Re: new article on EMDR

Don, thanks for your thoughtful reply, and I do have some thoughts to offer you.

1) Indeed, I am quite able to clarify what I mean about EMDR being less painful for both patient and clinician. CBT is a relatively more arduous and painful procedure for several reasons, enumerated below:

a) In CBT, the history of the trauma has to be obtained, blow by blow, in interview or written narrative by the client, including the situation, the smells, the sounds, the tastes, the pictuers, the meaning. Getting that history is grueling for the patient and highly arousing. With EMDR, getting that blow by blow up front before the EMDR begins is not necessary. generally.

b) Exposures have to be repeated in CBT more frequently than in EMDR. Typically, in CBT one takes the patient through multiple repetitions of the traumatic scene point by point. The whole point of the PTSD is to keep the brakes on, but here we are taking them through it, like driving with the brakes on. Typically in EMDR for a single adult onset trauma, the whole thing processes through in one long episode.

c) In CBT, we often have to expose them to the memory one time, at least, for each of the above sensory/memory channels. Many exposure sessions, all arduous. In EMDR, typically, the channels play all at once, like a videotape. I don't have to utter the exposure words to them, and they don't have to read the incident from a script. The thing just plays like a videotape. I just have to know how to get it unstuck. This is much easier for both.

d) As a therapist, I can't assure clients that CBT exposure will be curative, because I know full well that the drop out rate is so high that many won't stay on board that long. With EMDR for simple PTSD, I can give assurances that soon they and I will be looking back on the old days when they had symptoms, and within a few weeks, my words come true.

e) I'm not a sadist, I like to heal people in the kindest way. EMDR is so much kinder, I have never looked back. I still incorporate CBT in my case formulation, and skills building EMDRs, but it is so much bigger than CBT.

2a). You may not intend to scare people away -- I don't know you or your motives. But I have observed these frustrating parallel realities since 1991, where honorable and well intentioned people, usually academics, refused to see these plain facts, and further, say untrue things about the procedure and the people using it. My favorite is the one about EMDR people being a cult. But people are scared away by these overtly negative comments. Today, for example, a woman no showed for an appointment for EMDR, and her husband called and explained that she had read some things on the internet (not this forum) that scared her. In trained hands, there is nothing to fear.

2b) Contrary to the notion that EMDR doesn't really do much, there is a problem that with any power tool, in untrained hands, you can cut off a thumb. Who would have thought that in this field there could be power tools - like in surgery? It is the opposite problem of a placebo effect -- it is the table saw effect. Look out.

2c) Who would have thought that a few cranky academic naysayers could delay the acceptance of what is likely to be seen as the greatest break through in psychology of the twentieth century? If what I'm saying is true, hypothetically, what is the human cost of that delay? Do the nay sayers who reject out of hand weigh their own responsibility to do no harm by standing in the way of something powerful good and healing?

3a) Yes, let's talk about data. I got a Ph.D., I revere data, there are three Ph.D.'s in my family. We all worship at the alter of empirical evidence. And we all know that our notions of evidence, our measurements, are flawed and full of noise and bias, and ossified and even corrupt politics. Sure, we still have to duke it out with data, but let's not forget what empirically means -- observable and measurable. I'm telling you, when I see a gorilla fall out of a tree, I don't need a micrometer to measure it. If you are willing, you will see it too. If you wear blinders, you'll be as rigid as you charge Francine with being.

3b) Yes, let's talk about Francine, knowing full well she'll be virtually reading over our shoulders here. I haven't laid eyes on her for several years (so much for the cult theory), but when I did hear her talk in the old days, and when I hear the trainers in the current workshops (I am a facilitator who gives supervision in the trainings), she and they said, "we don't know why it works but here are some ideas, research is underway". So when you say her theory, I guess you must be referring to Accelerated Information Processing theory and its language, which is somewhat novel. Please be sure to distinguish that AIP theory from the practice of EMDR. EMDR works, whether AIP theory holds up or is exactly on point. I for one think that AIP theory needs an injection of self-psychology to explain what we see when EMDR gets stuck and what gets it unstuck (I wasn't trained in self-psychology either) - but that is another story for another day.

Yes, Francine is zealous about EMDR's effect, but only fond of AIP theory, and willing to adjust it if and when the evidence suggests it needs enhancement. I think some have misunderstood her zeal, but I know why it is there. See, I think when God assigned responsibilities for this lifetime, he said, "let's see, we can't have Don do EMDR -- his job is to defend the status quo, that's important, --- and we can't have Sandra do it, she would see its elegant beauty, but she is too faint hearted and would quickly give up or become tubercular or something. No, it will have to be Francine, she is the only one with the guts and fortitude and chutzpah to tolerate incessant criticism and rebuke for years, and never lose sight of the goal -- healing my traumatized children. Don, Francine has better things to do than argue about this. She has large numbers of people she is training to cure even larger numbers of people in humanitarian assistance efforts around the world, whereever there are wars, disasters, -- you know, the full panoply of human misery. And people accuse her of being corrupt? And these are empiricists???

4) The studies are there, the videotapes are there, the patients' enthusiastic self-reports are there, the clinicians' self reports are there --- and the EMDR is there. The rules of evidence begin at home -- go get some EMDR -- surely you have SOME furniture you'd like to have rearranged. It doesn't have to be PTSD, just make sure you go to someone good. Now please excuse me, I have to go perform a couple of minor miracles in the morning with EMDR.

Warm Regards, --Sandra

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