Talk:Eye movement desensitization and reprocessing/Archive 10

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WP:MEDASSESS and WP:MEDDEF

@GreatBigCircles, see this part of our medical sourcing guidelines:

• Even in reputable medical journals, different papers are not given equal weight. Studies can be categorized into levels of evidence,[6] and editors should rely on high-level evidence, such as systematic reviews. Low-level evidence (such as case reports or series) or non-evidence (such as anecdotes or conventional wisdom) are avoided.
• Using small-scale, single studies makes for weak evidence, and allows for cherry picking of data. Studies cited or mentioned in Wikipedia should be put in context by using high-quality secondary sources rather than by using the primary sources.
• Lower levels of evidence in medical research come from primary studies

Do not use primary sources like this [1] to make broad and sweeping statements like EMDR is widely used and generally considered by researchers and clinicians to be a safe and effective treatment for PTSD as you did here. It portrays a personal bias in reading this primary article and finding it convincing or choosing which secondary sources to trust and which to disregard, when our best available high-level evidence is more contradictory (e.g. [2][3][4][5][6][7][8][9][10].)

There is a reason we do not unequivocally state this in wiki-voice. It's because our secondary sources disagree. — Shibbolethink ^{(♔ ♕)} 20:44, 13 June 2023 (UTC)

Good point. Following the general consensus among academic sources is typically the only time something can be considered for Wikivoice pending a consensus. DN (talk) 20:52, 13 June 2023 (UTC)

The secondary sources don't really disagree on "widely used" or "generally considered to be effective". Even critical sources agree on those points; the point they disagree about is the "why". Loki (talk) 21:00, 13 June 2023 (UTC)

(edit conflict) Also, I note that many of the sources you link are quite old. WP:MEDDATE's guideline of trying to find sources from the last 5 years applies to nearly all those sources, and several of them are even over 20 years old. So I'm not that convinced that your list of sources, though long, actually represents current consensus in the field. Loki (talk) 21:08, 13 June 2023 (UTC)

MEDDATE has more to do with the overall speed of the field, not a hard 5 year cutoff. Rigid adherence to 5 years was not the point of MEDDATE. The field is also "psychology" not "EMDR". — Shibbolethink ^{(♔ ♕)} 21:10, 13 June 2023 (UTC)

I agree it's not a hard 5 year cutoff, and I never said anything about the field being EMDR not psychology. But surely you have to agree that if you're including six 20 year old sources in your list of nine, something's up, right? Loki (talk) 21:15, 13 June 2023 (UTC)

I would be more interested to see what secondary literature has arisen in the intervening years that says EMDR is not a purple hat therapy, with insignificant addons etc. — Shibbolethink ^{(♔ ♕)} 21:25, 13 June 2023 (UTC)

"generally considered to be effective" is what statements from some of the sources above contradict. E.g.

• Thyer 2015: given that there is no evidence that anything unique to EMDR is responsible for the positive outcomes in comparing it to no treatment and the florid manner in which it has been marketed, we are including it in this book
• Sikes 2003: The variable findings regarding whether its effects are for reasons unique to this treatment, however, have become the focus of extensive discussion and debate
• Novella: Time and effort are wasted clinically in studying, perfecting, and using these methods, rather than focusing on the components of the interaction that actually work
• Devilley: To date it has become increasingly clear that (1) EMDR is more effective than no treatment; (2) eye movements per se do not contribute to therapeutic effectiveness; (3) the reprocessing (“R”) component of EMDR may be relatively inert; (4) full treatment packages utilizing competently administered exposure techniques are more effective than EMDR in the treatment of anxiety disorders; and (5) being trained by the EMDR Institute has no significant effect on treatment effectiveness.

among many many others. — Shibbolethink ^{(♔ ♕)} 21:08, 13 June 2023 (UTC)

None of those contradict the claim that it is effective, and Sikes and Devilley are 20 year old sources to boot. They are saying that the reason why it is effective means clinicians shouldn't recommend it, but not saying that it's not effective. Loki (talk) 21:11, 13 June 2023 (UTC)

