Medscape Rebuttal

The following letter was written by Louise Maxfield and sent to the editor of Medscape
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Re your news article, Jan 22, "Eye Movement Desensitization and Reprocessing Debunked."

I am writing to object to your use of irresponsible journalism. EMDR has not been debunked and you do your readers a serious disservice by making such unfounded allegations. You have allowed Medscape to be used for the
political purposes of a small group of vocal critics. An article correcting the errors in your news release is advised.

Your news article gives the impression that EMDR has not been adequately tested: "the shortcomings of EMDR research, such as comparison of EMDR with no treatment, ... and comparison of EMDR with therapies that have not been
identified as valid for the condition." There have been 12 randomized CBT studies, and 16 randomized EMDR studies, investigating PTSD treatment outcome. The controls used in these studies are almost identical.

These studies have found EMDR to be efficacious and EMDR appears to be equivalent in effects to CBT, and perhaps more efficient. EMDR and CBT have been recognized by the International Society for Traumatic Stress Studies as the only 2 psychotherapies that are efficacious in the treatment
of PTSD (Foa, Keane, & Friedman 2000).

CBT studies, with civilian participants, utilized a prescribed 16-24 hours of imaginal exposure treatment and homework, and reported a 55-65% elimination of PTSD. Imaginal exposure plus in vivo treatment (including
50-100 prescribed hours of homework) has resulted in a 75% decrease in PTSD diagnosis. In comparison, randomized EMDR studies, with civilian participants, consistently report a 70-90% decrease in PTSD diagnosis with 4-9 hours of treatment.

Your news release inaccurately states "In other instances, studies showed evidence of therapist allegiance, ethusiasm, and involvement artifacts." This statement is completely false, and Medscape should publish a correction. There is not even one published randomized controlled study that has investigated the issue of therapist allegiance in EMDR
treatment.

Herbert et al. (2000) are correct when they state that there is no conclusive evidence to date that eye movements contribute uniquely to outcome. This lack of evidence is indeed problematic. It is, to some extent however, the result of poor methodology, combined with inadequate
power (e.g., about 7 subjects per condition). Your article neglects to tell readers that every dismantling PTSD clinical study has found some evidence that eye movements improved outcome. Because there has not been any rigorous dismantling study of EMDR, that used a large sample of
participants diagnosed with PTSD, the role of eye movements in EMDR has not yet been adequately assessed.

The politicization of psychotherapy is extremely unfortunate. It robs resources from the important areas of investigation and development. It is disturbing to see Medscape participating in such endeavors.

regards,
Louise Maxfield

Foa, E.B., Keane, T.M., & Friedman, M.J. (Eds.) (2000). Effective treatments for PTSD: Practice guidelines from the International Society for Traumatic Stress Studies. New York: Guilford Press.

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