Still confused

First, I must say that I am still confused. I actually offered 4 sources of data in my posts above(research, theapist experience, patient experience,and independent review)ALL of which had been dismissed by those who find EMDR objectionable. The arguement had nothing to do with authority, but rather that the 4 sources of data yielded the same outcome. We obviously disagree about what the research says and how various research reports should be interpreted. But to say that I was resorting to the "authority arugement" is simply not true.

Second, your statement that according to the Div 12 criteria, almost every type of therapy (which had 2 positive reports) no matter how strange would be supported as valid is actually not true. The Div 12 report lists a rather small subset of the hundreds of interventions that you can find in the literature over the last few decades. The vast majority were dismised by Division 12 as having no empirical support. Making the cut might have been easier than you would have liked (I actually would agree with this assessment), but most interventions that Division 12 could consider were dismissed as having no evidence of empirical validity. Could the criteria been more stringent? sure, of course. Did most therapy procedures described in the literature over the years qualify, no they did not. Did EMDR qualify, yes it did. Did CBT qualify, yes it did.

A review of the Div 12 discussion lists from May to July of 1997 shows that the cognitive therapy community initially argued that EMDR shouldn't be considered as a seperate modality because it was simply another form of cognitive therapy. That is, the initial objection was that it was just cbt and so should not be treated as a seperate modality. Div 12 rejected that arguement, and explained why.

This debate began because research that supported EMDR was deemed unreliable by its critics. At the same time, research that did not support EMDR was offered as being well conducted and therefore reliable. We obviously don't agree with what research was flawed and what was signficant. That is part of what science is about, and I would have been surprised if we had agreed. Part of the task of Div 12 and ISTSS was to weed through this same research, throw out the flawed research (on both sides) and see what was left. They did so. You don't necessarily agree with their judgements and quite frankly I don't either. Should we run out and blindly accept their judgements, no of course not. Are you, or I, or anyone free to disagree with the findings of Div 12 or ISTSS, yes of course. Does their inclusion of EMDR mean that they are right and those who disagree are wrong, no of course not. Should critics of EMDR give up their disagreements out of some sort of respect for the authority of ISTSS or Div 12, no never.

The research on both sides is less than perfect, often far less than perfect. I think that is clear, at least to me and most of those who I know who support EMDR. More research is needed and is underway. I welcome the research that supports EMDR AND the research that does not support EMDR. The goal is not to support EMDR. The goal is to advance knowledge so that we can be more effective helping our patients. When my understanding of the research or my clinical experience leads me to believe that EMDR is flawed, I will stop practicing EMDR. I reserve the right to throw out research that is flawed (for example, using EMDR to target one traumatic memory out of all such memories that fill a 12 month combat tour in a small group of veterans, leaving the other memories untreated and then assessing for PTSD years later and being surprised at finding PTSD and declaring that this disproves the effectiveness of EMDR). I would certainly agree that others also have the same perogative to throw out research that they find flawed.

In my judgement, the data and my experiences lead me to judge EMDR to be effective for a wide variety of patients (not all patients, just many of them). You are welcome to disagree and you are welcome to never practice EMDR. Please give me the same priveliges.

Oh one last suggestion, read the post somewhere below from the wife of a Vietnam veteran with ptsd. It made me cry a bit. That's what our work is about.

Bob

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Re: Still confused, by , 5/10/00

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