In any case, the new statement covers the same ground as the preexisting second paragraph of the lead, we don't need two treatments of the same subtopic. MrOllie (talk) 21:06, 13 June 2023 (UTC)

The second paragraph is about official recommendations; it does not say that EMDR is 1) widely used, 2) generally considered effective, or 3) the subject of controversy. All three statements are abundantly supported by the sources. GreatBigCircles (talk) 21:12, 14 June 2023 (UTC)

It's all the same stuff. Why is it recommended? Because it has some evidence of effectiveness and safety. Why is it widely used? Because it is recommended. The sources are not so clear an unequivocal as you seem to think. MrOllie (talk) 21:37, 14 June 2023 (UTC)

@GreatBigCircles, wikipedia tells us to describe the situation, not to tell our readers what we think about it. We describe evidence, instead of telling them it's effective. Especially given that different guidelines disagree on the level of effectiveness. — Shibbolethink ^{(♔ ♕)} 12:53, 15 June 2023 (UTC)

PLoS is given as an example of a "high-quality journal" by WP:MEDRS. It says: Eye Movement Desensitisation and Reprocessing (EMDR) is a method in psychotherapy for which meta-analyses have reliably demonstrated effectiveness in treating symptoms of posttraumatic stress disorder, PTSD. This is not a primary source, it is high-quality medical journal referencing multiple secondary sources.

None of the sources you referenced contradict the fact that it is generally considered safe and effective. In fact, literally all of the very quotes you selected say that it works:

• Thyer 2015: given that there is no evidence that anything unique to EMDR is responsible for the positive outcomes in comparing it to no treatment and the florid manner in which it has been marketed, we are including it in this book
• Sikes 2003: The variable findings regarding whether its effects are for reasons unique to this treatment, however, have become the focus of extensive discussion and debate
  • (The previous sentence: Eye-movement Desensitization and Reprocessing (EMDR) has been widely supported in the literature for its effectiveness in treating Post-traumatic Stress Disorder (PTSD) and a variety of other diagnoses and symptoms.)
• Novella: Time and effort are wasted clinically in studying, perfecting, and using these methods, rather than focusing on the components of the interaction that actually work
• Devilley: To date it has become increasingly clear that (1) EMDR is more effective than no treatment; (2) eye movements per se do not contribute to therapeutic effectiveness; (3) the reprocessing (“R”) component of EMDR may be relatively inert; (4) full treatment packages utilizing competently administered exposure techniques are more effective than EMDR in the treatment of anxiety disorders; and (5) being trained by the EMDR Institute has no significant effect on treatment effectiveness.

Before you revert my constructive contributions yet again, show me one recent reliable source that actually says EMDR doesn't work. GreatBigCircles (talk) 21:10, 14 June 2023 (UTC)

No one needs to find sources to refute a Strawman argument. MrOllie (talk) 21:39, 14 June 2023 (UTC)

@MrOllie, rather than repeatedly reverting other people's hard work, would you be willing to make a constructive attempt at compromise? GreatBigCircles (talk) 21:46, 14 June 2023 (UTC)

Rather than repeatedly making edits you know others disagree with, You should have a read of WP:BRD and set about getting consensus backing for your changes before you make them again. It is a great thing to be open to compromise and discussion, but discussion is not a filibuster you can use to keep your preferred changes in the article. MrOllie (talk) 21:47, 14 June 2023 (UTC)

discussion is not a filibuster you can use to keep your preferred changes in the article
Indeed. While discussion is ongoing, we should be leaving it at WP:STATUSQUO. — Shibbolethink ^{(♔ ♕)} 12:55, 15 June 2023 (UTC)

@GreatBigCircles The PLoS paper you cited is a WP:MEDPRI primary article. It is a piece of new research. Published as a "research article" instead of a "review article." See also this sentence from their conclusion (emphasis mine): We demonstrate first time evidence for a putative neurobiological basis of the bilateral alternating stimulation as used in the EMDR method Please read up more on the different types of scholarly journal articles. — Shibbolethink ^{(♔ ♕)} 12:54, 15 June 2023 (UTC)

