Eye movement desensitization and reprocessing: Difference between revisions

Revision as of 08:02, 12 February 2025

Revision as of 11:13, 12 February 2025

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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.

==Technique==

==Classification and technique==

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 is typically undertaken in a series of sessions with a trained therapist.<ref>{{cite web |title=Post-Traumatic Stress Disorder |url=https://www.nice.org.uk/guidance/ng116/chapter/Recommendations#assessment-and-coordination-of-care |publisher=[[National Institute for Health and Care Excellence]] |quote=1.6.20 EMDR for adults should: be based on a validated manual; typically be provided over 8 to 12 sessions, but more if clinically indicated, for example if they have experienced multiple traumas; be delivered by trained practitioners with ongoing supervision; be delivered in a phased manner and include psychoeducation about reactions to trauma, managing distressing memories and situations, identifying and treating target memories (often visual images), and promoting alternative positive beliefs about the self; use repeated in-session bilateral stimulation (normally with eye movements) for specific target memories until the memories are no longer distressing; include the teaching of self-calming techniques and techniques for managing flashbacks, for use within and between sessions. |date=2018-12-05 |access-date=2021-12-03 }}</ref> The number of sessions can vary depending on the progress made. A typical EMDR therapy session lasts from 60 to 90 minutes.<ref>{{Cite web|url=https://www.emdria.org/about-emdr-therapy/experiencing-emdr-therapy/|title = Experiencing EMDR Therapy}}</ref>

=== Trauma and PTSD ===

The person being treated is asked to recall an image, phrase, and emotion that represent a level of distress related to a trigger while generating one of several types of bilateral sensory input, such as side-to-side [[eye]] movements or hand tapping.<ref name=feske>{{cite journal | vauthors = Feske U |title=Eye Movement Desensitization and Reprocessing Treatment for Posttraumatic Stress Disorder |journal=Clinical Psychology: Science and Practice |date=June 1998 |volume=5 |issue=2 |pages=171–181 |doi=10.1111/j.1468-2850.1998.tb00142.x | issn = 0969-5893}}</ref> The 2013 World Health Organization practice guideline says that "Like [[cognitive behavioral therapy]] (CBT) with a trauma focus, EMDR aims to reduce subjective distress and strengthen adaptive beliefs related to the traumatic event. Unlike CBT with a trauma focus, EMDR does not involve (a) detailed descriptions of the event, (b) direct challenging of beliefs, (c) extended exposure or (d) homework."<ref name="WHO 2013">{{cite report |publisher=World Health Organization |year=2013 |title=Guidelines for the Management of Conditions that are Specifically Related to Stress |___location=Geneva |url=https://www.who.int/mental_health/emergencies/stress_guidelines/en/ |archive-url=https://web.archive.org/web/20131129075320/http://www.who.int/mental_health/emergencies/stress_guidelines/en/ |url-status=dead |archive-date=November 29, 2013 |page=Glossary page 1 |pmid=24049868}}</ref>