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Unraveling the EMDR controversy: Does the treatment really work as advertised?
Eye movement desensitization and reprocessing (EMDR) is a form of psychotherapy that is currently recommended by many authorities for the treatment of post-traumatic stress disorder (PTSD), but its effectiveness and scientific basis are still controversial in the psychology community. EMDR was developed by Francine Shapiro in 1987 and was originally designed to relieve pain associated with traumatic memories. This therapy requires the patient to recall the traumatic event and simultaneously move the left and right eyeballs or use other forms of bilateral stimulation to achieve therapeutic purposes.
"The purpose of EMDR is to reduce subjective distress related to trauma and strengthen adaptive beliefs about related events."
Various government and medical agencies, including the World Health Organization and the U.S. Department of Veterans Affairs, are divided on their recommendations for EMDR. The National Academy of Medicine found insufficient evidence for the effectiveness of EMDR. In addition, the American Psychological Association believes that EMDR may be helpful in the treatment of adult PTSD. Treatment guidelines state that the effectiveness of EMDR is statistically similar to trauma-focused behavioral therapy (TF-CBT), and the Australian National Health and Medical Research Council points out that this may be because EMDR contains core elements of cognitive behavioral therapy.
When discussing the effects of EMDR, many experts remain skeptical about the mechanisms behind it. The eye movement mechanism of EMDR lacks a scientific basis, and some opponents believe that this therapy is just a formal addition to exposure therapy rather than a real innovation. This effect has even been described as "purple hat therapy", which means that its efficacy mainly comes from the basic treatment methods, not the uniqueness of EMDR.
"The effectiveness of EMDR comes primarily from the treatment strategy behind it, not its specific technology."
Treatment of severe trauma often requires patients to retell the painful experience, but the practice of EMDR is relatively different. According to the World Health Organization's 2013 guidelines, EMDR does not involve detailed descriptions of events, direct challenges to beliefs, prolonged exposure, or homework assignments. Therefore, this makes EMDR different in some aspects, but it also causes a lot of controversy.
EMDR operation and training
EMDR usually requires multiple sessions, performed by a professionally trained therapist, and a session usually lasts between 60 and 90 minutes. However, Shapiro’s repeated upgrades to EMDR training and certification standards have been criticized by some experts, who have accused the changes of promoting self-interest.
Although some symptoms show that EMDR is effective for some patients, many systematic review reports point out that there are many shortcomings in the research methods, including small sample sizes and poor control group settings. While EMDR has shown significant improvements in PTSD and depressive symptoms in some studies, the overall strength of evidence for its effectiveness remains low, showing uncertainty in the results.
"Many randomized trials have been criticized for poor control groups and small sample sizes, making EMDR therapy controversial."
For example, a Cochrane systematic review found that EMDR was equally effective as TF-CBT in treating chronic PTSD, but these results need to be interpreted with caution due to the small number of included studies. A 2021 systematic review also noted that client perceptions of the effectiveness of EMDR are mixed, reflecting the individualized and subjective nature of treatment outcomes.
Social and cultural influences
The popularity of EMDR has been further expanded among some celebrities. Celebrities including Sandra Bullock, Prince Harry, and others have publicly shared their experiences with EMDR, which has led to increased awareness of the therapy in society. However, whether this fully represents the scientific basis of EMDR is still worthy of further discussion.
"The popularity of therapies like EMDR may be related to celebrity effect to some extent, but its scientific nature cannot be easily recognized."
After all, is the efficacy of EMDR really as convincing as advertised? In the collision of soft evidence and empirical research, how should this therapy develop in the future? Perhaps it is worth pondering for each of our readers?