That paper contains new research, but I am not referencing its new research; I am referencing its summary of past meta-analyses, as I quoted above. But no matter how much you challenge this one source, I—and you—have provided many other reliable sources that say EMDR is effective, and you have yet to provide one that says it isn't. GreatBigCircles (talk) 15:29, 15 June 2023 (UTC)

you have yet to provide one that says it isn't
That's because I'm not interested in saying in the article "EMDR isn't effective". I'm interested in making sure it complies with NPOV and not saying something that isn't supported broadly by a consensus of our available high quality sources. We already describe in the LEAD exactly which of such sources support its effectiveness. — Shibbolethink ^{(♔ ♕)} 15:32, 15 June 2023 (UTC)

@Shibbolethink Will you please suggest wording for a sentence in the first paragraph clearly stating that evidence shows EMDR to be effective for PTSD? There are currently four weasel-worded sentences in the first paragraph about criticisms of EMDR, and not a single one about its well-established effectiveness for PTSD, which is its primary use. GreatBigCircles (talk) 18:38, 21 June 2023 (UTC)

Seems like a push to be selective to the point of POV. There is some evidence EMDR is effective for PTSD, but it's almost certainly not down to the pseudoscience fripperies its vendors charge for. We need to give the whole picture and especially make sure the pseudoscience aspect is clear. Bon courage (talk) 15:24, 21 July 2023 (UTC)

"Fuelled by marketing hype"

"Fuelled by marketing hype" is absolutely another account of your use of weasel words. Please refrain in the future. Enix150 (talk) 03:51, 18 August 2023 (UTC)

1) That's not 'weasel words', and 2) You are using a book from 2005 to cite a claim about numbers of practicioners in 2012. That's also not 'weasel words'. You're changing the article in unsupported ways with an obviously false edit summary. - MrOllie (talk) 03:55, 18 August 2023 (UTC)

I removed weasel words. I did not add or cite anything. Please see the edit history if you are confused. Enix150 (talk) 18:14, 18 August 2023 (UTC)

That's simply false, as anyone can verify by reviewing the diff MrOllie (talk) 18:15, 18 August 2023 (UTC)

@MrOllie: I simply undid your edit that added weasel words, I didn't contribute anything. Merely subtracted unsupported words by reversion. Feel free to re-add without the weasel words though. Enix150 (talk) 18:22, 18 August 2023 (UTC)

You're making a mistake here. You definitely did contribute content. Specifically, you changed a sentence to say "by 2012 more than 60,000 therapists had been trained in its use". This is not supported by the cited source. Then you edit warred to keep this in the article. Firefangledfeathers (talk / contribs) 18:29, 18 August 2023 (UTC)

No, I simply undid this edit.[11] Enix150 (talk) 18:34, 18 August 2023 (UTC)

That edit removed 183 bytes of content. The edits you've been implementing have been 21 byte subtractions. It is not true that you simply undid MrOllie's edit. If you're saying it was a partial reversion, then why those parts? Why re-add content that is unsupported by the cited source? Firefangledfeathers (talk / contribs) 18:39, 18 August 2023 (UTC)

@Firefangledfeathers: Yes, a manual revert since it was too late for an undo. I saw no issue with their addition of citations, but I restored the paragraph that had been weasel worded. Enix150 (talk) 18:46, 18 August 2023 (UTC)

Ok. Please be careful when doing so in the future. Firefangledfeathers (talk / contribs) 18:52, 18 August 2023 (UTC)

I'm not the original author of that text. Which edit of mine are you undoing? Others on the talk agree there are no weasel words to be removed here. Perhaps you meant to undo some other edit? MrOllie (talk) 18:31, 18 August 2023 (UTC)

This edit. [12] Enix150 (talk) 18:36, 18 August 2023 (UTC)

Your edit is more involved than that. And in any case: Why, exactly? What are you trying to accomplish here? Have you read the rest of the comments in this talk section? You just keep repeating the phrase 'weasel words' in the face of disagreement from multiple other editors. MrOllie (talk) 18:43, 18 August 2023 (UTC)

