EMDR FORUM ARCHIVE, 2000
Re:Here's the point
Ricky Greenwald · 04/25/03 at 3:02 PM ET
There are several problems with Landry's post. I feel like I wrote this paper already, in my published response to McNally a couple of years ago. But the smear campaign lives! Oh well... Landry wrote in part: This is one problem. We should not be talking about me, or about how popular a position might be. That's like saying, "40,000 clinicians have been trained in EMDR, they can't all be wrong." We don't want to count on that kind of logic. "Ricky, strip away all the superfluous speculations about this and that and you are left with a solid RCT" I agree. This is one of the EMDR/PE RCT's to be reckoned with. "(the best to date IMO because it even has researcher allegience effects effectively ruled out)" This cannot be assumed. First authors generally have final say. We have no way of knowing what the other others might have to say about this. I have heard of more than one published RCT comparing EMDR to CBT in which co-authors have made serious complaints, for example that the first author squelched data that was favorable to EMDR. These are not my stories to tell, but the point is that we can't assume things about co-authors or researcher allegiance effects. We also do not know (at least I don't) whether Taylor might have a bias or not, and if so, in what direction. This is why we rely on peer review, but even so, that's not a foolproof process. "that demonstates that exposure is more effective than EMDR" More effective in some ways, but requiring a lot more homework. Yes, PE beat EMDR in this study. When EMDR beats PE in a well-designed RCT, we say, "Okay, but this is just one study, we need to aggregate findings from many studies." This study is of high quality, but no more definitive than several others. Let's use the same standard regardless of the findings of a specific study. "(which makes sense given the hypothesis that EMDR is exposure lite). The question of what is effective in EMDR is another issue entirely. Perhaps it is effective because of its exposure element, but not as effective as proper exposure because it is not done most effectively." Rogers, Maxfield, Smyth, and others have addressed this issue at length. First of all, you're not even in the right conversation if you choose to selectively ignore the bulk of the research, which at this point indicates, roughly, that PE and EMDR both work about as well. Then comes the point that EMDR seems to work while violating some of the core empirically-based principles of exposure; for example, PE uses prolonged, repeated, focused exposure, whereas EMDR uses short burst of exposure as well as free association to new exposure targets. Then you have to wonder what makes EMDR work about as well as PE while not using the methodology that we "know" makes PE work. "Who knows, because we are wasting our time testing an ineffective treatment." What's up with this? What kind of response can you expect when you say something like this? The APA and ISTSS reviews have concurred that EMDR works. And that was before most of the better studies showing same were published. If you are really intending to be in conversation with people, you might as well stick with the facts. On the other hand, if your real goal is to get people to reject you and refuse to deal with you (perhaps so you can then say that they were biased and write them off) then this would be a good strategy. "Let me explain. My point was that it is time to do away with "EMDR" the business, and focus on what element(s) of these treatments are effective. Let me give you a hint to start off with...it ain't the eye movements." Again, this has been addressed at length elsewhere, as well as on this forum. Several studies have shown a possible effect of eye movements; also, if eye movements are only one of several active elements in EMDR, a large N would be needed to detect a true/actual effect. It is definitely premature to assert that eye movements have no role, just because no role has been definitevely proven - especially given the inadequacy of the studies finding no effect for eye movements, as well as the other studies that did find an effect. The practice of repeating false assertions can be effective as demagoguery (it apparently works pretty well for "W") but has no place in a professional/scientific forum. "There is no reason, given the wealth of data we have now, to sink more money into horse race studies between CBT Form1 and CBT Form2." In conclusion, if you persist in ignoring and discounting available data that is inconsistent with your views, and if you persist in making false and provocative assertions based on your preferred data set only, then certain outcomes can be predicted: 1) You may find that those interested in true dialogue and in furthering the science of clinical practice will eventually not wish to engage with you. 2) You may find that your professional "friends" are those who choose the same biases. 3) You and your "friends" may be successful in doing some damage to EMDR and to science. Demagoguery can have impact.
"Notice that you are the only one jumping forward to try to argue otherwise."
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