral therapytreatment, andbut the Australian National Health and Medical Research Council notesindicates that thisit mayis beprobably dueeffective tofor includingtreating mostadult ofPTSD. the core elements of [[cognitive behavioral therapy]] (CBT).

Systematic analyses published since 2020 suggest that EMDR treatment efficacy for adults with PTSD is equivalent to trauma-focused cognitive and behavioral therapies (TF-CBT), such as [[Prolonged exposure therapy]] (PE) and [[Cognitive Processing Therapy]] (CPT). However, bilateral stimulation does not contribute substantially, if at all, to treatment effectiveness. The predominant therapeutic factors in EMDR and TF-CBT are [[Exposure therapy|exposure]] and various components of [[cognitive-behavioral therapy]].

There is debate about how the therapy works and whether it is more effective than other established treatments.<ref name="Blum_2022" /><ref name="Sikes_2003" /> The eye movements have been criticized as having no scientific basis.<ref name="non"/> The founder promoted the therapy for the treatment of PTSD, and proponents employed [[Pseudoscience#Falsifiability|untestable hypotheses]] to explain negative results in controlled studies.<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> EMDR has been characterized as a pseudoscientific [[purple hat therapy]] (i.e., only as effective as its underlying therapeutic methods without any contribution from its distinctive add-ons).<ref name=ps-in>{{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 |pages=106, 146 |doi=10.1891/9780826177698.0004 |isbn=9780826177681}}</ref><ref name="Fasce2017">{{cite journal | last=Fasce | first=Angelo | title=What do we mean when we speak of pseudoscience? The development of a demarcation criterion based on the analysis of twenty-one previous attempts [¿Qué queremos decir cuando hablamos de pseudociencia? El desarrollo de un criterio de demarcación basado en el análisis de veintiún intentos anteriores] | journal=Disputatio: Philosophical Research Bulletin | volume=6 | issue=7 | pages=459–488 | date=22 December 2017 | issn=2254-0601 | doi=10.5281/ZENODO.1433737 | quote=a technique that avoids [criteria] 1 and 3 but not 2 [and is therefore a pseudoscience based on the classification method described on the previous page]}}</ref>

Because eye movements and other bilateral stimulation techniques do not uniquely contribute to EMDR treatment efficacy, EMDR has been characterized as a [[purple hat therapy]], i.e., its effectiveness is due to the same therapeutic methods found in other evidence-based psychotherapies for PTSD, namely exposure therapy and CBT techniques, without any contribution from its distinctive add-ons.

==Classification and technique==