No, it was a manual revert since it was too late for an undo. I saw no issue with your addition of citations, but I restored the paragraph that had been weasel worded. Enix150 (talk) 18:55, 18 August 2023 (UTC)

Please address the comments below that explain that those are not weasel words. That's a summary of the cited source, which explicitly relates the growth in EMDR practitioners to aggressive marketing efforts. Also, once again, I did not originally write that text or add that source, please do not assign credit to me that is not mine. MrOllie (talk) 18:58, 18 August 2023 (UTC)

This is a bizarre claim. Can you please spend some more time explaining your reasoning here? Firefangledfeathers (talk / contribs) 18:17, 18 August 2023 (UTC)

Enix150, could you please re-read MOS:WEASEL? I am not seeing how it applies here, so maybe you could quote the most applicable parts and explain the connection? Firefangledfeathers (talk / contribs) 03:59, 18 August 2023 (UTC)

My guess:

Weasel words are words and phrases aimed at creating an impression that something specific and meaningful has been said, when in fact only a vague or ambiguous claim has been communicated.

"Marketing hype" is a pretty vague term. What does it actually mean? On first glance, it sure sounds like it means something, but can you actually define it in a way that distinguishes it from any attempt to promote anything? Presumably Aaron Beck had to get the word out about CBT somehow; what's actually concretely different about EMDR, and if there is some concrete difference why aren't we saying that instead? Loki (talk) 04:42, 18 August 2023 (UTC)

It means hyperbolic claims used for promotion. Fits in with what is reported elsewhere in the article. English language innit. Bon courage (talk) 04:55, 18 August 2023 (UTC)

I wouldn't necessarily distinguish "marketing hype" from "any attempt to promote". They live on a spectrum with each other. I think something specific and meaningful is being said. Firefangledfeathers (talk / contribs) 12:41, 18 August 2023 (UTC)

The source attributes EMDR's 'rapid spread' to 'marketing and almost cult-like atmosphere that have accompanied other psychological pseudosciences'. We can use something closer to the wording of the source if you want to say something concrete. MrOllie (talk) 13:27, 18 August 2023 (UTC)

Closer to the wording of the source would be better on the MOS:WEASEL issue, but then we get into the issues of using MOS:LABELs (like "cult-like") from only one source.

I think "hyperbolic", as suggested by BC, is an important word here. If we were to say "Fueled by hyperbolic marketing claims," we might have something that avoids both concerns a little better. (But I'd still prefer some detail about, y'know, what sort of hyperbolic marketing claims.) Loki (talk) 02:24, 19 August 2023 (UTC)

"Controversial"

BC and I have been going back and forth on the word "controversial" in the lead a few times, so let's take it to talk before it becomes a full edit war.

Basically, I keep reverting edits calling EMDR controversial because, due to MOS:CONTROVERSIAL, we should by the letter of the MOS never be calling anything "controversial" in Wikivoice in any article. (Personally I think there are extreme circumstances which can be exceptions, but here isn't one.) The thing that's most commonly done instead is to explain the controversy... but we do that already. In the lead, even. Loki (talk) 19:44, 22 August 2023 (UTC)

The lede does explain the controversy by outlining the pseudoscience and effectiveness questions (we should add more maybe about the superfluous training). Many sources say it's cpntroverial and this is long-standing text in the article. MOS is guidance; NPOV is policy and cannot be swerved. Bon courage (talk)

NPOV is policy, but nobody is saying we should ignore NPOV. Indeed, all the content that NPOV would demand we include is already in the lead. What you're suggesting is a rewording of that information to include a MOS:LABEL, and how we word things is absolutely the domain of the MOS. Loki (talk) 02:54, 23 August 2023 (UTC)

Follow the reliable sources, which widely call this stuff controversial. Bon courage (talk) 06:51, 23 August 2023 (UTC)

For the umpteenth time, this is not a matter of sourcing. You could, by the text of the MOS, have infinite sources and not be able to call something "controversial" in Wikivoice.

