EMDR FORUM ARCHIVE, 2000
Reply to the So-Called Debunking of EMDR
Don D. Rosenberg, MS · 02/03/01 at 1:21 ET
This e-mail is a response to an article on www.Medscape.com in which a Reuters article was cited, one which announced boldly that EMDR is debunked. The Reuters article was about a Herbert article. It was a one-sided report and not rebuttal or balance was sought either by Reuters or by Medscape. In addition to this e-mail I have sent two e-mails to Medscape insisting upon a reply and a new artcile printing correct information about EMDR. I have received only two boilerplate replies from Medscape so far. BELOW, 3 e-mails are collated: my letter to the EMDR Institute reporting on what I found in Medscape and what I wrote to Medscape, the entire Medscape e-mail, and then a copy of the Medscape article from Reuters on EMDR. Subj: Very important forwarded email from Medscape The highly respected service, Medscape, at the e-mail which I am forwarding to you below, includes a highly inappropriate news piece about a supposed 'debunking' of EMDR. Here is the e-mail which Medscape distributed to thousands of subscribers. If you click on it, you will see a news article with which I am sure you are familiar. The article was on Reuters. I hope the Institute will sent Reuters a request to print a balanced view. It is poor journalism to print an editorial piece, i.e., one opinion, without getting the alternative viewpoints. Please do something about this. I sent Medscape a reply. Later I thought I should also send the Institute the text of my e-mail to Medscape. That is below. It is based upon my reading of the Herbert et al article in The Skeptic. Thank you. This is my reply to Medscape. << I strongly object to your inclusion of this unbalanced article on your weekly e-mail. Unlike the usual scientific fare of this valuable service, the article in question is merely opinion. And it presents only one side of the issue. In no way does the work of Dr. Herbert "debunk" EMDR or even fairly represent EMDR. For example, the article you cite says, "These include claims of extremely high cure rates for relatively refractory conditions, vividly presented case studies, and extensive media attention. The researchers criticize "'the use of obscurantist language to compensate for an absence of content and to discourage would-be skeptics...'" I cannot let this inflammatory statement go by without comment as if it were a fact. In fact controlled studies abound to show 80%+ success rates. The fact that a condition is refractory should not make us throw out a new treatment because it shows effectiveness as if that must be impossible to achieve. By that logic, throw out Clozapine! Every treatment presents vivid case studies. There is nothing wrong with that. Every advance in medicine attracts media attention. There is nothing wrong with that. And I no of no obscurantist language used in EMDR. Just because the Herbert group throws out such language themselves does not make for truth! Further, for example, Herbert claims that exposure therapy has been the handiwork of Psychologists for 20-30 years. That is true and in fact I trained in 1974 with one of the earliest practitioners in the field, Thomas Stampfl, who developed Implosive Therapy as early as 1967. Herbert is unable to explain, however, why those exposure methods produced inconsistent and often limited results and were not certified as a treatment for PTSD, and that only with the addition of the entire EMDR protocol has the success rate for resolving PTSD exceeded 80-85+%. Dr. Herbert and his colleagues, Lohr, Lillienfield, and others, represent an extreme skeptical view. Some of their criticisms are disingenuous. They have some valid points regarding methodology in EMDR studies and regarding claims by EMDR therapists to have effectiveness for a wide range of conditions for which well controlled studies do not yet exist. But they also ignore the powerful preponderance of evidence which validates EMDR as the most effective and efficient treatment for trauma. They equate the few studies in which EMDR was not as effective, some of which have questionable fidelity to the EMDR procedure, with the large number of studies in which it was successful, an unfair comparison. The number of successes have led to EMDR being designated a treatment of choice for PTSD by the International Society for Traumatic Stress Studies. At the present moment it borders on the unethical NOT to recommend EMDR or Cognitive Behavioral Therapy to PTSD sufferers. There is a big leap from claiming, as they do, that EMDR has not proven the critical importance of bilateral stimulation as a part of the procedure to going on to claim that EMDR is ineffective, and implying near fraud by EMDR and its practitioners. Similarly, systematic desensitization by