EMDR Forum Archive, 1999
Re: A response to Shapiro (part II)
Shapiro · 2/15/00 at 3:03 pm ET
4) Renfrey & Spates (1994) state in the discussion that the role of a visual task needs to be evaluated because they found the eye movements tasks to be more efficient. While the 8 participants in each cell did not allow for significance, the "marginally significant" finding for rapidity is important. With power this low it is difficult to come to any conclusions. You are the one who cited it as "proving" the eye movements were superfluous. That is an inaccurate statement. I suggest you read more than the abstracts of articles before making your judgments or disseminating them. I further suggest you read the component analysis parameters I published in my EMDR textbook in 1995. Component analyses of clinical treatments should be done with a diagnosed population capable of change in the small number of sessions alotted in the study. With EMDR, that means diagnosed single trauma PTSD. Look at those studies before you make a judgment. 5) As I noted previously, Rosen's article is completely misinformed. The EMDR procedures were fully in place before any replication research was completed. Further, I refer you again to: Lipke, H. (January, 1999) "Comments on 'Thirty years of behavior therapy...' and the promise of the application of scientific principles" the Behavior Therapist, p.11-14 This gives you a first hand account of the fidelity checks given to one study highlighted in Rosen's article. Rosen's rendition is simply inaccurate. And do you really think there is a valid argument for the publication of treatment outcome research or component analysis without appropriate fidelity checks from pre-assessed experts? Fidelity checks are a gold standard in the field. In a previous post at the top of the bulletin board you state that "competent cognitive therapists are hard to find" as an answer to why cbt might not help a client. Would you like incompetent ones to test cbt in research? 6) You have continued to cite Lohr et al. (and Rosen is one of Lohr's co-authors in other articles) without researching the documented discrepancies. I repeat: None of my citations of data errors published in my 1996 article have ever been contradicted: Shapiro, F. (1996). Errors of context and review of eye movement desensitization and reprocessing research. Journal of Behavior Therapy and Experimental Psychiatry, 27, 313-317. The same types of errors have been documented by Lipke in the article cited above. I cited a published meta-analysis: You claim you can't find it. Although two other meta-analysis were presented at major conferences: Maxfield and Hyer: Association for the Advancement of Behavior Therapy and Lamprecht et al.: American Psychiatric Association, you dismiss them and continue to cite already refuted review articles. You decry a lack of openness. Yet skeptical comments on this forum certainly exist. I don't care what is put on this list as long as it is respectful and scientifically based. You, however, have indulged in ad hominem attacks and continued to move to tangents instead of sticking to the point. Once again, the Lohr et al reviews misreported the data on the single subject component analysis. Four of the studies they listed as "proving" the eye movement was superfluous were actually supportive of the eye movement: Such as one study that found the eye movements were necessary in 5 out of 6 subjects. You choose to ignore that and all the other documented discrepancies. You unequivocally stated to clients and clinicians making earnest inquiry on this list that EMDR was nothing more than placebo and good old exposure therapy. Yet you cannot cite one exposure therapy study that has reported an 80% successrate in only three sessions which is the hallmark of EMDR. 1. EMDR effects are largely limited to verbal reports and not objective measures. 2. Eye movements are clinically unnecessary for improvement. 3. Improvements are consistent with nonspecific factors. 4. Imaginal exposure appears to account for EMDR's success which is not different from traditional cognitive behavioral therapies. 5. The more controlled the study, the less successful EMDR is versus controls. 6. The theoretical basis of EMDR is unfounded. I’ve dealt with 1-5. EMDR controlled studies have compared EMDR to the same controls and used the same standardized measures as exposure therapy studies. Eye movements and other bilateral stimulation have not been found to be superfluous. I’ll again refer you to my Journal of Anxiety Disorder article. Further, you did not address my comment that controlled studies of imaginal exposure therapy alone have only reported a 50% remission of PTSD. For an 80% success rate (generally found with 3 sessions of EMDR) imaginal plus invivo exposure was prescribed for 100 hours (Marks et al., 1998). Therefore, how can you, or anyone conceive of EMDR as simple, standard exposure therapy? How can you say the improvements are consistent with nonspecific factors when the effect sizes are so large and rapidly achieved. And I’ll repeat, meta-analyses have shown that the more rigorous the study the more pronounced the EMDR effect. As for #6: The EMDR theory predicted more rapid treatment effects than previously reported in the scientific literature. This has been shown in repeated studies to be true. As I've said previously, when you can cite an imaginal exposure study that achieves an 80% success rate in 3 sessions, or refute any of the data errors I’ve cited, I'm happy to listen. But I do not consider ad hominems and tangents as attempts to be scientific or evenhanded. Instead, I think you owe an apology to the clients and clinicians you’ve insulted by your patronizing comments regarding "placebo." I remind you: After a lengthy and rigorous examination of the controlled literature EMDR has been found to be empirically supported by independent researchers. These researchers fortunately were not wed to any particular orientation. Clients and clinicians need treatment choices—not an academic turf war between cognitive behaviorists and EMDR.
I will also state unequivocally that I simply will not tolerate a repetition of this kind of behavior on this forum in the future. Anytime you come onto this list with talk of "finger wagging," insulting the integrity of clinicians and the intelligence of clients I will simply delete your post without response. When a client calling herself "Loving Mom" posts on this bulletin board to share her joy at her child's recovery with EMDR it deserves respect. When you state the recovery is due to "placebo" and compare it to faith healing you have stepped far beyond the bounds of decency. Unfortunately, I was offline for a week and whatever damage was done cannot be undone. However, I will not allow a repetition.
Perhaps you are merely a victim of the misinformation that has been circulated in the review articles you cited. You certainly do not seem to have read the original data. EMDR stands solidly on a foundation of empirical science. No amount of ridicule or misinformation will alter that fact. If you would like to cite the studies or data corrections I requested I certainly invite you back. However, I will not permit you to insult the members of this forum with your insensitive misbehavior. Anyone searching for the truth of matter is invited to read the original controlled studies in the light of the reasonable clinical and scientific validity parameters I've set out in the 1995 text. If you cannot refute the parameters, please don't misrepresent the data.
Instead of addressing the science and refuting any of the errors I cited in these articles you have defended them by resorting to ad hominem attacks. I've asked you to justify your statement that EMDR adds nothing to simple exposure therapies by citing one cognitive behavior therapy controlled study that reports an 80% success rate in three sessions. You have not.
You claim I’ve not covered the material in your original posting, but rather obscured the issues. On the contrary, here is your list:
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