Why? Because it's not a content issue, it's a style issue. Infinite sources that refer to "the pope" or "president Washington" would not make us stop referring to either of those people with capitalized titles either. We don't have any obligation to follow the specific wording of the sources, and the MOS says explicitly in this case we should not word things this way. So we don't: instead we word the same content a different way already. Loki (talk) 00:01, 25 August 2023 (UTC)

You're treating MOS:CONTROVERSIAL like some ironclad rule that overrides over concerns - that's not what it is. Wikipedia articles can and do use the word 'controversial' when appropriate. We even have articles that use it as part of the title, for instance List of controversial video games, Controversial Reddit communities, etc. There are dozens of them. MrOllie (talk) 00:31, 25 August 2023 (UTC)

Indeed, the iron non-negotiable 'rule' on Wikipedia is NPOV. Many texts in fact call this stuff 'extremely controversial' so Wikipedia's coyness about this is a POV problem. Bon courage (talk) 05:31, 25 August 2023 (UTC)

That's pretty classic WP:OTHERSTUFFEXISTS. Neither of those articles should exist, or at least not under those titles.

Now, I agree that there are some circumstances where any of the labels in MOS:LABEL could be appropriate. In particular, the section calls out "pseudoscience" as a contentious label that nonetheless actively should be used if the sources support it. But there's also plenty of other cases where contentious labels are appropriate. We call Adolf Hitler and Richard B. Spencer Nazis, and David Icke a conspiracy theorist, and that's fine. WP:IAR is a thing for a reason, and frankly the language in MOS:LABEL about literally never getting to use the label in Wikivoice is clearly too strict.

However, the existence of exceptions doesn't mean that this particular case is an exception, and the reason I'm very confident that this particular case is not an exception is, again, because we describe the controversy in detail already. All the relevant content is already there. Loki (talk) 23:41, 25 August 2023 (UTC)

Neither of those articles should exist, or at least not under those titles. Like I said, there are many, many instances of this. If you really think these are policy violations, it sounds like you have a lot of work to do. But I think it much more likely you're simply mistaken. MrOllie (talk) 23:53, 25 August 2023 (UTC)

It's pretty trivial to find articles that contain obvious violations of WP:NPOV or WP:V and those are core content policies. The example I can think of immediately is that most of the many articles on any vaguely major religion are clearly written by adherents of that religion, and often very poorly cited. See for instance Oven of Akhnai, which is barely cited at all, or Ihram, an even longer article with only three barely used sources.

Heck, you spend a lot of time on WP:FTN, right? How many articles have you run across that push something fringey? Because just from following it for a few months I can tell that concerningly fringe stuff gets posted there all the time. Loki (talk) 01:52, 26 August 2023 (UTC)

The point is you are taking an extreme interpretation of a MOS guideline that is shared by almost no one. This isn't a stray example or two or a policy violation no one has noticed yet - there are dozens (maybe hundreds) of counterexamples that show your interpretation is not the standard one. Guidelines are descriptive, not proscriptive - when you read a policy in a way that conflicts with a plain examination of the 'Pedia itself, it means you're wrong about what the guideline means. How many articles have you run across that push something fringey? Well, we're on the talk page of one right now, so... MrOllie (talk) 02:05, 26 August 2023 (UTC)

This is the mainstream opinion of this guideline. Trust me, I have been on the opposite side of this argument against people who really do believe there is no context whatsoever where we can say the word "controversial" on Wikipedia.

I could find you hundreds of examples of articles that violate WP:NPOV or WP:V or both. It'd be trivial, in fact. Most articles on Wikipedia violate a core content policy, as can be seen pretty starkly if you just go through a bunch of random articles. There's a reason why WP:OTHERSTUFFEXISTS (and WP:OTHERCONTENT) is specifically called out as a bad argument. Loki (talk) 07:09, 26 August 2023 (UTC)

(Oh, and if you don't believe me that this is the mainstream interpretation, here's a recent and well-attended RFC about exactly the language you're talking about.) Loki (talk) 07:13, 26 August 2023 (UTC)

Seems irrelevant. Anyway, seems like you don't really get it from the NPOV perspective, so we should just go ahead and restore this. If you really applied your argument you'd remove it from the body too. Seems you just don't want this knowledge prominent in the lede right? Bon courage (talk) 07:20, 26 August 2023 (UTC)

I missed that we have it in the body and rephrased that line.