reciprocal inhibition (Wolpe's method) was proven highly effective even though later studies questioned the theory of reciprocal inhibition by relaxation. The later research led to a change in procedure and explanation, but not an invalidation of the idea of systematic desensitization. In other words, the mechanism of action may not be clear, but the procedure is a valuable addition to the therapeutic armamentarium. If one could not revise a theory about the mechanism of action and essential elements of a procedure, as Herbert et al suggest may not be done, then by their criteria most psychopharmacology is unethical because the mechanism of action is uncertain and theories about the latter tend to be revised. In other writing, these authors claim EMDR is not effective based upon two other dubious leaps of logic. 1) My impression is that they cite disconfirmatory studies, some of which are problematic, without critiquing those problems, while not giving due weight to the large number of confirmatory studies, as if ANY disconfirmation invalidates ALL confirmations. 2) Another problem with their idea is that they argue EMDR is invalid because EMDR made a claim that eye movements are critical and then switched it to claim that tapping or other bilateral stimulation can produce desensitization. They believe this is misleading and unfair and that the treatment which was researched is different from the one which is practiced and promoted. EMDR has not insisted upon eye movements alone for years and has been discussing bilateral stimulation as a more general concept for a number of years. As with so much criticism of EMDR, it is a straw man who is being criticized as if it were what EMDR practitioners actually do. Every treatment approach grows from its historical root methods and evolves -- psychoanalysis, Rogerian, behavioral, etc. I always thought THAT is SCIENCE, the use of experimental evaluation and feedback to improve theory and practice. But these authors deny EMDR that right. I guess I missed the point somewhere in my education that science consists only of proposing a theory and then never letting it change or evolve, then calling it Pseudoscience when empirical findings lead to its revision. I want Medscape to solicit a response from the EMDR Institute and to send an article on the e-mail list indicating that EMDR was approved as a treatment of choice for PTSD, and citing the many studies listed at www.emdr.com (under "Publications and Controlled Studies"). I think anything less is extremely harmful to patients everywhere and a disservice to the profession. Don Rosenberg, MS, LP, LMFT, CCSII, NBCDCH *************************************************************** ----------------- _______________________________________________________________________ ADVERTISEMENT Data from a Decade of Celexa Therapy Reviewed In the January issue of the Journal of Clinical Psychiatry, For complete prescribing information about Celexa BOOK REVIEW - NEUROLOGY FOR NON-NEUROLOGISTS, 4TH EDITION PERSONALITY DISORDERS: A CHALLENGE FOR TRANSPLANTATION DEPRESSION, RACE, HYPERTENSION, AND THE HEART MEDSCAPE PSYCHOPHARMACOLOGY TODAY COMMUNITY-BASED TREATMENT OF SCHIZOPHRENIA AND OTHER SEVERE MENTAL _______________________________________________________________________ PAROXETINE SAFER FOR PATIENTS WITH RHEUMATOID ARTHRITIS THAN AMITRIPTYLINE EYE MOVEMENT DESENSITIZATION AND REPROCESSING DEBUNKED ANTENATAL DEPRESSION INCREASES RISK OF ADVERSE OBSTETRIC AND NEONATAL OUTCOMES 'MIND-BODY THERAPIES' MAY HAVE LIMITED ROLE IN TREATMENT OF FIBROMYALGIA MOST US PATIENTS ON ANTIDEPRESSANTS REPORT INCOMPLETE CONTROL OF SYMPTOMS SOME NONPHARMACOLOGIC TREATMENTS ENDORSED FOR MIGRAINE HIGH PREVALENCE OF INSOMNIA FOUND IN CHINESE WOMEN UK LAUNCHES CAMPAIGN TO PERSUADE PARENTS MMR VACCINE IS SAFE MORE SEVERE DEPRESSION MAY REQUIRE LENGTHIER TREATMENT OLDER WOMEN WHO LIVE ALONE NOT AT HIGHER RISK OF POOR HEALTH OUTCOMES FLUOXETINE PLUS OLANZAPINE SHOWS PROMISE IN TREATMENT OF RESISTANT DEPRESSION EARLY MORNING LIGHT EXPOSURE BENEFITS SEASONAL AFFECTIVE DISORDER PATIENTS HYPONATREMIA MAY FOLLOW COLONOSCOPY PHYSICIANS PRESCRIBING ANTIPSYCHOTICS FACE ARRAY OF NEW LIABILITY ISSUES ANTIHYPERTENSIVES MAY PROTECT AGAINST DEMENTIA _______________________________________________________________________ GET THE MEDSCAPE TOOLBAR FREE! 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Subj: Re: [EMDR] Re Missing replies to pseudoscience guy
Date: 1/29/2001 9:11:27 AM Central Standard Time
From: Don729
To: pbookm@HOME.NET
Date: 1/27/2001 4:45:26 PM Central Standard Time
From: Don729
To: inst@emdr.com
<
the string of invalidated therapies that have been promoted for treatment
of anxiety and trauma, according to a review by Dr. James D. Herbert, of
MCP Hahnemann University in Philadelphia, and associates.
