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Confusion, misinformation and charges of "pseudoscience"

Some misconceptions will be addressed below:

1) EMDR is only superior to no treatment and/or has not been throughly tested.

This is inaccurate. EMDR has been found superior in controlled studies to Veterans Administration (V.A.) standard care, biofeedback assisted relaxation, simple relaxation, active listening, and various forms of individual psychotherapy used at an HMO (e.g. exposure, cognitive, psychodynamic). It has also been compared to and found generally equal to forms of exposure therapy with and without forms of cognitive therapy. While exposure therapy used 1-2 hours of daily homework, EMDR has achieved equivalent results with none [view Efficacy].

2) EMDR is only exposure therapy.

This is inaccurate. EMDR has been found to be equivalent to exposure therapy in 5 studies. However, exposure therapy uses 1-2 hours of daily homework and EMDR uses none. In addition, the EMDR practices have little in common with exposure therapy. A process analysis of the two found significant differences (Rogers et al., 1999) and some researchers subsequent to another study stated: "In strict exposure therapy the use of many of ['a host of EMDR-essential treatment components'] is considered contrary to theory. Previous information also found that therapists and patients prefer this procedure over the more direct exposure procedure" (Boudewyns & Hyer, 1996, p.192) For additional references and details see Is EMDR an exposure therapy?

3) There is no theory for EMDR effects or reasons for the eye movements.

This is inaccurate. The information processing model was articulated in 1991 and has been thoroughly described in three texts. A number of neuropsychologists have also given detailed theories and descriptions of reasons for EMDR's effects. Numerous researchers have also articulated theories and conducted hypothesis driven research supporting the use of eye movements and other dual attention stimulation.
For references and details see:
Theory: The Adaptive Information Processing Model
Eye Movements and Alternate Dual Attention Stimuli
What has research determined about EMDR's eye movement component?
What are some hypothesized mechanisms of action for eye movements in EMDR?

4)Perkins, B. R., & Rouanzoin, C. C. (2002). A critical examination of current views regarding eye movement desensitization and reprocessing (EMDR): Clarifying points of confusion. Journal of Clinical Psychology, 58, 77-97.

EMDR is an active psychological treatment for PTSD that has been surrounded by confusion in the research review literature. One article (Perkins & Rouanzoin, 2002) examined the original empirical research in light of the review literature in order to understand the contradictory conclusions that had been drawn by various authors and some significant conclusions were suggested.

The confusion appears to be due to (a) an inadequate awareness of the lack of placebo effects in treating PTSD; (b) a theoretical and methodological lack of distinction between EMDR and exposure procedures; (c) debates over the importance of the eye movement component of EMDR; (d) poorly designed outcome studies; and (e) historical misinformation which then becomes confounded with empirical research findings.

In considering these issues it is important to understand that PTSD is highly refractory to nonspecific treatment factors and that the effects of EMDR are much larger than would be expected by such placebo effects. Secondly, while the general treatment effects of EMDR and exposure procedures appear to be approximately equivalent, EMDR is much more efficient in producing the therapeutic changes. Furthermore, the EMDR method (which involves brief interrupted periods of exposure) is inconsistent with exposure theory that prescribes extended, uninterrupted periods of exposure. Third, the role of eye movements has not received adequate empirical exploration primarily due to inadequate sample sizes, inappropriate populations, and poor treatment fidelity. Until that is accomplished, the eye movements are a part of the validated procedure and their removal is without empirical justification.

Moreover, there are general methodological and fidelity problems in some empirical studies that confuse the outcome research, including poor fidelity to the EMDR method as well as inadequate treatment dosage, poor research designs, and truncated protocols (especially as it pertains to multiply traumatized populations). And finally a relatively small group of authors appear to have engaged in the inaccurate and selective reporting of past research findings as well as the misstatement of historical events in the development of EMDR.

Readers of research reviews will find it helpful to have a knowledge of research design as well as the EMDR method to assess the generalizability of research findings and the adequacy of treatment fidelity respectively. Then when confusion arises, the reader can frequently reduce or eliminate the confusion by reading the original research.

For more information on these and related issues, see Perkins, B. R., & Rouanzoin, C. C. (2002). A critical examination of current views regarding eye movement desensitization and reprocessing (EMDR): Clarifying points of confusion. Journal of Clinical Psychology, 58, 77-97 or see a preprint of the article at www.perkinscenter.net. To obtain a more detailed description of how historical misinformation and personal slurs were confounded with the findings of well designed empirical outcome studies assessing the efficacy of EMDR, see Beutler, L. E., & Harwood, T. M. (2001). Antiscientific attitudes: What happens when scientists are unscientific? Journal of Clinical Psychology, 57, 43-51.

Resource: Perkins, B.R., & Rouanzoin, C.C. (2002). A critical examination of current views regarding eye movement desensitization and reprocessing (EMDR): Clarifying points of confusion. Journal of Clinical Psychology, 58, 77-97. A preprint of the article is available at www.perkinscenter.net.