...and that's a clear WP:PA, please stop. (It's also false, because as I've been telling you repeatedly, the information is already in the lead. I just object to the word.) Loki (talk) 00:22, 28 August 2023 (UTC)

And I object to rephrasing the body in a way that introduces a significant difference in meaning. If you simply object to the word, feel free to propose a change of term that preserves the meaning (here first please). MrOllie (talk) 00:24, 28 August 2023 (UTC)

Not a PA at all. We've had the (correct) "controversial" text in the body as the consensus text for months, and you've not objected. Bon courage (talk) 17:20, 28 August 2023 (UTC)

Loki, this discussion has been had many times. There is just too much RS supporting controversial. Your reading of MOS:CONTROVERSIAL needs to take a back seat, as MOS usually does to WP:RS. If we do it for "racist" we should for a much less loaded and much less pejorative term like "controversial". It's accurate and succinct. All the proposed options I've seen are obtuse and wordy. DolyaIskrina (talk) 15:43, 28 August 2023 (UTC)

I'm in rough agreement, though I'd say here that the policy the MOS needs to take a back seat to is NPOV. I'm on record as thinking that MOS:CONTROVERSIAL frequently leads to this bizarre clash and that it needs some rethinking. Firefangledfeathers (talk / contribs) 17:00, 28 August 2023 (UTC)

What do you mean? The alternative is already in the article. We already describe the dispute in question at length. There's no need given that to call it "controversial" as well.

I'm fine with exceptions to MOS:CONTROVERSIAL, but I just don't think this is one, for that reason. Honestly, I feel like there are fewer exceptions for "controversial" than there are for "racist": the reason to include a MOS:LABEL is not a matter of how loaded the word is but how easily the word can be avoided. When the sources are clear about "racist", there's no other word that will do, but even when sources are clear about "controversial" it's almost always trivial to just describe what the controversy is. And this is almost always better writing, in that it conveys a clearer and more accurate picture to the reader than just a single loaded word. Loki (talk) 06:58, 30 August 2023 (UTC)

Well you already admitted the concept by adding[13] "has caused controversy" to the lede, which is just a gawky rewording of the same idea. Seems you're just hung up on one particular word. I think the bigger picture is what matters here, not which particular sequence of letters is used to convey the concept we all agree should be here. Bon courage (talk) 08:04, 30 August 2023 (UTC)

The MOS is all about particular words, though. Of course this is about the particular word. Loki (talk) 20:15, 30 August 2023 (UTC)

Not really, MOS is a means to an end not a string-matching exercise. There are no forbidden words or expressions on Wikipedia. Bon courage (talk) 04:55, 31 August 2023 (UTC)

Sure, but I think that the end being pursued by not using this word is valid. Saying something is "controversial" creates bad connotations around it while giving the reader almost no new information. Explaining the controversy (like, again, we already do) instead gives the reader actual information.

This is, incidentally, why I'm much more of a stickler about "controversial" than I am about other MOS:LABELs. "Racist" or "pseudoscience" or "cult leader" are all strong words but they do at least mean something specific, and when that specific meaning is warranted, there are few adequate replacements. "Controversial", on the other hand, in addition to being a MOS:LABEL is also a weasel word: it's both contentious and has very little substantive meaning. Loki (talk) 23:51, 31 August 2023 (UTC)

It means something, especially as we use it. Bon courage (talk) 11:34, 1 September 2023 (UTC)

"Criticisms" not "Controversial" is the norm on Wiki? In wiki psyc. science articles similar "https://en.wikipedia.org/wiki/Cognitive_behavioral_therapy" .. we see "Criticisms" listed at the end. They do not use the word "Controversial" at any point. The.Wiki.Enthusiast (talk) 23:43, 6 November 2023 (UTC)

WP:CSECTION. --Hob Gadling (talk) 06:57, 7 November 2023 (UTC)