http://psychiatry.medscape.com/32733.rhtml?srcmp=psy-012601
Read it Here >>
Don Rosenberg, Level II
Milwaukee, Chicago
Subj: COMMENTS Re: Medscape's Psychiatry MedPulse 26-Jan-01
Date: 1/27/2001 4:35:41 PM Central Standard Time
From: Don729
To: news@medpulse.medscape.com
IMPORTANT:
In a message dated 1/27/2001 10:39:52 AM Central Standard Time, news@medpulse.medscape.com writes:
EYE MOVEMENT DESENSITIZATION AND REPROCESSING DEBUNKED
Eye movement desensitization and reprocessing (EMDR) is just the latest in
the string of invalidated therapies that have been promoted for treatment
of anxiety and trauma, according to a review by Dr. James D. Herbert, of
MCP Hahnemann University in Philadelphia, and associates.
http://psychiatry.medscape.com/32733.rhtml?srcmp=psy-012601
Read it Here >>
Milwaukee, Chicago
Here is the entire Medscape weekly e-mail within which the EMDr article is listed. This e-mail goes to a large number of psychiatrists and other interested mental health personnel.
***************************************************************
Forwarded Message:
Subj: Medscape's Psychiatry MedPulse 26-Jan-01 --Get Tarascon E-Pharmacopoeia for the Palm OS
Date: 1/27/2001 10:39:52 AM Central Standard Time
From: news@medpulse.medscape.com (Medscape's MedPulse)
>>> MEDSCAPE's Psychiatry MedPulse(R) <<<
http://psychiatry.medscape.com
_______________________________________________________________________
a review is published of 30 controlled clinical studies of
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Neurology for Non-Neurologists was written for medical students, residents,
and practicing physicians.
MedGenMed, January 23, 2001
http://psychiatry.medscape.com/32886.rhtml?srcmp=psy-012601
Readit Here
Review the definition and diagnostic criteria for personality disorders,
and the value of possible interventions for treating this population.
Progress in Transplantation 10(4):226-232, 2000
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Depression and hypertension often coexist, and both may be important
modifiable risk factors for coronary heart disease.
J Clin Hypertens 2(6):410-412, 2000
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Readit Here
MECHANISMS OF ACTION
We know these drugs work, but we have very little idea how. Any discussion
of mechanisms of action of psychotropic medication needs to maintain a
healthy respect for our ignorance.
Medscape Mental Health 6(1), 2001
http://psychiatry.medscape.com/32671.rhtml?srcmp=psy-011901
Readit Here
DISORDERS: TREATMENT OUTCOMES
Community-based treatment of severe mental disorders
Medscape Mental Health 6(1), 2001
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Readit Here
Eye movement desensitization and reprocessing (EMDR) is just the latest in
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of anxiety and trauma, according to a review by Dr. James D. Herbert, of
MCP Hahnemann University in Philadelphia, and associates.
http://psychiatry.medscape.com/32733.rhtml?srcmp=psy-012601
Readit Here
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Here is the Reuters article cited in the Medscape e-mail.
********************************************************************
Eye Movement Desensitization and Reprocessing Debunked WESTPORT, CT (Reuters
Health) Jan 19 - Eye movement desensitization and reprocessing (EMDR) is just
the latest in the string of unvalidated therapies that have been promoted for
treatment of anxiety and trauma, according to a review by Dr. James D.
Herbert, of MCP Hahnemann University in Philadelphia, and associates. "The
eye movement component is what makes EMDR unique. Take that away, and there's
nothing left in the package that's unique," Dr. Herbert told Reuters Health.
"We know now from study after study that the eye movements don't add anything
to the protocol." Dr. Herbert claims that without the eye movements, EMDR is
"the same stuff psychologists have been doing for 20, 30 years, exposing
patients to the thing that they're afraid of, and the reprocessing or
cognitive restructuring." In the current issue of Clinical Psychology Review,
dated November, he and colleagues point out some of the shortcomings of EMDR
research, such as comparison of EMDR with no treatment, assessment of
treatment outcome by investigators who were not blind to treatment
conditions, and comparison of EMDR with therapies that have not been
identified as valid for the condition. In other instances, studies showed
evidence of therapist allegiance, enthusiasm, and involvement artifacts.
Marketing tactics are also responsible for the widespread acceptance of
therapies based on pseudoscience, Dr. Herbert said. These include claims of
extremely high cure rates for relatively refractory conditions, vividly
presented case studies, and extensive media attention. The researchers
criticize "the use of obscurantist language to compensate for an absence of
content and to discourage would-be skeptics. Dr. Herbert's group concludes,
"If a procedure is heavily promoted through extraordinary claims, those
claims must be accompanied by equally extraordinary empirical evidence." Clin
Psychol Rev 2000;20:945-971.
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