EMDR FORUM ARCHIVE, 2000
Re:Dangers of EMDR
Sandra Paulsen Inobe PhD · 02/05/03 at 2:26 PM ET
This is as good a place as any to mention something I don't think I have mentioned before. Again, it is a clinical observation. My source of information is that I have conducted both exposure/cbt treatment of PTSD, and EMDR treatment of PTSD, and found them to be very different. I came from a rather behavioral and cognitive behavioral academic clinical psychology (PhD) program by the way at the University of Hawaii Manoa. One of the differences in the two from this clinicians point of view is that with EMDR, both the clinician and the client know when they are doing it. With exposure treatment with cbt "interweaves" to borrow a term from EMDR parlance, it is not nearly as clear when one is doing it (meaning, exposure treatment) and when one is just talking, even if talking about the trauma. This is important because when people are talking, it is easy to not experience the affective and somatic components of the trauma. Its easy to block it and just stay in the cognitive domain. After all, that's the point of CBT, the primacy of cognition over affect. With EMDR, because of the targeting of the cognitive (verbal), visual, affective and somatic features of the trauma, and because of the presence of sets of eye movements or other bilateral stimulation, both parties are always clear whetherh they are doing EMDR or not. It is clear when the client is blocking or dissociating the traumatic material, which maintains the PTSD, and when the client is allowing him/herself to experience the traumatic material, which allows it to be desensitized and completed, transformed. If the client is blocking/dissociated the material in EMDR, it is evident that it is time to do an interweave. In exposure treatment, it is not so clear. In the case of eye movements per se (not with the other forms of bilateral stimulation), the therapist can actually see whether the eyes are tracking in a smooth pursuit fashion, or whether there are little flickers or fixations that are associated with dissociative moments. I can tell during EMDR processing if a person has processed most of the material but skipped over a small piece of it by observing those little eye flickers. When I go back and clarify, typically they glossed over an especially horrifying or shameful piece of the memory, as evident in the eye flicker. Like they stumbled on a curb but kept going. And by the way, As I recall, I don't think the conclusion that Shawn Cahill made is that there is incontrovertable proof that eye movements are placebo only, rather that their merit has not been proven with existing studies. That's a different conclusion. Your analogy about voo doo is not persuasive to me as currently constructed. If you want a response on the analogy you'll have to build your case more about how EMDR is like voodoo, I mean, procedurally. Otherwise, it seems like just another way to call EMDR snake oil and voodoo or alien abductions, which cheap shots are precisely what gets so tiresome. I'm confident you didnt' intend a cheap shot so by all means build your case.
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